Equine-Assisted Mental Health Interventions

Harnessing Solutions to Common Problems

Kay Sudekum Trotter, Jennifer N. Baggerly, Kay Sudekum Trotter, Jennifer N. Baggerly

• Publisher: Routledge
• Year: 2018
• ISBN:
  9781351673259
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy Counselling
• Index: Psychology

Written by internationally renowned equine-assisted mental health professionals, this edited collection teaches counselors how to design and implement equine-assisted mental health interventions for different populations and various challenges. Supported by ethical considerations and theoretical frameworks, chapters cover common issues including depression, anxiety, grief, ADHD, autism, eating disorders, substance abuse, self-esteem, social skills and communication, couples and family work, and professional development. Each chapter provides practical tips for implementing treatment strategies, case studies with transcript analyses, and sample session notes. This book will appeal to both the expert equine-assisted mental health counselor and the seasoned counselor who is open to partnering with an equine practitioner to help their clients in new and innovative ways.

Section 1

ETHICAL CONSIDERATIONS AND THEORETICAL FRAMEWORK

1

ETHICAL CONSIDERATIONS IN EQUINE-ASSISTED INTERVENTIONS

Meeting the Needs of Both Human and Horse

Kirby Wycoff and Maya Gupt.

INTRODUCTION

Across our country, on a daily basis, we are seeing more and more animals serving humans in need. From miniature horses providing trauma-based relief work at natural disasters and school shootings to prison programs working with off-the-track thoroughbreds, and mustang herds teaching executives about leadership, not a day goes by where we do not hear about the use of animals to alleviate human suffering or improve the human experience. Advocates of animals used in service of humans believe that serious attention must be given to the animal’s physical ability and training for the work, as well as the handler’s ability to advocate for his/her animal-assisted intervention (AAI) partner (Wycoff, 2014). Ethical consideration is needed for both the human who is being served and the animal who is doing the serving. Specifically, there are three key foundational ethical concerns of providing equine-assisted interventions. First, there are the goals of the interaction, then the appropriateness of the client for the specific modality, finally the suitability and preparation that the horse has for the work. As clinicians, it is our objective to honor and respect our human clients and our equine partners to deliver high-quality, ethical services.

The principle of also honoring and respecting the animal and those that care for the animal is often overlooked in animal-assisted interventions. As a human-centric society, we often put the needs of humans above those of animals. While there may be nothing inherently wrong with this perspective, as clinicians we have a responsibility to consider our animal partners if we are going to have them provide professional services. Those that have chosen to read this book are likely doing so because they have an interest in equine-assisted interventions. Note that the term equine-assisted interventions (EAI) will be used here to include a wide range of activities, therapies, and educational experiences. Maybe you are already doing EAI and want to improve your practice or perhaps you are just delving into the field for the first time. You may have a lifetime of experience with horses or perhaps have never set foot inside a barn. You chose your professional path into the helping field, to advance your knowledge by reading this book, and considered this line of work. You, like these authors, made a choice. However, our equine partners have no choice; they are drafted into the role. It is our responsibility, both ethically and morally, to give our animal partners choice in the work they do, for how long they do it, with whom they do it, and if they even do it at all (Wycoff, 2014).

ETHICAL CODES AND EQUINE-ASSISTED INTERVENTIONS

Ethics codes in the helping professions are put into place to protect the rights and needs of the humans that are being served. All major mental health organizations include an ethical code as part of their professional training guidelines and licensing practices. Ethical codes set professional standards and define appropriate and inappropriate behavior. Generally speaking, these codes put forth a set of guidelines that are intended to mitigate risk to the client above all else. The law indicates a minimum standard that will be tolerated and enforced, while ethics represent an ideal set of standards (Corey, Corey, & Callahan, 2014). Ethical codes typically express the professional values of a field as well. Most start by noting that the ethical code is intended to build trust in the public and honor the public trust in the professional services provided therein (American Association for Marriage and Family Therapy, 2017). Through the means of the ethics code, aspirational core values and an obligatory set of rules are put forth to those in the profession.

American Psychological Association

In its Ethical Principles of Psychologists and Code of Conduc., the APA noted that the goals of the document are to:

provide a common set of principles and standards upon which psychologist’s build their professional and scientific work… It has as its goal the welfare and protection of the individual and groups with whom psychologists work and the education of members, students and the public regarding ethical standards of the discipline.

(American Psychological Association (APA), 2017, p. 3)

The ethical code is more than just a code of conduct, however; it is also intended to be a way of thinking, being and viewing oneself. As noted above, the APA’s code focuses on the “welfare and protection” of clients. However, there are some statutes that are relevant to the provision of equine-assisted interventions and may also consider the welfare and protection of our equine partners (Allen & Colbert, 2016). Kirsten Allen and Lindsey Colbert, from the Graduate School of Professional Psychology at the University of Denver, considered the specific APA code statues specific relevance for those clinicians practicing in animal-assisted interventions. Competence and human relations from the APA code are highlighted below and can be found at: www.apa.org/ethics/code/index.aspx. Standard 2: Competence. Standard 2.01: Boundaries of Competence.

Standard 2. Standard 2 focuses on competence and the boundaries of competence. It is essential that practitioners provide services within their competence based on their “education, training, supervision, consultation, study or professional experience” (APA, 2017, p. 5). Standard 2:01 specifies that “psychologists planning to provide services in an area that is new to them must engage in the appropriate education, training, supervision, and consultation to do so” (APA, 2017, p. 5). For this standard, the code notes that for emerging areas, where recognized standards do not yet exist, “psychologists must take reasonable steps to ensure competence in their work and protect clients” (APA, 2017, p. 5). This is critical for equine-assisted clinicians, as animal-assisted therapies are an emerging sub-specialty in the mental health field. While there has been great movement in the field, there is still a paucity of research with sound methodological basis to support its use (Anestis, Anestis, Zawilinski, Hopkins, & Lilienfeld, 2014). Standard 2.05 also held relevance when considering that a mental health professional may need to partner with and delegate aspects of the equine-assisted intervention to others (Allen & Colbert, 2016). For example, if working on a team of four (the animal, the animal handler/trainer, the client, the therapist), the therapist is delegating some of the aspects of the work to the both the animal and the animal’s handler (Allen & Colbert, 2016). The latter model is often used when working with horses (Allen & Colbert, 2016).

Standard 3. Standard 3 focuses on human relations and Standard 3.05 highlights the significance of multiple relationships that can occur when working in a team of three in delivering animal-assisted interventions (APA, 2017). A triad model exists (animal, therapist, and client) wherein the therapist is both the expert on the human and the expert on the animal (Allen & Colbert, 2016). Here, the therapist is serving dual roles, as both the animal handler and the clinician; balancing the needs and considering the safety of both (Allen & Colbert, 2016). This directly leads to Standard 3.06, Conflict of Interest. If the therapist has responsibility for both the human and the animal, this could prove challenging. Further, if the therapist actually owns the animal (as may be the case in equine-assisted interventions and is often the case in working with smaller animals), this may impair the objectivity and competence of the clinician (APA, 2017). For example, in no other sub-specialty of mental health service provision does the therapist share a home (or even a bed) with their co-therapist. Standard 3.05, Exploitative Relationships, may also be relevant in equine-assisted work. In the therapeutic interactions, the psychologist has responsibility for the equine co-therapist, and we must be diligent to ensure that we are not exploiting them. This is directly related to Standard 3.10, Informed Consent (APA, 2017). Forcing an animal into a client interaction without their consent is a form of exploitation.

Other Professional Associations

In 2016, the American Counseling Association’s Center for Counseling Practice, Policy and Research disseminated a document entitled Animal-Assisted Therapy in Counseling Competencie. (Stewart, Chang, Parker, & Grubbs, 2016), which provides clear guidelines for their membership on competencies in animal-assisted therapy (AAT). While a number of animal-central organizations (Eagala, PATH Intl., Opaquest) have ethical guidelines, this is one of the first official documents from a professional mental health organization to publish such guidelines.

As noted elsewhere, it is the belief of these authors, as well as Stewart et al. and many others, if professionals in the helping fields are to provide AAT services (including equine-assisted interventions) ethically and effectively, specialized knowledge and training are necessary for both the human and the animal. Using a ground theory investigation model, Stewart et al. (2016) proposed nine critical competency areas for professional counselors using animal-assisted therapy practices. Stewart et al. break down those nine overarching competencies into three domains: knowledge, skills, and attitudes. A summary of these is provided below, but for a more in depth examination of this framework, please see www.counseling.org/docs/default-source/competencies/animal-assisted-therapy-competencies-june-2016.pdf?sfvrsn=6.

We suggest that Stewart et al.’s framework can be used as a set of guidelines to help you build your competent and ethical practice as it relates to equine-assisted interventions. Stewart and her team outlined the following three areas:

1. Knowledge: Formal training In-depth animal knowledge, and knowledge of existing ethical requirements.
2. Skills: mastery of basic counseling skills, intentionality, and specialized skill set.
3. Attitudes: animal advocacy, professional development and professional values.

(Stewart et al., 2016, p. 4)

This framework offers readers the opportunity to consider their strengths and areas for growth relative to the three domains of competency. Self-awareness and guidance from mentors and supervisors in evaluating one’s competencies is a critical aspect of becoming an ethical service provider.

While the original authors note that the guidelines are intended only for counselors who incorporate their animals into their work, we would suggest that these guidelines can be used for equine-assisted clinicians who are working with horses who do not belong to them. However, it is important to note that Stewart (2017) had raised worthwhile questions regarding the welfare of animals living in institutional settings: do they have someone advocating for them to the same extent the owner of a therapy animal would, and who ensures that they receive adequate downtime given that they reside within the therapeutic setting and do not get to go home with their handler at the end of the day?

In addition to general frameworks like the one offered by the American Counseling Association above, there are a number of existing organizations that have also outlined a set of ethical guidelines and principles for their organizations. Two of the most well-known equine-based therapeutic organizations are Eagala and PATH Intl. We strongly encourage readers to access and review both Eagala and PATH Intl.’s guidelines on Ethical Standards for additional considerations (see Eagala, 2015).

International Institute for Animal Assisted Play Therapy™

One additional organization is notable for the holistic and robust approach they take to training mental health professionals and considering the needs of animals in therapeutic work. The International Institute for Animal Assisted Play Therapy™ (Van Fleet & Faa-Thompson, 2017), documented an entire philosophy and set of guiding principles that considered the needs of both humans and animals. All too often in the AAT field, the animal’s needs, suitability, and appropriateness are not taken into consideration and when there is a poor fit or an animal is stressed, anxious or otherwise ill-suited to the work, both the human client and animal partner are at risk (Wycoff, 2014). The Animal Assisted Play Therapy™ model shares these concerns and addresses these in the training of future Animal-Assisted Play Therapists (Van Fleet, 2014; Van Fleet, & Faa-Thompson, 2010, 2017). These authors noted that many therapy animals are exposed to emotional distress and physical stress in therapeutic interactions (Van Fleet & Faa-Thompson, 2017). They noted the importance of overall animal welfare in working with animals in a therapeutic setting. One of the first guidelines noted is respect, which is defined as “Equal and reciprocal respect of clients and animals. The needs of humans and nonhuman animals are considered equally” (Van Fleet & Faa-Thompson, 2017). Here, the focus on balance and reciprocity is highlighted. The principles further expanded when considering things such as enjoyment and acceptance. The authors noted that the therapeutic interactions should indeed be enjoyable and pleasant for both the human and the animal, with bot. always having an option to not participate in the interaction. This is a critical aspect to consider because it highlights the importance of voluntary involvement in therapeutic interactions for all involved. How we evaluate things such as enjoyment and acceptance will be expanded below. In discussing acceptance as a guiding principle, the authors noted that the “therapist accepts the clients and the animals for who they are” and focus on meeting both client and animal in the here and now and accepting and appreciating the attributes and skills that the individuals bring to the setting (Van Fleet & Faa-Thompson, 2017).

ETHICAL DECISION-MAKING AND SELF-AWARENESS

With the formal ethics codes in mind, it is important to acknowledge the role of ethical decision-making in the provision of equine-assisted interventions. Ethical decision-making is one way that ethics is integrated into our everyday experience. Corey, Corey, and Callahan (2014) noted a number of key aspects that are central to ethical decision-making. They noted that values (beliefs and attitudes of an individual) provided guidance and direction in everyday life (Corey et al., 2014). These value systems are essential in living an ethical life and being an ethical professional (Corey et al., 2014). Morality, as defined by our perspective, on proper conduct in any given cultural context, is also an important aspect of ethics (Corey et al., 2014). This consideration is particularly interesting in light of the historical context of the human–equine relationship. Beliefs related to animals in any given society are shaped by culture, religion, language, and historical context among any number of other things. As clinicians, we may wonder, “Are horses beasts of burden to be used by humans, or are they sentient beings that can show emotion, preference, and attachment?” For a more robust discussion on the capacity of horses to experience feelings, see the incomparable and highly influential work of neuroscientist, Dr. Jaak Panskeep, who, in his book Affective Neuroscience: The Foundation of Human and Animal Emotion., documented animals’ abilities to experience a wide range of emotions (Panskeep, 2004). Social psychologist and equine researcher Dr. David Stang aptly summarized equines’ ability to feel and perceive. He noted, “Sentience is the capacity to feel, perceive, or experience subjectively. Any species that can suffer, can feel pain, is sentient” (Stang, 2017, p. 340). While this could be construed as anthropomorphism, attributing humanlike characteristics, emotions, perceptions, intentions to non-humans, we suggest here that animals have characteristics, emotions, intentions, and perceptions that are uniquely their own yet are described with the human language system. The rich and complex conversation on anthropomorphism and humans versus non-humans is beyond the scope of this chapter, but it is important to note that

treating agents as human versus nonhuman has a powerful impact on whether those agents are treated as moral agent’s worthy of respect and concern or treated merely as objects, on how people expect those agents to behave in the future, and on people’s interpretations of those agents’ behavior in the present

(Epley, Waytz, & Caciopp., 2007, p. 864)

Considering your own experience and belief system (likely impacted by culture and religion) will encourage you to draw your own conclusions on the moral debate around humans versus non-humans.

Our personal beliefs about ourselves and the horses we partner with will intersect with our professional practice. Our obligation as ethical professionals is to have self-awareness around these issues. Corey, Anderson, Knapp, and others all noted the importance of self-awareness in the provision of ethical service provision. Being aware of the influence of one’s own needs, experiences, personality, values, and beliefs is a critical aspect of the work (Corey et. al, 2014). Examining your own beliefs around issues such as sentience and the emotional experience of an...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Contents
• Preface
• About the Editors
• About the Contributors
• Section 1 Ethical Considerations and Theoretical Framework
• Section 2 Depression
• Section 3 Anxiety
• Section 4 Grief
• Section 5 ADHD
• Section 6 Autism
• Section 7 Oppositional Behavior
• Section 8 Eating Disorders
• Section 9 Substance Abuse
• Section 10   Self-Esteem
• Section 11 Social Skills and Communication
• Section 12 Couples and Family
• Section 13 Professional Development
• Index