Combat Veterans diagnosed with posttraumatic stress disorder (PTSD) represent a vulnerable population that requires effective psychotherapeutic interventions. However, not all established treatments are universally effective for the estimated 20% of Veterans diagnosed with PTSD. A need for innovative approaches to manage symptoms of combat-related PTSD has been suggested in order to support traditional psychotherapeutic methods. Consequently, therapists have embraced complementary and alternative interventions for Veterans that include equine facilitated/assisted psychotherapy (EFP/EAP). Therapists who include EFP/EAP have agreed that interacting with horses in a therapeutic environment can have a positive impact on the health and behavior of individuals experiencing symptoms of PTSD. This descriptive phenomenological study, pursued through a common factors lens, explored the lived experiences of five licensed/credentialed mental health professionals who included EFP/EAP with Veterans diagnosed with PTSD. Semi-structured face-to-face interviews were conducted with participants selected from the East and West Coasts of the United States. The research questions addressed why therapists chose to include the EFP/EAP intervention, how they conceived the EFP/EAP treatment as efficacious for Veterans, and how the common factors of the client, therapist, and collaborative relationship, in addition to specific factors, were reflected and involved in the EFP/EAP therapeutic process. Therapists' descriptions revealed seven major themes: "The horse-human relationship," "Building trust," "It engages people both mentally and physically," "From the beginning," "Nonverbal communication," "Emotional safety," and "A faster vehicle." Additionally, therapists' descriptions supported the common factors paradigm in psychotherapy. Findings indicated that therapists in this study chose EFP/EAP as a treatment option for Veterans diagnosed with PTSD because qualities of the horse evoked positive past subjective experiences in the therapists, the EFP/EAP intervention supported their primary theoretical orientations as psychotherapists, and the horse and its environment can address treatment goals relevant to behavioral and psychosocial difficulties in Veterans' lives. A recommendation for future research is for larger, international studies that explore the viewpoints of therapists who practice equine therapies in other countries in order to expand the knowledge base and address the competency and standards discussion in the EFP/EAP field.
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