Man O War Project
Dr. Yuval Neria
Dr. Yuval Neria, Professor of Medical Psychology at Columbia University, Director of the PTSD Research Center
Dr. Prudence Fisher
Dr. Prudence Fisher, Associate Professor of Clinical Psychiatric Social Work at Columbia University

STUART S. JANNEY III: For years, The Jockey Club has worked to help Thoroughbreds when their racing and breeding careers come to an end. We have funded and supported numerous initiatives with this goal, including the Thoroughbred Incentive Program, the Thoroughbred Aftercare Alliance, the Thoroughbred Charities of America, and the Thoroughbred Retirement Foundation.

In 2015, Ambassador Earle Mack approached The Jockey Club with something different, a project called the Man O War Project, that was to be the first university-led research study to examine the effectiveness of equine-assisted therapy in treating veterans with post-traumatic stress disorder.

The Jockey Club wholeheartedly agreed to help fund the study. Not only will it help our veterans and others with PTSD, but equine-assisted therapy is a wonderful job for retired Thoroughbreds.

Dr. Yuval Neria, who led the Columbia team on this study, and Dr. Prudence Fisher are going to share with us some of the fantastic results derived from the study and the importance of using horses to help treat PTSD.

DR. YUVAL NERIA: Its an honor to address the Thoroughbred industry today at this prestigious round table. Im here with Dr. Prudence Fisher with whom I direct the Man O War project at Columbia University Irving Medical Center.

Ill start with a short video to give you a feel of what we are about.

[VIDEO TRANSCRIBED]

AMBASSADOR EARLE I. MACK: The suicide rate for veterans is 22 veterans a day commit suicide because theyve given up all hope.

DR. YUVAL NERIA: We used to think that we need to target our treatment directly to the traumatic memories. We dont do that when we treat patients with horses.

DR. PRUDENCE FISHER: Horses are big mirrors, and they pick up what people pick up. And the veterans get that.

DR. YUVAL NERIA: We see improved mood, we see reduction in depression. This is really changing the life for many, many veterans.

AROCH BOLANOS: My expectations were very low, Im not going to lie. But once I started the program, I started noticing the differences. I wasnt angry. I felt it was working.

[END VIDEO TRANSCRIPTION]

DR. YUVAL NERIA: The Man O War project was borne out of Ambassador Earle Macks concern about the mental health crisis facing our veterans, veterans who suffer high rates of suicide and PTSD. Earle was also interested in the aftercare of racehorses. So Earle came along to Colombia to see if he could entice researchers to find out whether equine-assisted therapy, or EAT, actually worked and whether it may be a good fit for retired service.

Thats where David Shaffer, Prudence, and I came in, and the Man O War project was born.

DR. PRUDENCE FISHER: Well, right away we found that there are lots of equine programs, many for veterans, and lots of claims for its benefits. But there was no research whatsoever.

DR. YUVAL NERIA: We worked with experts in psychotherapy, experts in PTSD, and with EAT providers to create the first standardized protocol for delivering EAT to veterans with PTSD. And we published a paper about the protocol development in January 2020.

DR. PRUDENCE FISHER: We then did a clinical trial with the help of 63 veterans with PTSD, and for that we used the same rigorous assessment methods we used for other psychiatric treatment studies.

Now, this was an open trial. Open trials are the first step when youre testing a new intervention, and theyre used to look for a signal that it likely works. And the signal was there. We were very pleased with our results. As you can see from the graph, there was significant improvement in both the symptoms of PTSD and for the symptoms of depression.

DR. YUVAL NERIA: The improvements were seen in both expert clinician ratings as well as on questionnaires filled out by the veterans themselves. And unlike other treatments for PTSD where many patients drop out, only five patients failed to complete the protocol.

DR. PRUDENCE FISHER: This is actually amazing for any PTSD treatment. In fact, the veterans wanted the treatment to continue beyond the eight-week program. The results from this study are about to be published at the journal of clinical psychiatry.

DR. YUVAL NERIA: After the clinical trial was well underway, we added the brain imaging MRI scan component, another first for the equine field. We had 19 of the patients underwent MRI before and after treatment, and the findings were very interesting.

We saw measurable changes in the brain, both in function and structure, over the course of the eight-week treatment. The areas that changed the most were those involved in the capacity to seek and experience pleasure. Because people with PTSD are frequently depressed and lose their ability to enjoy life, our findings are extremely encouraging. We published these findings this February.

DR. PRUDENCE FISHER: As you can tell, were really pleased with what weve accomplished so far with the veterans. And were excited to take this work to the next level.

So where do we go from here? We plan to capitalize on our work thus far by creating the Man O War Center at Columbia University, and its mission will be to advance the promising field of EAT. The center will coordinate and carry out many initiatives that further our work. So what are the goals of the new center?

DR. YUVAL NERIA: Currently we have four. One is to provide training to others in the field. Over the last two to three years, we have been approached by many programs who are eager to learn from us and implement our protocol.

DR. PRUDENCE FISHER: We collaborated with the Professional Association of Therapeutic Horsemanship, known as PATH, and, under a grant from the Bob Woodruff Foundation, took our first stab at training others on the EAT protocol we developed. Well be making the revised manual available to the EAT field at large, and we will start offering comprehensive training by our own team from this fall.

DR. YUVAL NERIA: Second, we plan to adapt our protocol for use with other groups, beyond veterans with PTSD, for example, children and adolescents and also others. With support from Ambassador Mack, this fall well be carrying out a pilot study with anxious youth.

DR. PRUDENCE FISHER: Third, to continue our research on the original protocol by undertaking a randomized control trial. Now, this would be a larger study, and we plan on partnering with other sites that we will train to make it work.

DR. YUVAL NERIA: Finally, a critically important part of our mission is to expand the number of retired Thoroughbred racehorses that are used in the EAT programs. Suitable Thoroughbreds can make wonderful partners in equine-assisted therapy because they are intelligent, theyre quick learners, theyre reactive, and, frankly, beautiful and majestic creatures.

DR. PRUDENCE FISHER: One of our star equine participants in the original study, a great favorite of the veterans, was a retired racehorse named Crafty Star, who ran 37 times over his four-year career.

Crafty was eventually adopted by the Bergen Equestrian Center in Leonia, New Jersey, where he found his way into the Man O War program and a new rewarding life.

We are proud to partner with the Thoroughbred Aftercare Alliance to connect groups trained in the Man O War protocol with accredited Thoroughbred aftercare facilities. Its a great way to incorporate more retired Thoroughbreds in the EAT programs throughout the country.

DR. YUVAL NERIA: We are confident that this partnership will benefit both veterans with PTSD and others with anxiety issues, and at the same time give retired Thoroughbreds an opportunity for a noble second career.

DR. PRUDENCE FISHER: So, again, thank you for listening to us today.

DR. YUVAL NERIA: And thank you for your support of our work.

STUART S. JANNEY III: Thank you, Dr. Neria and Dr. Fisher. The results of that study and the work you are still conducting should give all of us hope for helping our veterans and for helping our retired racehorses.


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