Running Head: EQUINE ASSISTED LEARNING

Equine Assisted Learning: An Evidence-Based Intervention for Families
Allison K. Solarz
Arizona State University

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Abstract

Background: It is estimated that 50% of all mental illness arises prior to age 14, an incident
attributed in part to disruptions and imbalances within the family system. Equine assisted
learning is a complementary and alternative approach to family therapy which is being used
increasingly to promote mental health in both adults and children. This study sought to build and
deliver an evidence-based, family-centered equine assisted learning program aimed at promoting
family function, family satisfaction and child social-emotional competence, and to measure its
acceptability and preliminary effect.
Method: Twenty families with children 10 years and older were recruited to participate in a 3week equine assisted learning program at a therapeutic riding center in Phoenix, Arizona.
Sessions included groundwork activities with horses used to promote life skills using experiential
learning theory. The study design included a mixed-method quasi-experimental one-group pretest
posttest design using the following mental health instruments: Devereaux Student Strengths
Assessment, Brief Family Assessment Measure (3 dimensions), and Family Satisfaction Scale to
measure child social-emotional competence, family function, and family satisfaction,
respectively. Acceptability was determined using a Likert-type questionnaire with open-ended
questions to gain a qualitative thematic perspective of the experience.
Results: Preliminary pretest and posttest comparisons were statistically significant for
improvements in family satisfaction (p = 0.001, M = -5.84, SD = 5.63), all three domains of
family function (General Scale: p = 0.005, M = 6.84, SD = 9.20; Self-Rating Scale: p = 0.050, M
= 6.53, SD = 12.89; and Dyadic Relationship Scale: p = 0.028, M = 3.47, SD = 7.18), and child
social-emotional competence (p = 0.015, M = -4.05, SD 5.95). Effect sizes were moderate to

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large (d > 0.5) for all but one instrument (Self-Rating Scale), suggesting a considerable
magnitude of change over the three-week period. The intervention was highly accepted among
both children and adults. Themes of proximity, self-discovery, and regard for others emerged
during evaluation of qualitative findings. Longitudinal comparisons of baseline and 3-month
follow-up remain in-progress, a topic available for future discussion.
Discussion: Results help to validate equine assisted learning as a valuable tool in the promotion
of child social-emotional intelligence strengthened in part by the promotion of family function
and family satisfaction. For mental health professionals, these results serve as a reminder of the
alternatives that are available, as well as the importance of partnerships within the community.
For therapeutic riding centers, these results help equine professionals validate their programs and
gain a foothold within the scientific community. Additionally, they invite future riding centers to
follow course in incorporating evidence into their programs and examining new directions for
growth within the mental health community.
Keywords: equine assisted learning, families, mental health

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Equine Assisted Learning: An Evidence-Based Intervention for Families
In the wake of a growing public interest in alternative treatments and therapies, equine
assisted learning emerges as a novel alternative approach to mental health. This report offers a
detailed account of a unique and innovative family-centered intervention, built and delivered
from start to finish, thus inviting new perspectives in mental health, learning, and the power of
animals.
Background and Significance
It has been estimated that nearly half of all adult cases of mental illness begin prior to age
14 years (National Institute of Mental Health, 2018). According to the World Health
Organization, as many 1 in 5 children struggle with social, emotional, or behavioral challenges
(2012). Left untreated, many of these issues will progress well into adulthood, manifesting in
criminality, drug abuse, and homelessness (American Psychiatric Association, 2013), and
ultimately, they will be long-term predictors of success or failure in life itself (Thomson,
Richardson, Gademann, Emerson, Shoveller, & Guhn, 2019).
Social-Emotional Health
Within the different domains of child development, social-emotional health is of
particular interest to mental health professionals. Child social-emotional health is now being
recognized as an important prerequisite for success across a wide variety of outcomes. Skills like
self-control, conflict resolution, cooperation, teamwork, and emotional regulation are among the
many non-cognitive or “soft” skills which have been noted in longitudinal studies to influence
future career, relationship and life success (Lippman, Ryberg, Carney, & Moore, 2015).

EQUINE ASSISTED LEARNING
Children who fail to develop skills within the social-emotional domain are predictably
more likely to suffer from mental illness, including mood disorders, behavioral issues, and
internalizing and externalizing symptoms (Thomson et al., 2019). Similarly, rates of criminality,
substance use, school failure, physical illness, and suicidality are much higher (Moffitt et al.,
2011). For these reasons, and in recognizing the value of prevention, it is relevant to begin
discussing how these skills might be better cultivated.
Role of Parenting
Adolescence is now being recognized as the second most critical neurodevelopmental
period in one’s lifetime (Dahl, Allen, Wilbrecht, & Suleiman, 2018). As children enter emerging
adulthood, supportive relationships and structure become vital, and it is thought that parenting
plays a critical role in child social-emotional health. Actions like sharing, showing sensitivity,
and seeing from another’s perspective allow parents to promote altruism and moral reasoning in
children during brain development (Lam, 2018). Cohesive relationships between family
members, especially those that include support, affection, and closeness, are predictive of child
well-being during this vulnerable period (Crespo, Kielpikowski, Pryor, & Jose, 2011). Within
these respects, the quality of the parent-child relationship cannot be overemphasized.
This places an undue burden on parents today, who are challenged by the slow decay of
the traditional family structure. Divorce, separation, and single parenthood are among some of
the signficant barriers adults face in raising emotionally healthy children (O’Connell, Boat, &
Warner, 2009). Separation is now listed as an adverse childhood experience (CDC, 2016), and
divorce is an ever-growing concern. Of all marriages in the United States, approximately 3%
each year will end in divorce, comprising about half the rate of new ones (CDC, 2018). Among

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other factors, family dysfunction appears to contribute significantly to the development and
perseverence of mental illness within children (O’Connell et al., 2009).
The modern era brings with it challenges never before seen. The value of spending
quality time with your children is now burdened by an ever-growing wave of digital age
distractions. Today, teens are inundated with a flood of social media demands, text messages,
video games and other diversions, predisposing them to new threats like cyberbullying, gangs,
and peer pressure, which are now being recognized as risk factors for self-harm, suicide and
mood disorders (John et al., 2018). Today, 95% of teens own a smartphone and 45% report they
are online “almost constantly,” yet nearly 70% do not see any clear positive benefit (Anderson &
Jiang, 2018). The long-term effects of increased screen time on the developing brain largely
remain to be seen. Meanwhile, parents are faced with the increasingly arduous task of connecting
meaningfully with their children.
Conventional Approaches
When traditional family approaches fail, therapy is the mainstay of treatment.
Conventional approaches like Whole Family Therapy, once the gold standard of treatment, have
been in a steady state of decline over the last few decades, partly due to emerging therapies like
Relational Therapy and Marital Family Therapy (Breunlin & Jacobsen, 2014). These newer
approaches focus on a subset of the family unit, an unfortunate reality for children. Therapists
today are reluctant to allow children in sessions, and upon doing so, fail to engage them as active
participants. Reasons for this include therapists’ unfamiliarity in working with children, lack of
training, and a lack of confidence in implementing strategies required for child engagement
(Lund, Zimmerman, and Haddock, 2002).

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Probably most significant is the loss of physical touch which has become the archetype
for professional behavior among mental health professionals today. While this “hands-off”
approach is meant to set a precedent for healthy boundaries, in doing so, providers fail to deliver
the essential non-verbal messages of care, compassion and security inherent in these actions
(Kelly et al., 2017). For many families, therapy will be avoided altogether. The stigma of mental
illness is ever-present and remains a major barrier to treatment. Feelings of shame and blame are
prevalent among people with mental illness (Parcesepe & Cabassa, 2013). The restrictive nature
of the traditional office setting creates additional challenges. The thought of visiting a mental
health professional, for many, provokes feelings of insecurity, guilt, and self-recrimination (Shea,
1998). Herein lies the problem with traditional approaches to mental health care; they simply
lack the sensory stimulation and emotional connectivity to captivate audiences.
Animals and Mental Health
In the history of human and animal interactions, humans have developed the capacity to
form intimate emotional connections with other species. The human-animal bond, as otherwise
known, is a phenomena that deserves greater consideration in modern medicine, and especially
in mental health. Animals possess many inherent qualities which make them ideal for psychiatric
treatments. While a seasoned mental health professional may strive to exert unconditional
positive regard, for animals it is a natural inclination. Their need for proximity resonates easily to
humans, sending a message that they desire love, affection, and companionship. Animals simply
want to be near us. Until recently, the impact of animals on humans was a phenomenon neither
well understood nor well described in scientific literature. In the wake of a growing interest in

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alternative medicine, however, this past decade has seen research abound in animal assisted
interventions for mental health (Fine, 2010).
Equine Assisted Learning
Equines have seen increasing public interest in the last few decades for their
contributions to mental health. Apart from other domesticated animals, equines possess unique
species traits which make them particularly useful for psychiatric education. For such large
creatures, horses are extremely emotional beings. As a pray species, they are highly attuned to
their environment and as such will react dramatically and immediately to very subtle changes in
the ambience. This inherent herd quality provides a valuable opportunity for learning insofar
emotions and behaviors of participants are mirrored by the horse (Fine, 2010). This heightened
awareness is another reason why, when given a verbal command, horses will choose either to
follow or to refuse, based on the confidence of the commander rather than his articulative skills.
This ability to prioritize body language is a valuable tool, and perhaps one reason why horses are
often used for leadership training and corporate events. Finally, horses are noble creatures that
require an abundance of care by their owners. This provides an opportunity for emphasizing the
relationship between ownership and responsibility, skills which offer an added philanthropic
benefit (Fine, 2010).
Equine Applications in Mental Health
No longer just anecdotal, information today is abound on the therapeutic benefits of
horses (Maujean, Pepping & Kendall, 2015). Studies involving these creatures are now
supported by complex psychosocial measures and biophysiologic processes. In the last twenty
years or so, equine assisted learning programs have concentrated their interests to several

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populations, the first being children with autism. Beginning in the mid-1990’s, the impact of
equines on various outcomes for children with autism has been studied extensively. Among
mental health outcomes, equines have been found to improve communication and social
interaction and reduce problematic behaviors in these children (Mcdaniel Peters & Wood, 2017).
A more recent population of interest is the incarcerated. For example, by 2013 there were already
13 states in which research was available on prison-based equine programs (Bachi, 2013). Here,
equine training programs serve as a source of revenue for prisons, and in turn, they offer
rehabilitative benefits for the incarcerated. Probably one of the most recent developments still
has been the study of at-risk youth, specifically children referred from school welfare teams or
rehabilitation centers. Here, similar psychological benefits are seen, including improvements in
social skills and reduction in problematic behaviors. Also seen are improvements in broader
measures like self esteem and quality of life (Kendall et al., 2015).
It would appear at present that mental health and equine professionals have aligned their
interests in recognizing the value of skill building within the social-emotional domain. Here, the
potential exists for long-lasting partnerships between professions, however significant barriers
exist. Reimbursement by third party payers remains a major challenge; one which could be
eliminated with improved riding center accreditation and implementation of best practices. To
date, only a fraction of riding centers are accredited through national authorities like the
Professional Association of Therapeutic Horsemanship, International (PATH, Intl.), which
provides standards for safety and equine welfare (2019). In addition, it is unclear to date whether
or not these facilities are implementing best practices to maximize client outcomes for their
clients. Progress in these areas will certainly help to increase scientific rigor of programs

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delivered, and will ensure sustainability of partnerships within the community, including those
with mental health professionals.
Problem Statement
Families of today face a number of unique challenges, predisposing them to increased
dysfunction and placing undue burden on children, who rely on relationships for development
and refinement of social-emotional skills. Mental health professionals are limited in their ability
to help families because trends suggest that all-inclusive family therapy programs are dwindling,
and the fact remains that many simply do not want these types of treatments.
In the last decade, therapeutic riding centers have begun to assume a greater role in
promoting mental health and particularly so in building of social-emotional skills. With the
growing public demand for alternatives, and given riding centers’ growing interest in serving the
public and families, it is unclear to date whether these centers are equipped to deliver newer
programs. It therefore becomes critical to determine whether evidence from the literature is
sufficient in guiding development and implementation of a family-centered equine learning
intervention, and upon doing so, whether or not this informed program may be effective in
promoting child social-emotional health and family function.
Evidence from Scientific Literature
In order to gain knowledge of the most current evidence to date on equine assisted
learning programs, a scoping review of the literature was conducted using Arizona State
University’s online databases. To guide this literature search, the following PICOT question was
developed:

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“In a population of Phoenix families, does implementation of an evidence-based,
equine assisted learning intervention improve elements of family function or
social emotional health in children?”
Following this search, a critical appraisal of articles and a synthesis of evidence were conducted
to gain insight in the building of a family-centered intervention. These processes and subsequent
findings are described in detail here.
Search Strategy
To begin, 4 scientific databases were searched using Arizona State University’s online
library, including Cumulative Index of Nursing and Allied Health Literature (CINAHL),
Cochrane, PubMed, and ProQuest PsychINFO databases. Advanced search criteria included
articles: obtained from peer-reviewed journals in medical or social sciences, written in English
language, available in full text, and less than 10 years of age from the original date of
publication. Keywords used in the search included: equine, child, youth, family, socialemotional, and mental health. Due to a paucity of research in equine-assited activities for
children and adults with mental illness, more refined searches did not return equally refined
results. For this reason, combining the term “equine” with 1 or 2 other search terms using
Boolean feature was optimal in achieving relevant studies meeting initial criteria for critical
appraisal. This search strategy was implemented for all 4 databases (Figures 1-4, Appendix A).
After accounting for duplicates, there remained 19, 6, 9, and 42 articles from the respective
databases. Four additional literature reviews and a meta-analysis were retained as resources for a
hand ancestry search. From this list, 94 articles in total were examined for relevance to the
PICOT question. Those involving psychotherapy or hippotherapy as a primary intervention were

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excluded, as these interventions are outside the capacity of the horsemanship professionals at our
project site. Studies with geriatric populations, studies examining children with attention-deficit
hyperactivity disorder, or those involving children with physical disabilities (such as cerebral
palsy) or major cognitive deficits (such as autism) were also excluded due to anticipated
difficulties in working with or evaluating the effectiveness of these special populations within
our program, resulting in a final count of 11 articles retained for critical appraisal.
Rapid Critical Appraisal
The last decade has seen mounting evidence in support of equine assisted interventions, a
change in part due to recognition by the scientific community that higher quality studies were
needed. Today, this quality is manifested in study designs that use randomization, wait-list
controls, and even use of inanimate objects as controls. Summarized below is a synthesis of the
highest quality evidence to date on equine-assisted activities and interventions for children and
young adults with mental illness, from 4 continents of the world (Tables 1 and 2, Appendix B).
Of the 11 studies chosen for appraisal and synthesis, 7 were exclusively quantitative by
design, using randomization or a control group or both. Three others were strictly qualitative in
nature, and 1 included a quasi-experimental design. A review of levels of evidence showed that 5
articles were level II evidence, 2 articles were level III, 1 was level IV and all 3 of the qualitative
studies were level VI (LoBiondo-Wood & Haber, 2006). Use of wait-list controls was common.
Despite this increase in higher level studies, the enduring presence of descriptive studies in the
literature suggests that certain phenomena within equine programs, such as the human-animal
bond, are compelling yet difficult to describe using parametric language (Kendall, Maujean, &
Pepping, 2014).

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Population Characteristics
The target population for this literature review was children and young adults, and
summaries are seen in the corresponding synthesis tables (Tables 1 & 2, Appendix C). All 11
studies involved interventions for children or young adults. Children were boys and girls aged
10-17, adults were men and women aged 18 to 29 years. Two-thirds of the studies included only
children. Several of the studies targeted children through after-school programs or by working in
coordination with school welfare teams. Others were recruited by case managers of group homes
or through referrals by officers at local detention centers. Overall, 9 studies in total recruited
participants using teams of professionals established through partnerships. This may be an
important consideration for future recruitment and sustainability efforts. Demographic variables
in studies were often sparse, as were discussions about children’s feelings and attitudes towards
animals or their skills with horses prior to the interventions.
Program Characteristics
Programs were reviewed and described using several synthesis tables (Tables 1 & 2,
Appendix C). On the surface, there appeared to be a great degree of heterogeneity in level of
exposure through session length and duration. This was evident by inconsistencies in hours per
session (45 minutes to 3 hours, M = 1.9 hours per session), total number of sessions (3 to 24
sessions), and total program duration (3 to 16 weeks). Beyond these aspects, however, programs
were actually quite similar. For example, all 11 programs included groundwork activities with
horses, and 5 of these also incorporated riding activities. The vast majority of studies involved
interventions using group activities (n = 10); of these, four also contained individual activities.
This is consistent with other findings from the literature, which discuss the importance of groups

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in providing an atmosphere for interpersonal interactions and respectful dialogue (Kendal et al.,
2014). Furthermore, this extensive use of groups in equine-assisted learning programs helps to
validate the application of a family-focused intervention.
The majority of programs’ interventions (n = 9) and outcomes of interest (n = 9) focused
on the core social-emotional aspects of human development (Table 3, Appendix C). The
aforementioned use of group activities was also reflected in the widespread use of session themes
that included an interactive component, such as communication, relationships, and teamwork.
What is interesting is that, despite this widespread use of groups and use of interactive session
themes, outcomes were highly individualized. This represents a methodological weakness that
has been noted in other reviews of equine programs (Kendall et al., 2015).
Theory is important because it provides a framework for the development and delivery of
programs, and offers some degree of consistency over time. Although only about half of the
riding centers had formal programs in place (n = 7), nearly all referenced a theoretical framework
in support of each’s program. Theories varied considerably, from Aboriginal Worldview to more
contemporary models. Experiential learning was the most common theory, accounting for more
than half of the studies examined (n = 7). For horsemanship professionals, experiential learning
theory has great significance. The outdoor environment through which equine programs are
delivered offers an exceptional sensory experience, ideal for the application of experiential
learning theory.
Only about one-half of the reviewed programs were delivered by certified horsemanship
professionals. Less than half of these specified any riding center accreditation. Riding centers
with certification offer additional measures that ensure the safety and consistency of programs

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delivered, an important consideration when involving children. A failure to mention accreditation
or certification in studies is also consistent with findings in literature reviews (Kendall et al.,
2015).
Overall, information from the critical appraisal and synthesis was beneficial in that many
similarities were noted. The program that was subsequently developed was unique in that it
contained elements of individual programs from the literature, as well as group activities also
thought to benefit the those who participated.
Purpose Statement

Evidence from the literature was sufficient in guiding an informed approach to the
development and delivery of a family-centered equine assisted learning program. The purpose
herein was to describe the recommendations made and the implementation process, and also to
examine the preliminary effects of this program on family function, family satisfaction and child
social-emotional intelligence. This project additionally sought to determine among adults and
children the acceptability of the intervention, as well as to gain a qualitative perspective of the
participant experience.
Procedural Frameworks

Theoretical Framework
Experiential learning was first described by such notable minds as Dewey, Lewin and
Piaget, and was later expanded by David A. Kolb, who has dedicated his life’s effort to exploring
and refining this theoretical model (Kolb, 2015). While a number of models have been identified
in equine assisted learning programs, experiential learning theory is of particular interest because

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equine activities and the outdoor environment both offer a rich sensory experience. Experiential
learning is well-supported and validated by professional horsemanship associations, including
PATH, Intl., whose certified staff are specially trained in these concepts and techniques (2018).
Experiential learning is a complex, adaptive process that involves collective interaction of
many key brain regions (Figure 1, Appendix D). Within Kolb’s framework, there are 4 key
concepts: the concrete experience, a reflective observation, an abstract conceptualization, and
active experimentation. During the concrete experience, participants are awakened by their
environment, promoting sensory and motor stimulation. Next, participants make reflective
observations about activities and challenges (i.e. what worked and what didn’t), enhancing
memory and emotional processing. Through abstract conceptualization, participants make deeper
connections between concepts, thus engaging the frontal cortex and higher learning. During
active experimentation, participants apply these abstract concepts in a new setting (i.e. the
home), promoting active decision-making. Behavior change becomes possible when participants
gain insight and use knowledge productively to sharpen these skills (Kolb, 2015). When
delivered in sequence, these mechanisms can greatly enhance learning and promote enduring
change.
Evidence Based Practice Model
Selecting an evidence-based practice (EBP) model for a therapeutic riding center was
challenging. The project site for our EBP implementation was a therapeutic riding center that
employed a small group of non-healthcare professionals, many of whom had overlapping roles
and responsibilities. It became clear that an organized approach was needed in order to identify
the ideal EBP model for project implementation. For this reason, best-fit determinants were

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developed to identify key components of an ideal model. This included the degree of
collaboration required, the degree of ambivalence to change, and the number of opportunities for
feedback before, during, and after project implementation. Through these determinants, Johns
Hopkins Nursing Evidence-Based Practice Model was selected as a model that was best suited
for project development and implementation (Johns Hopkins Medicine, 2017). Equally beneficial
is the fact that this model is designed for individual rather than organizational use, a key feature
which makes it an ideal framework for applications in smaller settings (Schaffer & Sandau,
2013).
The most attractive element of the Johns Hopkins Nursing EBP Model is the ongoing
collaborative exchange that occurs prior to project implementation (Figure 2, Appendix D). This
component was fundamental to program development and refinement prior to implementation at
the riding center. For example, it was advised that a refined screening process was needed for
applicants. When resistance was met, evidence was needed to support this change, which
required more information gathering, additional meetings, and further deliberation. The cycle of
translating evidence into practice was ongoing prior to the start of the intervention, and it helped
inform processes continuously as they developed. Upon completion of the intervention and once
data were collected and analyzed, additional revisions were likely, this is where the opportunity
for feedback became highly relevant. There was an expressed interest in continuing the program
for years to come, so recommendations would be necessary in order to ensure future
sustainability of the program.
Recommendations for Program Development

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Based on a rigorous evaluation of the most current evidence to date on equine assisted
learning programs, four separate recommendations were made in the building of an evidencebased, family-centered intervention. These recommendations included:
1. Use of experiential learning theory
2. Session duration of 3 weeks minimum
3. Content and outcomes within the social emotional domain
4. Participant age minimum of 10 years
These recommendations, discussed in detail below, comprise the informed approach to the
development and delivery of an evidence-based family-centered equine assisted learning
intervention.
Experiential Learning
Programs rooted in theory are extraordinary becasue theory provides a framework for
curriculum development, delivery, and replication. Experiential learning theory is seen time and
again in the literature on equine assisted learning. It is a necessary component for equine assisted
learning programs. According to the theory, concepts must be delivered in succession in order for
behavior change to occur. Prior to project implementation, riding center staff were educated on
the importance of the theory and its core concepts, and were given examples of how to apply
abstract conceptualization in round-up discussions following each learning activity.
Session Duration
The average duration for any equine assisted learning program in the literature is 7.8
weeks, with the minimum program being delivered over a 3-week period. Prior to an evidencebased application, the pre-existing program was offered as a single-session with the option of

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add-on sessions. Recommendations from the literature suggests that, in order for a program to
demonstrate both effectiveness and lasting impact over time, it must meet the minimum required
number of weeks duration. Due to time and cost constraints, due to the limited number of
available sessions per week, and in order to meet the goal of recruiting 20 families over a 7month period, session duration greater than 3 weeks would be optimal but not feasible for the
purposes of this study. For this reason, it was decided that a minimum of 3 weeks duration would
be appropriate.
Session Themes
The pre-existing program contained a number of different sessions available to families.
From a large list, four session themes were chosen based on their association with the socialemotional domain and their potential for interpersonal interaction among group members. These
themes included perspective, communication, understanding and accepting differences, and
boundaries. Session themes within the social-emotional domain were matched with outcome
measures that supported them, which will be discussed in detail later.
Participant Age
Age of children was an important consideration in building this program. For the
purposes of this study, children were required to be at least 10 years old for two reasons.
Experiential learning theory uses abstract concepts that are not appropriate for children of all
ages. Abstract conceptualization, an important concept within the theory, requires that the learner
be capable of thinking abstractly and applying ideas in a different context. For example, upon
failing to communicate effectively with a horse, a child must not only be able to understand that
body language is important for horse communication, but these actions also have consequences

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in human interaction. Another reason for the age limit was acceptability of the intervention.
Acceptability would be measured using a 6-item Likert-type questionnaire; children would be
required to complete items like “strongly agree, agree, neutral,” and so on. Generally speaking,
children younger than 10 years tend to have difficulty with Likert-type concepts (Mellor &
Moore, 2014). Therefore, it was determined that 10 years would be an appropriate cutoff for age.
In order to avoid turning down families with younger children, it was decided that children ages
7 through 9 would be permitted to participate in sessions alongside family members but would
remain invisible from a research perspective. This decision was based on riding center
restrictions, which allowed children ages 7 and older to participate in programs.
Program Description
Based on the most recent evidence to date on equine assisted learning programs,
recommendations from the literature were used to inform the development of a family-centered
equine assisted learning program. The Program included a 3-week, 3-session intervention
involving groundwork activities with horses. Each family, which consisted of at least one adult
caregiver and one child 10 years or older, participated separately in a 1-2 hour session each week
under the supervision of an equine specialist, during which time they learned about life skills
through horsemanship activities. Themes of perspective, communication, understanding and
accepting differences, and boundaries were incorporated into sessions consistent within the
social-emotional domain of health. After each activity, families gathered for a “round-up”
discussion in which they reflected on skills learned using the Cowboy Code of Ethics, a talking
point for discussion (Center for Cowboy Ethics and Leadership, 2018). During this time,
participants were encouraged to conceptualize this knowledge in an abstract way and apply it in

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a different setting. Outcomes measured for the study were reflective of session themes and
included measures within the social-emotional domain of health, to include child socialemotional competence, family satisfaction, and family function.
Method
Setting
All sessions of the program were carried out at a therapeutic riding center in Phoenix,
Arizona. The riding center, built in 1987, serves the the needs of the cognitively, physically, and
mentally disabled. The riding center and its employees are both accredited and certified by
PATH, Intl. All sessions were facilitated by an equine specialist in mental health and learning
(ESMHL). Four ESMHL staff with varying levels of experience facilitated the sessions, with one
ESMHL assigned to each family during the 3-week intervention. In addition, 1 to 2 volunteers
with Level II Horsemanship training were also used during each session to move horses between
activities and to provide passive support to participants. For program consistency, all ESMHL
staff received training and practice sessions prior to the start of the intervention and were
provided with note cards to maintain a scripted criterion for each of three sessions. To prevent
bias, ESMHL facilitators were blinded from family dysfunction endorsed during the eligibility
screening process which occurred prior to the intervention.
Horses were selected for the activities based on each’s individual temperament and on
availability. Six horses in all were used for the intervention, including four quarter horses (two
geldings and two mares), one morgan cross mare and one gypsy vanner gelding. All horses at the
riding center were required to complete a preliminary trial prior to being used for programs at the

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facility; this included being tested and observed for adverse behaviors which might compromise
the safety of participants.
Recruitment
Over a period of 6 months, 20 families were recruited by rolling convenience sampling
from the greater Phoenix Area using flyers, social media outlets, newspaper articles, open house
invitations, and word of mouth. Screening for eligibility occurred in two distinct phases. Families
interested in the program first contacted the program coordinator and were screened for initial
criteria. Families were required to include at least 1 parent or caregiver and at least 1 child aged
10-17 years, as well as an expressed willingness to attend all 3 sessions.
Those who met initial criteria were referred for secondary screening by a mental health
professional. Participants were selected based on their account of expressed concern regarding
family dysfunction (such as recent divorce, separation, or single parenthood) or statements of
risk factors for child social-emotional issues (such as a parent-child relational conflict,
behavioral concerns, or school concerns). Children were excluded from the study if it was
determined that safety might be compromised (i.e. if children had a history of physical
aggression towards people or animals, a history of fire setting, or significant a fear of horses), or
if they endorsed any cognitive or physical disability which might prevent them from completing
the activities and the post-intervention survey (i.e. child must be able to read, write and
understand English).
Ethics
Prior to the start of sessions, consents and assents were obtained from all adult and child
participants, respectively. Participants were given the opportunity to ask questions or voice

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concerns in a quiet, safe place. Participants also completed a liability release form and health
information form based on requirements established by the riding center. Prior to the start of
sessions and intermittently throughout, staff members reinforced safety measures required when
handling horses or being in close contact with them. Permission for the study was granted by the
Office of Research Integrity & Assurance at Arizona State University. Through contact with
Institutional Animal Care and Use Committee it was determined that a full review was not
necessary for the purposes of this study.
Instruments
Three professional mental health instruments were utilized for the purposes of measuring
outcomes related to social-emotional health, which are discussed here. The first of these was the
Family Satisfaction Scale (FSS; Olson, Gorall, & Tiesel, 2006), which was developed in 1983 as
a shortened version of the original FACES IV instrument. The tool measures the degree that
family members are satisfied with one another using three dimensions (cohesion, flexibility, and
communication). It is a 10-item Likert-type scale that is written at a 6th grade level, can be
scored in less than 5 minutes, and has an alpha reliability of 0.92 and a test-retest alpha
coefficient of 0.85.
The Brief Family Assessment Measure III (Brief FAM-III; Skinner, Steinhauer, & Santa
Barbara, 2008) is an instrument designed to measure 3 dimensions of family functioning. These
dimensions include the General Scale (a parent’s evaluation of the family), the Self-Rating Scale
(a parent’s evaluation of self in relation to family), and the Dyadic Relationship Scale (a parent’s
evaluation of the parent-child relationship). Each subscale contains 14 Likert-type questions, all

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of which can be completed in less than 10 minutes. The alpha reliability is 0.86 to 0.95, and
validity has been affirmed in a number of cross-cultural studies.
Devereaux Student Strengths Assessment (DESSA; LeBuffe, Shapiro, & Robitaille,
2018) is a mental health instrument that is used to measure social-emotional competence in
children. DESSA-mini is the shortened form, which is widely used among teachers, parents, and
mental health professionals. The DESSA-mini includes 8 Likert-type items which can be
completed in less than one minute. The test-retest reliability for DESSA mini ranges from 0.88 to
0.94 with a median alpha reliability coefficient ranging from 0.915 to 0.924. DESSA-mini has
excellent positive and negative predictive values, as well as sensitivity and specificity ratings,
making it an ideal tool for measuring social-emotional competence in children (Naglieri, LeBuffe
& Shapiro, 2011).
A program feedback form (PFF) was completed by all participants at the end of the third
and final session. This form was initially developed by the staff at the riding center and altered
slightly for the purposes of this intervention. It included 6 reverse Likert-type questions (1 =
strongly agree, 5 = strongly disagree), which were used to measure acceptability of the
intervention, and 5 open-ended questions (e.g. “What was the best part about today’s activity for
you?”), which were used to gain a qualitative perspective of the participant experience. A child
version was available for persons less than 18 years old. In addition, a socio-demographic form
was used to collect information on participant characteristics such as age, gender, number of
children in family, race, parents’ highest level of education, and whether or not children in the
family qualified for free or reduced school lunch.
Collection Points

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One parent from each family completed mental health instruments for the entire family,
including the Family Satisfaction Scale, Brief Family Assessment Measure, and Devereaux
Student Strengths Assessment. These instruments were completed at 3 separate collection points
by the same family member. Collection points were as follows: prior to the first session (T0),
immediately following the third and final session (T1), and 3-months post completion of the
intervention (T2). In addition, this same adult family member also completed a sociodemographic form prior to the beginning of the intervention. The program feedback form was
completed by all adults and children age 10 years and older immediately following the third and
final session (T1).
Statistical Methods
Due to the small sample size, nonparametric statistics were implemented for all pretest
and posttest measures using Wilcoxon Signed-Ranks test. A confidence interval was set at 95%
with a corresponding level of significance of p = 0.05. Mean sum scores for 20 pretest and 19
posttest measures were compared first for Family Satisfaction Scale. For Brief Family
Assessment Measure and DESSA-mini, and prior to calculation, sum scores for each scale were
matched with corresponding t scores. Effect sizes were calculated using Cohen’s D and were
based on the following scale: d > 0.8 (large), d > 0.5 (moderate), and d > 0.3 (small). Due to time
constraints, T2 data were not yet available at the time of this analysis, so comparisons of pretest
and posttest only (T0 vs T1) are provided and discussed hereafter. Acceptability was calculated
separately for adults and children and expressed first as a percentage of the whole based on 3
separate groupings (Agree or Strongly Agree, Neutral, or Disagree or Strongly Disagree) and

EQUINE ASSISTED LEARNING

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next as a mean score. Content analysis was used to examine the 5 open-ended questions from the
Program Feedback Form for themes that emerged regarding the participant experience.
Results
Sample Characteristics
Twenty families were successfully recruited to participate in the intervention. Of the
twenty families enrolled, nineteen (95%) completed the 3-week intervention and posttest surveys
(T1); the remaining family withdrew for personal health reasons. Six families had 1 session
cancelled due to rainy weather or health reasons (i.e. sick child, sick grandparent), however all 6
of these families were able to reschedule and attend a make-up session within the same 3-week
intervention period. While families were encouraged to bring all members for the intervention,
children under 7 years of age were not permitted in classes due to riding center restrictions.
Children aged 7-9 years were permitted to attend sessions with their families (n = 5) but were
excluded from the study and also hereafter from the discussion.
Sample characteristics are summarized in Table 1 (Appendix E). Families in attendance
ranged from 2 people (one adult and one child) to 5 people (two adults and three children or
three adults and two children). Five families included non-parent relatives, including 3
grandparents, an aunt, and a cousin. Participants were primarily of Caucasian ethnicity (85%),
the remainder were Hispanic or Latino (15%). One parent or guardian from each family was
invited to complete pretest (T0) and posttest (T1) mental health instruments. A total of 20 parents
or guardians completed pretest and 19 completed posttest measures. These parents’ ages ranged
from 30 to 50 years (M = 42.2), and 80% were female (n = 16). Three quarters (n = 15) of
families had at least 1 parent who completed a bachelor’s degree education or higher, and one-

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fifth of families (n = 4) had children who qualified for free or reduced school lunch. Child
participants included 13 girls and 12 boys aged 10 to 17 years (n = 25, M = 12.3 years). A single
child from each family was selected by a parent to be evaluated using the DESSA-mini and the
Brief FAM-III Dyadic Relationship Scale.
Family Satisfaction
Results for family satisfaction are summarized in Table 2 (Appendix E). Family
satisfaction showed positive improvement between pretest (T0) and posttest (T1) comparisons, a
change that was also statistically significant (p = 0.001, M = -5.84, SD = 5.63). Effect size was
large (d = 1.05), and greatest among all other instruments used, suggesting the largest magnitude
of change from the 3-week intervention.
Family Function
Three dimensions of family function were evaluated using Brief Family Assessment
Measure, the results of which are summarized in Table 3 (Appendix E). All 3 scales showed
positive improvements in family function. The Brief FAM-III General Scale was statistically
significant (p = 0.005, M = 6.84, SD = 9.20) with a moderate effect size (d = 0.74). The SelfRating Scale was also statistically significant (p = 0.050, M = 6.53, SD = 12.89) with a moderate
effect size (d = 0.51). The Dyadic Relationship Scale also showed positive change that was
statistically significant (p = 0.028, M = 3.47, SD = 7.18). Effect size for Dyadic Relationship was
small (d = 0.48) and yet nearly moderate, but overall with the smallest magnitude of change of
the 3 family function measures.
Child Social-Emotional Intelligence

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Devereaux Student Strengths Assessment was used to compare child social-emotional
health using pretest and postest mean t scores. Results are summarized in Table 4 (Appendix E).
Social-emotional health showed positive improvement over the course of the 3-week
intervention, and this change was also statistically significant (p = 0.015, M = -4.05, SD = 5.95)
with a moderate effect size (d = 0.68). Level of significance for parametric and nonparametric
measures were comparable for all 3 mental health instruments, further validating these findings
and also suggesting that the population sample, though small, assumed a fairly normal
distribution.
Acceptability
A total of 55 participants, including adults (n = 32) and children (n = 23), completed the
Program Feedback Form, the first 6 questions of which were used to measure acceptability of the
intervention. Results for percentages are seen in Table 5 (Appendix E). All adults (100%) either
agreed or strongly agreed that the program was positive, educational, and engaging. Additionally,
100% also either agreed or strongly agreed that they could apply the Cowboy Code of Ethics to
their own life and that they would recommend this program to friends or family. Similarly,
96.9% of adults either agreed or strongly agreed that the round-up questions were helpful, and
only 1 family member was neutral. Nearly all (87.5%) of adults either agreed or strongly agreed
that they learned something new about themselves or their family members during the sessions.
Mean scores for all 6 questions on the reverse-Likert scale all fell below 1.5, suggesting that the
program was well-accepted among adults (Figure 1, Appendix E).
Children also accepted the intervention however to a lesser extent. Results for
percentages can be found in Table 6 (Appendix E). For example, over 95% of children either

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agreed or strongly agreed that the program was positive, educational, and engaging. Seventeen
children (74%) either agreed or strongly agreed that they could apply Cowboy Ethics to their life,
and that the roundup questions were useful. Only two-thirds (64%) of child participants either
agreed or strongly agreed that they learned something new about themselves, while the other
third (36%) were either neutral or in disagreement. About three-quarters (78%) of child
participants either agreed or strongly agreed they would recommend this program to others.
Mean scores for all 6 questions fell below 2.1, suggesting that the intervention was well-accepted
by child participants (Figure 2, Appendix E).
Qualitative Findings
Fifty-five participants, including both adults (n = 32) and children (n = 23) answered
open-ended questions from the second half of the program feedback form. These 5 questions
were used to gain a qualitative perspective of the participant’s experience. Using content
analysis, 3 themes emerged from the answers provided, which are discussed here.
Proximity. One experience shared by adults and children was proximity with the horses.
When asked about their favorite part of the program, many participants cited proximity. This
took the form of petting, hugging, walking alongside, and grooming the horses. One child
participant stated “Just being with the horses made my day!” This desire for closeness is a basic
human need, however in the presence of horses, it appeared to be more evident. It is possible that
our interest in other species is representative of a potentially unmet need for love and affection
within our own.

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Self-Discovery. Through activities with horses, children and adults gained personal
insight and reflected upon this. Adults commented frequently on their parenting roles. One adult
participant noted “I guess I doubt my ability to lead horses just like I often doubt my parenting
skills.” Another parent noted “I could be less assertive.” Children discovered things about
themselves as well. One child noted “I am stronger than I thought.” These comments suggest that
activities with horses allowed both children and adults to discover personal attributes that were
not otherwise evident prior to sessions.
Regard for Others. Participants cited regard for others on multiple occasions. This took
the form of watching their family members working with the horses or attempting to gain new
skills. One participant stated “It was very nice to just stop and be with family and horses, to
observe them and observe ourselves in an unusual situation.” Within this context, a number of
people also considered how their actions might affect others, and participants explored ways they
might change in order to benefit others. “My energy is visible to those around me. I have the
ability to set the tone for the group through my behavior.” This suggests that participants were
able to gain personal insight and apply it in a broader sense by considering its impact on others.
These themes signified that the experience was very personal, and yet it extended beyond
the self insofar participants gained awareness of an obligation to others within the family. This is
consistent with the widespread use of the word “family” in feedback given by parents and
children, which occurred 47 times in the qualitative data. The topic of family was an enduring
theme when participants reflected on activities at the riding center. Overall, these themes suggest
that parents and children were able to conceptualize activities beyond a simple concrete message,

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gain personal insight and meaning from the experiences, and apply this knowledge in meaningful
ways both personally and within the context of their own families.
Discussion
Design Limitations
The small sample size and non-representative sample limited the external validity
(generalizability) of the findings. This study used a one-group pretest posttest design due to the
small sample, and as such, the study was neither randomized nor controlled. For these reasons it
is challenging to assure that the program was the sole source of the positive effect, as preexisting factors were not taken into account. Similarly, it cannot be inferred that the intervention
is truly what caused the measured effects. As with other equine studies, blinding of participants
is difficult, yet without it, studies like this one carry the potential for bias by the rater, and this
degree of bias remains unknown.
While most instruments in the study were completed by a single family member,
information from additional family members might have improved validation and added depth to
the conversation, especially measures like the Brief Family Assessment Measure which is
designed to gain multiple family members’ perspectives. This was not without benefits, however,
as several of the instruments allowed one family member to rate another member (i.e. DESSAmini), reducing the possibility of monomethod bias.
Program Duration
Program duration was extremely short compared to other equine learning programs,
which can extend as long as 16 weeks. For studies of shorter duration, it is generally not

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recommended to use such broad indicators like quality of life or, in our example, family
satisfaction (Kendal et al., 2015). This indicator surprisingly showed the largest magnitude of
change, a result which may have occurred for several reasons. The Family Satisfaction Scale
inquired about families’ ability to spend quality time together and share positive experiences.
Based on comments from the Program Feedback Form, it was evident that these two elements
were easily achieved.
Program duration is an important aspect to consider, as interventions involving equines
can be quite expensive. Riding centers benefit from determining the lowest dose required for a
therapeutic effect. Some equine interventions such as therapeutic riding have achieved
effectiveness in as little as one week (Kaiser, 2004), however it is unlikely these results are
maintained over time. A third data point, collected at 3-months’ follow-up (T2), will provide
valuable feedback and will help to determine the Program’s enduring effect, as there is limited
information to date on the longitudinal impact of equine learning programs (Selby & SmithOsborne, 2013). By examining the rate of decline (if such is the case), adjustments can be made
either by increasing total program duration, offering additional sessions at some point in the
future, or taking greater precautions to ensure that the skills learned are in fact retained.
Educating staff in experiential learning theory may help to ensure that skills learned are
enduring. Concepts within experiential learning theory, particularly abstract conceptualization,
can be difficult for children to achieve. Child developmental psychologist Jean Piaget has
asserted that abstract conceptualization is not typically achieved until about age 11; this may
explain why about one-third of our child participants were either unsure or in disagreement that
the program helped them to learn something about themselves (Saddock, Saddock & Ruiz,

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2015). If ESMHL staff are unfamiliar with these techniques it may be important to provide more
opportunities for learning, either through local educational events or regional conferences.
Making Headway
The project described here is the first of its kind to design, implement and test an equine
assisted learning intervention for families. This was achieved using evidence from the literature
on individual programs, which most often were found to be delivered in group settings. The
group dynamic is an element that deserves greater attention in equine literature. Groupwork
provides a climate for building interpersonal skills necessary for successful relationships. Given
that parent-child relationships are an important predictor of childhood mental health outcomes, it
becomes necessary to gain a perspective of the relational benefits seen from these activities. The
improvements in family function and family satisfaction seen here between pretest and posttest
comparisons suggest that more research is needed in this area.
The program described here was highly accepted by participants, and especially among
adult participants. Parents provided a rich description of self-discovery during the 3-week
intervention that often included reflections on their parenting styles. It’s possible that equine
learning programs may be of particular use for parents seeking to gain skills within this
important leadership role. A number of riding centers to date offer leadership and team building
retreats for corporations, this is one area to consider for future direction.
Community Partners
Community partnerships are important to the successful recruitment and sustainability of
therapeutic riding centers. As seen in the above review of literature, most participants were
recruited using referrals from school welfare programs, foster homes, and youth detention

EQUINE ASSISTED LEARNING

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centers. While time constraints within this study prevented the establishment of community
partners, connections with the community are important nonethelesss.
To date there are over 5,000 mental health nurse practitioners in the United States
(American Association of Nurse Practitioners, 2019). This number continues to grow, as does the
demand for alternative and complimentary services. As equine specialists in mental health and
learning gain a greater foothold within the scientific community, they too will begin to assume a
more prominent role in mental health. This project serves as an example of how two emerging
professions can benefit one another simply by sharing common interests.

EQUINE ASSISTED LEARNING

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Conclusion

In recent years, equine assisted learning has made great strides among animal assisted
interventions in the promotion of mental health. Findings from this project suggest that the
development and implementation of an evidence-based, family-centered equine assisted learning
intervention is possible. These findings also suggest that family-centered programs hold promise
in promoting both individual outcomes such as child social-emotional health, as well as group
outcomes, such as family function and family satisfaction.
The use of animals in the promotion of mental health in humans is a phenomena that
deserves greater attention in modern medicine, and especially in mental health. Today, it is
estimated that over 60% of households own a pet, suggesting that animals have value beyond the
metrics scientists would use to describe them. This paper gives a unique account of a mental
health intervention for families using equines; its success demonstrates how evidence-based
practice can be used in unpredictable places. What is more, this project represents a unique
opportunity for two very different fields to connect and make progress toward a common goal,
and in doing so, improve outcomes for the community.

EQUINE ASSISTED LEARNING

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Shea, S. C. (1998). Psychiatric interviewing: The art of understanding (2nd Ed.). Philadelphia,
PA: Saunders Company.

EQUINE ASSISTED LEARNING

!42

Skinner, H., Steinhauer, P., & Sitarenios, G. (2008). Family Assessment Measures (FAM) and
Process Model of Family Functioning. Journal of Family Therapy, 22(2), 190-210.
Thomson, K. T., Richardson, C. G., Gademann, A. M., Emerson, S. D., Shoveller, J., & Guhn,
M. (2019). Association of childhood social-emotional functioning profiles at school entry
with early-onset mental health conditions. JAMA Network Open. Advance online
publication. doi:10.1001/jamanetworkopen.2018.6694
U.S. Centers for Disease Control and Prevention. (2018). Provisional number of divorces and
annulments and rate: United States, 2000-2017 [National Data Archive]. Retrieved from
https://www.cdc.gov/nchs/data/dvs/national-marriage-divorce-rates-00-17.pdf
U.S. Centers for Disease Control and Prevention. (2016). Adverse Childhood Experiences
(ACEs) [ACE Study]. Retrieved from https://www.cdc.gov/violenceprevention/
childabuseandneglect/acestudy/index.html
World Health Organization. (2012). Social determinants of health and well-being among young
people. Health behavior in school-aged children (HBSC) study: International report from
the 2009/2010 survey. Copenhagen: WHO Regional Office for Europe. Retrieved from
http://www.euro.who.int/__data/assets/pdf_file/0003/163857/Social-determinants-ofhealth-and-well-being-among-young-people.pdf

EQUINE ASSISTED LEARNING

!43
Appendix A

Figure 1
CINAHL Database Search

EQUINE ASSISTED LEARNING

!44
Appendix A

Figure 2
Cochrane Database Search

EQUINE ASSISTED LEARNING

!45
Appendix A

Figure 3
Pubmed Database Search

EQUINE ASSISTED LEARNING

!46
Appendix A

Figure 4
PsychINFO Database Search

Appendix B
Table 1
Quantitative Evaluation Table
Article,
Publication,
Ethics

Framework &
Program
Description

Design,
Purpose

Sampling/
Setting

Major
Variables
Studied

Data
Measuremen
t & Analysis

Findings

Use in
Practice

Authors:
Alfonso,
Alfonso,
Llabre, &
Fernandez

Conceptual
Theories: CBT,
IDEA, TALK

Design:
RCT Pilot

Target
Population:
Young females
with social
anxiety

IV: 6 week
EAA + CBT
intervention

Instruments:
Liebowitz
Social
Anxiety
Scale,
Posttest
acceptability
scale

Quantitative:
Statistically
significant
reduction on
social anxiety
from baseline
to posttest (p=
0.008) and
baseline to 6month follow
up (p=0.003).
Change scores
not
significantly
different
between
posttest and
follow-up

Level of
evidence: II

Publication
date: 2015
Journal:
Explore
Country:
United States
Ethics:
Approved by
University of
Miami IRB
Funding:
Horses &
Humans
Research
Foundation
Setting:
Good Hope
Equestrian
Training
Center

Formal
Program:
Project Stride
Description:
EAA + CBT
Program
Delivered By:
Research
Facilitators
Duration and
Frequency: Six
sessions over six
weeks, 2-2.5
hours each
Groundwork or
Riding:
Both
Group Work or
Individual:
Both
Session Themes:
CBT, problem
solving,
modeling, role
playing, selfreflection,
communication,
relationships,
teamwork, &
emotional
expression

Purpose:
Study aim was
to determine
whether a
combined
EAA + CBT
program
would help to
reduce
symptoms of
social anxiety
in young
women
Study also
sought to
determine
whether
program was
accepted
among
participants
and feasible to
implement

Recruited
From: Passive
and active
recruitment
from a local
university
campus
Sample Size:
n=12
Demographics
Females ages
18-29
Inclusion
Criteria:
Eligibility
screen required
a minimum of
4 “yes"
responses to
Liebowitz
Social Anxiety
Scale
Exclusion
Criteria: ND

DV1: Social
anxiety
DV2:
Acceptability

Frequency
of Measures:
Pretest,
posttest and 6
weeks post
completion
Quantitative
Analysis:
Independent t
test was used
to examine
effect of
intervention
Qualitative
Analysis:
N/A

High
acceptability,
100% agreed
or strongly
agreed that
information
was useful and
applicable and
could be
applied to real
life, and that
they would
recommend
intervention to
friends

Rationale:
Experimental
design which
included
randomization
and a control
group
Strengths:
Experimental
design, formal
program,
mneumonics
used. Program
was well
described.
Limitations:
Sample size
was small and
difficult to
generalize to
population,
interventionists
were
researchers not
clinicians, no
mention of a
certifying body
for riding
center.

Qualitative:
N/A

Riding Center
Certification:
ND

ANOVA - Analysis of variance, ANCOVA - Analysis of covariance, CASEL - Collaborative Academic Social & Emotional Learning, CBT cognitive behavioral therapy, EAA - Equine assisted activities, EAL - Equine assisted learning, EAGALA - Equine Assisted Growth and
Learning Association, EAP - Equine assisted psychotherapy, EBP - Evidence Based Practice, EFL - Equine facilitated learning, ES - Equine
specialists, HAI - Human-animal interaction, IDEA - Identify, Develop, Evaluate, Act, IACUC - Institutional Animal Care and Use Committee,
IRB - Internal review board, LASSO - Leading Adolescents to Successful School Outcomes, MH - Mental Health, ND - Not discussed, PATH Professional Association of Therapeutic Horsemanship, PYD - Positive youth development, RCT - Randomized, controlled trial, TALK Timing, Assertive Communication, Location, Know what to say

Appendix B
Table 1
Quantitative Evaluation Table
Article,
Publication,
Ethics

Framework &
Program
Description

Design,
Purpose

Sampling/Setting

Major
Variables
Studied

Data
Measurement
& Analysis

Findings

Use in
Practice

Authors:
Frederick,
Hatz, &
Lanning

Conceptual
Theory:
Experiential
reflection
discussed, role
theory inferred

Design:
Experimental, longitudinal,
repeated
measures
design

Target
Population: Atrisk adolescents

IV: 5-week
EAL
Program
DV1: Hope
DV2:
Depression

Quantitative:
Statistically
significant
change in hope
and depression
with
Friedman's
ANOVA

Level of
evidence: II

Recruited From:
Charter school in
central Texas

Instruments:
Adolescent
Domain
Specific Hope
Scale & Major
Depression
Inventory

Purpose: To
determine
whether
EAL
program has
impact on
levels of
hope and
depression
in at-risk
youth

Sample Size:
n=26,
treatment=14,
control=12

Publication
date: 2015
Journal:
Community
Mental Health
Journal
Country:
United States
Ethics:
Requirements
for IRB and
IACUC met
Funding: ND
Setting: ND

Formal
Program:
LASSO Program
Description:
EAL
Program
Delivered By:
Unspecified
equine
professional
Duration and
Frequency: Five
weeks, one
session per week.
Groundwork or
Riding:
Groundwork only
Group Work or
Individual:
Group work
Session Themes:
Observations,
relationships,
communication,
problem-solving,
obstacles in life,
achieving goals,
vulnerabilities

Demographics:
Nine males,
seventeen females,
eleven whites,
seven blacks, two
hispanics, and six
“other,” ages
12-18 yrs
Inclusion
Criteria: All
students met at
least one criteria
for Texas
Education
System's definition
of "at risk”
Exclusion
Criteria: ND

Frequency of
Measures:
Data collected
at pretest,
posttest, and 4
points inbetween
Quantitative
analysis:
Friedman’s
ANOVA with
Pillai’s Trace at
each time
point, also
paired samples
t test with
bootstrapping
Qualitative
analysis: N/A

Test-retest
correlation
coefficients of
hope
statistically
significant at
nearly each
point in time
over six points
Qualitative:
N/A

Rationale:
Experimental
design with
randomization
and a control
group
Strengths:
Experimental
design, formal
program,
delivered by
equine
specialists.
At risk youth
well-defined,
targeted
recruitment,
contained
longitudinal
aspect
Limitations:
Riding center
not described,
no certification
mentioned for
riding center or
equine
specialists,
duration of
sessions
unknown

Riding Center
Certification:
Not discussed

ANOVA - Analysis of variance, ANCOVA - Analysis of covariance, CASEL - Collaborative Academic Social & Emotional Learning, CBT cognitive behavioral therapy, EAA - Equine assisted activities, EAL - Equine assisted learning, EAGALA - Equine Assisted Growth and
Learning Association, EAP - Equine assisted psychotherapy, EBP - Evidence Based Practice, EFL - Equine facilitated learning, ES - Equine
specialists, HAI - Human-animal interaction, IDEA - Identify, Develop, Evaluate, Act, IACUC - Institutional Animal Care and Use Committee,
IRB - Internal review board, LASSO - Leading Adolescents to Successful School Outcomes, MH - Mental Health, ND - Not discussed, PATH Professional Association of Therapeutic Horsemanship, PYD - Positive youth development, RCT - Randomized, controlled trial, TALK Timing, Assertive Communication, Location, Know what to say

Appendix B
Table 1
Quantitative Evaluation Table
Article,
Publication,
Ethics

Framework &
Program
Description

Design,
Purpose

Sampling/
Setting

Major
Variables
Studied

Data
Measurement & Analysis

Findings

Use in
Practice

Authors:
Hauge,
Kvalem,
Berget,
EndersSlegers &
Braastad

Conceptual
Theory: Biophilia
implied

Design: RCT
Wait-list
crossover
design

Target
Population:
Healthy
adolescents

IV: A fourmonth equine
assisted
activity

Instruments:
Social
Support Scale,
Global Self
Worth Scale,
General Self
Efficacy
Scale, and
“questionnaires for
intervention in
relation to
activities with
horses" scale

Quantitative:
Perceived social
support showed
a significant
difference at
pretest and
posttest for the
intervention
group compared
with the control
group, no
significant
change noted for
self-esteem and
general selfefficacy

Level of
evidence: II

Formal Program:
No
Description: EAA

Publication
date: 2015
Journal:
International
Journal of
Adolescence
and Youth
Country:
Norway
Ethics:
Approved by
the Regional
Committee
for Medical
Research
Ethics (REK)
Funding:
Funded by
the
Norwegian
University of
Life Sciences
and
Norwegian
Horse Centre
Setting:
Thirteen
farms in
eastern
Norway

Program
Delivered By:
Farmers with
various backgrounds and horse
experience, all
were ride
instructors
Duration and
Frequency: A
two-hour session,
once weekly for
four months
Groundwork or
Riding: Both
Group Work or
Individual: Pairs
of two
Session Themes:
Relational and
task-specific skills.
handling and
communicating
with horse, picking
hooves, tacking
haltering, catching
horse, and riding
Riding Center
Certification:
N/A

Purpose: To
determine the
effect of a 4month EAA
program on
perceived
social
support, selfesteem, and
self efficacy
in
adolescents
attending
lower
secondary
school

Recruited
From: Ten local
schools in
eastern Norway
Sample Size:
n=75,
treatment=42,
control=33
Demographics:
Norwegian
adolescents,
ages 12-15
years, 86%
female and 14%
male.
Inclusion
Criteria:
Adolescents
attending lower
secondary
school, farms
selected based
on competence
of farmer,
proximity to a
school, and farm
size
Exclusion
Criteria: None
discussed but
potentially
excluded if no
pretest
questionnaire
delivered (n=4)

DV1:
Perceived
social support
DV2: selfesteem
DV3: selfefficacy
DV4: selfreport
perceptions of
activities with
horses

Frequency of
Measures:
Questionnaires were
delivered at
pretest and
posttest for
the
intervention
group, and at
pretest for the
control group
(4 months
prior to
intervention).
Quantitative
analysis:
Paired
samples t-tests
were used to
measure
differences
between
groups
Qualitative
analysis: N/A

Significant
correlation between lower
level of
perceived social
support prior to
intervention and
increase in skills
with horse,
medium-high
correlations
between three
psychological
variables
Low level of
perceived social
support predicted increased
development of
learning skills
with horses
during
intervention

Rationale: A
randomized,
wait-list
control design
Strengths:
Large sample
size and use
of control
group, long
duration of
intervention
at potentially
reduced cost.
Limitations:
Program
delivery not
consistent,
administered
by farmers
with varying
levels of
experience.
Researchers
not present
for
intervention.
Limited
recruitment
focus,
included
healthy
children.
Inconsistent
administratio
n of questionnaires.

Qualitative:
N/A

ANOVA - Analysis of variance, ANCOVA - Analysis of covariance, CASEL - Collaborative Academic Social & Emotional Learning, CBT cognitive behavioral therapy, EAA - Equine assisted activities, EAL - Equine assisted learning, EAGALA - Equine Assisted Growth and
Learning Association, EAP - Equine assisted psychotherapy, EBP - Evidence Based Practice, EFL - Equine facilitated learning, ES - Equine
specialists, HAI - Human-animal interaction, IDEA - Identify, Develop, Evaluate, Act, IACUC - Institutional Animal Care and Use Committee,
IRB - Internal review board, LASSO - Leading Adolescents to Successful School Outcomes, MH - Mental Health, ND - Not discussed, PATH Professional Association of Therapeutic Horsemanship, PYD - Positive youth development, RCT - Randomized, controlled trial, TALK Timing, Assertive Communication, Location, Know what to say

Appendix B
Table 1
Quantitative Evaluation Table
Article,
Publication,
Ethics

Framework &
Program
Description

Design,
Purpose

Sampling/
Setting

Major
Variables
Studied

Data
Measurement
& Analysis

Findings

Use in
Practice

Authors: Ho,
Zhou, Sheng
Fung, & Jade
Kua

Conceptual
Theory: Habit of
Mind

Design:
Wait-list
control
crossover
study

Target
Population:
Youth at risk of
school failure

IV: A 12week
EQUAL
intervention

Instruments:
Habit of Mind
Likert scale
questionnaire

Level of
evidence: II

Recruited
From: Prevocational
schools, from
underprivileged
backgrounds

DV1:
Persistence
DV2:
Thinking
flexibility
DV3:
Taking
responsible
risks
DV4:
Managing
impulsivity
DV5:
Empathy

Frequency of
Measures:
Pretest, posttest
and midintervention
measures were
obtained for
five Habit of
Mind outcomes

Quantitative:
Significant
intervention by
time for all five
Habits of Mind
except for
Managing
Impulsivity in
year 2014.

Publication
date: 2016
Journal:
Cogent
Education
Country:
Singapore
Ethics:
Approved by
SingHealth
Institutional
Review Board
Funding:
Sponsored by
Temasek
Cares, Tote
Board, Lee
Foundation,
Far East
Organization,
Singapore
Business
Foundation,
Keppel Ltd,
and multiple
sponsors from
the community
Setting:
Singapore
Equestrian
Federation

Formal Program:
Equine Assisted
Learning
(EQUAL) Program
Description: EAL,
EAP, &
hippotherapy
Program
Delivered By:
Psychologist,
professional
equestrian
instructor,
and volunteers
Duration and
Frequency: Once
weekly 3-hour
sessions over 12
weeks duration
Groundwork or
Riding: Both
Group Work or
Individual:
Groups only
Session Themes:
Horse play, stable
management,
riding, 5 themes of
Habit of Mind
incorporated into
sessions.

Purpose:
To examine
the effect
of a 12week
EQUAL
intervention on five
outcomes
of Habit of
Mind in
adolescents
at risk for
school
failure

Sample Size:
n=274,
treatment=133,
control=141
Demographics:
Sample of 83
males and 50
females, ages
12-14 years
Inclusion
Criteria:
Failure to
complete
national exit
exam or
complete
primary school,
enrollment in
pre-vocational
schools
Exclusion
Criteria: None
specified.

Comparison
with grade
point
average
scores

Quantitative
analysis:
Linear mixed
effect model
was used to
examine
changes over
time, and
ANOVA with
HolmBonferonni
was used to
determine
statistical
significance
over time.
Qualitative
analysis: N/A

Positive
correlations
found between
Habits of Mind
and grade point
average in two
of four groups
receiving
intervention in
most outcomes
of interest
Qualitative:
N/A

Rationale:
Study achieved
randomization
with control
group
Strengths:
Strong design,
large sample,
and targeted
recruitment,
intervention
was well
described and
theory-based,
program
duration was
12 weeks with
three
measurement
points
Limitations:
Limited
strength of
instrument
used, and
scoring by
teachers, no
power analysis
performed, a
complex
intervention,
specialists and
center without
certification

Riding Center
Certification: ND

ANOVA - Analysis of variance, ANCOVA - Analysis of covariance, CASEL - Collaborative Academic Social & Emotional Learning, CBT cognitive behavioral therapy, EAA - Equine assisted activities, EAL - Equine assisted learning, EAGALA - Equine Assisted Growth and
Learning Association, EAP - Equine assisted psychotherapy, EBP - Evidence Based Practice, EFL - Equine facilitated learning, ES - Equine
specialists, HAI - Human-animal interaction, IDEA - Identify, Develop, Evaluate, Act, IACUC - Institutional Animal Care and Use Committee,
IRB - Internal review board, LASSO - Leading Adolescents to Successful School Outcomes, MH - Mental Health, ND - Not discussed, PATH Professional Association of Therapeutic Horsemanship, PYD - Positive youth development, RCT - Randomized, controlled trial, TALK Timing, Assertive Communication, Location, Know what to say

Appendix B
Table 1
Quantitative Evaluation Table
Article,
Publication,
Ethics

Framework &
Program
Description

Design,
Purpose

Sampling/
Setting

Major
Variables
Studied

Data
Measurement &
Analysis

Findings

Use in
Practice

Authors:
Holmes,
Goodwin,
Redhead, &
Goymour

Conceptual
Theory:
Metaphorical
analysis

Design:
Exploratory
study

Target
Population:
Adolescents
with emotional,
behavioral, or
learning
difficulties

IV: Foursession
EAA
intervention

Instruments:
Rosenberg Self
Esteem Scale,
Spence Children’s
Anxiety Scale

Level of
evidence: III

DV1: Trait
anxiety
DV2: Self
esteem
DV3:
Approach
or
avoidance
behavior

Frequency of
Measures: Social
anxiety measured at
baseline and post
2nd, 3rd, and 4th
sessions,
behavioral
observations and
horse interactions
noted every 15 sec.
for 2nd, 3rd, and
4th sessions,
behaviors classified
as avoidance or
approach

Quantitative:
Friedman’s
ANOVA
showed
statistically
significant
reduction in
trait anxiety
from baseline
to each
collection point
and between
sessions 1 & 2,
and 1 & 3.

Publication
date: 2012
Journal: Child
Adolescent
Social Work
Journal
Country:
England
Ethics:
Approved by
University of
Southampton
Psychology
Ethics
Committee

Formal
Program:
Greatwood
Racehorse &
Rehab. Centre
(GRRC)
Description:
EAA
Program
Delivered By:
Without a
trained
therapist
Duration and
Frequency:
Four sessions,
3 hours each

Funding: ND
Setting:
Greatwood
Racehorse &
Rehab. Centre
(GRRC)

Groundwork
or Riding:
Groundwork
only
Group Work
or Individual:
ND
Session
Themes:
Safety, picking
hooves,
grooming,
fitting collars
and rugs
Riding Center
Certification:
ND

Purpose:
To
determine
the effects
of an EAA
program
without a
trained
therapist on
mental
health
outcomes
such as trait
anxiety,
self-esteem,
and
behavioral
interactions

Recruited
From: Two
local schools
Sample Size:
n=11
Demographics:
Ten females,
one male, ages
12-14 years
Inclusion
Criteria:
Identified
unspecifically
as having
emotional,
behavioral, or
learning
difficulties
Exclusion
Criteria: ND

Quantitative
analysis:
Friedman’s ANOVA
to compare baseline
with each collection
point and change
between sessions 1
& 2, and 1 & 3
Wilcoxon signed
ranks to examine
difference in
behaviors between
sessions
Spearman’s Rho
used to correlate
anxiety with
behavioral
observations

Friedman's
ANOVA
revealed no
statistical
significance in
self esteem
between
sessions
Small negative,
positive
correlation
between
anxiety and
approach and
avoidance
behavior,
respectively,
not statistically
significant
Qualitative:
N/A

Rationale:
Control used
Strengths:
Use of
inanimate
control,
comparison of
self-report
instruments
and behavioral
observations,
formal
program with
detailed
description of
activities and
horses used
Limitations:
No
randomization
discussed,
small sample
size, difficult
to generalize to
population,
limited
discussion of
horsemanship
professionals
used for
program, no
certification
mentioned

Qualitative
analysis: N/A

ANOVA - Analysis of variance, ANCOVA - Analysis of covariance, CASEL - Collaborative Academic Social & Emotional Learning, CBT cognitive behavioral therapy, EAA - Equine assisted activities, EAL - Equine assisted learning, EAGALA - Equine Assisted Growth and
Learning Association, EAP - Equine assisted psychotherapy, EBP - Evidence Based Practice, EFL - Equine facilitated learning, ES - Equine
specialists, HAI - Human-animal interaction, IDEA - Identify, Develop, Evaluate, Act, IACUC - Institutional Animal Care and Use Committee,
IRB - Internal review board, LASSO - Leading Adolescents to Successful School Outcomes, MH - Mental Health, ND - Not discussed, PATH Professional Association of Therapeutic Horsemanship, PYD - Positive youth development, RCT - Randomized, controlled trial, TALK Timing, Assertive Communication, Location, Know what to say

Appendix B
Table 1
Quantitative Evaluation Table
Article,
Publication,
Ethics

Framework &
Program
Description

Design,
Purpose

Sampling/
Setting

Major
Variables
Studied

Data
Measurement
& Analysis

Findings

Use in
Practice

Authors:
Morgan

Conceptual
Theory:
Experiential learning

Design:
Quasi
experimental design

Target
Population:
College
students
Recruited
From: College
students
recruited by
convenience
sampling from
2-year liberal
arts college

Instruments:
Perceived Stress
Scale (PSS),
Present Moment
Stress Scale
(PMSS), weekly
participant
journal entries

Quantitative:
Posttest PSS
statistically
significant for
experimental
group
compared to
control group.
Postintervention
PMSS
measures
statistically
significant,
also true for
time and
modality

Level of
evidence: III

Purpose:
To
determine
efficacy of
a combined
stress
management course
for college
students,
determine
effectiveness of each
modality,
and
describe
qualitative
experience
of student
participants

IV:
Semesterlong
multimodal
stress
management
program

Publication
date: 2017
Journal:
Journal of
Creativity in
Mental Health
Country:
United States

Formal Program:
Unspecified college
program in
behavioral sciences
division
Description:
Multimodal: EAL,
yoga, & mindfulness
hiking

Ethics: ND
Funding: ND
Setting: Offcampus
location, ND

Program Delivered
By: EAGALA
trained ES & MH
psychotherapist
Duration and
Frequency:
Semester-long
program, EAL
portion of 3 weeks
duration, 45 minutes
each
Groundwork or
Riding:
Groundwork only
Group Work or
Individual: Group
work only
Session Themes:
Emotions, role
playing, metaphoric
analysis, life’s
challenges,
symbolism, and
journal reflection

Sample Size:
n=42,
treatment=24,
control=18
Demographics: Twenty six
males and 16
females,
twenty-nine
whites, 10
blacks, 1 asian,
and 2
multicultural
students
Inclusion
Criteria:
Enrollment in
college
psychology
course
Exclusion
Criteria: ND

DV1: Selfreported
perception
of stress
DV2:
Symptom
experience
of present
moment
stress
Experience
of students
was a
desired
outcome for
qualitative
aspect of
study

Frequency of
Measures:
Pretest and
posttest PSS
measured, also
PMSS measured
at pretest and
after each of
three
interventions
Quantitative
analysis:
Univariate
ANCOVA to
compare
differences
between groups
for PSS,
repeated
measures
ANOVA used to
determine within
group
differences for
PMSS
Qualitative
analysis:
Analysis of
students’ weekly
journals using
thematic
interpretation

Qualitative:
Three themes
emerged,
including
psychsocial
stressors, (i.e.
family
responsibilities, family
conflict,
relationship
problems, and
work
demands)
concerns
about
finances, and
concerns
about career
planning and
the future

Rationale: No
randomization
achieved
Strengths:
Adequate
description of
program
activities and
horses (and
donkeys) used,
instructors
certified
Limitations:
Participation
was included
as coursework
in college
program, also
PMSS
instrument
developed by
principle
investigator of
this study, both
are potentially
biased, setting
not described,
intervention
not counterbalanced for yoga
session, and
multimodal
approach
resulted in
limited EAL
exposure

Riding Center
Certification: ND

ANOVA - Analysis of variance, ANCOVA - Analysis of covariance, CASEL - Collaborative Academic Social & Emotional Learning, CBT cognitive behavioral therapy, EAA - Equine assisted activities, EAL - Equine assisted learning, EAGALA - Equine Assisted Growth and
Learning Association, EAP - Equine assisted psychotherapy, EBP - Evidence Based Practice, EFL - Equine facilitated learning, ES - Equine
specialists, HAI - Human-animal interaction, IDEA - Identify, Develop, Evaluate, Act, IACUC - Institutional Animal Care and Use Committee,
IRB - Internal review board, LASSO - Leading Adolescents to Successful School Outcomes, MH - Mental Health, ND - Not discussed, PATH Professional Association of Therapeutic Horsemanship, PYD - Positive youth development, RCT - Randomized, controlled trial, TALK Timing, Assertive Communication, Location, Know what to say

Appendix B
Table 1
Quantitative Evaluation Table
Article,
Publication,
Ethics

Framework &
Program
Description

Design,
Purpose

Sampling/
Setting

Major
Variables
Studied

Data
Measurement
& Analysis

Findings

Use in
Practice

Authors:
Pendry, Carr,
Smith, &
Roeter

Conceptual
Theory: HAI, PYD
Perspective, &
Experiential
Learning

Design:
Randomized, waitlist controlled design

Target
Population:
Adolescents
with low social
competence, atrisk youth

IV: Elevenweek EFL
intervention

Purpose:
To
determine
effect of an
11-week
EFL
program on
social
competence
and
behavior in
children
5th-8th
grade

Quantitative:
Both positive
behavior and
negative
behavior
increased and
decreased,
respectively
and
significantly
over duration
of 11-week
program

Level of
evidence: II

Formal Program:
No name provided

Instruments:
Devereaux Student Strengths
Assessment,
Animal Assisted Therapy,
Psychosocial
Session Form

Publication
date: 2014
Journal:
Journal of
Primary
Prevention
Country:
United States
Ethics:
Approved by
University
Committee of
Research
Involving
Human
Subjects,
monitored by
IACUC

Description: EFL
Program Delivered
By: PATH certified
instructor, various
students, and
counseling
psychologist
Duration and
Frequency: Once
weekly sessions, 90minutes each, over
an 11-week duration
Groundwork or
Riding: Both

Funding:
Grant funding
via Eunice
Kennedy
Shriver
National
Institute of
Child Health
& Human
Development
and private
funding from
Mars-Waltham

Group Work or
Individual: Both,
about eight children
per group

Setting: PATH
accredited
center

Riding Center
Certification:
PATH accredited
center

Session Themes:
Communication,
trust, boundaries,
leadership, respect,
confidence,
overcoming
challenges, selfregulation

Recruited
From: Ten
different schools
in two
university towns
Sample Size:
n=131,
treatment=53,
control=60
Demographics:
41 males, 72
females, 82%
white, 8% asian,
1.6% black, 8%
multiracial.
Inclusion
Criteria:
English
competency and
no serious
physical or
mental
disability,
normal children
as well as those
with low social
competence
recruited to
participate
Exclusion
Criteria: ND

DV1: Social
competence
DV2:
Positive
and
negative
behaviors
Comparison with
session
attendance

Frequency of
Measures:
Pretest and
posttest social
competence
rated by
parents, behaviors rated by
two program
facilitators and
one independent researcher over 11week duration
Quantitative
analysis:
Series of oneway ANOVAs
to compare
pretest and
posttest social
competence,
paired-samples
t test and linear
regression to
examine
relationship
between
attendance and
positive
behaviors on
all participants
(including
control group)

Statistically
significant
improvement
in social
competence at
posttest
compared to
pretest
Higher levels
of attendance
associated with
steeper
trajectory of
positive and
negative
behaviors
Qualitative:
N/A

Rationale:
Randomization
achieved,
controlled
design
Strengths:
Theory-based
program with
excellent
description of
activities, site
and instructors
held national
certification,
comparison of
ratings by
parents and
facilitators,
larger sample
of 11-week
duration
Limitations:
Potential for
bias as some
behaviors rated
by program
instructors

Qualitative
analysis: N/A

ANOVA - Analysis of variance, ANCOVA - Analysis of covariance, CASEL - Collaborative Academic Social & Emotional Learning, CBT cognitive behavioral therapy, EAA - Equine assisted activities, EAL - Equine assisted learning, EAGALA - Equine Assisted Growth and
Learning Association, EAP - Equine assisted psychotherapy, EBP - Evidence Based Practice, EFL - Equine facilitated learning, ES - Equine
specialists, HAI - Human-animal interaction, IDEA - Identify, Develop, Evaluate, Act, IACUC - Institutional Animal Care and Use Committee,
IRB - Internal review board, LASSO - Leading Adolescents to Successful School Outcomes, MH - Mental Health, ND - Not discussed, PATH Professional Association of Therapeutic Horsemanship, PYD - Positive youth development, RCT - Randomized, controlled trial, TALK Timing, Assertive Communication, Location, Know what to say

Appendix B
Table 1
Quantitative Evaluation Table
Article,
Publication
, Ethics

Framework &
Program
Description

Design,
Purpose

Sampling/
Setting

Major
Variables
Studied

Data
Measurement
& Analysis

Findings

Use in
Practice

Authors:
Perkins

Conceptual
Theory:
Experiential
learning

Design:
Exploratory
pilot study

Target
Population:
Adolescents
from group
home

IV: An 8week EAL
intervention

Instruments:
Non-specific
Likert scales
used for both
measures

Quantitative:
Self-report
instrument
revealed only
one significant
improvement,
which was
emotional
regulation

Level of
evidence: IV

Publication
date: 2018
Journal:
Journal of
Creativity in
Mental
Health
Country:
United
States
Ethics:
American
Counseling
Association
Code of
Ethics
Funding:
Work
supported
by the
Gaston
County
Family
Advisory
Board
Setting:
EAGALA
supported
center,
unspecified

Formal Program:
Cowboy Trails
Program
Description: EAL
Program Delivered
By: Equine
specialist, ranch
hand, and therapist
Duration and
Frequency: A onehour each week for
8 weeks
Groundwork or
Riding:
Groundwork only
Group Work or
Individual:
Group work only
Session Themes:
Life skills included
partnership, respect,
boundaries,
communication,
emotional
regulation, problem
solving, teamwork,
and a review session
Riding Center
Certification:
EAGALA certified
ES and MH
professional

Purpose:
To examine
the impact
of an 8week EAL
program on
life skills of
partnership,
respect,
boundaries,
communica
tion,
emotional
regulation,
problemsolving, and
teamwork

Recruited
From: Local
foster care
organization,
group home
residents
Sample Size:
n=7
Demographics: Six
females and
one male, six
whites and one
black
participant
Inclusion
Criteria:
Members of
local foster
care
organization
who attended
regular group
therapy
Exclusion
Criteria:
Number of
participants
increased to 18
but only those
completing at
least 5 or 8
weekly
sessions were
included in
study

Observational
instrument:
DV1:
engagement
DV2:
confidence
DV3: respect
DV4:
communication
DV5: work
ethic
Self-report
instrument:
DV6:
Partnership
DV7: Respect
DV8:
Boundaries
DV9:
Communication
DV10:
Emotional
regulation
DV11:Problem solving
DV12:
Teamwork

Frequency of
Measures:
Data collected
by self-report
instrument at
pretest and
posttest
intervals
(seven life
skills). Data
also collected
by an observer
from therapy
team who
scored
participant
after each
session (5
areas)
Quantitative
analysis:
Paired samples
t test used to
compare
pretest and
posttest
assessments,
paired samples
t test also used
at select data
points (T1 and
T4; T1 and T7;
T1 and T8) for
observational
assessment
Qualitative
analysis: N/A

Observational
instrument at
T4 showed
significance in
engagement,
interaction
with animals
and others,
confidence,
understanding,
animal respect,
animal
communication, determination, and
communication
Observational
instrument at
T7 showed
significance in
engagement,
interaction
with animals
and others,
work ethic,
understanding,
communication
with animals,
and
determination.

Rationale: Not
randomized
controlled or
blinded
Strengths:
Program well
described and
theory-based,
targeted
recruitment
and use of a
vulnerable
population,
self-report and
observational
findings
applied
Limitations:
Small sample
size, limited
generalizability
to public,
attendance
varied
considerably,
not all data
points were
examined
statistically
due to
fluctuations in
attendance,
instruments not
discussed or
affirmed from
other studies

Qualitative:
N/A

ANOVA - Analysis of variance, ANCOVA - Analysis of covariance, CASEL - Collaborative Academic Social & Emotional Learning, CBT cognitive behavioral therapy, EAA - Equine assisted activities, EAL - Equine assisted learning, EAGALA - Equine Assisted Growth and
Learning Association, EAP - Equine assisted psychotherapy, EBP - Evidence Based Practice, EFL - Equine facilitated learning, ES - Equine
specialists, HAI - Human-animal interaction, IDEA - Identify, Develop, Evaluate, Act, IACUC - Institutional Animal Care and Use Committee,
IRB - Internal review board, LASSO - Leading Adolescents to Successful School Outcomes, MH - Mental Health, ND - Not discussed, PATH Professional Association of Therapeutic Horsemanship, PYD - Positive youth development, RCT - Randomized, controlled trial, TALK Timing, Assertive Communication, Location, Know what to say

Appendix B
Table 2
Qualitative Evaluation Table
Article,
Publication,
Ethics

Framework &
Program
Description

Design,
Purpose

Sampling/
Setting

Major
Variables
Studied

Data
Measurement
& Analysis

Findings

Use in
Practice

Authors: Dell,
Chalmers,
Bresette,
Swain, Rankin,
& Hopkins

Conceptual
Theory: Aboriginal
Worldview,
Experiential
Learning, 7
Grandfather
Teachings (virtues)

Design:
Qualitative
study

Target
Population:
First Nations
and Inuit youth

IV: 10-week
EAL
program

Instruments:
Interviews
conducted,
journal entries
reviewed

Quantitative:
N/A

Level of
evidence: VI

Qualitative:
Eleven themes
emerged,
reduced to 3
key themes.

Rationale:
Descriptive
measures only

Publication
date: 2011
Journal: Child
Youth Care
Forum
Country:
Canada
Ethics:
Approved by
University of
Saskatchewan
Behavioural
Research
Ethics Board
Funding: ND
Setting:
Keystone
Equine Center
& Lambton
Equine
Assisted
Learning
Centre

Formal Program:
Specific curriculum
for both centers, but
no formal program
Description: EAL

Purpose:
To explore
the benefit
of an EAL
program
on youths
healing

Recruited
From: Nimkee
NupiGawagan
Healing Centre
(NNHC)
residential
substance
abuse
treatment
center

Program Delivered
by: Facilitated by 2
teachers and 1
counselor, equine
staff not described

Sample Size:
n=15, 7 male
and 8 female
youth

Duration and
Frequency: 10
weeks, one hour per
week

Demographics: Substance
abuse history,
adolecscents

Groundwork or
Riding:
Groundwork only

Inclusion
Criteria:
NNHC
residents

Group Work or
Individual: Groups
Session Themes:
Respecting space,
harmony in
relationships,
getting beyond self,
life force

Outcomes of
interest
included
youths’
experience
with EAL
program, its
impact on
their healing,
&
congruence
of horse
program
with
teachings at
NNHC

Frequency of
Measures:
Interviews
conducted
postintervention,
weekly
journals
reviewed
Quantitative
analysis: N/A
Qualitative
analysis:
Interviews
digitally
recorded and
transcribed,
thematic
analysis and
codes
developed

These included
spiritual
exchange
(spending time
and connecting
with horses),
complimentary
communication
(applying
concepts of
horse
interactions to
human
counterparts),
and authentic
occurrence
(overcoming
barriers)

Strengths:
Session themes
similar to
Western
applications
Limitations:
Qualitative
design, not
generalizable
beyond cohorts
studied,
English was
second
language for
many
participants,
many were
limited in
writing
abilities

Exclusion
Criteria:
Unable to
obtain consent
from adult

Riding Center
Certification: ND

ANOVA - Analysis of variance, ANCOVA - Analysis of covariance, CASEL - Collaborative Academic Social & Emotional Learning, CBT cognitive behavioral therapy, EAA - Equine assisted activities, EAL - Equine assisted learning, EAGALA - Equine Assisted Growth and
Learning Association, EAP - Equine assisted psychotherapy, EBP - Evidence Based Practice, EFL - Equine facilitated learning, ES - Equine
specialists, HAI - Human-animal interaction, IDEA - Identify, Develop, Evaluate, Act, IACUC - Institutional Animal Care and Use Committee,
IRB - Internal review board, LASSO - Leading Adolescents to Successful School Outcomes, MH - Mental Health, ND - Not discussed, PATH Professional Association of Therapeutic Horsemanship, PYD - Positive youth development, RCT - Randomized, controlled trial, TALK Timing, Assertive Communication, Location, Know what to say

Appendix B
Table 2
Qualitative Evaluation Table
Article,
Publication,
Ethics

Framework &
Program
Description

Design,
Purpose

Sampling/
Setting

Major
Variables
Studied

Data
Measurement
& Analysis

Findings

Use in
Practice

Authors:
Hemingway,
Meek, & Hill

Conceptual
Theory:
Experiential
learning discussed

Design:
Qualitative
Study

Target
Population:
Incarcerated
high-risk
young adult
offenders

IV: A sevensession EFL
intervention

Instruments:
Observations
of body
language and
structured
interviews used

Quantitative:
N/A

Level of
evidence: VI

Qualitative:
Observations of
participant
body language
previously
found to be
weak, tense or
ineffective
progressed to
body language
that was later
described as
assertive,
confident,
focused, calm
and gentle

Rationale:
Descriptive
measures only

Publication
date: 2015
Journal:
Society &
Animals

Formal Program:
Pareli Natural
Horsemanship
Program (PNH)
Description: EFL

Country:
England
Ethics: Project
informed by
ethics process
required by
prison service
Funding: Not
discussed
Setting: A
sports field

Program
Delivered By:
PNH certified
course facilitator
Duration and
Frequency: Seven
sessions, 2.5 hours
each, over 7 days
Groundwork or
Riding:
Groundwork only
Group Work or
Individual: Teams
of two participants
Session Themes:
Cooperation,
mutual respect,
communication,
assertive body
language,
bonding, selfcontrol, empathy,
& mindfulness
Riding Center
Certification:
PNH Center

Purpose:
To explore
and
describe the
impact of a
sevensession
intervention
on
behavioral
responses
and
reflections
of learning
in young
male
offenders

Recruited
From:
Recruited by
convenience
from a young
offenders
prison in
England
Sample Size:
n=20
Demographics: All males,
ages 18-21
Inclusion
Criteria: All
were
incarcerated in
a young
offenders
prison in
England, at
risk for
reoffending,
and with
reported
disruptive or
disengaged
behavior
Exclusion
Criteria: ND

Data were
collected in
the form of
observations
by
researchers,
recorded
interviews
conducted
by course
facilitator,
and recorded
interviews
by an
independent
researcher
Focus of
interviews
was
reflection of
participant
experiences,
knowledge,
and learning

Frequency of
Measures:
Observations
conducted
pretest and
posttest
Quantitative
analysis: N/A
Qualitative
analysis:
Information
was gathered
by observation
over two days
and by
conducting
semi-structured
interviews with
participants
using
independent
researchers and
audiotaped
conversations

Themes that
emerged included qualities of
self, qualities of
the program,
being more
relaxed, and
increased
confidence, not
giving up and
staying focused.
Participants
also reflected
on feedback
received from
the facilitator as
well as the
immediate
feedback that
the horses
provide through
their emotions
and reactions

Strengths:
Observations
of body
language
provide richer
comparison of
body language
and selfreports.
Targeted
vulnerable
population
used
Limitations:
Qualitative
study that
cannot infer
causation
between
intervention
and participant
reactions.
Interviews
conducted by
program
facilitator, a
potential
conflict of
interest

ANOVA - Analysis of variance, ANCOVA - Analysis of covariance, CASEL - Collaborative Academic Social & Emotional Learning, CBT cognitive behavioral therapy, EAA - Equine assisted activities, EAL - Equine assisted learning, EAGALA - Equine Assisted Growth and
Learning Association, EAP - Equine assisted psychotherapy, EBP - Evidence Based Practice, EFL - Equine facilitated learning, ES - Equine
specialists, HAI - Human-animal interaction, IDEA - Identify, Develop, Evaluate, Act, IACUC - Institutional Animal Care and Use Committee,
IRB - Internal review board, LASSO - Leading Adolescents to Successful School Outcomes, MH - Mental Health, ND - Not discussed, PATH Professional Association of Therapeutic Horsemanship, PYD - Positive youth development, RCT - Randomized, controlled trial, TALK Timing, Assertive Communication, Location, Know what to say

Appendix B
Table 2
Qualitative Evaluation Table
Article,
Publication
, Ethics

Framework &
Program Description

Design,
Purpose

Sampling/
Setting

Major
Variables
Studied

Data
Measurement
& Analysis

Findings

Use in
Practice

Authors:
Saggers &
Strachan

Conceptual Theory:
CASEL & Five Core
Competencies,
Experiential Learning
Discussed

Design:
Qualitative,
exploratory
pilot study

Target
Population:
Adolescents
at risk for
school failure

IV: An 8week EFL
intervention

Instruments:
Data gathered
from two semistructured indepth
interviews

Quantitative: N/A

Level of
evidence: VI

Qualitative:
Two main
themes
emerged,
included
horsemanship and
resilience

Rationale:
Qualitative
study, no
randomisation
or comparison
groups

Publication
date: 2016
Journal:
Child &
Youth
Services
Country:
Australia
Ethics:
Approved
by Human
Research
Ethics
Committee
of
University
& Public
Education
System
Funding:
ND
Setting: An
unspecified
equestrian
center

Formal Program:
CASEL Programming
Description: EFL
Program Delivered
By: Delivered by two
EFL staff trained in
PATH, assistance from
two teachers and
volunteers
Duration and
Frequency: Sessions
2 hours each, twice
weekly for 8 weeks
Groundwork or
Riding: Both
Group Work or
Individual: Both
Session Themes:
Included self
management, self
awareness, decisionmaking, relationships,
social awareness,
trust, emotional
regulation,
communication,
teamwork, social
emotional learning, &
relaxation
Riding Center
Certification: ND

Purpose: To
describe the
impact of an 8week EFL
program on
resilience,
socialemotional
learning, and
ultimately
school
engagement.
The project
targeted
student
perceptions of
the EFL
program and
what they
thought would
be achieved
and what they
felt was
actually
achieved

Recruited
From:
Purposive
sampling,
referred from
a Special
Education
Unit’s (SEU)
school
welfare team
Sample Size:
n=11
Demographics: Five
male and 6
female
participants,
ages 10-13,
with low
socioeconomic status
Inclusion
Criteria:
Invited by
SEU,
determined at
risk for
school failure
due to socialemotional
and
behavioral
difficulties.
Exclusion
Criteria: ND

DV1:
Resilience
DV2:
Socialemotional
learning
DV3: School
engagement

Frequency of
Measures:
Interviews
conducted once
before and
once upon
completion of
program
Quantitative
analysis: N/A
Qualitative
analysis:
Recorded
interviews
were
transcribed
verbatim, key
experiences
were identified,
then in a
second reading
line-by-line
coding and
links were
noted, two
external
researchers
confirmed
accuracy and
reviewed lineby-line coding,
comparing
results finally
with initial
audio
recording.

A positive
influence
was noted
on social
emotional
learning
with
specific
aspects that
emerged,
including
gaining
confidence,
developing
communication skills,
regulating
emotions,
coping with
teasing and
bullying,
learning to
relax and
manage
stress, and
attending
and
perseverating in
tasks

Strengths:
Targeted
recruitment,
rich descriptive
analysis
provides
direction for
future EFL
studies,
program well
described and
delivered by
certified
equine
professionals
Limitations:
Small sample
size, difficult
to generalize to
population.
Qualitative
design,
causation
undetermined

ANOVA - Analysis of variance, ANCOVA - Analysis of covariance, CASEL - Collaborative Academic Social & Emotional Learning, CBT cognitive behavioral therapy, EAA - Equine assisted activities, EAL - Equine assisted learning, EAGALA - Equine Assisted Growth and
Learning Association, EAP - Equine assisted psychotherapy, EBP - Evidence Based Practice, EFL - Equine facilitated learning, ES - Equine
specialists, HAI - Human-animal interaction, IDEA - Identify, Develop, Evaluate, Act, IACUC - Institutional Animal Care and Use Committee,
IRB - Internal review board, LASSO - Leading Adolescents to Successful School Outcomes, MH - Mental Health, ND - Not discussed, PATH Professional Association of Therapeutic Horsemanship, PYD - Positive youth development, RCT - Randomized, controlled trial, TALK Timing, Assertive Communication, Location, Know what to say

Appendix C
Table 1
Synthesis of Quantitative Data
Alfonso

Frederick

Hauge

Ho

Holmes

Morgan

Pendry

Perkins

II

II

II

II

III

III

II

IV

Population
Target

Females
w/ social
anxiety

At risk
adolescents

Health
adolescents

At-risk youth

At-risk
youth

Healthy
college
students

At-risk
youth

Adolescents
from group
home

Population
Age Range

18-29

12-18

12-15

12-14

12-14

ND

10-14

ND

No

Yes
school

Yes
schools

Yes
schools

Yes
schools

No

Yes
schools

Yes
foster care

Theoretical
Framework

CBT,
IDEA,
TALK

Exp.
Learning,
Role theory
inferred

Role theory
inferred

Habit of Mind

Metaphorical
analysis

Exp.
Learning

HAI, PYD
Perspective,
Exp.
Learning

Exp.
Learning

Formal
Program

Project
Stride

LASSO

ND

EQUAL
Program

GRRC

ND

ND

Cowboy
Trails

Description

EAA +
CBT

EAL

EAA

EAL, EAP &
HIPPO

EAA

EAL, CBT,
yoga, hiking

EFL

EAL

Delivered By

RF

Equine
Professional

Farmers, all
riding
instructors

Psychologist,
Equine
instructor,
volunteers

W/O
trained
therapist

ES & MH
psychotherapist

Instructor,
students,
psychologist

ND

Setting

RC

ND

Farms

RC

RC

ND

RC

RC

Center, HP
Certification
Discussed

No

No

No

No

No

EAGALA

PATH

EAGALA

Program
Duration

6 weeks

5 weeks

16 weeks

12 weeks

ND

EAL portion
3 weeks

11 weeks

8 weeks

Session
Duration

2-2.5 hrs

ND

2 hours

3 hours

3 hours

45 min.

90 min.

60 min.

Total number
of sessions

6

5

16

12

4

3

11

8

Groundwork
or riding

Both

Ground

Both

Both

Ground

Ground

Both

Ground

Groups or
Individual

Both

Groups

Both

Groups

ND

Groups

Both

Groups

Level of
Evidence

Recruitment
Collaborative

ANOVA - Analysis of variance, ANCOVA - Analysis of covariance, CASEL - Collaborative Academic Social & Emotional Learning, CBT cognitive behavioral therapy, EAA - Equine assisted activities, EAL - Equine assisted learning, EAGALA - Equine Assisted Growth and
Learning Association, EAP - Equine assisted psychotherapy, EBP - Evidence Based Practice, EFL - Equine facilitated learning, ES - Equine
specialists, HAI - Human-animal interaction, IDEA - Identify, Develop, Evaluate, Act, IACUC - Institutional Animal Care and Use Committee,
IRB - Internal review board, LASSO - Leading Adolescents to Successful School Outcomes, MH - Mental Health, ND - Not discussed, PATH Professional Association of Therapeutic Horsemanship, PYD - Positive youth development, RCT - Randomized, controlled trial, TALK Timing, Assertive Communication, Location, Know what to say

Appendix C
Table 2
Synthesis of Qualitative Data
Dell

Hemingway

Morgan

Saggers

Level of Evidence

VI

VI

III

VI

Population Target

At risk youth

Incarcerated youth

Healthy college students

At-risk youth

12-17

18-21

ND

10-13

Recruitment
Collaborative

Yes
Substance abuse center

Yes
Young offenders prison

No

Yes
school

Theoretical Framework

Aboriginal Worldview,
Exp. Learning, 7
Grandfather Teachings

Exp. Learning

Exp. Learning

CASEL, Exp. Learning

Formal Program

ND

PNH Program

ND

SEL Program

Description

EAL

EFL

EAL, CBT, yoga, hiking

EFL

Delivered By

Teachers, counselor

Course Facilitator

ES & MH psychotherapist

EFL staff, teachers, &
volunteers

Setting

RC

RC

ND

RC

Center, HP Certification
Discussed

ND

PNH

EAGALA

PATH

10 weeks

7 days

EAL portion was 3 weeks

8 weeks

60 minutes

2.5 hours

45 min.

2 hours

10

7

3

16

Groundwork or Riding

Ground

Ground

Ground

Both

Groups or Individual

Groups

Groups

Groups

Both

Population Age Range

Program Duration
Session Duration
Total Sessions

ANOVA - Analysis of variance, ANCOVA - Analysis of covariance, CASEL - Collaborative Academic Social & Emotional Learning, CBT cognitive behavioral therapy, EAA - Equine assisted activities, EAL - Equine assisted learning, EAGALA - Equine Assisted Growth and
Learning Association, EAP - Equine assisted psychotherapy, EBP - Evidence Based Practice, EFL - Equine facilitated learning, ES - Equine
specialists, HAI - Human-animal interaction, IDEA - Identify, Develop, Evaluate, Act, IACUC - Institutional Animal Care and Use Committee,
IRB - Internal review board, LASSO - Leading Adolescents to Successful School Outcomes, MH - Mental Health, ND - Not discussed, PATH Professional Association of Therapeutic Horsemanship, PYD - Positive youth development, RCT - Randomized, controlled trial, TALK Timing, Assertive Communication, Location, Know what to say

Appendix C
Table 3
Synthesis of Session Themes and Outcome Domains
Articles Alf.

Fred.

Hau.

Ho

Hol.

Mor.

Pen.

Per.

X

X
X
X
X
X

Dell

Hem.

Sag.

Session Themes:
Commun.
Teamwork
Boundaries
Prob. Solv.
Emot Reg.
Relationships
Leadership
Flexibility
Respect
Empathy
Reflection
Responsibility
CBT

X
X

X

X

X
X
X

X

X

X
X

X

X
X
X

X

X
X

X

X

X

X

X

X

X

X

X
X
X

X
X
X
X
X
X

X

X
X

X

X

X

Outcome Domains of
Interest:
Social-Emotional
Behavioral
Cognitive
Other

X

X

X
X
X

X
X
X

X
X

X

X

X
X

X
X
X

X
X
X
X

X

ANOVA - Analysis of variance, ANCOVA - Analysis of covariance, CASEL - Collaborative Academic Social & Emotional Learning, CBT cognitive behavioral therapy, EAA - Equine assisted activities, EAL - Equine assisted learning, EAGALA - Equine Assisted Growth and
Learning Association, EAP - Equine assisted psychotherapy, EBP - Evidence Based Practice, EFL - Equine facilitated learning, ES - Equine
specialists, HAI - Human-animal interaction, IDEA - Identify, Develop, Evaluate, Act, IACUC - Institutional Animal Care and Use Committee,
IRB - Internal review board, LASSO - Leading Adolescents to Successful School Outcomes, MH - Mental Health, ND - Not discussed, PATH Professional Association of Therapeutic Horsemanship, PYD - Positive youth development, RCT - Randomized, controlled trial, TALK Timing, Assertive Communication, Location, Know what to say

Appendix D
Figure 1
Experiential Learning Theory

Figure 1. Experiential learning theory asserts that learning is a complex, adaptive process that
engages different key brain regions to promote learning. Through the concrete experience, the
learner gains sensory and motor stimulation. Reflective observation enhances memory and
emotional processing. Abstract conceptualization engages the frontal cortex and higher learning.
Active experimentation promotes decision-making and ultimately, behavior change. (Kolb, 2015)

Appendix D
Figure 2
Johns Hopkins Nursing Evidence Based Practice Model

!
Figure 2. The most attractive element of the Johns Hopkins Nursing EBP Model is the ongoing
collaborative exchanges involving practice and learning that occured prior to project
implementation. This component was fundamental to program development and refinement prior
to implementation at the riding center. In addition, the Model is designed for implementation in
smaller settings, making it ideal for use in our therapeutic riding center.

Appendix E
Table 1
Sample Characteristics

Adult and Child Attendees

n = 61

Female

Male

Adults (age 18 & up)

36

20

16

Children (age 10-17)

25

13

12

Non-Primary Relatives

5

5

-

Parents Completing Surveys

n = 20 % total

Caucasion or White Families

17

85%

Hispanic or Latino Families

3

15%

Avg. No. of People in Family

3.65

-

Bachelor’s Degree or Higher

15

75%

High School Graduate or Some College

5

25%

Child Qualifies for Reduced School
Lunch

4

20%

Appendix E
Table 2
Results for Family Satisfaction Scale

Sum Scores

n

M

SD

Minimum

Maximum

T0 Family satisfaction

20

31.85

6.07

18.00

42.00

T1 Family satisfaction

19

38.32

8.16

20.00

50.00

Z score-3.400b
Asymp. Sig (2-tailed) 0.001

Appendix E
Table 3
Results for Brief Family Assessment Measure

t scores

n

M

SD

Minimum

Maximum

T0 General

20

49.00

11.06

30

66

T1 General

19

41.89

9.08

28

60

Z score-2.788b
Asymp. Sig (2-tailed) 0.005
T0 Self-Rating

20

53.10

15.85

24

76

T1 Self-Rating

19

46.11

13.80

28

80

Z score-1.963b
Asymp. Sig (2-tailed) 0.050
T0 Dyadic Relationship

20

51.80

12.21

34

76

T1 Dyadic Relationship

19

47.79

10.45

32

70

Z score-2.203b
Asymp. Sig (2-tailed) 0.028

Appendix E
Table 4
Results for Devereaux Student Strengths Assessment (DESSA-mini)

Sum Scores

n

M

SD

Minimum

Maximum

T0 Social emotional comp.

20

50.05

8.49

37

67

T1 Social emotional comp.

19

54.53

9.39

41

71

Z score-2.444b
Asymp. Sig (2-tailed) 0.015

Appendix E
Table 5
Acceptability Results for Adults, Expressed as Percentage

Questions 1-6

% Adults (n = 32)
A or SA

N

D or SD

Positive and Educational

100

-

-

Engaging

100

-

-

Learned Something New

87.5

12.5

-

Can Apply Cowboy Ethics to Life

100

-

-

Roundup Questions Meaningful

96.9

3.1

-

Would Recommend to Others

100

-

-

SA = Strongly Agree, A = Agree, N = Neutral, D = Disagree, SD = Strongly Disagree

Appendix E
Figure 1
Acceptability Results for Adults, Expressed as Mean

Appendix E
Table 6
Acceptability for Children, Expressed as Percentage

Questions 1-6

% Children (n = 23)
A or SA

N

D or SD

Positive and Educational

95.7

4.3

-

Engaging

95.7

4.3

-

Learned Something New

65.2

13

21.7

Can Apply Cowboy Ethics to Life

73.9

26.1

-

Roundup Questions Meaningful

73.9

13

13

Would Recommend to Others

78.3

21.7

-

SA = Strongly Agree, A = Agree, N = Neutral, D = Disagree, SD = Strongly Disagree

Appendix E
Figure 2
Acceptability Results for Children, Expressed as Mean