Table 1 Study and intervention characteristics of equine-assisted services incorporated into substance use disorder treatment

Adams et al., 2015 [26]

First Nations female youths attending the Cartier Equine-Assisted Learning program in Saskatchewan, Canada as part of their residential treatment for volatile substance misuse between June 2010 and June 2012.

Qualitative

n = 26

Equine-Assisted Learning

(EAL)

EAL Program Facilitator

20 weeks

Non-riding/ground activities.

Participant self-development; internalization and generalization of awareness developed during EAL sessions to other life situations; cognitive and behavioral change.

Atherton et al., 2020 [25]

Adolescents with an active diagnosis of a SUD referred to the study by a local resident provider in a medium-sized rural city in the Southeastern US. Years of recruitment not provided.

Quasi-experimental

n = 10

Equine-Facilitated Psychotherapy (EFP)

Addiction Counselor

Equine Specialist

Horse Trainer

6 weeks (1.5 h/week)

Horseman’s handshake; herd observation; grooming; groundwork (e.g., catching the horse, leading the horse around the arena, leading the horse through obstacle courses with and without a lead rope and halter, directing the horse to circle around the participant when attached to a long rope).

Each EFP session's theme and corresponding therapeutic and horsemanship goals were developed based on choice theory's connecting behaviors: listening, trusting, encouraging, respecting and accepting, and negotiating differences.

Brenna et al., 2013 [23]

Individuals undergoing treatment at the Oslo University Hospital’s Department of Addiction treatment- Youth in Oslo, Norway. Years of recruitment not provided.

Qualitative

n = 8

Horse-Assisted Therapy

(HAT)

HAT Therapist- Experienced therapists that were also qualified riding instructors

12 sessions

Stable work (e.g., grooming and feeding); groundwork; mounted work.

Planned part of overall SUD treatment; agreed goals between therapist and participant (e.g., management of anxiety or aggression, need to set and maintain safe limits).

Dell et al., 2011 [24]

First Nation and Inuit youth attending the Keystone Equine Center and the Lambton Equine Assisted Learning Centre in Ontario, Canda as part of their residential treatment for solvent abuse from October 2008 to April 2009.

Qualitative

n = 15

Equine-Assisted Learning

(EAL)

EAL Program Facilitator

12 weeks (1 h/week)

Non-riding activities.

Increasing self-esteem; modifying behavior; healing while having fun.

Gatti et al., 2020 [30]

Adult inpatients with a primary diagnosis of mental and behavioral disorders due to psychoactive substance use (ICD-10) receiving treatment at the Department of Addiction Treatment (Youth) at Oslo University Hospital from January 2013 to January 2016.

Randomized Control Trial

n = 37

Complementary Horse-Assisted Therapy

(cHAT)

HAT Therapist- Qualified psychotherapists specializing in equine-facilitated psychotherapy

6 weeks (2 90-min sessions/week)

Herd behavior observation; stable work; groundwork; mounted work; vaulting; driving a carriage.

Planned part of overall SUD treatment; agreed goals between therapist and patient; Challenges related to SUDs (e.g., boundary setting, development of trust, control of emotional affect).

Kern-Godal et al., 2015 [31]

Inpatients and day patients admitted to the Department of Addiction Treatment- Youth at Oslo University with a primary diagnosis of mental and behavioral disorders due to psychoactive substance use (ICD 10) between January 1, 2011 and June 30, 2012.

Prospective Cohort

n = 108

Horse-Assisted Therapy

(HAT)

HAT Therapist- Qualified therapists that were also Norwegian Level 1 Riding Instructors

6 weeks (2 90-min sessions/week)

Herd behavior observation; stable work; groundwork; mounted work; driving work.

Planned part of overall SUD treatment; agreed goals between therapist and patient (e.g., strengthen boundaries setting, reduce anxiety/depression/aggression).

Kern-Godal, Brenna, Arnevik, et al., 2016 [27]

Individuals undergoing treatment at the Department of Addiction Treatment (Youth), Oslo University Hospital in Oslo, Norway between November 2012 and end of January 2013.

Qualitative

n = 8

Horse-Assisted Therapy

(HAT)

HAT Therapist- Experienced therapists that were also qualified riding instructors

12 sessions

Not Provided

Planned part of overall SUD treatment; agreed goals between participant and therapist.

Kern-Godal, Brenna, Kogstad, et al., 2016 [28]

Individuals at a SUD treatment facility in Oslo, Norway who participated in at least one hour of HAT between 2012 and early 2013.

Qualitative

n = 8

Horse-Assisted Therapy

(HAT)

HAT Therapist- Experienced psychotherapists that were also riding instructors and skilled horse handlers

Not Provided

Grooming; feeding; riding; mucking out; moving hay; tack cleaning.

Not Provided

Stiltner et al., 2013 [29]

Adolescent boys with dual diagnoses of substance abuse and mental disorders living at a residential treatment center that incorporates equine-assisted psychotherapy into its overall treatment program. Years of recruitment not provided.

Qualitative

n = 8

Equine-Assisted Psychotherapy

(EAP)

EAP Therapist- Therapists trained through the Equine Assisted Growth and Learning Association’s model

Horse Professional Handler

1 day/week

Leading the horse; maneuvering the horse around obstacles; riding the horse.

Not Provided