Horses for courses

I

There’s nothing on the hoof about the advantages of
riding therapy for service users. In our latest web exclusive
practice feature, Sarah Bartlett, canters through three
programmes that promote the serious and therapeutically beneficial
nature of horseplay.

We don’t often hear about the benefits of using horses in
therapy and education. And yet these benefits were recorded almost
2,500 years ago by the Greek physician Hippocrates, the
“father of medicine”.

“Hippotherapy”, the treatment with the help of the
horse (“Hippo” is Greek for “horse”), has
become medically recognised in most countries. A hippotherapist
manipulates the movements of the horse to facilitate treatment
rather than the rider controlling the horse. In 1999 the American
Hippotherapy Certification Board was set up to promote “the
professional growth of physical, occupational and speech-language
therapists interested in using the movement of the horse as a tool
in treatment”. In Britain riding therapy was offered to
wounded soldiers at the Oxford Hospital during the First World
War.

Equine assisted therapy (EAT) is practiced in some form
throughout the world. In Britain, EAT and equine facilitated
therapy (EFT) programmes are more common than hippotherapy. They
differ because they actually involve the rider controlling the
horse. This is considered a complete form of therapy which has a
positive effect on the physical and psychological well-being of the
rider.

A horse can teach us a lot about our own movements and how to
improve them because they move in a similar way that we do: they
move in a three-dimensional motion; from side to side, forward and
backwards and up and down. The rhythmical three-dimensional
movement and the warmth of the horse can help the rider’s
muscles to relax, mobilise their lower body and pelvis, reduce
involuntary movements and encourage symmetrical body movement.
Riding a horse constantly throws the rider off-balance which
requires that their muscles contract and relax in an attempt to
rebalance. This exercise reaches deep muscles not accessible to
conventional physical therapy.

Riding a horse eliminates the need to concentrate on standing so
the rider can devote their efforts to refining balance and
co-ordination. This shifts the focus to treating the abilities
rather than the disabilities.

For wheelchair users riding a horse can offer the opportunity to
see the world in a new way. They can visit places and experience
scenery which may otherwise be denied them. Upon a horse the visual
obstacles are fewer and the view of the world is expanded. This can
lead to a dramatic change in the rider’s perception of their
capabilities.

Below we look at three riding therapy
programmes:

Hunkapi Programme, Arizona State University,
USA

The hunkapi programme is Arizona State University’s
(ASU’s) therapeutic horseback riding programme. The programme
originally worked specifically with children with attention
deficit/ hyperactivity disorder (AD/HD) and autism, and those
emotionally at risk. The programme is named after the Native
American (Sioux) hunkapi ceremony (“making a relative”)
which marks the relationship between two people who become closer
than kinship. It reflects the aims of the programme in establishing
bonds between the rider and the horse, where children learn to love
and experience feelings for the first time.

The programme was launched five years ago, following three years
of research which showed that children with AD/HD improved their
perceptual motor skills (reaction, movement and anticipation time)
and psychological well-being after an eight week programme.
Similarly, autistic riders can show improved self-concept and
emotional control. More recently the programme has extended to
at-risk youth and people with Down’s syndrome, obsessive
compulsive disorder and depression.

Now in its sixth year the programme serves 300 people each week.
It is part of ASU’s Alternative Intervention Research Clinic
(AIRC). “The most consistent intervention among all the
different kinds of children was horseback therapy,” says
Debbie Crews, director of AIRC. “The basic eight-week therapy
programme is simple. The children are taught to interact with the
horse – including lessons in safety and grooming, preparing it for
a ride and eventually riding the horse. Beyond the equestrian
skills, they are learning to control the horse, the situation and
ultimately themselves”.

Crews believes the horse to be the perfect kind of animal for
therapy, as they are generally able to interpret a person’s
emotional state. She says, “The horse acts as a mirror for
the child. Whatever the child is feeling, the horse will mimic. If
the child is angry or scared, the horse won’t move. But when the
child is comfortable and confident, the horse will do anything the
child wants.”

The programme, which is non-residential, has a mixture of
children who pay for services and those who are covered through
grants. Some children are referred to the programme by a therapist
or by the court.

The hunkapi programme has a long list of success stories. One
child with autism was able to speak for the first time after
completing the programme. Another child, with severe trust and
abandonment issues, was able to bond with her horse and tell it
that she loves it. “It is not unusual, especially in the case
of autism, for the child to verbally communicate spontaneously for
the first time with ‘their’ horse,” says Terra
Schaad, director of therapeutic riding for Hunkapi.

“We have had kids start talking who have never spoken
before and we have had kids stay in our programme who have been
kicked out of every other programme. When you see a kid who has
never talked start talking, and you see a kid who has never loved
start to love, it is more rewarding than any other accomplishment
you could ever have” she adds.

Contact information:
Web:
www.asu.edu/asunews/community/horsetherapy_041202.htm

Norfolk – Equine Assisted Therapy (EAT)
programme

The equine assisted therapy (EAT) programme began in Norfolk in
1990, when a severely depressed client of Ruth McMahon, now senior
occupational therapist with one of the community mental health
teams in Norfolk Mental Health Care Trust, said that her only
positive memory was of horse riding. McMahon responded to this by
organising a riding lesson. “I was inspired during that first
riding session by the remarkable changes brought about through
contact with the horse,” she says. A depressed and anxious
woman was transformed into a smiling, relaxed and focused
individual who enjoyed discovering positive aspects of herself. The
EAT programme now offers a weekly group therapy session for up
to 10 community-based clients experiencing a wide range of mental
health needs. There is no set time period for the therapy. The
programme has a rolling membership and people can be involved in
the programme for anything from three months up to two years. Often
people are reluctant to leave the programme and offer their time
back as helpers.

McMahon says that some people, who have had no previous
experience of horses, express the concern that they are “big
animals with big teeth and big feet”. However, people
suffering with mental health needs benefit because it allows them
to experience risk and power, and offers the opportunity to
experience themselves responding to, and coping with, an immediate
situation. In experiencing themselves differently a person gains a
new perspective on their life.

While everyone has a unique experience of the programme there
are a number of benefits which are consistently reported. People
feel an improved sense of wellbeing and normality as they
experience themselves coping with the present and being in control.
McMahon says that the programme has seen people develop trust and
respect, demonstrate greater self confidence and self esteem and
has resulted in friendships from their shared interest. Other
benefits included: increase in communication and assertiveness
skills; better coping and decision making skills; more in touch
with self and outside world; an increased sense of responsibility
for self and an improved awareness of senses. These are skills
which have helped people to into full- or part-time work, further
education or voluntary work.

Now, past and present services users have set up The Equine
Assisted Therapy Association, a not-for-profit organisation. The
association was set up with the aim of increasing access to this
service.

Contact information: Equine Assisted Therapy Association
Web – www.equineassistedtherapy.org.uk

Call – 01603 421 576
Fax – 01603 421 453

The Fortune Centre of Riding Therapy

The Fortune Centre of Riding Therapy, approved by the British
Horse Society, is a residential specialist college for people with
learning, emotional and behavioural difficulties. Its full time,
three-year course, further education through horsemastership,
accepts students aged between 16 and 25.

The course works with the specific goal of using students’
motivation to work with horses to create learning opportunities.
Each student has an individual learning plan to help them achieve
their potential. The emphasis is on the students gaining long-term
life skills rather than a qualification. “The course aims to
equip people to live in their reality,” says centre director,
Jennifer Dixon-Clegg, who stresses the emphasis on helping the
students to learn life skills which will better equip them to cope
in their day-to-day lives. This requires a realistic understanding
of their environment and their coping skills.

“Students come here having been non-learners and perceive
themselves as failures”, says Dixon-Clegg. The centre
transfers the students’ motivation to learn about and work
with horses to help them learn life skills. “Many naturally
occurring routines and activities in a horse environment act as the
basis of new understanding. If horses interest and motivate an
individual, then learning about them provides a learning purpose.
We transfer what someone wants to learn into what they need to
learn,” she adds.

For example, the motivation to muck out a stable is used to
teach a life skill: mucking out a horse means learning how to sort
the dirty from the clean straw. This skill can be transferred to
sorting washing. Similarly, the involvement in grooming a horse
teaches a student about their own personal care. “Learning to
wash a horse’s mane has encouraged many people to become
independent in their own hair washing,” says Dixon-Clegg.

Students can be referred to the centre by specialist careers
advisers, social workers, teachers, doctors and other
professionals. Funding for this course, depending on age and need,
is provided mainly by the Learning and Skills Council.

Contact information: The Fortune Centre of Riding Therapy
Web – www.fortunecentre.org
Call – 01425 673 297
E-mail – info@fortunecentre.org