The purpose of this research is for the multi-disciplinary team at an inpatient psychiatric hospital to investigate more innovative ways to engage service users in order to promote wellbeing and emotional regulation. In particular, there is a focus on engaging patients who do not routinely engage with the Psychology Team. As such, we are aiming to explore the effectiveness of Equine Assisted Psychotherapy (EAP) with the service users on a specialist Personality Disorder ward.

EAP is the deliberate inclusion of an equine (e.g. horse, alpaca) amongst a therapy team to improve patient outcomes. This therapy team includes a mental health professional and certified equine specialist, along with equine(s) and client(s). EAP can offer specific psychotherapeutic treatment goals such as addressing trauma and emotion dysregulation. The presence of an equine removes the need for verbal communication, which allows for non-verbal approaches that support self-development; identifying and discussing the feelings, emotions and behaviours generated through interaction with the horse. The presence of equine also provides a unique opportunity for traumatised individuals to build trust with other sentient beings that value connection, safety, and trust.

These specific psychotherapeutic treatment goals are especially relevant for those with a diagnosis of Emotionally Unstable Personality Disorder (EUPD). Service users with EUPD present with complex mental health difficulties, often with problems with emotional regulation, attachment, and self-harm.

This research will use a qualitative, single arm design in which all participants (inpatients who have received an Emotionally Unstable personality Disorder diagnosis) engage in a novel psychotherapeutic intervention (6 sessions of Equine-Assisted Psychotherapy). Their experiences of this psychotherapeutic intervention will be explored using semi-structured interviews. Researchers and participants will collaborate in using Thematic Analysis to analyse the content of these interviews.

Inclusion Criteria:

• Inpatient on the ward (name of ward not included for confidentiality).
• Has received a diagnosis of Emotionally Unstable Personality Disorder.
• Since participants will be under Section 3 of the Mental Health Act, they must have the required Section 17 therapy leave at the time of recruitment.
• Service users will have been assessed for their capacity to consent by the Multi-Disciplinary Team and deemed to have capacity at the time of recruitment.
• All participants on the ward are female and between 18-65.

Exclusion Criteria:

• If the Multi-Disciplinary Team's assessment is that they do not have capacity to consent.
• Those who do not have the relevant Section 17 leave.
• Patients who have a planned discharge date that is before the intended end date of the research.
• Patients who have previous experience with Equine Assisted Psychotherapy.