An innovative way of working to improve the emotional health and well-being of young people
Client group: NHS Child and Adolescent Mental Health Services (CAMHS) Residential Unit – Greater Manchester
Young people attending a Residential Mental Health Unit in Greater Manchester have a wide range of emotional issues. The charity HorseHeard believed that introducing the young people to a different intervention could have positive impacts and bring benefits to this group. Consequently, HorseHeard developed a four week programme, ‘Me, Myself and I’. This used Equine Facilitated Learning, a coaching tool to develop life skills such as emotional resilience, using practical activities with horses on the ground.
The young people enjoyed the programme and reacted to it positively. They highlighted a number of qualities they had developed or improved as a result, including:
Horses are herd animals and as such are strongly aware of the energy, intentions and non-verbal communication of others and also being prey animals they are constantly sensitive to their environment and those around them. Horses respond without judgement, providing an instantaneous truthful reflection of how the young person is in a given moment. Trained facilitators use these qualities in the horses as a sounding board to encourage self-awareness, confidence and self-esteem in young people.
Using Equine Facilitated Learning enabled the team to create a safe environment for the young people to spend time around horses. In turn this made the young people feel comfortable and encouraged them to share feelings and emotions around new situations, experience being out of their comfort zone and challenging themselves to do something unfamiliar. It also gave them the opportunity to try out new behaviours, get immediate feedback and reflect on their learning.
This programme involved the young people completing an initial questionnaire to identify positive personal qualities they recognised in themselves, and additional qualities they would like to improve or develop in order to feel happier and live life more fully. This individual feedback was then used by the team to decide what activities with the horse would benefit each young person.
The exercises set by the facilitators are simple and varied, the magic happens when the individual young person is with the horse and the horse mirrors back to them behaviours they are not even aware of. An example would be one of the young men was asked to go for a walk with the pony and the pony wouldn’t move. The discovery was he had to believe he could do it – the pony walked with him the minute he did. There was a real sense of achievement in completing the tasks and new learning.
A key aspect was to take these learning moments with the pony to enable the young people to continue to work on their own challenges outside of the HorseHeard session. A great example was a young woman who had not been joining in classes, but found how much she had enjoyed the ‘horsey experience’. In setting a task to do from one session to the next she chose to try something else new, she not only attended an art class but produced a painting of our mascot Aitch Aitch! She said: “It gave me confidence to do other things in the future”.
The following quotes also demonstrate some of the positives they took away:
“I was surprised that I could connect with the horses so quickly and take control”
“It made me think if I can take control here of the horse, what else can I take control of”
“The programme had taught me the importance of being clear to my team members”
“It has encouraged me to try new things”
“To be more confident in myself, by speaking louder”.
The effectiveness of the programme was also evaluated by using the Warwick Edinburgh Mental Well Being Scale (WEMWBS) a questionnaire using a 14-item scale covering subjective wellbeing and psychological functioning used by public health professionals. See https://warwick.ac.uk/fac/med/research/platform/wemwbs/
The WEMWBS score for the whole group increased, suggesting that mental wellbeing meaningfully improved over the course of the programme. However due to the small group number and the fact that not every young person attended every session, this cannot be seen as statistically reliable.
When looking at the items of the WEMWBS individually, all seven young people felt they had improved or remained the same in relation to the following items:
I have been dealing with problems well
I have been feeling good about myself
I have been feeling more confidence
I have been interested in new things
Support staff attending the programme with the young people felt the project had been successful in terms of observing changes to the young people in that moment. They were then able to use their observations to support the young people in other situations, which were unfamiliar or challenging. Reflecting on their achievements with the horses, staff also witnessed moments of joy and learning whilst also being carefree teenagers having fun together.
Staff also noted a positive change in their motivation, such as being up and ready for the session, taking medication and being prepared to head to the stables. The group left at 9.10am every week and this was during the school holidays and was a great achievement for some!
An Occupational Therapist from another CAMHS Unit observed the final session of the programme, she said: “I really enjoyed the experience, in particular seeing the young people’s confidence grow and linking it to their personal goals i.e. go to college, ask others for help, speak louder, communicate more effectively, control one’s own thoughts. They were so focused – the young people and ponies were very much in tune! It was brilliant.”