Reducing Anxiety and Stress among Youth in a CBT-Based Equine-Assisted Adaptive Riding Program.
Authors: Hoagwood Kimberly, Vincent Aviva, Acri Mary, Morrissey Meghan, Seibel Lauren, Guo Fei, Flores Chelsea, Seag Dana, Peth Pierce Robin, Horwitz Sarah
Journal: Animals : an open access journal from MDPI
Summary
# Editorial Summary: Equine-Assisted Cognitive Behavioural Therapy for Youth Anxiety Reining in Anxiety (RiA) integrates structured cognitive–behavioural therapy with therapeutic riding instruction, delivering evidence-based anxiety treatment through a medium already familiar to equine professionals. This feasibility and efficacy trial enrolled 39 young people (aged 6–17) with mild-to-moderate anxiety in a ten-week programme, measuring outcomes via caregiver-reported anxiety symptoms, emotional regulation and self-efficacy scores, alongside physiological markers (salivary cortisol and oxytocin) collected from both participants and horses at weeks one, four, seven and ten. Caregiver-reported anxiety decreased significantly from baseline to completion, and emotional regulation improved, though self-efficacy showed no measurable change; within-session cortisol levels decreased consistently whilst oxytocin increased at two timepoints (weeks 1 and 7), and critically, horse stress markers remained unchanged throughout, confirming the intervention posed no welfare concern. The capacity to deliver evidence-based mental health treatment through adaptive riding instructors working in naturalistic settings—rather than clinical environments—positions RiA as an accessible, scalable model for addressing rising youth anxiety; however, practitioners should recognise that whilst the programme demonstrates promise in reducing self-reported anxiety and improving emotional regulation, further comparative research with other animal-assisted interventions and cost-effectiveness analyses are needed to establish its place within broader therapeutic provision.
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Practical Takeaways
- •Therapeutic riding instructors can confidently deliver CBT-based anxiety interventions in natural riding settings without stressing horses, expanding access to mental health support for youth
- •The program's manualized CBT structure (exposure, cognitive restructuring, psychoeducation, relaxation) provides a replicable framework that riding professionals can implement with proper training
- •Salivary biomarker collection from both riders and horses is feasible in field settings, offering objective stress monitoring alongside subjective outcome measures
Key Findings
- •Caregiver-reported anxiety significantly decreased from pre- to post-test in youth (n=39) following 10-week CBT-based equine-assisted intervention
- •Emotional regulation scores increased significantly from baseline to post-intervention
- •Salivary cortisol decreased and oxytocin increased during riding sessions at weeks 1 and 7, indicating acute stress reduction and relaxation
- •Horse saliva cortisol and oxytocin showed no significant changes, demonstrating the intervention does not increase stress in horses