Archives for February, 2012
Equine therapy studies are hard to find. And perhaps even more challenging to find are studies that utilize sound research protocol. This leaves many well intentioned mental health practitioners to question the validity of equine therapy, and at the same time, many potential recipients of equine therapy wishing that their insurance company would cover equine work so that they may partake in it.
There is no shortage of stress reduction strategies, particularly these days. And for the most part, these interventions can be incorporated into the traditional psychotherapeutic model quite easily. When this occurs, a triage-like form of care can be offered to the patient which leaves less room for unmet needs that may cause problems later. No other area is this more true than in the case of substance abuse recovery. Addicts have often more than one additional psychological issue or concern that is often underlying their using. Certainly, using drugs alone has its own host of effects on a person, and more now than ever, professionals are realizing that if the physical, emotional and sometimes neuropsychological ramifications of long term drug abuse are not remedied, the person remains at high risk. A quick search of substance abuse treatment programs also very quickly reveals that more and more, these programs are turning toward a more holistic model of care, often offering yoga, massage, neurolinguistic programming, personal training, meditation, and equine therapy.
Intra-Family violence can be one of the most challenging issues to treat in therapy. Much of the complexity results not only from the family’s likely mistrust of the system and the professionals that are a part of it -- particularly in cases where Child Protective Services may have already intervened -- but also, the prevalence of co-occurring disorders, such as addictions. Often, these families will minimize the extent of the violence, possibly target one family member as the “problem” or offer the therapist platitudes -- compliance in the service of resistance -- that obfuscate the reality of the situation. While the therapist may suspect the violence is much more severe than is presented, there is a chance that if they gently confront the family, the family may become defensive, increase resistance, or leave the therapy all together. This dynamic combined with the family’s general mistrust of therapeutic settings places the therapist in a very difficult bind.
The definition of “Zen” is a “calm and unified mind,” but actually, the idea of a quiet mind has been around for some time. Dating back as far as 1967, Dr. William Sargeant described the mind as “unquiet” in his well read book, The Unquiet Mind. Now, a litany of resources exist to develop this sought after meditative state. Yet, for all our resources, many people would attest that racing thoughts, constant worry and endless frustrations pollute their daily thoughts. For many, the idea of staring at wall -- recommended by many zen masters to clear their mind -- almost seems to bring the problem to the fore. So if we don’t find zen by staring at a wall, where do we find it? Well, maybe we should look to horses -- after all, they live in the state of zen.
A position statement written by AETNA health insurance labels equine therapy as experimental. In further elaborating on what constitutes experimental, AETNA continues to say that equine therapy is experimental “because there is insufficient scientific data in the peer reviewed medical literature to support the effectiveness of hippotherapy for the treatment of individuals with these indication,” (referring to those with Cerebal Palsy). So just what is the difference between experimental and standard treatment? In an article written for HealthAffairs, SJ Reiser (1) outlines two basic principles that separate standard care from experimental care. The first guideline is that standard care must be certain, meaning that outcomes resulting from this treatment can be said to have a “known effect resulting from definitive experience.” On the other hand, experimental care would produce only “hypothetical or ambiguous” results, according to Reiser.
Horses have been domesticated for many years, and from the very beginning, it was us teaching them. We attached our ropes, harnesses, saddles, and ideas onto them. We taught them what to be, think and do. And amazingly, they went along. Horses obliged us. When we asked them to carry us just where we wanted to go -- and sometimes in the most dangerous circumstances -- they did. After all, horses were the very first war vehicle. And when we asked them to carry us in the way we wanted to go, again, they did. We hitched their heads up high, and weighted their feet, so that the picture would be pleasurable to us. And still, they did. Regardless of how absurd and even threatening our ideas may have seemed to a horse, still they obliged our desires, putting their emotions, and even very primal need for protection aside. Simply because we asked.