Horse Care Helps Veterans with PTSD

A study by researchers at Rutgers University-New Brunswick found that military veterans with post-traumatic stress disorder (PTSD) who participated in a horse care program experienced improved mental health and relief from symptoms. The work is published in the diary Boundaries in psychiatry.

The researchers published the results of the study in the journal Frontiers of Psychiatry. According to them, the insights could open the door to a new approach to mental health care for veterans, as many veterans currently drop out of conventional therapy programs, even though these have been proven to be effective.

“When I think about the challenges our veterans with PTSD face, the results make sense,” said Andrea Quinn, one of the study’s authors and assistant director of the Center for Psychological Services at the Rutgers Graduate School of Applied and Professional Psychology (GSAPP).

Veterans with PTSD often get stuck in the past, she says, and are hyper-alert to what’s happening around them and what might happen.

“In the study, the veterans were asked to perform tasks that required them to be very present in the moment,” Quinn said. “They stayed calm and focused on the activity that was happening right in front of them: talking to the horses, grooming them, leading them. This kind of focus on the present moment is a skill that can be developed and can help make the symptoms of PTSD more manageable.”

Ellen Rankins, the paper’s lead author and then a PhD candidate, worked closely with the New Jersey Department of Military and Veterans Affairs.

Rankins recruited nine veterans for the study, all of whom had served in combat. Six were monitored while participating in Equine Activity, a horseback riding program in which professionals guide people through horse-based activities to improve their physical and mental health.

For comparison, a control group consisting of the remaining three veterans continued their normal daily activities without visiting the farm.

“We wanted to understand the effects of the interactions on the veterans and the horses, particularly in terms of their physiological and behavioral responses over eight sessions,” said Rankins, now a postdoctoral associate at the Temple Grandin Equine Center at Colorado State University.

The study was conducted in 2022 by the Rutgers Equine Science Center, part of the New Jersey Agricultural Experiment Station in New Brunswick, N.J. The researchers worked with the organization Special Strides in Monroe Township, where the study took place. Representatives from Special Strides provided the facilities, staff and trained horses.

To begin, participants filled out questionnaires and reported recent symptoms of PTSD, including flashbacks of traumatic events, angry outbursts, feelings of being attacked and sleep problems. They underwent blood tests to check for levels of hormones involved in the stress response — norepinephrine, epinephrine and cortisol — as well as oxytocin, which promotes positive feelings. Those levels were measured two more times, halfway through the study and at its conclusion.

Some veterans had never seen a horse up close before. They learned how to communicate with their assigned horse, as well as basic horse grooming techniques and how to lead a horse with a halter and lead.

Rankins said the participants’ military training made it easier for them to adapt to the program.

“They’re used to having that chain of command and understanding that ‘I’m the leader, I have to tell the horse where to go. And he looks to me for that,’” Rankins said.

Stress hormone levels in participating veterans were high at the beginning of the sessions, the researchers found, but declined over time. Oxytocin levels stayed the same. Participants reported fewer PTSD symptoms after the program ended. In contrast, hormone levels and PTSD symptoms in human control subjects remained high throughout the program.

“Veterans reported more positive interactions with their horses from week 3 onwards and this change was maintained through the end of the sessions,” Rankins said.

Additionally, scientists conducting the study also found preliminary evidence of a phenomenon known as co-regulation, in which the body rhythms of the veterans and the horses they were working with began to synchronize. Rankins said she plans to conduct a more detailed study of this occurrence.

Veterans in the control group were also allowed to take the horse riding course after the eight-week study period.

According to Karyn Malinowski, co-author of the study and professor in the Department of Animal Sciences at Rutgers School of Environmental and Biological Sciences, the horses that participated in the riding exercises showed no signs of stress compared to the horses that did not participate in the sessions.

“This is important because there is increasing concern in the general population about the welfare of horses,” said Malinowski, who is also the founder of the Rutgers Equine Science Center. “The study showed that horses participating in this activity did not show any indicators of stress.”

On average, PTSD is slightly more common among veterans than civilians, according to the U.S. Department of Veterans Affairs’ National Center for PTSD. At some point, seven out of every 100 veterans will develop PTSD. In the general population, six out of every 100 adults will develop PTSD in their lifetime.

However, the number of veterans with PTSD varies by service period. Surveys conducted by the VA show that veterans of Operation Enduring Freedom in Afghanistan have the highest rates of PTSD, with 29 percent of veterans experiencing it at some point. The group with the next highest rate of PTSD, according to VA studies, are veterans of Operation Iraqi Freedom in Iraq, with 21 percent experiencing PTSD.

Research also shows that deployment increases the risk of PTSD.

Unfortunately, veterans often have more difficulty with treatment programs than civilians, says Quinn, who works with veterans in her role as director of the Rutgers Anxiety Disorders Clinic, a specialized clinic under the umbrella of GSAPP’s Center for Psychological Services.

“Some of the most widely used psychotherapy interventions for PTSD, such as Prolonged Exposure and Cognitive Processing Therapy, have shown that about a third of participants drop out before completing treatment,” Quinn said. “This number is even higher among military veteran populations, somewhere between 50 and 60 percent, and so studies looking at alternative treatments are valuable.”

The researchers plan to expand their studies from this pilot study to collect more data and further validate the equine approach.

“Studies like this are important because information about the effectiveness of different interventions for PTSD is used to guide policy and funding decisions,” Rankins said. “Having data to support the effectiveness of incorporating horses into PTSD treatments makes it more likely that these types of interventions will be available to veterans and others dealing with PTSD.”