بررسي اثر بخشي مداخلات اسب درماني بر بهبود شاخص هاي رواني بزرگسالان داراي افسردگي و اضطراب

Equine-Assisted Therapy Program for Improvement of Psychological Symptoms of Adults with Depression and Anxiety

زمينه و هدف: افسردگي و اضطراب دو عامل كليدي در ايجاد بحران ناتواني جهاني به‌شمار مي‌رود. اسب‌درماني از مداخلاتي بوده كه به‌تازگي براي بهبود محدوديت‌هاي موجود در الگوهاي درمان در روان‌شناختي، ازقبيل اضطراب و افسردگي و حتي بيش‌فعالي و اوتيسم پيشنهاد شده است؛ لذا مطالعهٔ حاضر با هدف بررسي اثربخشي مداخلات اسب‌درماني بر سطح افسردگي و متغيرهاي مرتبط با آن انجام شد. روش‌ بررسي: روش پژوهش حاضر از نوع نيمه‌تجربي و طرح تحقيق از نوع پيش‌آزمون‌پس‌آزمون همراه با گروه‌هاي آزمايش و گواه بود. جامعهٔ آماري را بيست نفر خانم 25تا35 سال با سطح افسردگي متوسط تشكيل دادند كه به‌شكل تصادفي در قالب دو گروه گواه و اسب‌درماني قرار گرفتند. آزمون‌هاي پنج‌عاملي ذهن‌آگاهي (بائر و همكاران، 2006) و اختلال خواب پيتزبورگ (بويس و همكاران، 1989) و اضطراب و افسردگي بك (بك و همكاران، 1961) در پيش‌آزمون اجرا شد و پس از گذشت شانزده هفته و 32 جلسه اسب‌درماني، در پس‌آزمون مجدداً به‌كار رفت. از سطح معناداري 0٫05 و نرم‌افزار SPSS و آزمون آناليز واريانس دوراهه براي تحليل آماري استفاده شد. يافته‌ها: براساس نتايج آزمون آناليز واريانس دوراهه، تأثير تمرين اسب‌درماني بر متغيرهاي افسردگي (0٫012=p)، ذهن‌آگاهي (0٫001

Background & Objective: Literature reveals that animal therapy was created as early as 1792 at the Quaker Society of Friends York Retreat in England. The US military improved the use of dogs as a therapeutic animal for treating psychiatric patients. Equine–assisted psychotherapy (EAP) is a specialized type of psychotherapy using a horse as a therapeutic tool. Horse, who has an advanced ‘fight or flight’ instinct, is much more aware of the body language and emotions reflected by a client. The horse is extremely aware of its environment and the intent of those who are approaching. Therefore, the horse suggests more benefits than a cat or a dog. Horse therapy is a smart, intentional and fully controlled application of the horse and the riding for remedy and curing problems, evaluating and educating children and adults with different or normal developmental and psychological profiles. Horse riding as therapy and as a sport designed to elevate the quality of life of those people with health at risk. This method designed to improve self–esteem and personal confidence, communication and interpersonal effectiveness, trust, and some other skills in humans. The purpose of the present study was to examine EAP facilitators’ perspectives on the psychosocial benefits and therapeutic results of EAP for adults experiencing depression and/or anxiety. Methods: Over a 6–month period, adults referred to a psychotherapist for treatment of various depression and anxiety conditions in Mashhad (Razavi Khorasan province, northeast of Iran) selected to the study. Referrals visited with local therapists specifically for EAP. Each person interviewed by the therapist to determine the suitability for EAP. Using a multicenter two–way parallel group, adults with depression and anxiety (aged 25–35) were randomly assigned to EAP (n=10) and control (n=10) over a period of 16 weeks. EAP training consisted of 32 sessions of 30 tasks each session for 2 hours. Five Facet Mindfulness Questionnaire (FFMQ), Pittsburgh Sleep Quality Index and Beck depression and anxiety questioners were used for assessment of mindfulness, sleep quality, depression and anxiety at pre–posttests. Results: A series of repeated measures model ANOVAs performed on samples. According to the results the time main effect for all the factors (depression and anxiety, mindfulness and sleep quality level) were significant improvements. Accordingly, depression (F=7/818, p=0.012), mindfulness (F=126.582, p<0.001), anxiety (F=9.753, p=0.006), sleep disorder (F=10.616, p=0.004) which reveled improvement of training group over time in compare to control. Conclusion: We found significant increases in mindfulness following the program. Training and discussions focused on an unbiased accepting awareness, and the high emotional intelligence of the horses may improve and develop mindfulness. It seems that EAP encourages a depressed person to involve in a more ‘hands–on’ approach during a session and change focus direction from the mental health issue to the task, a change of environments for the person, such as participating in outdoor activities rather than sitting in one–on–one therapy.