Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Wednesday, February 9, 2011

Clever Hans Rides Again: Equestrian Therapy for RAD?

Do you remember Clever Hans (or Kluge Hans without translation)? This early- 20th- century performing horse almost certainly turned up in your introductory psychology textbook, if you had one-- and he’s usually seen in sociology and education books too. Hans, a handsome stallion, was exhibited by his owner because he could do arithmetic. The owner would ask audiences to present Hans with arithmetic problems. (These were simple number problems, not compound interest or anything very serious; still, they were more than you’d expect of the average horse.) Hans would listen, and then stamp out the answer with his forefoot: 22 + 11= 33 stamps. The owner had no idea how Hans managed this.

Careful observation, of course, showed that Hans really couldn’t do arithmetic. Instead, his owner, unaware of his own actions, was signaling to Hans by tiny movements when to stomp and when to stop. If the owner didn’t know the answer, Hans couldn’t do that problem.

The message that textbooks have passed on from Clever Hans is that it’s all too easy to influence behavior and to bias the results of an experiment, even if you are trying to be perfectly honest. That’s one of the reasons why people like me keep on and on about the (admittedly dreary) rules of empirical research. It’s also why we find it so difficult to accept personal experiences as evidence, in the absence of more reliable information.

But here’s the real reason I thought of Clever Hans today. I received an e-mail from a colleague, giving me another e-mail from a person I don’t know. (I’m not going to name either of these people, so I can’t cite a source on this one.) The two of them had been discussing the “fringe” child psychotherapy called Attachment Therapy and the fact that a leader in that treatment was going to run a “camp” in their state. One of the correspondents, a conventional psychotherapist, noted that she had a child patient who attended “equestrian therapy” sessions recommended by Attachment Therapists for children with Reactive Attachment Disorder. The treatment was paid for by the state family services department. The therapist recounted the story told her by this child and the child’s mother:

“The instructor reports herself as having been a RAD kid [that is, she believes she had reactive Attachment Disorder as a child]. She puts kids on different horses because each horse can perceive what the child is thinking and feeling. Then she stops the horse and asks the child ‘Is there anything you need to tell me?’ According to the parent of my client, the horse nods his head ‘yes’ if the child lies. Then they pry until the child tells the truth. She has told my client that she [the child] does not have bipolar disorder (she has [five diagnoses] and is on medication and was in residential [treatment] for 2 years but is instead ‘just RAD’. … She keeps nagging my client to talk about her childhood (client is adopted) and client refuses. My client told her, ‘You are not my therapist’. The instructor told her, ‘When you are here I am your therapist.’ She also has client do her dishes and light housework as client likes to hang out there after school. This instructor referred them to a RAD group in [a neighboring town]. “

It would appear that family services ought to be paying for this treatment in oats and sugar lumps, as the horse is supposed to be a co-therapist! But, folks, let’s think it through. Clever Hans couldn’t really do arithmetic. Can this therapy horse actually tell whether someone is lying? Isn’t it more likely that a signal, possibly unintentional, from the instructor, determines whether the horse nods or not? And what is the effect on the child’s trust in other people and understanding of the world when she’s informed that horses know whether you tell the truth? If a family chose to pay for this experience on their own, there’s little anyone can or perhaps should do about it. But how is it that public money can be spent on such an enterprise?

Here is a list of my concerns. 1. Obviously, the instructor is not being truthful about the horse’s behavior, although I suppose she may think she is. 2. The instructor does not understand the differences between her training and abilities and those of a professional; this is why we have licensing and supervision. 3. The instructor is taking advantage of her position to make inappropriate statements contradicting the information the family has received from knowledgeable persons. 4. The instructor wants to be in the position of a therapist, but lacks understanding of professional ethics, as we see in her dual relationship with the child; it is not suitable for her to allow the child to hang around, and certainly not for her to put the child to work. A neighbor might do this, but a professional therapist would not. 5. The instructor appears to believe that her own childhood experiences are relevant and appropriate information to disclose to clients, whereas they are neither. 6. The instructor makes the common mistake of assuming that all emotional disturbances have a background in early childhood. 7. Equestrian therapy was devised for children with physical disorders like cerebral palsy, who benefited from the stretching involved; that does not mean that all disorders of mind and nervous system can be treated this way.

My horse says this is a bad deal.

12 comments:

  1. Unreal.

    Although I can see the value in equestrian therapy for help in coping with emotional issues as well as physical issues, what you describe more resembles a snake oil salesman.

    Horses are very smart and I believe intuitive in a way, but they're not THAT smart, or psychic!

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  2. It wasn't just Hans' owner - anyone who knew the answer to the question could be "read" by him. If no one knew the answer, or there was no one there to read, he never stopped tapping.

    I still think that was an impressive thing for a horse to learn.

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  3. What I wonder is, what signals this therapy horse to nod? Does it always nod, or just occasionally? Does it sometimes lower its head spontaneously, and then with the right cue, like Hans, keep on doing it until the signal says to stop?

    I certainly agree, this is an impressive thing to learn, and I'd love to know how many animals have learned things like this that we never hear about.

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  4. Just a quick comment about this post - This was a complete waste of time...Not only for me to read it but for whoever wrote it. Jean knows nothing about what she's talking about here and is giving advice about something she has never personally studied or observed. I know the people who she is writing about in this article and know the "client" and her mother said nothing even remotely close to what is being reported. If the child reported anything out of the ordinary it was, in my opinion, the testament of a RAD child who is playing her therapist to the max...therefore the conclusion is irrelevant.
    To answer Jean Mercer's question: The horse nodded its head just the one time, and therefore should not really be compared to Clever Hans. We are not talking about an intelligence that can decipher or come to any grand conclusions here; it’s about a special sense, a “horse sense.” There are other reactions by the horse that may or may not indicate "something's wrong" but have to be accessed one at a time. Not all can be figured out to what the horse is trying to tell. Also, some responses from these magnificent animals are not always in the negative.
    It might not be an exact science but because Jean can't explain it, she assumes it must be bogus. I've personally seen the results of this form of therapy and you can call it what you want, but it works and it has worked in this situation better than any councilor or therapist has ever been able to do for that child in over 15 years. It would do anyone good to investigate it with an open mind. I was a skeptic once, and within 1 hour of watching this program in action I definitely wanted to see and know more.
    By the way, I know because names were not given in this example, it does not violate any confidentiality laws that protect the client and the family but this is about as close to it as you can come. The parents and the client feel violated and betrayed by its contents. This information was given in the strictest confidence that it would be used to support the program and not defile it; in other words they were tricked into telling how they felt about it and then misquoted or misunderstood.
    You criticize the instructor for not being professional but then you wrote this to slander him/her without a lick of evidence. You should get off your high horse and get with the program. I have more to say but want to wait until Jean’s Colleague can be contacted by the parents of this child to find out why she would give a report like this, when she knows how far her client has come in the past year because of it. Until then, you shouldn’t come to any conclusions on this matter until you have all the facts and all the information pertaining to the case…which I doubt will ever happen if I have anything to say about it!

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  5. Hmmm. You really think the horse makes a decision? I would certainly like to hear more about that.

    But if you're positive you know what's going on, why don't you want me or other readers to know? Surely, if you're right, the more information we have,the more convinced we'll be.

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  6. Was the "high horse" part an intentional joke?

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  7. First I want to say that I don’t think I said the horse made a decision. Well, at least not a decision like a human would. Yes these horses respond to stimuli, but not in the way you are comparing to Clever Hans. Second, I didn’t say I didn’t want you to know more about the program, in fact I encouraged it. I merely stated that you were not going to know any more about the particular case mentioned if I had anything to do with it.
    At this point however, I would fear to tell you anything I know or understand just because I feel you would pick it apart and I really don’t want to try to debate with you on this subject any more than I have to. Partially because I don’t know if I am qualified to give you a correct response or what it would take to convince you otherwise; but mostly because I don’t feel you are open minded enough. However if you do want to know more, I would dare say the thing that would convince you the most would be the horses themselves...after all that’s how I saw the light. With that said though, I want to make sure you realize or understand that I have only been witness to one of these programs and so cannot say all of them are ran the same (or get the same results.) Anything I have said thus far is solely based on the experiences I have had and seen.
    I do understand however this particular program is working for many RAD people (and not just children.) I don’t know if I could fully explain it or not, but this I do know, IF the instructor is giving signals to the horses as you presume is happening then you better give the instructor more credit than you have been, because whatever it is – it’s working. But for the record, I am convinced the instructor is not giving deliberate signals of any kind to manipulate the horses into reacting in a specific way. Remember I was a skeptic once and was watching for anything out of the ordinary such as that.
    Thanks

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  8. I have a lot of questions for you. How are you, or whoever it is,diagnosing RAD, especially in adults? And what evidence can you provide that there's improvement in something following the treatment-- what I presume you mean when you say "it's working"?

    As for deliberate signals, no, of course that was not implied. There's no need for it to be intentional.That's why a careful investigation is needed before you make this claim about effectiveness.

    I don't question that a pleasant experience like riding can be helpful, and the social connections with people and animals also beneficial for kids who have been having a hard time. But that's a very far cry from saying that this is an effective therapy for treatment of a specific problem.

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  9. Well, that’s what I meant by picking it a part - Thanks for not letting me down. I guess I deserved it though after I went against my better judgment and went too far with my last response. Let me reiterate: I have no credentials and as I stated, I’m probably not qualified to respond to your questions. I only want your “followers” to know that your opinions on this matter are merely biased and this type of treatment can be, in my opinion, worth looking into more carefully. If it’s absolute proof you need then I don’t know if it exists. Although there are studies out there on the web concerning the effectiveness of Equine/Riding Therapy for RAD patients, here is a link to one such example: http://www.attachment.org/pages_therapists_equine.php/
    I understand your concern is about a program that isn’t state certified or approved; and that you wouldn’t endorse one without proof of its success. I don’t blame you for that, however without breaking confidentiality I can’t or won’t provide anything to substantiate what I’ve seen; so you’ll just have to take my word for it. At the risk of going over the line I will say this though: My understanding is simple; I’ve seen a person who was so defiant the parents of this child were at a breaking point. The child’s behavior was out of control and state authorized facilities and counselors were not helping.
    With the advice of the child’s case worker who had heard of a local “Horse Therapy” program having some success, they decided to try it. Being a nontraditional method, some conditions had to be set up where the parents paid part of the fee and it would be monitored for progress in a reasonable amount of time. Within a few months they were seeing some encouraging results, even the child was happy with what was going on and was relieved from feeling negative and contentious. The child looks forward to therapy where it was rejected before. Is it perfect? Are there better programs? Is it for everybody? I don’t know. The important thing is the state, the parents and the child are all happy with the outcome thus far.
    If using the word “therapy” offends you because neither the horses nor the instructor are certified then I will be happy to use different terminology – Behavioral Adjustment Program comes to mind. It seems to me that you’re upset at the fact the instructor has not been to school and paid her dues, perhaps like you felt you had to do. I would assume in order for any program to get “authorized” by the government, it would mean making some changes according to how the government would require it should be done. How can anything be proven if techniques are being changed only to satisfy the uncertain?
    As for Adults having RAD, I don’t see how you can deny a child can just grow out of a disorder such as this. Yes, maybe they can learn to control or repress it, but outgrow it? I don’t think so…again, my opinion. If you don’t believe RAD is a real illness (I know some don’t,) then I don’t know what to say. As for diagnosis, I have to take the word of those few I’ve associated with that they or their family member actually have been diagnosed by a real doctor. All I know is there are a bunch of adults that go to this place and ride every week because it helps them deal with their “RAD” better.
    As far as I’m concerned I’m done with this…I know you’ve probably never had someone so determined to go against what you believe in and you might just be a bit defensive about it. That’s okay, I understand. Let’s just get to the part where we agree to disagree. I told you I didn’t want to debate this but you persisted. I only want you to understand I do NOT have anything vested into this program or the instructor. I am merely a bystander who believes in the program and would be happy to help in any way I could to see it succeed. Right now, I only see you as a deterrent that will say or do anything to sabotage it. If this program is to fail, it will fail on its own, without any help from you or your misleading remarks.
    Thanks

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  10. M.-- you do realize, don't you, that Terena Thomas' statements contain no evidence other than that she and Nancy T. think it's a great idea?

    I said nothing about whether people who actually have Reactive Attachment Disorder as children still have it as adults. I said, there's no protocol for diagnosing it in adults, so there's really no point trying to claim that adults with RAD have been treated effectively in this way. There would be no way to know whether they had or hadn't.

    My concern here is with the possibility, even probability, that something harmless but ineffective is being sold as a treatment, and is consuming the time and resources of families that may need effective help. I don't enjoy seeing troubled families inveigled into this kind of thing, when genuine help is available.

    But you're not unique in the kind of claims you make-- lots of people like to argue that what they think must be right, whether they can provide any evidence for it or not.

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  11. Jean, what you describe as equine therapy is like nothing I've ever heard of, and I have been practicing it for years. And yes, I am a licensed and highly trained pscyhotherapist. It seems you are painting an entire field (pun intended)with one very narrow brush. You really should educate yourself otherwise you sound very close-minded and old fashioned "If the earth is round, how come it looks flat!?" Thousands have benefited from equine-assisted therapy.

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  12. Perhaps you need to tell the people I referred to that they are not doing it the right way.

    Meanwhile, can you tell me where the evidence has been published showing that thousands have benefited? I'm so old-fashioned that I pay a lot more attention to peer-reviewed professional journals than to anecdotes.

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