Building Internal Resilience through Horses: Final Report
Introduction
Project goals and objectives
1) To design, deliver, and evaluate through intervention research an innovative trauma- and violence-informed program for enhancing resilience of young women who have been exposed to family violence. The program is based on the multi-factor/multi-level model of resilience and utilizes the experiential modality of Equine-Assisted Learning (EAL) to help build personal capacities and coping skills for young survivors of interpersonal trauma. This community-based initiative was founded on the expectation that the hands-on EAL programming, combined with trauma-informed psychoeducation, would help enhance participants’ internal resiliency resources, which would in turn contribute to their improved mental health outcomes and reduced risk of harm in the future.
2) To enhance the community capacity for resilience promotion and trauma- and violence-informed practice in Peterborough ON and surrounding regions. By producing and disseminating resilience and trauma-related resources, and by facilitating integration and knowledge exchange opportunities across various service providers working with families and youth, the project aimed to contribute to a resourceful local community that was better equipped to support survivors of family violence.
3) To promote the knowledge and use of trauma-informed approaches nationally and internationally. By documenting the program in a manual and conducting rigorous intervention research, the project aimed to add to the growing body of empirical evidence on resilience interventions for youth, and on the use of EAL as a promising alternative modality for trauma survivors.
Project contributors
Building Internal Resilience Through Horses was a multi-sectoral community-based collaboration between Kawartha Sexual Assault Centre (KSAC), The Mane Intent, and Trent University. All collaborating partners provided in-kind contributions that supported project activities. The Public Health Agency of Canada (PHAC) provided $622,983 from October, 2016 to March, 2021 through the Supporting the Health of Survivors of Family Violence investment.
Key activities and outputs
Core program
Between Spring 2017 and Fall 2019, the program was delivered to 12 groups of 83 young women (ages 13 to 18 years) from Peterborough and surrounding areas, who had experienced or witnessed violence in their home, or experienced intimate partner violence in dating relationships.
The core program curriculum consisted of eight weekly 2-hour EAL sessions, book-ended by two expressive arts sessions. Three additional expressive arts booster sessions were delivered as wellness check-ins at 1-month, 6-month, and 12-month follow-ups after the core program completion. Expressive arts sessions were based on regular programming offered by KSAC, used to provide trauma-informed psychoeducation and facilitate alternative forms of self-expression. These sessions were also used to administer assessment forms for the intervention research.
All sessions were delivered in small groups (5-8 participants per group), with no previous horse experience required. EAL sessions took place on The Mane Intent horse farm; transportation to and from the farm was offered at no cost. The expressive arts sessions were held at KSAC. The program delivery team included two certified EAL facilitators and one or two mental health professionals, all with trauma- and violence-informed training.
Program evaluation results for the core program are summarized in the Project Outcomes section.
Referral partners
Although Building Internal Resilience Through Horses was actively advertised through community and media outreach, the long-term sustainability of the program was achieved by fostering strong relationships with youth service providers in the area, who were already in trusting relationship with potential program participants. Potential referral partners were invited to The Mane Intent to participate in a Community Champion Day, where they could meet the program delivery team and personally engage in some of the EAL activities. This ensured that the service providers were well informed to set accurate program expectations with youth and make appropriate participant referrals. If an agency was not available to participate in the Champion Day, the team met with them in their space. During these outreach activities, the team also facilitated dialogues focused on trauma- and violence-informed practice. Referring agencies for Building Internal Resilience Through Horses included:
Peterborough Youth Services • Kawartha/Haliburton Victim Services • Peterborough Police Victim Services • Northumberland Victim Services • CMHA Peterborough and Lindsay • Kawartha-Pine Ridge District School Board (Norwood HS, Crestwood and Norwood HS) • Mon Ami • Family and Youth Clinic (Peterborough Regional Health Centre) • Sexual Health Unit • New Canadians Centre • Curve Lake First Nation Health Centre • Elizabeth Fry Society • Niijkiwendidaa Anishnaabekwewag Service Circle • Nogojiwanong Friendship Centre • Rainbow Youth at PARN • Women’s Health Care Centre (Peterborough Regional Health Centre)
Knowledge dissemination and exchange activities
Event organization.
Capstone event was the national Inviting Resilience Conference, organized by the project partners and hosted at Trent University (May 21-22, 2019). This two-day event, filled with high-profile keynotes, academic sessions, experiential workshops, and networking, was aimed at building community capacity around the newest evidence-based practices, community-driven initiatives, and trauma-informed and strength-based programming. Around 200 delegates from across Canada attended the conference, including researchers, educators, healthcare professionals, social workers, and other service providers. A post-conference EAL workshop was held at The Mane Intent. The conference was funded by the Public Health Agency of Canada, Trent University Vice-President Research and Innovation Strategic Initiatives Fund, and sponsorships from Peterborough Police Services and other local organizations. The conference attracted local and national media coverage.
Proceeds from the conference were used to fund the Somatic Experiencing® workshop (April 4-5, 2020). This two-day professional workshop for therapists, counselors, and social workers provided over 15 hours of theory, discussion, and hands-on training for 80 attendees, focused on the understanding of trauma and its physiological impacts on the body from a polyvagal perspective.
The Peterborough Healthy Families community event, organized in collaboration with Peterborough Public Health and Victim Services (April 26, 2018), included a public screening of the award-winning film Resilience: The Biology of Stress and the Science of Hope (KPJR Films), followed by a discussion with the project lead researcher. The documentary sheds light on the direct link between adverse childhood experiences and ill health. The film also calls for the widespread adoption of trauma-informed approaches to health, education, and social services. The event was well attended not only by service providers, but also by teachers, parents, and youth.
Professional training. Project team members delivered professional development training on trauma- and violence-informed care and resiliency to the following groups: Women’s Health Care Centre for counsellors, sexual assault and domestic violence nurses (April 2019); Grand Rounds for general physicians at the Peterborough Regional Health Centre (October 2019); Peterborough Family Health Team for mental health clinicians (January and February 2020); Trent University Nursing Program for nurses in training (January 2020); Train the Trainer with Durham Rape Crisis Centre and Sexual Assault and Violence Intervention Services of Halton (February 2020); and 60 frontline workers from various agencies through Question of Care, a local capacity-building initiative focused on addressing the intersections between trauma, stigma, substance use, and mental illness (February 2020).
Communities of practice. As one of 18 projects funded by the PHAC Supporting the Health of Survivors of Family Violence investment, this project was a member of the Knowledge Hub, a national community of practice engaged in knowledge exchange and mobilization activities, including project Research Briefings. Project team members also presented at local events promoting the sharing of best practices and multi-sectoral collaborations, including the Peterborough Youth Services Partners Forum held annually in September, and the local conference Empowering Resilience (May 2017).
Conference presentations. Project team members presented the core EAL program and the intervention research to large audiences of researchers, professionals, and practitioners at the following national and international conferences: Canadian Psychological Association (Virtual 2020), Facilitated Equine Experiential Learning Conference (Ottawa 2019), CAST Canada Grounding Trauma Conference (Alliston 2018), International Congress of Applied Psychology (Montreal 2018), and HETI International Congress of Equine Facilitated Programmes (Dublin, Ireland 2018).
Educational materials. Created a new online resource, containing information and resources on family violence, trauma, resilience, and youth services. The website also houses the Building Internal Resilience Through Horses Program Manual, a comprehensive 140-page reference document outlining the principles, research, and curriculum for the program. The Manual is available for download at no cost in English and French, and it is intended for use by health professionals and EAL facilitators interested in offering the program in their communities. Resilience books were donated to the Peterborough Public Library, to invest in resources for youth and their families. The lead researcher developed a graduate course on Trauma and Resilience, offered through the Psychology M.Sc. program at Trent University, to advance training of future researchers and professionals.
Media outreach. Building Internal Resilience Through Horses received regular coverage in the local media. The project was launched at a media event hosted at The Mane Intent in January 2017, where the Hon. Maryam Monsef, MP for Peterborough-Kawartha, announced the federal funding. The event was also attended by the Hon. Kim Rudd, MP for Northumberland-Peterborough South, and other local dignitaries. Project team members have since appeared in several TV interviews and segments, in addition to the news coverage of the community events listed above. The program was also promoted through the project partners’ social media sites and The Mane Intent blog.
Program adaptations
Using a flexible approach is key to creating programs that work. Due to the restrictions posed by the COVID-19 pandemic, the core ten-week program scheduled for Spring 2020 was delivered as a single full-day EAL session in Fall 2020, following required public health protocols. As community knowledge about the program grew, interest in the one-day adaptation of the program increased among groups serving Indigenous Peoples, newcomers, and LGBTQ+ youth. To extend the reach of the project and meet the intersectional needs of these specific communities, the project partners pursued and secured additional funding to pilot the program with new populations.
An extension of PHAC funding supported the offer of culturally appropriate and accessible sessions for young newcomer women, in collaboration with the New Canadians Centre. Proceeds from the Inviting Resilience Conference were used to offer a one-day session for Indigenous Trent University students, in collaboration with the First Peoples House of Learning. A Community Foundation of Greater Peterborough (CFGP) grant supported Curve Lake First Nation and the Nogojiwanong Friendship Centre to offer culturally appropriate sessions for groups of Indigenous youth (age 10-14), families, and women. These sessions were enhanced with cultural teachings and the presence of Knowledge Holders. The team was also to offer a CFGP-funded session to LGBTQ+ youth at Trent University’s Camp fYrefly as part of their leadership training in Summer 2020; however, the camp was cancelled due to the COVID-19 pandemic, and instead a one-day session was offered to PARN Rainbow Youth Group.
One-day program offerings were treated as pilots and not included in the intervention research. Feedback was collected at the end of the experience to inform future program delivery. Each community provided unique feedback on how the program can be strengthened and adapted to be accessible and culturally meaningful. Consultation and relationships developed through respectful dialogue are most important for program adaptation.
Project outcomes
Research methods
The core program was evaluated through a mixed-methods research design aimed to assess changes in participants’ resiliency and mental health outcomes following the program, and to understand participants’ experiences in the program and the program’s processes contributing to the outcomes.
Key outcomes included indicators of resilience (emotion regulation, sense of mastery, sense of relatedness) and indicators of mental health (depressive and posttraumatic symptoms). These outcomes were assessed using standardized scales validated for use with youth. Participants completed the assessment forms at pre-test (one week before the eight-week EAL module), at post-test (one week after the EAL module), and at 1-month, 6-month, and 12-month follow-ups.
Throughout the program, participants completed a brief feedback form at the end of each EAL session, rating their satisfaction, comfort with the group, session helpfulness, and how much they learned. Participants were also invited to leave comments about their experiences, take-away learnings, and any other feedback. Program facilitators completed session fidelity checklists and post-program debriefs. All research forms and procedures were approved by the Trent University Research Ethics Board.
Research results
Research results indicate that Building Internal Resilience Through Horses is a promising approach to building internal resilience in young women who are survivors of interpersonal trauma. The program elicited consistently high attendance rates, with 77% of the participants attending over half of the EAL sessions; when participants did miss sessions, it was primarily due to life circumstances. This suggests that most participants found the program appealing, accessible, and worthwhile. Indeed, 72 to 98% of the participants (depending on the session) rated their experience as mostly or very helpful. The unique value of learning with horses was regularly expressed in the participants’ comments:
“[The horses] taught me things I thought I could never learn. The horses are exceptional teachers.”
“Having a grasp on leading the horse without feeling any sense of doubt – I can apply what I learned today to my personal life.”
Most participants (70 to 85%, depending on the session) also reported gaining new knowledge, skills, and insights from their EAL experiences, including emotional awareness, grounding strategies, empathy, boundary setting, confidence, leadership, connection, and self-care:
“I learned how to look at my emotions and had the horses help with understanding them.”
“[I am] learning from the horses to release all the overwhelming emotions, not to hold it in.”
“The horses taught me so much in so little time. The horses taught me about how to help and understand personal space and respect others space.”
“I learned that I have needs and they can be met, and I’m not selfish for thinking that.”
“[I learned] that I can impact my own wellness in positive ways. Small changes can make big differences.”
“Today, I felt very courageous/proud. I felt this way because I learned how to say no, which is difficult.”
“Today’s session was very good. It made me feel like the boss and confident. I felt strong and completed.”
“[I learned that] I can still trust even after having my trust broken a lot.”
Consistent with these themes, the outcome measures showed significant improvements in participants’ resiliency indicators, including increased emotional awareness and adaptability, stronger sense of personal mastery, and improved interpersonal and relational skills. Many of these improvements were sustained over the long term at 1-month, 6-month, and for some core competencies even at 12-month follow-up, suggesting that the skills taught in the program are lasting and transferable.
Changes in the outcomes were directly linked to participants’ engagement and experiences in the program, lending more confidence in attributing those changes to the effects of the program. Participants who attended more EAL sessions, and who reported deriving more satisfaction, learning, and value from the activities, showed greater improvements in their resiliency indicators, and experienced less decline in their mental health indicators after the program. These positive outcomes were not realized for participants who attended fewer EAL sessions and who reported getting less value out of the program.
Changes in the outcomes were stronger for resiliency indicators than for mental health indicators. This finding is in line with the nature and goals of the EAL approach, which was intended to be a strength-building community-based program for developing resiliency skills and mindsets. Resilience is not the same as the absence of posttraumatic symptomology; it is the capacity for resourcefulness that can co-exist with, and facilitate coping with the adverse consequences of trauma. Many of the program participants had clinical levels of depressive symptoms at the start of the program. Although the program by itself was not sufficient to alleviate these mental-health issues, the boost to resilience capacity provided by the program might empower participants to seek further support. It is important to provide additional services for individuals with acute mental-health concerns.
Overall, research showed that the program met its primary objective of building core internal resiliency competencies, at least among those participants who found value in this approach. However, not all participants had equally valuable experiences, and not all participants showed equally positive outcomes following the program. This suggests that Building Internal Resilience Through Horses – like any program – is not a one-size-fits-all approach. Health and wellbeing following trauma are complex and multi-determined outcomes. It is essential to build capacity for a diverse range of programs and supports for individuals, families, and communities.
Next steps
The time, effort, and resources invested through this four-year project into building multi-sectoral partnerships and community capacity for strength-based, trauma- and violence-informed practices is one of the most significant and lasting contributions of this initiative towards supporting the community’s capacity to cope with adversity.
Relationships fostered among the project partners and with other service providers in the area represent the most sustainable and generative products of this project. The condensed one-day adaptation of the program will likely be more feasible and more adaptable to the needs of clients of diverse ages, cultural backgrounds, and sexual and gender identities.
The materials and resources produced and disseminated as part of this project, as well as by the Knowledge Hub community of practice, are freely available and can be used to support further training, research, and programming.
