Equine-Assisted Psychotherapy s Impact on the Self-Efficacy of Adult Female Victims of Interpersonal Violence

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1 Equine-Assisted Psychotherapy s Impact on the Self-Efficacy of Adult Female Victims of Interpersonal Violence Dr. Wanda Whittlesey-Jerome, Principal Investigator, & Karen Longenecker, Observer, New Mexico State University Deborah D. Pierson & Linda Schelander, EAGALA-Certified Professionals, Guadalupe Stables, LLC Rhonda Day, Clinical Director, & Lynn Gentry Wood, Executive Director, Domestic Violence Resource Center Summer 2013

2 Abstract The purpose of this exploratory pre-post comparison group study was to measure the impact of equine-assisted psychotherapy (EAP) on the self-efficacy of adult female victims of interpersonal violence. Over the course of eight weeks, two groups of seven women were to participate in on-going individual and group therapy with their agency. The seven women in the comparison group (COM) did not receive EAP, whereas the six women in the experimental group (EAP) added a weekly two-hour EAP session to their existing agency services. Both groups were similar demographically. Existing agency data on depression, anxiety, and global assessment of functioning were analyzed in addition to the general selfefficacy data collected by the researcher. Study results showed greater improvement across all measures for the EAP group with the exception of anxiety which was accounted for by one COM participant adding anti-anxiety medication to her treatment plan during the study. Importantly, several women from the EAP group were making big life-changes (leaving their perpetrators) upon completion of the intervention, which may have been reflected in their anxiety levels at post-test. Statistical significance was found within groups comparing pre-test to post-test, but not between groups on change scores (difscores) due to the small sample size. Nevertheless, rich qualitative data from the women s journals adds breadth and depth to the findings through their personal stories of sadness, shame, and, in the case of several women from the study, triumph over oppressive and destructive relationships. This study adds its support to the growing evidence base for the use of EAP with under-represented and under-served at-risk populations, especially marginalized women of color.

3 Ethnicity of Participants by Group

4 Age of Participants by Group

5 Weeks in Agency by Group

6 A Visual Comparison of Pre-test and Post-test Mean (x ) Scores by Group Pre-test Post-test

7 BDI, BAS, GAF, & GSES Mean (x ) Difscores by Group

8 Mean (x ) Difscore Changes

9 Paired t-test of Pre-Post Scores Within Groups Indicating Statistical Significance

10 Independent t-test of Pre-Post Scores Between Groups Indicating Statistical Significance We found statistically significant differences between the EAP Group and the Comparison Group on Self-Efficacy Pre-test and Post-test. [F values of and.320 (p.15)]

11 Analysis of Variance (ANOVA) A Multiple t-test for Statistical Significance Between Groups Comparing Pre-test and Post-test Scores

12 ANOVA General Linear Model A Multiple t-test for Statistical Significance Between Groups on Pre-Post Difscores No Statistical Significance Found Study samples of this size typically do not show statistical significance between groups on change scores (difference in scores, or Difscores).

13 Correlations (Relationships) Depression and Anxiety & Ethnicity and Depression

14 ANOVA on Possible Effects of Ethnicity on Depression Pre-Post Change Difscores Between Subjects

15 From the Women In Their Own Words The qualitative data rich with depth and breadth on shame, guilt, sadness, anger, abuse, and the rise to overcoming barriers to self-efficacy and recognizing strengths and believing in the value of their lives courtesy of EAGALA (2013)

16 I like being in the arena w ith the horses. This is so different from my regular life. I w onder w hat they think. Do they like w hen people come and pet them? Are some in a bad mood and don t w ant us to w alk by them? What do w e look like to them? Are w e sort of color-coded by our anxiety or w hatev er emotion w e have? Seems they aren t complicated in their minds like me. EAP Study Participant

17 Today I felt all alone in the arena w ith my horse. Like I w as stuck in a nightmare w here you are screaming for help but nothing comes out. But I knew I had to go in. Then, I got angry at myself. Where have I gone? What happened to my courage? My self-esteem? How did I let someone take my self-w orth, my voice, my value away? -EAP Study Participant

18 Today I got to pick my horse. I chose the red one because she w as hanging around as if saying I m here pick me and I felt like she needed attention. Grooming her I felt a sense of happiness and calming relief. I told her about [the abuser]. I felt like crying. Brushing her tail, she seemed happy. Why can t I be happy and w ell I guess not today it s just not my time yet. Yuck, w hy do I feel like crying? Aghh this sucks having feelings my heart feels like someone stomped on it then put it back. Aghh I can t stop cr ying. Wow I feel like a riv er w ants to r un out of my eyes. Wow this sucks. I m telling a horse my feelings and I w ant to just cr y a lot. I feel so much pain and I don t know how to stop it. Focus. The horse is looking at me like Hello I m here for you. Stop w orrying. You can tell me. I ll listen w hile you cry. Wow it s so emotional... this huge horse is letting me tell my feelings, and she just has so much compassion for me that s so w eird. EAP Study Participant

19 This is a tw o-hour island in my w eek w here I am transported to a place w here I feel safe a place that I haven t experienced before. These other w omen in the group w e are girls w ho put other people ahead of ourselv es and w e w onder if w e are ok? Are w e nice? I am SO surprised at my lev el of grief. It feels enormous and I had no idea I harbored so much. It feels almost that I am consumed w ith it. EAP Study Participant Finally, nearing the end of the study, one woman wrote this in her journal, Okay w ow all of this journaling has led me to the revelation w ell no w onder it s so f----ing diff icult to sweep my floors and do my chores I am shifting my entire being!

20 Ultimately, two main factors were observed to influence the EAP group s outcomes being with the horses and being with each other. The horses provided a safe place where the women could project their own stories, their fears, their feelings, their dreams and their questions. Their journals were proof of how much the horses seemed to be listening to them. Secondly, because they had felt isolated prior to EAP group, their weekly conversations with each other indicated they felt part of a larger community one where other people experienced similar situations. The EAP group was motivated to change in a relatively short period of time eight weeks. The EAGALA facilitators did not interfere in the change process, as the women gleaned more from their interpretation of their own experience than a classic meaning-making process often seen in traditional talk therapy. The ultimate message the women participants in the EAP group were able to hear was this You are not alone. You are strong. You can change.