Examining effects of equine-assisted activities to help combat veterans improve quality of life

It is well documented that a high number (24%) of veterans returning home from military deployments in Iraq and Afghanistan experience varying degrees of posttraumatic stress disorder symptoms and impaired quality of life [1–2]. Helping veterans successfully reintegrate into civilian life has become a focus of both the military and private psychological services, as well as other community-based groups. While psychological treatment for veterans is provided by the Department of Veteran Affairs, the Department of Defense, and private services, many veterans do not seek the help they need out of fear of the negative stigma associated with mental health care [1]. Recently, efforts have been made to reduce barriers to treatment by developing interventions that are more “veteran friendly,” such as educating unit members about mental health issues and including them in the treatment. In addition, soliciting the support of leaders and supervisors in the identification and assistance of veterans receiving treatment is proving to be beneficial [2]. One specific intervention that incorporates fellow veterans and leader support in the treatment is the Professional Association of Therapeutic Horsemanship (PATH) International Equine Services for Heroes program (formerly known as the Horses for Heroes program). This unique program includes a horse as part of the treatment, with the goal to help wounded military service personnel and veterans improve both physically and mentally [3]. The therapeutic effects of interacting with a horse on the ground or riding on top of the horse are not new and date back to earlier times. The ancient Greeks gave horseback rides to raise the spirits of the chronically and incurably ill [4–5]. It was not until 1875, however, that the first systematic study of therapeutic riding (TR) was reported. After prescribing pony riding as a treatment for a variety of conditions, French physician Chassaign concluded that riding was helpful in the treatment of certain types of neurological paralysis. He noted improvement in posture, balance, and joint movement and a striking increase in morale [6]. The PATH International Equine Services for Heroes program, built on these early findings, is a broad program designed to help veterans through the use of a variety of equineassisted activities and therapies (EAATs). In an effort to understand how an intervention that partners a veteran with a horse may help improve quality of life, we examined a specific EAAT known as TR. TR uses equine-assisted activities (EAAs) for the purpose of contributing positively to the cognitive, physical, emotional, and social wellbeing of people with disabilities [3]. Because this program is fairly new,