Promoting mental health in military veterans. Methodology and evaluation tools in a pilot study involving an Equine-Assisted Intervention.

Abstract

Aims: Military veterans exposed to stressful or traumatic events may experience adjustment difficulties in the post-deployment period, developing a high risk of mental health-related issues. Promising complementary practices such as Equine-Assisted Therapy (EAT) are now widely used, although standardized protocols are missing. The present study aimed to develop an EAT standardized intervention.

Material and methods: A total of 16 veterans were enrolled for the study (11 veterans for the EAT group and 5 veterans for the control group). The EAT lasted 9 months and both a quantitative (State-Trait Anxiety Inventory Scale; Hamilton Depression Rating Scale; Symptom Checklist 90 Scale; Warwick Edinburgh Mental Well-Being Scale) and a qualitative evaluation (observations and guided discussions) were carried out.

Results: While standardized scales did not show significant results, the qualitative evaluation revealed improvements in participants' attitudes and behaviors (autonomy, self-confidence, sense of agency), coping strategies, management of anxiety and the gradual overcoming of interpersonal difficulties.

Discussion and conclusion: The EAT intervention was particularly appreciated with a high adherence. The empathetic relationship with the horse allowed the participants to establish positive relationships within the group. A self-awareness process emerged during guided discussions and the EAT intervention allowed veterans to rediscover a new group identity. The intervention methodology proved feasible and sustainable although with important limitations due to the low number of participants, the lack of female veterans and the distance between the equestrian rehabilitation centre and the participant's residence. The present study highlights the potential of the human-horse relationship in managing adjustment difficulties, consolidating coping strategies and developing veterans' interpersonal skills.