The Effectiveness of Equine-Assisted Mental Health Interventions for Youth: A Meta-Analysis of Controlled Studies

Youth have experienced an increase in mental health concerns and can be challenging to work with using traditional talk-based prevention and treatment options. This meta-analysis aimed to synthesize existing studies on the effectiveness of equine-assisted interventions with youth for psychosocial outcomes, such as internalizing and externalizing problems, adaptive efficacy, self-esteem, and depressive symptoms. Search and selection procedures involved screening 3525 records to yield 16 controlled studies published between 2009 and 2021 with 1009 participants. The results showed a statistically significant, homogenous, and medium effect for the overall effectiveness of equine interventions for improving overall psychosocial outcomes for youth (n = 16, d = .535, 95% CI [.345, .726], p < .001, I² = 0.39). The results also showed similar statistically significant effects for externalizing problems, internalizing problems, and adaptive efficacy. However, the effectiveness of equine-assisted interventions for the self-esteem and depressive symptoms (when measured separately from internalizing problems) of youth was statistically non-significant. For self-esteem, the effects were heterogeneous, suggesting the studies may not be measuring the same effect. Future research on equine-assisted interventions for the mental health of youth should utilize designs with larger sample sizes, randomization and/or clear equivalence of comparison groups, a credible comparison treatment, complete and analyzable follow-up measurements, and adequate statistical analyses and reporting.