Fieldwork

Upon obtaining official permission, the researchers started the patients’ recruitment process according to the eligibility criteria. A total of 150 patients were screened, and of these 100 were enrolled. They were asked to fill in the data collection forms. The filled forms were collected by the researchers and reviewed for completeness. The patients were then randomized into the equine-assisted therapy intervention group and the control group.

The intervention group patients received weekly equine-assisted therapy 40–60 min sessions over a period of 6 weeks in addition to their standard regular therapy. In the frst session, the researchers gave a presentation of the program’s aim and objectives, its sessions, as well as the procedures to be followed throughout the intervention. The second to the sixth sessions were practical sessions. An equine therapy session typically consists of specific tasks and challenges to overcome, with the aid and guidance of horses. There is no riding involved and no specific skills are necessary to take part in these sessions, e.g., the session might involve the patient successfully leading the horse from one spot to another, or putting a halter on the horse, grooming, or feeding. By the end of the session, the patient discusses with the therapist what ideas and thoughts he/she used to complete the task. Once the session ends, the patients along with their therapists reflect on the experience and the emotions that were evoked by the interaction.

The control group had the same standard regular treatment modalities with the only exception of not having the equine-assisted therapy. At the end of the intervention, all patients in both groups were asked to fill in the self-administered questionnaire in order to assess the effectiveness of the equine-assisted therapy. Thus, data were collected at two points in time. To compensate for the potential bias of the open-label design where the intervention (due to its nature) could not be concealed from the patients and the researchers, blinding was applied during the processes of data collection and analysis. Therefore, the data collectors who dealt with the patients and the data analyst did not know whether the information came from a patient in the intervention or in the control group. The fieldwork lasted from February to July 2022..