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Introduction: Reining in Anxiety (RiA) is a therapeutic program for youth with mild to moderate anxiety delivered in a therapeutic riding setting by Certified Therapeutic Riding Instructors. RiA was developed after a rigorous review of the evidence base for Cognitive Behavioral Therapy (CBT) for youth anxiety, is manualized, and includes five core CBT components: in vivo exposure, cognitive restructuring, youth psychoeducation, relaxation, and caregiver psychoeducation about anxiety. This presentation will review this study and relate the stigma associated with traditional therapy to opportunities for alternative delivery systems that can ameliorate mental health and wellness.
Purpose: This study extended findings from a prior RCT [1] and examined (1) the feasibility of collecting saliva samples from horses and children to measure stress (cortisol) and relaxation (oxytocin); (2) whether changes in stress and relaxation occurred both during each lesson and over the course of the 10 week intervention for horses and youth; (3) whether changes in anxiety symptoms, emotional regulation, and self-efficacy found in the first trial were replicated; and (4) replication of fidelity to the program.
Methods: Youth participants (N=39) ages 6-16 with caregiver identified mild to moderate anxiety participated in a ten-week therapeutic intervention (RiA), which combined adaptive riding and five components of CBT. Physiological data and self-report measures were taken at weeks 1 (baseline), 4, 7, and 10 (posttest) for the youth and horses. Saliva assays assessed cortisol as a physiological marker of stress and anxiety, and oxytocin as a measure of relaxation. Fidelity data was recorded per session.
Results: Anxiety, as measured by caregiver self-report, significantly decreased from pre to posttest, while emotional regulation scores increased. No significant changes in self-efficacy from pre to posttest were observed. Saliva samples obtained from participants before and after riding sessions showed a consistent decrease in cortisol and a significant increase in oxytocin at two of the four timepoints (Week 1 and Week 7), but no overall pre to post changes. Horse saliva data were collected using a modified bit [2]; there were no significant changes in oxytocin or cortisol, suggesting that the horses were not stressed by the intervention.
Conclusion: RiA appears to reduce anxiety and stress among youth, as measured both by self-report and by physiological measures. Collection of salivary assays for both youth and horses is feasible, and the intervention does not increase stress in the horses. Importantly, RiA can be delivered by equine specialists in naturalistic (e.g., non-clinic-based) settings. As youth anxiety is a growing public health problem, novel interventions, such as RiA, that can be delivered naturalistically may have the potential to reach more youth and thus improve their quality of life.