Marchand William R, Joubert Katryna, Smith Judy, Nazarenko Elena, Klinger William, Sheppard Stephen, Hoopes Karl H
VISN 19 Whole Health Flagship Site, VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA.
Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA.
Mil Med. 2023 Jul 22;188(7-8). doi: 10.1093/milmed/usac028. Epub 2022 Mar 1.
The aim of this observational pilot study was to assess the safety, feasibility, preliminary outcomes, and predictors of participant response as a result of implementing an equine-assisted intervention within a residential substance abuse treatment program at a large Veterans Administration medical center. A secondary aim was to evaluate psychological instruments for use in future, more rigorous studies. The overarching goal was to complete the necessary work to prepare for a large randomized controlled trial of this intervention for Veterans with addictive disorders.
Participants were 33 Veterans, 29 males and 4 females, who participated in one 4-hour session of combined equine-assisted learning and equine-assisted psychotherapy during an admission to a residential substance abuse treatment program. Preintervention and postintervention instruments were utilized to assess changes in affect, anxiety, and craving. Demographic and diagnostic variables were evaluated for the potential to predict outcomes.
The intervention was safe and feasible to utilize as there were no adverse outcomes to patients, staff, or equines. The State-Trait Anxiety Inventory, Craving Experience Questionnaire, and Positive and Negative Affect Scale revealed preliminary findings of significant preintervention to postintervention decreases in anxiety, negative affect, and craving, as well as increased positive affect. Lastly, the presence or absence of a history of suicide attempts and/or suicidal ideation were predictive of some postintervention scores.
While more rigorous studies are needed, these results indicate that the intervention evaluated in this study is safe and feasible to utilize for Veterans admitted to a residential substance abuse treatment program. Furthermore, preliminary outcomes suggest that this intervention, and perhaps other equine-assisted interventions, has the potential to be beneficial to Veterans with addictive disorders as well as those at risk of suicide. The psychological instruments used in this intervention appear to be appropriate for use in future investigations. Additionally, more rigorous studies are warranted, and this work provides the necessary first steps needed to proceed with those investigations.
这项观察性试点研究的目的是评估在一家大型退伍军人事务部医疗中心的住院药物滥用治疗项目中实施马术辅助干预后参与者反应的安全性、可行性、初步结果和预测因素。第二个目的是评估用于未来更严格研究的心理测量工具。总体目标是完成必要的工作，为对患有成瘾性疾病的退伍军人进行这项干预的大型随机对照试验做准备。
参与者为33名退伍军人，其中29名男性和4名女性，他们在住院药物滥用治疗项目入院期间参加了一次为期4小时的马术辅助学习和马术辅助心理治疗相结合的课程。使用干预前和干预后的测量工具来评估情绪、焦虑和渴望的变化。评估人口统计学和诊断变量预测结果的可能性。
该干预措施的使用是安全可行的，因为对患者、工作人员或马匹均未产生不良后果。状态-特质焦虑量表、渴望体验问卷以及正负性情绪量表显示了从干预前到干预后焦虑、负性情绪和渴望显著降低以及正性情绪增加的初步结果。最后，自杀未遂和/或自杀意念史的有无可预测一些干预后的分数。
虽然需要更严格的研究，但这些结果表明，本研究中评估的干预措施对于入住住院药物滥用治疗项目的退伍军人来说是安全可行的。此外，初步结果表明，这种干预措施以及其他可能的马术辅助干预措施，有可能对患有成瘾性疾病的退伍军人以及有自杀风险的退伍军人有益。本干预中使用的心理测量工具似乎适用于未来的研究。此外，有必要进行更严格的研究，而这项工作为开展这些研究提供了必要的第一步。
