Cognitive and physiological impacts of psychotherapy incorporating human-equine interactions during substance withdrawal: A scoping review

The use of psychotherapy incorporating equine interaction (PIE) is becoming widely utilized for the treatment of a range of conditions; however, evidence supporting the efficacy of this treatment is highly variable, inconsistently defined, and largely anecdotal. Further, few studies have investigated its use in the withdrawing substance use disorder (SUD) population. This scoping review investigates the physiological and cognitive implications of withdrawal associated with SUD in conjunction with the effects of psychotherapy utilizing equine interaction on these parameters. This review was developed following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) scoping review protocol. The search utilized Google Scholar, PubMed, Medline, and PsychInfo databases to collect literature. Of the 556 articles within the initial review, 153 papers were reviewed in full and 122 met inclusion criteria. The information from this literature indicated addiction and withdrawal chronically elevate stress responses such as cortisol. This elevation has a negative impact on cognitive functions integral to recovery. Psychotherapy incorporating equine interaction has been cited to mediate these symptoms through potential physiological coupling, thus, supporting conclusions from literature that this treatment improves recovery rates. The literature revealed enhancements in therapeutic alliances, patient comfort, confidence, mental health, emotional stability, and communication skills associated with this therapeutic intervention. As such, the literature included in this review supports the potential for the use of psychotherapy incorporating equine interaction in SUD treatment, particularly during the period of withdrawal. However, there is a lack of literature investigating physiological impacts of PIE, especially within SUD treatment.