Equine therapy in the management of teenagers with anorexia nervosa: a qualitative study.

Background: Anorexia nervosa is a complex psychiatric pathology with limited therapeutic tools to reduce morbidity and mortality. Equine-assisted therapy could provide additional therapeutic benefits.

Objectives: We aimed to explore the effects of equine-assisted therapy on the experience of adolescents with anorexia nervosa.

Methods: Using a qualitative approach based on Interpretative Phenomenological Analysis, we conducted semi-structured interviews with nine participants who had taken part in equine-assisted therapy sessions.

Results: Three superordinate themes were found. Participants initially described an experience of insecurity when meeting the horses which were perceived as a source of fear within a displaced spatiotemporal framework. Equine therapy led to the development of emotional regulation through interactions that allowed for investment without fear of perceived social judgment, a reassuring experience through relational adjustment with the horse, and an experience of support from the humans present. Finally, equine therapy was a transformative learning experience, enabling participants to embody their physicality and care for someone other than themselves.

Conclusion: Equine-assisted therapy was found to provide bodily, emotional, and relational therapeutic benefits in anorexia nervosa. The setting, place, and function of the equine therapist, the participants' previous experience with horses, and the interaction with other care areas seem to be essential to ensure therapeutic benefit. Level of Evidence Level III.