Equine-assisted therapy for children and young people at risk of developing permanent mental illness

Background

Mental illness among children and young adults is increasing in Sweden. It is both a self-perceived ill health where children or young people themselves report more mental health problems as well as more people receiving a psychiatric diagnosis (National Board of Health, 2017). In parallel with the increased ill health, more children and young people are being prescribed psychotropic medication. Early psychosocial interventions for children at risk of developing lasting mental illness are important so that the mental illness does not worsen and negatively affect important aspects such as schooling and peer relationships.

Animal-assisted therapies have been shown to be a complementary treatment for children and young people with mental illness. Horse-assisted therapy (HUT) has shown biopsychosocial benefits and therapeutic results in various types of mental illness, and in today's high-tech care with an emphasis on medical treatment, it is of great importance to consider non-traditional treatment methods that can bring about significant change for individuals.

Aim

The project aims to describe experiences of horse-assisted therapeutic activities for children and young people between the ages of 7 and 18, with signs of mental illness who are at risk of long-term exclusion. The study is longitudinal and combines qualitative and quantitative design.

Participants in the intervention are children between the ages of 7 and 18 with mental illness due to stress symptoms such as pain problems and who have been judged by the treating psychologist to be able to benefit from horse-assisted treatment. The intervention takes place once a week for a total of 12 weeks. The participants come to the farm together with a parent or other relative and are received by the child and youth physiotherapist with OHI certification (the Organization for horse-assisted interventions) to perform horse-assisted therapy and who is also responsible for the therapy and leads the session. Each session is at least 60 min and includes horse-supported therapeutic activities that include horse preparation, riding and post-work with the horse.

Inclusion criteria for participation in the study are children and young people who show signs of psychological stress in the form of absence from school, stomach aches and difficulties in peer relationships, and who have been referred from child and youth clinics or children's clinics in north-west Scania via the treating psychologist to horse-assisted treatment at Sveahastar in northwestern Scania. In the study, Photovoice is used to enable active participation, which gives the children and young people the opportunity to express what they consider important to highlight in the research, as well as the questionnaire "The Mood and Feelings Questionnaire: Short Version (MFQ) specially adapted for children and parents to obtain quantitative data which are analyzed with non-parametric randomization test (NPRT. By using NPRT it is possible to examine differences during both peaks and troughs in the health status of the participants between the time before the intervention and during the ongoing intervention. Qualitative data are analyzed using Grounded Theory (Charmaz, 2014) alternatively qualitative content analysis (Graneheim and Lundman, 2004).

The project has received ethical approval from the ethics review authority in Lund department 3 (Dnr: 2019–00008) and intends to contribute to knowledge about experiences and effects of horse-assisted therapy for children and young people with signs of mental illness at risk of developing lasting mental illness. The project is expected to generate two to four scientific publications and so far, one qualitative study has been published in the international scientific journal "Issues in Mental Health Nursing".