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BIONÆR-Bionæringsprogram

HESTEFORSK Implementering av hesteassisterte intervensjoner i Dialectic Behavioural Therapy R-21-47-573

Alternative title: Implementation of horse-assisted interventions in Dialectic Behavioral Therapy

Awarded: NOK 3.0 mill.

Emotionally unstable patients experience emotional instability, impulsivity, interpersonal problems and high levels of suffering, often with frequent suicidal crises, ongoing self-harm, substance abuse and cognitive distortions. This group of patients requires a lot of resources from the health service, with variable treatment effects and a high risk of dropping out of treatment. There is also a patient group with a great loss of healthy life-years. Therefore, we see a great need for effective treatment interventions that patients are able to sustain over time and complete. Psychotherapy with horses is an innovative complementary approach to psychotherapy where horses can be included as part of, or a complement to, other treatments. A frequently reported effect of psychotherapy with horses is a lower dropout rate from treatment. More research is still needed on how horses can make a positive contribution to other treatments, and there is a lack of studies that have used horses as part of existing, manualized treatment options for emotionally unstable patients. We will investigate what psychotherapy with horses can contribute as a supplement to a well-established, method-based psychotherapeutic intervention, Dialectical Behavior Therapy (DBT) for emotionally unstable patients. The first aim of the project is to examine whether the use of psychotherapy with horses alongside DBT contributes to improvement in perceived quality of life, symptom reduction, increased experience of social support, strengthened socio-relational function, and lower drop-out from treatment. We will also explore the subjective experience of the significance of the horse for the patient’s process and treatment compliance. The patients’ experience of the relationship with the horse in therapy, and how it has affected their treatment and motivation to stay in DBT-treatment is of particular interest. Our second aim is to expand the current literature on why and how the horse is included in psychotherapy today, as our work until now has established that these questions have not been treated in much depth theoretically in the literature so far. Having a solid theoretical understanding of why adding horses to treatment may be beneficial will help strengthen the research field and can help guide and focus future interventions. Here we will connect literature on psychotherapy and attachment-theory with literature on horse-human interactions and studies of horses in psychotherapy to expand the field. The project is a mixed-methods study, using qualitative and quantitative methods, as well as videobased ethograms based on psychotherapy with horses.

Emotional instability, impulsivity, ongoing self-harm, frequent suicidal crises, interpersonal problems, substance use disorder, cognitive distortions, and severe internal pain are seen in patients with emotionally unstable personality traits. This is a patient group that requires lot of resources over time, with variable effect. We see a great need for interventions that can help reduce individual suffering and socio-economic challenges and prevent fatigue in the help system. Horse-assisted therapy (HAT) is an innovative complementary approach to psychotherapy. HAT is a sought-after and attractive offer, we shall investigate why and how this can contribute in a well-known method-based psychotherapeutic intervention, Dialectical Behaviour Therapy (DBT) for emotionally unstable adolescents. We shall investigate whether this contributes to symptom reduction, increased experience of social support, treatment retention, strengthened socio-relational function and improved quality of life.

Funding scheme:

BIONÆR-Bionæringsprogram