Warrior Camp: An Equine-Assisted Psychotherapy Program for Combat Trauma in Military Veterans

Combat deployment among military service members presents numerous challenges including exposure to traumatic events (e.g., combat), moral injury (e.g., demoralization, crisis in meaning) substance use disorders and disruptions in attachment. Effective treatments exist, but barriers to care abound, including poor access, stigma and drop out. Trauma and Resiliency Resources, Inc.’s Warrior Camp® (WC) program is a 7-day intensive therapeutic treatment designed to address the effects of combat. It incorporates Eye Movement Desensitization and Reprocessing (EMDR) therapy, EAGALA-model Equine Assisted Psychotherapy (EAP), Yoga and Narrative Writing in the context of a therapeutic community. WC uses self-report and clinician ratings at pretest and posttest to assess PTSD, dissociative experiences, moral injury, attachment, depression and substance use. Data from WC were collected as a routine part of WC. This preliminary analysis used an outcomes monitoring approach (Rossi, Lipsey & Freeman, 2004) to examine the self-report measures using a single-group pretest-posttest design for 63 participants across 5 iterations of WC. Analyses included repeated measures t-tests and effect size analysis for four of the self-report measures: the Mississippi Scale for PTSD, the Patient Health Questionnaire (PHQ-9), the Revised Adult Attachment Scales (RAAS) and the Moral Injury Events Scale. All measures except for the RAAS showed statistically significant reductions in distress. Effect-size analyses of the statistically significant tests show that Warrior Camp participants experienced relief from PTSD and depression of a medium to large magnitude (Hedges g = 0.64 and 0.61, respectively). This outcomes monitoring examination of WC showed that participants experienced improvement that was statistically significant and substantive for PTSD, depression and moral injury. The program design is unique in that it integrates multiple treatment components each with varying degrees of established efficacy and clinical utility for working with combat veterans. Research is limited on the topic of Equine Assisted Psychotherapy and this study makes a substantial contribution in this regard.