Human-Equine Therapy

Juliet Leshner
email: juliet.leshner@colorado.edu

Key Terms:
Equine-Assisted Therapy | huifbedrijden | wagon-bed riding | North American Riding for the Handicapped Association (NARHA) | Equine Assisted Growth and Learning Association (EAGALA) | British Riding for the Disabled Association (RDA) | Equine Assisted Counseling | animal assisted therapy | At-Risk children and adolescents | creativity | children | equine | intra-family violence | mental health |

What is Equine-assisted Therapy?

Equine-assisted therapy (EAP) is term used for a specialized form of treatment using the horse as a therapeutic tool. It can apply to several different forms of physical and psychological treatment. It is often referred to by the greek term "Hippo", meaning horse.

A brief history

While equine therapy is just now beginning to be regulated and acknowledged as a valuable therapy, using horses for the disabled is not a new idea. The concept of horses in therapy can be traced all the way back to the Greeks who wrote about its helpfulness in the physically disabled. Some documents date back to 600 BC.

The term "Hippo therapy" was initially coined in Germany, but the first mention of its use as a therapeutic treatment was by the French physician Cassaign. In 1875, Cassaign first noted that it was helpful in improving his patients' posture, balance, joint movements and overall psychological health. Beginning at the turn of the century, the idea of horses being used to treat physical disabilities began to gain momentum.

In the 1940s, Lis Hartel, a polio survivor from Denmark with lingering physical effects from the disease, went on to win two Olympic silver medals as an equestrian riding a horse name Jubilee. After retiring from a truly remarkable equine career, Hartel pioneered the use of equine therapy onto the world scene. She opened The Lis Hartel Foundation to raise money and awareness for therapeutic riding. Hartel then proceeded to travel the world, lecturing and teaching the benefits.

During the 1990s, Hippotherapy took another interesting turn in the Netherlands. "Huifbedrijden" or wagon-bed-riding was being used for patients with disabilities that no longer allowed them to be physically active. A thin canvas was stretched between two horses. The patient then rested in the dip between them. It seemed to stimulate the blood circulation and some vital functions, like metabolism and digestion. Wagon-bed-riding has even been reported to show some stimulation in coma patients. It continues to this day with about twenty stables in the Netherlands.

EAP as a physical therapy

EAP as a psychotherapy

Psychopathy is the newest form of EAP. This uses the horse as a tool in behavioral response and can be performed from the ground or on horseback. This type of therapy is often used in combination with conventional therapy.There are four main contributors to the equine therapy: an equine specialist, a mental health professional, the patient and, of course, the horse.

Groundwork therapy addresses a variety of mental health and human development needs including: behavioral issues, attention deficit disorder, Post Traumatic Stress Disorder (PTSD), substance abuse, eating disorders, depression, anxiety, relationship problems and communication needs. While most of the research done to promote EAP in this type of psychotherapy has been performed in at-risk youth (Schultz& Robbins, 2007), the benefits have been noted for a wide range of patients, from war veterans to professionals simply trying to regain balance in life.

As a method of psychological counseling, the methods are rather similar to the more familiar form of therapy. The goals of the therapy sessions are established by the therapist and client together. This generally happens before the therapy truly begins and can be slowly adjusted to meet the pace of the patient. The therapy is also "solution-oriented". This means that the patients' create the best solutions for themselves. Rather than instructing or directing solutions, patients are encouraged to experiment, problem-solve, take risks, employ creativity, and find their own solutions that work best for them.

As far as choosing a type of horse for counseling, the choice of the horse is usually left up to the equine specialist (ES). The ES chooses the horses to be used in sessions, works with the MH to develop activities, keeps an equine log to document horse behaviors in sessions, stays aware of safety and welfare of clients, horses, and team, and makes observations of horse SPUD’s (an EAGALA-developed observation framework taught in the certification training program) which can bring in potential metaphors.

Horses have many characteristics which lend them to being effective agents of change, including honesty, awareness, and ability with nonverbal communication. The goal of the session is not to change the horse, but let the person adapt to the horse. Horses are known to be incredibly sensitive animals who often sense and, therefore, react according to a persons emotions. Fear and exasperation are two traits that do not get you very far at all and often the horse will react in kind. It is beneficial for the patient to see these emotions deflected back at themselves.

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Posted by ABC News on Friday, June 5, 2015

Horses have several characteristics that are similar to humans in their behavioral responses and social structures. They can provide a mirror to gain insight in a unique and non-threatening environment. A horse is a large, intimidating animal that commands respect. Overcoming these obstacles and building a relationship between patient and animal promotes confidence, relationship skills and problem-solving skills. Equine-assisted therapy is designed to address self-esteem, personal confidence, communication, interpersonal effectiveness, trust, boundaries, limit-setting, and group cohesion (Kersten & Thomas 2000). Teens can then take these vital skills and apply them as they move on from treatment.

"There's nothing so good for the inside of a man as the outside of a horse." A quote repeated so many times, and often wrongly attributed to Winston Churchill, it is impossible to trace.

The North American Riding for the Handicapped Association (NARHA) non- profit was founded in 1969, the same year as the British Royal Family approved its counterpart, British Riding for the Disabled Association (RDA). The NARHA is the most widely recognized therapeutic riding advocate in the United States and, while based in Colorado, certifies satellite stables around the country and a number of operations based world wide. On a global scale, the NARHA has over 29,000 volunteers, 1900 instructors, 5800 program equines, and thousands of contributors.

However, Equine Assisted Counseling in cognitive impairments is a much newer concept. The NARHA is an umbrella program for the Equine Assisted Growth and Learning Association (EAGALA).

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Vision statement: EAGALA is committed to setting the standard of professional excellence in how horses and humans work together to improve the quality of life and mental health of individuals, families and groups worldwide.
Mission Statement: EAGALA provides education, standards, innovation, and support to professionals providing services in Equine Assisted Psychotherapy and Learning around the world.

With over 3,500 members in 38 countries world wide, the EAGALA manages to be a leading organization in taking equine therapy around the world. While based here in the U.S./Canada chapter, there are also satellite programs based in Europe/Middle East, Africa, Latino America, and Pacific. The objectives of the group include:
  • Establish standards of practice, ethics, and safety for EAP/EAL
  • Provide training for certification in the EAGALA Model of EAP/EAL
  • Conduct annual conferences to promote education and networking
  • Promote EAGALA as an effective model of therapy and treatment for at-risk populations
  • Provide educational, training, and support resources, such as books, videos, tapes, and web sites
  • Publish a bi-annual magazine
  • Encourage universities and colleges to develop and include the EAGALA Model in their curriculum
  • Support the establishment of EAGALA Model organizations around the world
  • Conduct and disseminate research on the effectiveness of EAP/EAL

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It is impossible to set a true standard for what type of horse to use because the most beneficial personality of the horse may vary from patient to patient. For instance, a pony that shies away from adults but responds well to children may be perfect for a child who needs to build confidence, while a more calm yet stubborn horse may be more beneficial to someone struggling with being more assertive. A skittish horse that was rescued from abusers may be beneficial for a young adult in a similar situation, a shared past allowing them bond.

After each session, the therapist is responsible for meeting with the patient, treatment planning, documentation of clients, and ensuring ethical practice. The treatment is built on the ES's horse observations and continues to bring in the metaphoric and therapeutic/learning relevance of the session.

o Equine Assisted Learning
♣ focus however is on education and learning specific skills as defined by the individual or group, such as improved product sales for a company, leadership skills for a school group, or resiliency training for our military warriors
• American Hippotherapy Association (AHA)
o Partner with NARHA
o Handling, grooming, longeing (or lunging, riding, driving, and vaulting
o Health professional working with equine professional
o Hippotherapy
♣ Occupational, physical, speech therapist specially trained to use equine movements to aid client
♣ Neuraldevelopmental treatment (NDT) and sensory integration (SI)
♣ Does not teach horseback riding
♣ shown to improve muscle tone, balance, posture, coordination, motor development as well as emotional well-being.

Solution-Focused Therapy
Matthews, William J. (1999). Brief Therapy: A problem solving model of change. The Counselor, July/Aug 99, pp29-32

AHA Curriculum

Journal Articles

EAGALA Model specific
Schultz, P., Remick-Barlow, G., & Robbins, L. (2007). Equine-assisted psychotherapy: A mental health promotion/intervention modality for children who have experienced intra-family violence. Health & Social Care in the Community 15(3), 265-271.
Trotter, K., Chandler, C., Goodwin-Bond, D., & Casey, J. (2008). A comparative study of the efficacy of group equine assisted counseling with at-risk children and adolescents. Journal of Creativity in Mental Health, Vol. 3(3), 254-284.
General Equine Assisted Psychotherapy services (other models utilized or not model specific)
Frewin, K. & Gardiner, B. (2005). New age or old sage? A review of equine assisted psychotherapy. The Australian Journal of Counselling Psychology, 6, pp13-17.
Kaiser, L., Spence, L.J., Lavergne, A.G., & Bosch, K.L. (2004). Can a week of therapeutic riding make a difference? A pilot study. Anthrozoos, 17, 63-72.
Klontz, B.T., Bivens, A., Leinart, D. & Klontz, T. (2007). The effectiveness of equine-assisted experiential therapy: Results of an open clinical trial. Society and Animals, 15 (2007), 257-267.
Zugich, M., Klontz, T., & Leinart, D. (2002). The miracle of equine therapy. Counselor Magazine, 3(6), 22-27.Scheidhacker, M., Friedrich, D., & Bender, W. (2002). About the treatment of anxiety disorders by psychotherapeutic riding: Long term observations and results of an experimental clinical study. Krankenhauspsychiatrie, 13, 145-152.

Academic Papers

EAGALA Model specific
Russell-Martin, L.A. (2006). Equine facilitated couples therapy and Solution Focused couples therapy: A comparative study. Doctorate of Philosophy, Northcentral University.
Shultz, B. (2005). The effects of Equine-Assisted Psychotherapy on the psychosocial functioning of at-risk adolescents ages 12-18. Unpublished Masters Thesis. Denver Seminary. Denver, CO.
Tetreault, A. (2006). Horses that heal: The effectiveness of Equine Assisted Growth and Learning on the behavior of students diagnosed with Emotional Disorder. Unpublished Masters Thesis. Governors State University, University Park, IL.