Key Takeaways
Extended Takeaways
- Engagement was strong in this veteran sample: only 5 patients (7.9%) discontinued EAT, including 4 patients (6.3%) before midpoint and 1 patient (1.6%) after, despite the intervention requiring weekly travel to an equestrian center.
- PTSD symptom improvement was already detectable by midpoint on both clinician-rated and self-report measures, with CAPS-5 improvement of d = 0.96 and PCL-5 improvement of d = 0.70, suggesting measurable benefit can emerge before the full 8-session course is completed.
- The largest PTSD change was observed from pretreatment to posttreatment, with CAPS-5 decreasing from 38.6 (8.1) to 26.9 (12.4) and PCL-5 from 50.7 (13.8) to 34.6 (16.7); posttreatment gains were then maintained at 3-month follow-up rather than continuing to increase.
- Depressive symptoms also improved, but effect sizes were smaller than for PTSD: HDRS showed d = 0.69 and BDI-II showed d = 0.49 from pre- to posttreatment, which may help set realistic expectations when discussing likely targets of equine-assisted therapy with patients.
- This protocol was delivered in a highly structured format that may be important for replication: 8 weekly, manual-guided, 90-minute group sessions, groups of 3 to 5 veterans, co-led by a licensed mental health professional and an equine specialist, with the same two horses used throughout each group.
- Interpret results in the context of substantial concurrent care: 47 enrolled veterans were already receiving psychotherapy alone (n = 5), pharmacotherapy alone (n = 11), or both (n = 31), and none were in a strict manualized progressive PTSD treatment such as prolonged exposure or cognitive-behavioral therapy.
