Saturday, June 11, 2011

Of Course, Of Course


Perhaps you remember that line from Mr. Ed's theme song? A horse is a horse, of course, of course, he'll give you the answer that you endorse....I'm tired of talking about the same old things at Shrink Rap, so here's a horse of a different color. And you thought ClinkShrink did all the bad punning!

Over on the Clinical Psychiatry News website, there's an article by M. Alexander Otto about a study done in a state hospital in New Jersey on Horse Therapy. Otto writes:

In all, 32 patients worked with three specially trained therapy horses for 10 weeks in a corral built on campus for the purpose. They didn’t ride the horses, but instead saddled, brushed, and put them through various activities.

The weekly sessions lasted about an hour; the horses couldn’t tolerate much more. "It was hard work" for them, Dr. Schleifer said.

The project was part of a larger trial in which patients were randomized to either horse therapy, dog therapy, standard care, or off-ward group therapy, just in case the mere act of taking patients to a different part of campus – necessary for the dog and horse groups – made a difference in violence.

You can surf over there if you'd like to read more. I found it disturbing that this treatment was being tried if it bothered the horses.

11 comments:

SteveBMD said...

The sessions lasted about an hour; the horses couldn’t tolerate much more. "It was hard work" for them, Dr. Schleifer said.

Well, it's nice to see I'm not alone in feeling this way about seeing patients.

Duane Sherry, M.S. said...

Dr. Miller,

I think being around, working with animals can be very healing, especially for someone who has been through trauma, or has been given a diagnosis of a "severe mental illness."

I have worked with blind people for many years, and I have seen, first-hand, the deep bond that is formed with their "guide dogs."

The Psychiatric Service Dog Society (PSDS) is doing some great work in this area, especially with with military veterans -

http://www.psychdog.org/veterans.html

Thank you for this post.

Duane Sherry, M.S.

jesse said...

This is very interesting, Dinah. It's a short study - each patient had ten sessions of one hour each, so I wonder whether the findings reflected the "newness" this had for the patients. I wish the author had explained, too, what made this "hard work" for the horses.

Affective disorders responded best. Not a major surprise. It is good to see interest in treatments that are not pharmacological.

Anonymous said...

"I found it disturbing that this treatment was being tried if it bothered the horses".

That statement is interesting. I take it you are a vegetarian. If not, I'd venture to say that the chickens and cows we eat have a tougher time than the horses who were groomed and put through various activitis, assuming none of the activities was slaughter.
And what about the animal trials of various potions and remedies that are carried out before human subjects are enrolled in studies?

Sunny CA said...

http://www.medscape.com/viewarticle/743756

I wondered why a horse would have trouble with a single one-hour session a week, so found the above link which explains the study more fully. The horses met with 100 patients a week in groups of 3 patients, so 33 groups. Neither of the "control" groups were held outdoors. The dog group had 10 patients per 1 dog. How are those controls? The dogs should have been outdoors in a similar setting with a similar number of patients per dog.
In reading this I wondered if what reduced the violence was the fact that the staff reduced the use of restraint and seclusion. Perhaps they expected improved results and cut down on the abusive isolation and restraint so the patient "behaved" better because he/she was treated better:
"One patient, hospitalized for 15 years, was moved to tears working with the animals, and preferred the largest ones. That patient had attacked others 17 times in the 3 months before the project, but attacks were reduced to 9 times in the 3 months after the program started. This patient also required less restraint and seclusion. "

I am for rethinking how in-patients are "handled" by staff.

moviedoc said...

"bothered the horses?"

Can't the horse work on it's "countertransference."

Duane is right about animals. Someone told me about a "puppy poultice." But it is not treatment. My dog comes to the office with me every day. Sometimes I believe patients appreciate visiting him more than me.

Sunny CA said...

I have found media comments such as those following to be interesting. Now it seems that the public believes that psychological therapy can "cure" someone from pursuing sexually charged encounters.

"Mr. Weiner has been talking with a therapist in New York City over the past couple of days, as fallout from his online scandal worsened and he absorbed the message from his colleagues and advisers that his conduct reflected not just bad judgment but perhaps a deeper psychological problem.

“Congressman Weiner departed this morning to seek professional treatment to focus on becoming a better husband and healthier person,” said his spokeswoman, Risa Heller. “In light of that, he will request a short leave of absence from the House of Representatives so that he can get evaluated and map out a course of treatment to make himself well.”

"......Ms. Pelosi concluded that his behavior required medical intervention."

moviedoc said...

Maybe Mr. Weiner just needs a wiener dog.

Anonymous said...

"......Ms. Pelosi concluded that his behavior required medical intervention."

Something surgical, I hope.

Rob Lindeman said...

in re the Furor Therapeuticus post-Weiner: Do we need more evidence of the complete medicalization of morals?

Anonymous said...

What were they doing to the horses that would tired them out in only an hour? As a kid, I would ride for hours all over the countryside. My horse didn't get tired in an hours, maybe they have geriatric horses.

It doesn't surprise me that this would make patients feel better than the standard of care (not sure what their standard of care is, but I'm guessing it is some kind of mindnumbing group). Sunlight, fresh air, a gentle horse with a velvety nose, and staff backing off a for a bit. That is bound to produce happier patients.

Leslie