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What Is Prozac?

Prozac (fluoxetine) is an antidepressant that was first introduced in the United States to treat depression in the 1980s. It is part of a class of medications known as selective serotonin reuptake inhibitors (SSRIs).

This article discusses how Prozac works and what you should know before taking it. It also covers potential side effects, interactions, withdrawal symptoms, and other medications you might consider.

How Prozac Works

As an SSRI, Prozac works by preventing the brain from reabsorbing naturally occurring serotonin. Serotonin is involved in mood regulation. In this way, Prozac helps the brain to maintain enough serotonin so that you have a feeling of well-being, resulting from improved communication between brain cells.

Research also highlights how medications such as Prozac may help in combination with psychotherapy. In a 2008 study in mice published in Science, Prozac helped the brain to enter a more immature and plastic state, possibly making it easier for therapy to have an effect.

Studies like this have provided insight into why combining medication such as Prozac with talk therapy can be effective for anxiety.

Using Prozac for Anxiety

Healthcare providers prescribe Prozac mainly for major depression, obsessive-compulsive disorder, and panic disorder (all of which are FDA-approved uses). However, they often use it off-label (a practice that’s legal and common) to treat other anxiety disorders. In fact, fluoxetine and other SSRIs are considered safe, effective first-line treatments for anxiety disorders, in part because their side effects tend to be more manageable than those of other types of treatment. Additionally, the risk of misuse and addiction is lower for Prozac than for other types of anxiety medications such as benzodiazepines.

However, you must follow a number of steps to get a prescription. Generally, a healthcare provider must diagnose you with a mental health disorder before prescribing Prozac or any other prescription treatment. It’s recommended that all adults younger than 65 should be regularly screened for anxiety. So, it’s important that you ask your doctor about getting tested for anxiety at your next visit.

Dosage and Administration

Prozac is usually prescribed at a low dose to start, and then gradually increased to 20 mg per day. The maximum dose is 80 mg a day. It can be taken as a liquid or capsule and should be used as prescribed. It can take several weeks for effects to show, so it is important not to stop taking Prozac abruptly even if you think it is not working.

Take the medication only as prescribed by a doctor or psychiatrist. Stopping suddenly could be dangerous and cause withdrawal symptoms.

Side Effects of Prozac

Some side effects of Prozac are more likely than others. Some people notice that side effects lessen over time, or become less bothersome.

Common side effects include:

• Anxiety
• Blurred vision
• Diarrhea
• Dizziness
• Dry mouth
• Fatigue
• Headaches
• Heartburn
• Loss of appetite
• Lightheadedness
• Nausea
• Sleep problems
• Sexual problems
• Sweating
• Yawning

Rare side effects include:

• Bleeding or bruising
• Extreme anxiety
• Feeling confused
• Fever
• Vomiting
• Seizures
• Rash/hives
• Suicidal thoughts or behavior
• Swelling
• Trouble breathing or swallowing

Precautions Before Taking Prozac

There has been some controversy about the safety of Prozac, due to a safety warning issued by the Food and Drug Administration (FDA) in 2007 about the risk for suicidal thoughts among certain groups.

Despite this warning, Prozac continues to be prescribed and can be used safely (or discontinued if adverse effects develop) under the guidance of a physician. If you have concerns about the safety of taking Prozac, discuss them with a healthcare provider.

Medication and Drug Interactions

Prozac should not be combined with monoamine oxidase inhibitors (MAOIs) or taken within 14 days of discontinuing an MAOI. You should also allow at least five weeks after stopping Prozac before starting an MAOI.

The antipsychotics pimozide and thioridazine also increase the risk involved in taking Prozac. Prozac should not be taken at the same time as tricyclic antidepressants (TCAs), or drugs metabolized by CYP2D6. Care should also be taken if using drugs that affect the central nervous system (CNS), such as benzodiazepines.

The result of medication interactions can be serious and potentially fatal, so discuss all medications you are taking with a healthcare provider to determine whether potential interactions exist.

Prozac should not be combined with alcohol, certain over-the-counter (e.g., aspirin, due to the risk of bleeding) and prescription medications, and nutritional supplements or herbs (e.g., St. John’s wort). Be sure to tell your prescribing physician about everything that you are taking.

Who Should Not Take Prozac

Prozac can be passed to babies during pregnancy and through breast milk. Consult with a doctor if you are pregnant or nursing before taking Prozac, to determine whether the benefits outweigh the risks.

There are also some potential risks for people aged 65 or older that should be discussed with a doctor. The safety and effectiveness of Prozac in children younger than 18 years of age has also not been established. 

Warnings

Prozac can carry risks, including the potential for clinical worsening and in rare cases, increased thoughts of suicide. Serotonin syndrome can also occur, particularly if Prozac is used in conjunction with certain other medications. Prozac may also activate mania in people who are prone to it. Close monitoring by a healthcare provider is important.

Prozac also comes with a black box warning that it may increase the risk of suicide in people younger than 25 years old. In these individuals, the drug may lead to suicidal thoughts or worsening of these types of thoughts. If you belong to this group, your prescribing doctor should monitor you, particularly in the early stages, for these serious issues.

Withdrawal

If you stop taking Prozac suddenly, you may notice withdrawal symptoms, including:

• Dizziness
• Confusion
• Nightmares
• Insomnia
• Irritability
• Crying spells

For this reason, never stop Prozac (or other medications) without consulting a doctor. Prozac should always be tapered off to avoid withdrawal effects.

Alternatives to Prozac

If Prozac is not well tolerated, other SSRIs that are sometimes prescribed for anxiety include: 

Effexor XR (venlafaxine) is another antidepressant called a serotonin-norepinephrine reuptake inhibitor (SNRI) that also may be effective in treating anxiety.

Benzodiazepines are another class of medication often used for anxiety, but they are generally a short-term solution because of a risk of dependence. Typical medications in this category include:

Summary

Prozac is an SSRI antidepressant that is sometimes used in the treatment of anxiety. It is often most effective when combined with psychotherapy. Discuss your options with a healthcare provider to determine if taking Prozac is the best approach to treat your symptoms. Potential side effects can occur and the medication may increase the risk of suicide in people age 25 and younger.

If you have obsessive-compulsive disorder (OCD), you may find yourself trying to figure out how to stop OCD thoughts. You are not alone. While managing obsessive thoughts won’t stop OCD, it can make coping with the condition easier.

However, what many people with OCD don’t realize is that the distressing thoughts they experience are not necessarily something that they have (or can have) control over. While this fact might initially make you feel stressed, understanding how your OCD thinking works and why it happens will help you develop more effective ways to cope.

What Are OCD Thoughts?

A 2014 study published in the Journal of Obsessive Compulsive and Related Disorders interviewed 777 college students in 13 different countries and found that around 94% of them had experienced at least one unwanted intrusive thought during the previous three months.

While many people experience these odd or even disturbing thoughts, most people don’t register them as an issue in their daily lives. The problem is when they become not just intrusive but obsessive.

A person with OCD can experience intrusive thoughts relentlessly and with an intensity that can seriously affect their well-being. Rather than having a neutral response to a passing thought, a person with OCD experiences a response in their mind and body.

The more they perseverate on the thought, the more anxiety they experience. The cycle can be distressing and may impact their ability to function.

If you have OCD and struggle with intrusive thoughts, here is some key information about why these thoughts happen and how you can learn to cope with them.

Thought-Action Fusion

People with OCD may believe that simply thinking about something disturbing (such as molesting a neighbor or killing their spouse) is morally equivalent to carrying out the act. They may even believe that if they have a thought (such as getting into a car crash or contracting a serious disease), it means the event will happen—unless they do something to prevent it.

This is called thought-action fusion, and it is one reason that intrusive thoughts are more distressing for people with OCD.

Compulsions & Obsessive Thoughts

Perceiving thoughts as being urgent and important makes a person feel that they must immediately act on or respond to them in the “right” way. A person with OCD may develop compulsions in response to their obsessive thoughts.

Behavioral Compulsions

Behavioral compulsions are actions and behaviors that are used in an attempt to alleviate the distress intrusive thoughts cause. Compulsions can be a little like superstitions for people with OCD. Often, the person recognizes that the behaviors are not rational (this is known as insight), but the fear of what they believe will happen if they don’t perform them is compelling.

For example, a person who obsesses about their home burning down while they are at work might compulsively check that the stove is off before they leave the house every day. When they return home at the end of the day and their house has not burned down, it reinforces the belief that their ritual (for example, checking a certain number of times or checking in a specific order) “worked.”

Mental Compulsions

Compulsions can also be mental. For example, a person might believe that if they do not “think through” or analyze a thought sufficiently, it will become a reality. Thinking about a “bad” thought can also be an attempt to neutralize it or “balance it out.”

In fact, it’s more likely to make a person’s anxiety worse. Perseverating also keeps the cycle of intrusive thoughts and compulsive behaviors going.

Why Thought Suppression Backfires

While you might want to know how to stop OCD thoughts, trying to suppress or eliminate such thoughts can actually backfire. If a person with OCD believes that their intrusive thoughts are dangerous, they may try to closely monitor them. It may feel like necessary vigilance, but the intensity with which someone monitors their own thinking can easily become hypervigilance.

Once a person labels a certain thought as dangerous and becomes hyperaware of it, they can become overwhelmed. When this happens, they might respond by trying to push the thought away.

While it might seem like a good solution, it’s not easy—and it doesn’t necessarily work. Research has shown that thought suppression in people with OCD can lead to the development of more intrusive thoughts.

What to Do Instead of Stopping OCD Thoughts

You can be aware of an intrusive thought without trying to stop it. You can start by trying to recognize that the thought is trying to control you (for example, by making you feel the need to perform a compulsion) and consciously challenging it.

It might be uncomfortable to consider the thought from a distance and resist the urge to perform a ritual. Over time, defusing your obsessive thoughts this way can actually help you feel more in control.

Once you are able to put some space between you and your thoughts, you can start to look at them more objectively. Then, you can figure out what triggers the thoughts and take a closer (but non-judgmental) look at how you react.

Try not to be too hard on yourself or get discouraged during this process. It takes practice to distance yourself from your thoughts. Obsessive thinking is intense and persistent by nature. Sometimes, instructing yourself not to think about a thought only brings more attention to it.

Separating Your OCD Thoughts From Your Identity

Even if you don’t experience thought-action fusion, you likely have to deal with obsessive thoughts on a daily basis if you have OCD. You may feel so overwhelmed at times that you would give anything to stop the cycle.

Although it is easier to say than to believe, thoughts are just strings of words and are not inherently dangerous. You are not obliged to take a thought seriously just because your brain generated it.

Moreover, your thoughts do not necessarily say anything about you. Having a “bad” thought does not mean that you are a “bad” person.

Try to remember that intrusive thoughts don’t always align with your core values, beliefs, and morals. In fact, OCD thoughts tend to attack and focus on the things that offend you. The same can be true for intrusive thoughts that cause fear, which tend to be based on what you are most concerned about (for example, the health and safety of your family).

Handling Guilt and Shame

People with OCD can feel an overwhelming amount of fear and guilt about the intrusive thoughts they experience. They may also experience deep shame, embarrassment, and even self-hatred.

Try to be kind and patient with yourself. Remember that everyone experiences intrusive thoughts at times, and they are not something you are expected to be in control of. It is a good practice to recognize the intrusive thought or feeling you are having, but that does not mean you have to identify with it.

Once you accept that you cannot completely control your thoughts, you can start building the habit of acknowledging them without letting them take control.

Getting Help with OCD Thoughts

If your OCD thoughts are making it hard for you to function at home, school, or work, and you feel that you cannot cope with them, talk to a doctor or mental health professional. While it can be difficult to ask for help, there are treatments for OCD that could help you feel better.

Medication for OCD

Many people with OCD take one or more medications to help them manage symptoms. They may take antidepressants, anti-anxiety medications, or other commonly prescribed drugs for mental health conditions.

Some people with OCD also use herbal or natural supplements to help manage their symptoms. However, it is not always safe to take these products with prescription medications. If you want to try an alternative remedy, ask a doctor.

Therapy for OCD

Several types of psychotherapy can be used to help someone with OCD manage obsessive thoughts. The most common is cognitive behavioral therapy (CBT), specifically an approach known as exposure therapy.

People with OCD are often treated using an approach called exposure and response prevention therapy (ERP). In ERP, you and a therapist will work directly with your obsessive thoughts as well as any associated compulsions. You will use techniques like role-playing situations that cause you distress and talking through your thought process with your therapist.

It might feel overwhelming or frightening to think about confronting your thoughts, but keep in mind that exposure work is done slowly, gradually, and with plenty of support.

Many people with OCD ultimately need more than one type of treatment to effectively manage their symptoms. A doctor or therapist can help you find the combination that works best for you.

Mindfulness for OCD

If you have OCD, mindfulness techniques may help you develop a more objective perspective on your obsessive thoughts. Mindfulness exercises might already be part of your therapy, but you can also try them on your own. There are even apps you can use to track your progress.  

Drive reduction theory suggests that behavior is motivated by the need to reduce physiological imbalances or ‘drives.’ It is based on the idea of homeostasis, or the need to maintain a steady state. When people experience drives such as thirst or hunger, they are motivated to take actions that will restore the balance and return them to a state of equilibrium.

The drive reduction theory of motivation became popular during the 1940s and 1950s as a way to explain behavior, learning, and motivation. The theory was created by behaviorist Clark Hull and further developed by his collaborator Kenneth Spence. According to the theory, the reduction of drives is the primary force behind motivation.

While the drive reduction theory of motivation was once a dominant force in psychology, it is largely ignored today. Despite this, it’s worthwhile for students to learn more about Hull’s ideas to understand his work’s effect and see how other theorists responded by proposing their own theories.

This article explores how drive reduction theory works, criticisms of Hull’s theory, and a few alternative motivational theories that have been proposed.

Overview of Drive Reduction Theory

Hull was one of the first theorists to attempt to create a grand theory designed to explain all behavior. He started developing his theory shortly after he began working at Yale University, drawing on ideas from a number of other thinkers including Charles Darwin, Ivan Pavlov, John. B. Watson, and Edward L. Thorndike.

Based on this idea, Hull suggested that all motivation arises as a result of these biological needs. In his theory, Hull used the term drive to refer to the state of tension or arousal caused by biological or physiological needs. Thirst, hunger, and the need for warmth are all examples of drives. A drive creates an unpleasant state, a tension that needs to be reduced.

In order to reduce this state of tension, humans and animals seek out ways to fulfill these biological needs. We get a drink when we are thirsty. We eat when we are hungry. We turn up the thermostat when we are cold. He suggested that humans and animals will then repeat any behavior that reduces these drives.

Conditioning and Reinforcement

Hull is considered a neo-behaviorist thinker, but like the other major behaviorists, he believed that human behavior could be explained by conditioning and reinforcement.

This reinforcement increases the likelihood that the same behavior will occur again in the future when the same need arises. In order to survive in its environment, an organism must behave in ways that meet these survival needs.

“When survival is in jeopardy, the organism is in a state of need (when the biological requirements for survival are not being met) so the organism behaves in a fashion to reduce that need,” Hull explained.

In a stimulus-response (S-R) relationship, when the stimulus and response are followed by a reduction in the need, it increases the likelihood that the same stimulus will elicit the same response again in the future.

Hull’s Drive Reduction Formula

Hull’s goal was to develop a theory of learning that could be expressed mathematically, to create a “formula” to explain and understand human behavior.

Hull’s approach was viewed by many as overly complex, yet at the same time, critics suggested that the drive reduction theory failed to fully explain human motivation. His work did, however, have an influence on psychology and future theories of motivation.

Criticism of Drive Reduction Theory

While Hull’s theory was popular during the middle part of the 20th century, it began to fall out of favor for a number of reasons. Starting as early as the 1950s, critics began pointing out the flaws in the drive reduction approach.

Lack of Generalizability

Because of his emphasis on quantifying his variables in such a narrowly defined way, his theory lacks generalizability.

However, his emphasis on rigorous experimental techniques and scientific methods did have an important influence on the field of psychology.

Does Not Address Secondary Reinforcers

Unlike primary drives such as hunger and thirst, secondary reinforcers do nothing to directly reduce physiological and biological needs. Take money, for example. While money does allow you to purchase primary reinforcers, it does nothing in and of itself to reduce drives. Despite this, money still acts as a powerful source of reinforcement.

Does Not Fully Explain Behavior

Another major criticism of the drive reduction theory of learning is that it does not explain why people engage in behaviors that do not reduce drives. For example, people often eat when they’re not hungry or drink when they’re not thirsty.

In some cases, people actually participate in activities that increase tension such as sky-diving or bungee jumping. Why would people seek out activities that do nothing to fulfill biological needs and that actually place them in considerable danger? Drive reduction theory cannot account for such behaviors.

Impact of Drive Reduction Theory

While Hull’s theory has largely fallen out of favor in psychology, it is still worthwhile to understand the effect it had on other psychologists of the time and how it helped contribute to later research in psychology.

For example, many of the motivational theories that emerged during the 1950s and 1960s were either based on Hull’s original theory or were focused on providing alternatives to the drive reduction theory.

Alternatives to Drive Reduction Theory

Other theories of motivation that have been proposed include:

• Arousal theory suggests that people are motivated to engage in behaviors to maintain a certain level of physiological arousal. The ideal level varies from person to person, leading people to seek stimulation or relaxation depending on what they need.
• Maslow’s hierarchy of needs emerged as an alternative to Hull’s approach. and suggests that human behavior is motivated by certain physiological and psychological needs. These needs begin with the most basic and progress to more complex ones.
• Incentive theory proposes that behaviors are motivated by external incentives. It suggests that what we do is directly influenced by external rewards. For example, you study to get a good grade or put in extra effort at work to receive a bonus.
• Self-determination theory suggests that people are motivated by the need to experience autonomy, competence, and connection. People want to feel in control of their actions, strive to become skilled in those actions, and need to experience a sense of belonging.

Other researchers have proposed a modern reformulation of Hull’s ideas that remedies some of the original theory’s failings.

Animals can offer an extraordinary amount of emotional support. Beyond the pet-owner relationship that many of us have lovingly experienced, animals are sometimes used in therapeutic settings to help clients navigate challenging emotional experiences.

What Is Equine Therapy?

Equine-assisted psychotherapy incorporates horses into the therapeutic process. People engage in activities such as grooming, feeding, and leading a horse while being supervised by a mental health professional.

Goals of this form of therapy including helping people develop skills such as emotional regulation, self-confidence, and responsibility. With mature horses weighing anywhere in the range of 900 to 2,000 pounds or more, it might feel a bit intimidating to have such a large, majestic creature participating in your therapy sessions.

However, equine-assisted therapy is growing in popularity due to its experiential approach and some burgeoning evidence of its effectiveness. There are a variety of terms used to describe or reference equine-assisted psychotherapy, including:

• Equine-assisted mental health
• Equine-assisted counseling
• Equine-facilitated psychotherapy
• Equine-assisted therapy

The last term, equine-assisted therapy, can also often refer to other forms of therapy where horses are used, such as with occupational therapy.

History of Equine Therapy

Horses have been used for therapeutic purposes since the time of the ancient Greeks. The Greek physician Hippocrates, known as the “Father of Medicine,” wrote about the therapeutic potential of horseback riding.

Riding became more popular as a therapy tool during the 1950s and 1960s. In 1969, the North American Riding for Handicapped Association was formed, which later became the Professional Association of Therapeutic Horsemanship (PATH) International.

Who It’s For

Equine-assisted psychotherapy (EAP) can be used with a variety of populations and in a variety of therapeutic settings. In fact, horses can be used in counseling with individuals of all ages, even with families and groups.

Offering a much different experience than traditional talk therapy, EAP brings people outdoors and offers an opportunity to use all senses while learning and processing through emotional challenges.

Children and Teens

Equine facilitated psychotherapy may be just as effective with children and teens as it is with adult clients. As with adults, children can experience challenges such as trauma, anxiety, depression, PTSD, and more.

Equine therapy offers them a therapeutic environment that can feel less threatening and more inviting than a traditional talk therapy office. The majority of children participating in EAP are between the ages of 6 to 18 years old.

Children often find it difficult to open up and process painful emotions and experiences. Equine-assisted psychotherapy allows youth, and people of all ages, to work on issues such as:

• Assertiveness
• Confidence
• Developing and maintaining relationships
• Emotional awareness
• Empathy
• Impulse control
• Problem-solving skills
• Social skills
• Trust in others
• Trust in self

Benefits

Although a variety of animals can be used in the psychotherapeutic process, horses offer unique traits that have made them a top choice for animal-assisted therapies. According to anxiety expert Dr. Robin Zasio, horses bring the following unique elements to the therapy process.

Non-Judgmental and Unbiased

As much as humans, especially therapists, do our best to offer a safe space for clients to explore deep emotional hurts and painful experiences, it can be uncomfortable for clients to openly share their thoughts.

Having the horse present may offer a sense of peace, as they only will react to the client’s behavior and emotions with no threat of bias or any judgment of their emotional experience.

Feedback and Mirroring

Horses are keen observers and are vigilant and sensitive to movement and emotion. They often mirror a client’s behavior or emotions, conveying understanding and connection that allows the client to feel safe.

This also allows for clients to maintain a sense of self-awareness, using the horse’s behavior and interactions for feedback and opportunities to check in and process what is happening in the moment.

Managing Vulnerability

As clients might find themselves vulnerable when trying to open up about emotional challenges, past experiences, or life transitions, the horse can offer a reference point to use for processing.

If something feels too painful to speak of, it can feel a bit easier for clients to process using the horse as an example, or to align their experience with the horse’s experiences in the moment. Externalizing the content in this way can make things easier to approach and process through.

Other Benefits

Some other potential benefits of equine therapy include increased:

• Adaptability
• Distress tolerance
• Emotional awareness
• Independence
• Impulse control
• Self-esteem
• Social awareness
• Social relationships

Horses also require work. They must be fed, watered, exercised, and groomed. Providing this type of care can often be therapeutic. It helps establish routines and structure, and the act of caring and nurturing something else can help build empathy.

Conditions

Equine therapy has some evidence supporting its effectiveness in helping to manage several conditions.

Anxiety

Anxiety disorders affect more than 17 million Americans. Although most people experience some level of anxiety at points in their lives, especially around experiences involving change and uncertainty, there are times when people experience anxiety that meets clinical diagnostic criteria. Anxiety-related conditions include, but aren’t limited to:

Many people who struggle with anxiety find themselves stuck in worry about their past and fear about their future. As Dr. Zasio points out, working with a horse during the therapeutic process can create an opportunity for clients to “stay present and focused on the task at hand.”

Since horses are vigilant and sensitive to behavior and emotions, they can sense danger and respond with a heightened awareness, which typically leads to a change in their behavior and possible attempts to get away. Clients who struggle with anxiety can relate to this ability to sense danger cues and respond in a heightened way.

Another benefit of using equine-assisted psychotherapy in the treatment of anxiety is helping clients practice vulnerability in a safe environment. As clients learn to interact with the horse and try new things, they are being asked to step out of their comfort zone with the help and support of the therapist and the horse.

Clients can then process their experience, such as the fears and challenges, as well as any insights, discoveries, or victories in those moments during therapy.

PTSD

Post-traumatic stress disorder (PTSD), a disordered marked by increased arousal and reactivity, intrusive memories and nightmares, and avoidance symptoms after a traumatic event, can feel debilitating. According to the Anxiety and Depression Association of America (AADA), it is estimated that 7.7 million people aged 18 or older struggle with PTSD.

Children, teens, and adults can struggle with PTSD. Although people can experience a variety of traumatic events that could influence the development of PTSD, those who have experienced sexual assault, as well as veterans who have experienced combat, are populations who tend to have higher rates of the development of PTSD.

Tess Hassett, a riding instructor at the Northern Virginia Therapeutic Riding Program, has a background in clinical psychology and is working with veterans using EAP.

Describing her work with veterans, Hassett noted, “A lot of them have said that after what they’ve been through with their PTSD and depression, they never thought they’d be able to bond with someone again and feel that personal connection. But with their horse, they’re feeling that connection. They’re able to take that into the rest of their lives and into their relationships.”

Addiction Treatment

It is known that drug and alcohol addiction continues to rise and be problematic in the United States. The Center for Disease Control and Prevention (CDC) estimates that over 70,000 people died from a drug overdose in 2017.

Many of those were a result of the opioid epidemic, with almost 50,000 deaths occurring as a result of opioid use. The need for effective therapies to help treat addiction is at an all-time high.

Equine-assisted psychotherapy offers a unique approach to treating addiction and co-occurring conditions. A co-occurring condition, which used to be referred to as a dual diagnosis, describes someone who struggles with addiction in addition to having another mental health condition—a common occurrence.

The ultimate goal of addiction treatment is to help clients live sober, healthy, and productive lives. Many times in addiction treatment, clients are also working hard to heal hurts within relationship dynamics, such as within a family or with their partner. Learning to trust, practice vulnerability, and communicate effectively can be a challenge during this treatment process.

ADHD

Attention-deficit/hyperactivity disorder (ADHD), is an additional area where equine-assisted psychotherapy can be helpful. Some report EAP is appealing to adults and youth with ADHD because it offers them an active, fun, and hands-on experience.

During equine-assisted therapy, the client is typically with a trained therapist, an equine specialist, and the horse. Riding isn’t necessarily involved with equine-assisted psychotherapy. Rather, the focus is on presence, attention, mindfulness, boundaries, social cues, and more.

Kay Trotter, PhD, a licensed professional counselor, author, and founder of Equine Partners in Counseling (EPIC) Enterprises, was one of the first to dedicate research to the effectiveness of equine-assisted psychotherapy.

Her study was one of the first published on the effectiveness of EAP, published in the Journal for Creativity in Mental Health. It has been shown that clients can experience a variety of benefit from equine-assisted psychotherapy, such as:

• Increased in self-esteem
• Increased in self-respect
• Improved adjustment to routines and guidelines
• Improved focus
• Less stressful friendships
• Reduced aggression

For clients struggling with ADHD, the sense of accomplishment in an equine-assisted psychotherapy session can be of great benefit. As a licensed clinical social worker, Kit Muellner says that “clients feel that they’ve achieved something on their own, rather than being told to do something by a parent or teacher.

A 1,500-pound animal responds the way you want him to because you were able to focus. So you’ve accomplished something you wanted to do, versus something that somebody else wanted you to do.”

This sense of accomplishment can feel significant for anyone, especially someone who struggles with ADHD. In those moments, they are getting instant feedback from their horse and learning how to develop trust, communicate effectively, and how to work toward meeting a personal goal or milestone.

Equine Assisted Therapists

The Equine Assisted Growth and Learning Association (EAGALA) is a non-profit organization dedicated to setting the standard for professionals working with horses in a therapeutic setting. They offer training and have established a specialized certification process for those wishing to become a recognized, trained equine-assisted therapy professional.

In addition to EAGALA, there are other programs dedicated to proper training and maintenance of standards for those working with clients in the field of EAP.

Equine-assisted therapy is a particular style and specialization within the field of psychotherapy, with clinicians seeking and earning special training and certification related to the practice of EAP.

Things to Consider

There are some factors to consider when deciding to explore equine-assisted therapy for yourself or a loved one. Always take physical ability and overall health into consideration. If you have scoliosis, spina bifida, or another back-related health issue, talk to your doctor before trying equine therapy. 

Timing

Depending on the challenges the client is facing, the timing may or may not be appropriate for EAP. For example, when someone is faced with addiction, they will need proper time to detox and establish compliance with an appropriate treatment program before possibly incorporating equine-assisted therapy services.

Fear

Although equine-assisted therapy has been shown to be helpful in the treatment of anxiety, a client may fear being around a large horse and not feel motivated to attend this type of treatment. There may also be a traumatic memory involving animals that would prevent someone from being willing to participate.

Cost

Because equine-assisted psychotherapy is only more recently growing in popularity and gaining traction as an effective treatment for mental health and substance abuse, keep in mind that this service may not be covered by insurance benefits.

The fees for EAP services will vary by location and can range in price. It is recommended that you contact your insurance company and your local equine therapy facility to discuss those details in advance.