Canadian PTSD First Responder Study

There have been multiple studies and programs devoted to the benefits of equine-assisted therapy (EAT) to people suffering from PTSD and other mental health issues. Horse-Canada.com has devoted several articles to the topic as well.

A new Canadian study, the first of its kind in our country, examined the benefits of equine-assisted therapy to first responders suffering from “occupational incapacitation from operational-related trauma.” In other words, the study focused on first responders whose PTSD symptoms were both debilitating and were received due to his or her work.

When we talk about first responders, generally we’re referring to police officers, fire fighters, paramedics and search-and-rescue personnel. However, since the global Covid pandemic, this definition has broadened to include nurses, doctors, and other health care providers.

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According to the study, within the general Canadian population there is an estimated 1.7% prevalence of PTSD; however, for our first responders the range increases from 8% to 32%. The Canadian pilot study included seven first responders who participated in an eight-week, 90-minute session EAT program. The program measured each participant’s levels of anxiety, depression, trauma, inflexibility, and avoidance prior to starting the therapy and after.

The program saw participants working with the horses in a round pen, facing obstacles, and also mindfulness and grounding exercises. One of the exercises is called “face your fear”: the participants had to find a way to lead a horse across a tarp that covers some 150 plastic water bottles. “All of the participants eventually led their horse across. The very fact that the horse trusted the participant enough to follow him/her had a profound impact on the first responder’s confidence and self-worth,” says Ute Lawrence, CEO/founder of the PTSD Association of Canada and a co-owner of Belvoir Estate Farm in Delaware, Ontario, where the study was conducted.

A participant walks with a horse during a round pen session.

The study was based on the work of renowned American neurosurgeon Dr. Allan J. Hamilton, who has studied the benefits and effects of human-horse interactions and is the author of Lead with Your Heart… Lessons from a Life with Horses: Finding Wholeness and Harmony at the End of a Lead Rope.

And the results were impressive. “Essentially, notable differences emerged by those participating in equine therapy over-and-above standard treatments,” says Dr. Charles Nelson, a clinical psychologist who led the study. “Some participants no longer met criteria for PTSD or major depressive disorder following the eight-week program.”

People with PTSD symptoms are able to translate what they learn in the program with horses into their real life through improved confidence and understanding, which helps to reiterate and validate the person’s private struggles that are often misunderstood. “Having first responders gain some familiarization and safety of basic horsemanship gives them an opportunity to self-regulate their own emotions because the horses mirror that back,” Dr. Nelson explains.

One of the study’s participants was Nathalie Tuttle, a paramedic who has been in the job for 18 years. Tuttle was diagnosed with PTSD, anxiety, and mild depression at the end of 2020. “I had symptoms for a long time before being diagnosed. I was in denial and pretended I was happy. I was pulling away from family and friends,” Tuttle admits. “I was angry and couldn’t control my emotions. I had insomnia, nightmares, flashbacks and was tired all the time.”

The result of these symptoms was to block and numb her feelings. She also had issues with her short-term memory and retaining information. “I couldn’t enjoy reading books anymore. I didn’t remember having conversations with people and would have them repeat what they had just said,” she explains. “It never affected my patient care at work, but my family didn’t recognize who I was anymore.”

Tuttle was told of the study and equine-assisted therapy by her therapist. She had always loved horses but had no prior experience with them. Despite her love of horses, Tuttle found the first couple of sessions challenging. “I was anxious and having trust issues which made me very anxious being close to horses, so I didn’t go near them. I was intimidated by them; they were so big up close,” she admits.

But on her third session, she worked with a horse named George and connected with him right away. “He kept me calm, made me realize I could now control my anxiety and I could trust again. From there on, I was looking forward every week to go to equine therapy and work with the horses.”

Paramedic and program graduate Nathalie Tuttle now has her own horse, Anch. (photo courtesy Nathalie Tuttle)

Tuttle said that during the program all of her symptoms started to improve. She became more confident, gained trust in herself and others and learned how to control her anxiety. “My memory improved, and I was able to read books again and not having people repeat themselves as much. I was sleeping better with less nightmares and flashbacks,” she explains. “I wasn’t numbing my feelings anymore. I got closer to my family and friends and stopped pushing them away. I was more patient and not angry all the time. I was happy and more positive.”

Tuttle wasn’t the only one who noticed the transformation. Her family also saw a difference and they were happy to see the positive changes. “I was also happy as to who I was becoming and didn’t want to go back to who I had become as a person before my diagnosis,” she adds.

Tuttle has returned to work full-time and while there have been challenges, she’s been able to manage them. “I am more positive and feel more present in my family’s life, I don’t push people away anymore,” she says. “To feel my feelings instead of numbing them has made a big difference in my recovery. I am very grateful for the horses for helping me control my emotions and also to help me feel my emotions.”

Tuttle loved being around horses so much she began leasing a horse named Anch last fall and has since become co-owner. “So, I still get to work with horses and I’m still learning every day. I now share my passion for horses with my mother and daughter.”

As for other first responders who want to continue with horses beyond the initial program, there currently isn’t a second tier to the program but that’s something Belvoir’s Lawrence hopes will change.

“The challenge is to find funding to help those who wish to continue. Equine therapy still does not get the recognition it deserves,” she says. “I do hope that the results of this research pilot will help. At this point the PTSD Association of Canada, which I founded in 2006, will conduct fundraisers to help fund the eight-week program for first responders and emergency workers.”