Equine Facilitated Psychotherapy with Young People: Why Insurance Coverage Matters
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Equine Facilitated Psychotherapy with Young People: Why Insurance Coverage Matters Isabel Ballard1 · Aviva Vincent1 · Cyleste Collins2 Accepted: 23 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract An increased understanding of integrated behavioral healthcare highlights the importance of mental and physical wellness anchored by person-centered interventions. Evidence is accumulating in support of non-traditional, empirically supported mental health interventions such as equine-facilitated psychotherapy (EFP). Historically and currently, insurance companies neglect to cover EFP as a prevention and treatment strategy for children, youth, and families. Without coverage, the cost of participating in EFP is a financial barrier to accessing the intervention. Not covering and not reimbursing costs for this non-traditional intervention represents a crucial misstep by the insurance industry. EFP’s strong history and professionalization, its comparable cost to talk therapy, a growing research base demonstrating EFP’s benefits for youth, and policy efforts toward increasing person-centered, innovative, integrated healthcare approaches suggest greater access to interventions such as EFP is needed. Because EFP may be more accessible to those who might not traditionally attend or respond positively to talk therapy sessions, it should not be available only to those with the most privilege. Insurance coverage and reimbursement for EFP is necessary to advance the field, aid service standardization, integrate service tracking systems, and increase the research quality, all of which would ultimately benefit youth mental health. This paper aims to serve as a resource for social work practitioners looking to recommend, engage in, or advocate for EFP. Keywords Equine-facilitated psychotherapy · Children and adolescents · Youth · Health disparities · Health insurance · Mental health · Human–animal interaction · Veterinary social work Including mental health as a component of overall health and well-being is a relatively recent cultural shift within the medical model in the United States. In part, this shift is due to an increased understanding of mental health challenges and their impact over the lifespan. The original Affordable Care Act (ACA) language included mental health care in 2010 (Patient Protection and Affordable Care Act, 2010), and in 2014, the ACA required most individual and small * Isabel Ballard [email protected] Aviva Vincent [email protected] Cyleste Collins [email protected] 1
Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
School of Social Work, Cleveland State University, Cleveland, OH 44115, USA
2
group health insurance plans to cover mental health and substance disorder services (Mentalhealth.gov, 2020). Increased coverage and treatment rates in 2014 led to a broader acknowledgment of the importance of parity; that is, that physical health should not be treated separate
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