Statistics reveal that over 353,000 military members have been diagnosed with PTSD and/or TBI resulting from war-related activities. With the rising number of war stress injuries, there have not been enough psychotherapeutic services to meet the current demand for the care of returning veterans from Iraq and Afghanistan. Although some intervention strategies have been deemed successful, the current standards of care (e.g., exposure therapy, cognitive therapy) are limited by training inadequacies, accessibility, and outcomes (e.g., retention, early drop out, resistance, non-responsiveness).
Therapeutic horse activities have been investigated as a potential treatment for physiological issues pertaining to war stress injuries. 78 Organizations around the U.S. have used therapeutic horse activities with veterans with spinal cord injuries, TBI, traumatic amputations, injuries due to shrapnel, and extending it to also include mental health issues (e.g., PTSD, anxiety, depression). According to the PATH Inti. (n.d.) website, over 300 organizations are providing this treatment specifically for veterans. Therapeutic horse activities have started to gain attention from the VA whom has begun to provide grants and funding for research, although, these resources are limited. In 2005, the North American Riding for the Handicapped Association (NARHA) and the VA established the program Horses for Heroes. This program specifically focuses on PTSD symptomology related to war stress injuries; however, it did not have a psychotherapy component. A review of the current research demonstrates that quantitative and qualitative studies regarding therapeutic horse activities demonstrate therapeutic promise for a variety of populations, problems, and age groups (Selby & Smith-Osborne, 2013). Most of these studies illustrate rapid and positive responses to the use of horses in therapeutic or educational/learning environments. Although most research conducted has been looking at the effects of children with cerebral palsy and intellectual disabilities (e.g., L. Kaiser, Smith, Heleski, & Spence, 2006; Lentini & Knox, 2009), this population is very dissimilar to the struggles of military veterans. Thus current body of research findings merits further study with the military population. The term, therapeutic horse activities, will be used to refer to the general use of horses for therapeutic and/or educational purposes. In the present review, a history and therapeutic value of the horse-human relationship is reviewed followed by a discussion of the terminology used to describe therapeutic horse activities. Next, quantitative and 79 qualitative studies are presented along with limitations of those studies. The chapter concludes with a discussion on studies specifically addressing the use of therapeutic horse activities with veterans and the benefits it may have.