针对慢性精神病住院患者的动物辅助治疗:马术辅助心理治疗与攻击行为

Animal-assisted therapy with chronic psychiatric inpatients: equine-assisted psychotherapy and aggressive behavior.

作者信息

Nurenberg Jeffry R, Schleifer Steven J, Shaffer Thomas M, Yellin Mary, Desai Prital J, Amin Ruchi, Bouchard Axel, Montalvo Cristina

机构信息

At the time of the study, Dr. Nurenberg, Dr. Schleifer, Dr. Desai, Dr. Amin, Mr. Bouchard, and Dr. Montalvo were with the Department of Psychiatry, Greystone Park Psychiatric Hospital, Morris Plains, New Jersey (

出版信息

Psychiatr Serv. 2015 Jan 1;66(1):80-6. doi: 10.1176/appi.ps.201300524. Epub 2014 Oct 31.

Abstract

OBJECTIVE

Animal-assisted therapy (AAT), most frequently used with dogs, is being used increasingly as an adjunctive alternative treatment for psychiatric patients. AAT with larger animals, such as horses, may have unique benefits. In this randomized controlled study, equine and canine forms of AAT were compared with standard treatments for hospitalized psychiatric patients to determine AAT effects on violent behavior and related measures.

METHODS

The study included 90 patients with recent in-hospital violent behavior or highly regressed behavior. Hospitalization at the 500-bed state psychiatric hospital was two months or longer (mean 5.4 years). Participants were randomly selected to receive ten weekly group therapy sessions of standardized equine-assisted psychotherapy (EAP), canine-assisted psychotherapy (CAP), enhanced social skills psychotherapy, or regular hospital care. Participants' mean age was 44, 37% were female, 76% had diagnoses of schizophrenia or schizoaffective disorder, and 56% had been committed involuntarily for civil or forensic reasons. Violence-related incident reports filed by staff in the three months after study intake were compared with reports two months preintake.

RESULTS

Interventions were well tolerated. Analyses revealed an intervention group effect (F=3.00, df=3 and 86, p=.035); post hoc tests showed specific benefits of EAP (p<.05). Similar AAT effects were found for the incidence of 1:1 clinical observation (F=2.70, df=3 and 86, p=.051); post hoc tests suggested benefits of CAP (p=.058) as well as EAP (p=.082). Covariance analyses indicated that staff can predict which patients are likely to benefit from EAP (p=.01).

CONCLUSIONS

AAT, and perhaps EAP uniquely, may be an effective therapeutic modality for long-term psychiatric patients at risk of violence.

摘要

目的

动物辅助疗法(AAT)最常与狗一起使用,目前越来越多地被用作精神病患者的辅助替代治疗方法。与较大型动物(如马)进行的动物辅助疗法可能具有独特的益处。在这项随机对照研究中,将马和犬形式的动物辅助疗法与住院精神病患者的标准治疗方法进行比较,以确定动物辅助疗法对暴力行为及相关指标的影响。

方法

该研究纳入了90名近期有住院暴力行为或行为严重退化的患者。这家拥有500张床位的州立精神病医院的住院时间为两个月或更长(平均5.4年)。参与者被随机选择接受为期十周的标准化马辅助心理治疗(EAP)、犬辅助心理治疗(CAP)、强化社交技能心理治疗或常规医院护理的团体治疗课程。参与者的平均年龄为44岁,37%为女性,76%被诊断患有精神分裂症或分裂情感性障碍,56%因民事或法医原因非自愿入院。将研究纳入后三个月内工作人员提交的暴力相关事件报告与纳入前两个月的报告进行比较。

结果

干预措施耐受性良好。分析显示存在干预组效应(F=3.00,自由度=3和86,p=0.035);事后检验显示马辅助心理治疗有特定益处(p<0.05)。在一对一临床观察发生率方面发现了类似的动物辅助疗法效果(F=2.70,自由度=3和86,p=0.051);事后检验表明犬辅助心理治疗(p=0.058)以及马辅助心理治疗(p=0.082)都有好处。协方差分析表明工作人员可以预测哪些患者可能从马辅助心理治疗中获益(p=0.01)。

结论

动物辅助疗法,或许马辅助心理治疗尤其如此,可能是有暴力风险的长期精神病患者的一种有效治疗方式。

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