1.Yun-Hee KIM, Korea Association of Therapeutic Horsemanship, Samsung Medical Center, Korea
2.Sanna MATTILA-RAUTIAINEN, HETI Federation, Finland
1.Diversification to Meet the Needs of the WorldDownload Margaret MANSFIELD, State University of New York, USA
2.Step Forward to the Evidence Based PracticeDownload Debbie SILKWOOD-SHERER, Central Michigan University, USA
Symposia I :
Date & Time
June 8 (Tue), 14:30~16:00
1.Jung Soon SHIN, Korea Racing Authority, Korea
2.Marie Therese KUYPERS, HETI Federation, Belgium
1.What’s in a Name? Sociological Insights on Creating and Uniformizing TerminologiesDownload Jérôme MICHALON CNRS (France), France
2.HETI TerminologyDownload Sanna MATTILA-RAUTIAINEN, HETI Federation, Finland
3.Optimal Terminology for Services in the US that Incorporate Horses to Benefit People : A Consensus DocumentDownload Kathy ALM,Professional Association of Therapeutic Horsemanship, International (PATH, Intl.), USA
Clinic to Arena I-1 :
Date & Time
June 8 (Tue), 17:00~18:00
1.Jeong-Yi KWON, Sungkyunkwan University School of Medicine Department of Physical and Rehabilitation Medicine, Samsung Medical Center Korea, Korea
2.Věra LANTELME-FAISAN, The Czech Equine Facilitated Therapy Association (CEFTA) / HETI, Czech Republic
1.Equine-Assisted Activities and Therapies in Children with Cerebral PalsyDownload Jeong-Yi KWON, Sungkyunkwan University School of Medicine Department of Physical and Rehabilitation Medicine, Samsung Medical Center Korea, Korea
2.Children with Cerebral Palsy in Equine ArenaDownload Jung Soon SHIN, Korea Racing Authority, Korea
Clinic to Arena I-2 :
Date & Time
June 8 (Tue), 17:00~18:00
1.Ji Hye HWANG, Samsung Medical Center/Sungkyunkwan University School of Medicine, Korea
2.Roswitha ZINK, Lichtblickhof Vienna Austria, Australia
1.Exercise-based Oncology Rehabilitation in Breast Cancer Survivors: Therapeutic Horseback Riding as an OptionDownload Ji Hye HWANG, Samsung Medical Center/Sungkyunkwan University School of Medicine, Korea
2.Who Am I Now? – Using Equine Assisted Therapy to Heal the Emotional Wounds of Breast CancerDownload Brenda TANNER, Equine Encounters Australia, Australia
1.Sanna MATTILA-RAUTIAINEN, HETI Federation, Finland
2.Roisin BRENNAN, HETI Federation, Ireland
1.Sanna Mattila-RAUTIAINEN, HETI Federation, Finland
2.Kathy ALM, Professional Association of Therapeutic Horsemanship International (PATH, Intl.), USA
3.Jérôme MICHALON, CNRS (France), France
Oral Presentation I-1 :
Date & Time
June 8 (Tue), 09:30-10:20
1.Sang Mi JEONG, Sangji University, Korea
2.Gisela Heimsath RHODES, HETI Federation, Germany
1.An Introductory Survey of Volunteer Administrators in Equine Assisted Service (EAS) OrganizationsDownload Amy TRIPSON HOPE, Horses Offering People Enrichment, USA
2.A Digital Knowledgebase for Equine Assisted Program Research – Is It Time?Download Evelyn MCKELVIE, HHRF, Canada
3.Analysis of The Therapy Equine Certification Program in The Czech RepublicDownload Vladimíra CASKOVÁ, The Czech Equine Facilitated Therapy Association (CEFTA), Czech Republic
Oral Presentation I-2 :
Date & Time
June 8 (Tue), 09:30-10:20
1.Jeong-Yi KWON, Sungkyunkwan University School of Medicine / Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Korea
2.Lorrie RENKER, Educated Equine, USA
1.The efficacy of Equine Assisted therapeutic exercises in gross motor function and performance in children with Cerebral PalsyAbstract Alexandra STERGIOU, HETI Board, Greece
2.Physical Therapy Incorporating Equine Movement: Kinetic Interactions between Children with Cerebral Palsy and the HorseDownload Priscilla LIGHTSEY, HOPE (Horses Offering People Enrichment), USA
3.Effect of Equine-Assisted Activities and Therapies on Cardiorespiratory Fitness in Children with Cerebral Palsy: A Randomized Controlled TrialDownload Yoonju NA, Samsung Medical Center, KOREA
Oral Presentation II-1 :
Education for Specialist
Date & Time
June 8 (Tue), 16:00-16:50
1.Inkyung LEE, School of Equine Science, Cheju Halla University, Korea
2.Alexandra STERGIOU, HETI Federation, Greece
1.Development of an ICF Based Assessment Tool for the Measurement of Equine Assisted Interventions: A Multi Center Evidence Based ApproachDownload Isabel STOLZ, German Sport University, Cologne, Germany
2.Teaching Very Low Functioning Children with Developmental Delays and Complex Needs How to RideDownload Nancy PASCHALL, Horses and Humans Research Foundation and Healing and learning Through Equine Relationships, USA
3.HOW We Teach Matters! Optimize Communication and Cueing to Enhance Learning and Focus in the Arena.Download Saebra PIPOLY, PATH Intl. Advanced TRI, CTRI, ESMHL, Mentor, Associate Faculty for RTRI Workshop & Certification, USA
Oral Presentation II-2 :
What's New in Adults
Date & Time
June 8 (Tue), 16:00-16:50
1.Soojin YOO, University of Texas-Rio Grande Valley, USA
2.Renate DEIMEL, Lichtblickhof Austria, Austria
1.Hippotherapy for Pain Syndrome in the Immediate Postoperative Period After Knee Endoprothesis in Women.Download Oksana KUZMINA, RIM LLC, Russia
2.Influence of Equine Facilitated Psychological Support on the Psychological Wellbeing of Healthcare Workers During the Initial Phase of the COVID-19 Pandemic in ItalyDownload Michela RICEPUTI, ASST Grande Ospedale Metropolitano, Italy
3.Case Study: The Equine Therapy Assistance Program in Skills Development in Addiction.Abstract Claudia MOTA, Instituto Passo a Passo, Brazil
June 9 (Wed)
Plenary II :
Widen the Spectrum
Date & Time
June 9 (Wed), 14:30~16:00
1.Yoo-Sook JOUNG, Department of Psychiatry, Samsung Medical Center / School of Medicine, Sungkyunkwan University., Korea
2.Jill CAREY, FESTINA LENTE ENTERPRISES, Ireland
1.Never too Old to Play - The Healing Power of Equine Assisted Play Therapy(™) with at Risk YouthDownload Tracie FAA-THOMPSON Turn About Pegasus / International Institute of Animal Assisted Play Therapy, UK
2.Equine Assisted Therapy for Patients with PTSD: Clinical and Neuroimaging Evidence Download Yuval NERIA, Columbia University Medical Center, USA
Clinic to Arena II-1 :
Date & Time
June 9 (Wed), 13:30-14:30
1.Dahye SHIM, Mind & Horse, Korea
2.Marie Therese KUYPERS, HETI Federation, Belgium
1.The Man o’ War Project: Equine Assisted Therapy for PTSDDownload Yuval NERIA, Columbia University Medical Center, USA
2.Clinic to ArenaDownload Saebra PIPOLY, PATH Intl. Advanced TRI, CTRI, ESMHL, Mentor, Associate Faculty for RTRI Workshop & Certification, USA
Clinic to Arena II-2 :
At Risk Youth
Date & Time
June 9 (Wed), 13:30-14:30
1.Sunju SOHN, Cheongju University, Korea
2.Anton SARATOV, HETI Federation, Russia
1.Changes in Gait Balance and Brain Connectivity in Response to Equine-Assisted Activity and Training in Children with Attention Deficit Hyperactivity DisorderDownload Doug Hyun HAN, Chung Ang University Hospital, Korea
2.The Journey from School Exclusion to Acceptance at Equine College Download Tracie FAA-THOMPSON, Turn About Pegasus , International Institute of Animal Assisted Play Therapy, UK
Kyung Taek OH, Korea Equestrian Association for Disabled (KEAD), KoreaDownload
1.Kyung Ja CHOI, Korean Society for the Cerebral Palsied, Korea
2.Geon Nam LEE, Inwoo ENC Co., Ltd. , Korea
3.Kyeong Hui NO, Daedeok Animal Husbandry, Korea
Oral Presentation III-1 :
What's New in Elderly
Date & Time
June 9 (Wed), 09:00-09:50
1.Soojin YOO, University of Texas-Rio Grande Valley, USA
2.Gunstavo Dos SANTOS, HETI Federation, Uruguay
1.Effects of Horseback Riding for Preventive Care on the Quality of Life, the Physical Function, and the Mental Health of Community Dwelling ElderlyDownload Maho KAWABE, Non-profit Organization Piskari, Japan
2.Effect of Hippotherapy on Functional Capacity and Stomatognathic System in Older AdultsDownload Edneia MELLO, School of Dentistry of Ribeirão Preto,University of São Paulo, Brazil
3.Development of a device for retaining good posture of elderly peopleDownload Rika MIURA, Non-profit Organization Piskari, Japan
Oral Presentation III-2 :
Date & Time
June 9 (Wed), 09:00-09:50
1.Chang Beom PARK, Sangji University, Korea
2.Anton SARATOV, HETI Federation, Russia
1.A Proposed Study to Shift TheHorseCourse Proven Equine-Assisted Intervention to VR Platform for Large-Scale ReachDownload Harriet LAURIE, The Horse Course, UK
2.VR in Hippotherapy for Children with Cerebral PalsyDownload Siena LEE, Asian Pacific International School, Korea
3.Research Readiness in Equine Assisted ServicesDownload Nancy PASCHALL, Horses and Humans Research Foundation and Healing and learning Through Equine Relationships, USA
Oral Presentation IV-1 :
Date & Time
June 9 (Wed), 10:00-10:50
1.Inkyung LEE, School of Equine Science, Cheju Halla University, Korea
2.Gisela Heimsath RHODES, HETI Board, Germany
1.Group-Housing of Horses – A Potential Source of Social Stress? Download Denise V. HEBESBERGER, Anglia Ruskin University,Cambridge, UK
2.Building Relationships in Equine-Assisted Activities: Overlaps and Differences in Horse and Human Friendship StrategiesDownload Emily KIESON, MiMer Centre, Sweden
3.Perception of the Client’S Voice by Horses Involved in Equine Facilitated PhysiotherapyDownload Magdalena SAMALOVA, Czech University of Life Sciences Prague, Czech Republic
Oral Presentation IV-2 :
Date & Time
June 9 (Wed), 10:00-10:50
1.Jung Soon SHIN, Korea Racing Authority, Korea
2.Marilyn SOKOLOF, Unbridled Therapy, USA
1.Horses Healing the Wounded Warrior: A Qualitative Inquiry of Equine-Facilitated Psychotherapy in Treating PTSD for Female VeteransDownload Rebecca WARA-GOSS, Eudaemonia Equine Connections, Inc., USA
2.Effects of Equine-Assisted Learning on Firefighters’ Psychological Stress: A Pilot StudyDownload Dahye SHIM, Mind & Horse, Korea
3.The Effects of Equine Assisted Learning on Improving Stress, Health and Coping Among Quarantine Control Workers in South KoreaDownload Sunju SOHN, Cheongju University, Korea
Dr. Lawrence Memorial Lecture
Date & Time
June 9 (Wed), 11:30-12:20
1.Yun-Hee KIM, Korea Association of Therapeutic Horsemanship / Samsung Medical Center, Korea
5.Henrika JORMFELDT, OHI (Organization of Horse-assisted Interventions), Sweden Download
6.Anita SHKEDI, Israel National Therapeutic riding Association Israel.(INTRA), Israel
Diversification to Meet the Needs of the World
Body of Abstract
Maintaining health through the past year has forced the world’s population to take an active role in their own well-being and the well-being of their community. We all have needed to assess information and data from experts around the world who have provided insight into maintaining wellness. We have navigated these waters and moved with the changing currents to address the possibilities for the future.
Equine assisted service programs have had to evaluate, assess, adapt and in some cases restructure. Programs continue to look for ways to meet their client and equine needs most effectively and efficiently. Due to the pandemic, provision of services changed and populations in some cases shifted. Some programs may never return to their previous offering and others gained new tools. Luckily, people and professionals in this industry are endlessly motivated and creative. Due to the catalyst of the COVID pandemic and the many restrictions imposed, there has been great innovation. The industry did not stand still; programs quickly adapted and met the needs of participants in new ways with farm drive throughs, virtual sessions, and one on one lessons with caregiver support. New populations are being served including first responders, caregivers, and medical providers and they are benefitting from interaction with a horse.
The pandemic has bought us closer together by encouraging us to reach out to our own community of professionals for support. Communities and groups have popped up and flourished in the virtual spaces among professionals of all backgrounds. Knowledge and ideas were shared and freely accessed. Collaborations on the international level have connected communities of learners and professionals. The HETI planning committee has had the foresight to be able to manage the everchanging requirements and mandates, moving from in person to hybrid while opening the conference on the international stage. While our methods of communication have limited us at times, virtual platforms have broadened our ability to connect with those from around the world. By speaking to those who may have seemed out of reach previously, we all have benefited from insight and perspectives outside our own.
As a professor at a college that is preparing students to become the professionals of the future, we hope to instill good insight, a dash of problem solving, common sense and a touch of wonder to keep exploring what is still to come. In a pandemic they have learned to navigate much more than students who have come before them: preparing virtual lessons for Veterans in a VA hospital, managing masks and weekly testing to keep needed equine assisted services in place, and videoing certification lessons.
As an Occupational Therapist, I try to look at things holistically. Even as we emerge from some of the toughest times most programs have ever experienced, I am energized at the many examples of resilience and innovation that has moved our field forward. We are working to put the welfare of horses and people first. This keynote will be a snapshot of the new normal and the many diversified offerings that change has brought about in the field of equine assisted services.
Step Forward to Evidence Based Practice
Body of Abstract
This session will cover the concept of Evidence Based Practice and its general effects on therapists’ treatment decisions. The presentation will provide a broad historical overview of the recent growth of evidence regarding the effectiveness of hippotherapy as a treatment tool for persons with impairments and disability. Further, the presenter will demonstrate how, through research and her personal experiences, this evidence has impacted the acceptance of hippotherapy as a treatment option into the practice of physical therapy, occupational therapy and speech language pathology. Finally, the presenter will offer suggestions for a potential research path forward for both rehabilitation professionals and researchers. Although specific examples will be geared toward hippotherapy, concepts regarding evidence based research that will be shared in this presentation may be applicable to, and of interest to, mental health practitioners and therapeutic riding instructors.
NEVER TOO OLD TO PLAY- THE HEALING POWER OF EQUINE ASSISTED PLAY THERAPY (™) WITH AT RISK YOUTH
Body of Abstract
This lecture will look at Equine Assisted Play Therapy (™)- full integration of Play Therapy with AAI, to enhance social education, physical and mental health and reduce anti-social behaviours through the use of play therapy for At risk Youth.
The impact of social isolation, social awkwardness, risk-taking and criminal offending behaviors are linked with specific AAPT interventions, which are effectively conducted with children, teens, adults, and in individual, family, and group formats.
The importance of playfulness in AAPT is highlighted for its role in facilitating engagement, emotional safety, affective expression, exploration, problem-solving, master, relationship building, safe risk-taking, self-responsibility, and self-efficacy.
AAPT models the humane treatment of animals as a metaphor for the mutually beneficial social relationship and emphasizes relationship development between child/ groups/ families and animal as a means of experimenting in a relationship which is honest and without guile as only animals can be.
Play and playfulness are essential ingredients of the interactions & the relationship.
If we feel emotionally safe we are free to be ourselves, relaxed, and able to take on new learnings.
We follow these guiding principles
guiding principles 1 Respect: equal for humans & animals Safety: physical & emotional for all Enjoyment: client & animal must enjoy it; either can opt out Acceptance: of client & animal for who they are
guiding principles 2 Training – nonaversive, positive, relationship-centered Relationship – relationship, not control; recognition & consideration of animal’s point of view, too Process – process-oriented therapy, but with general and specific goals
guiding principles 3 Foundations – grounded in theory & accepted practice, proper training to ensure ethical and beneficial treatment for client & animal. Consistent with current knowledge/practice in
¡Clinical & psychoeducational intervention
¡Humane animal treatment
In summary Equine Assisted Play Therapy (™) can be both fun, filled with laughter, therapeutic AND effective ALL at the same time.
Equine Assisted Therapy for Patients with PTSD: Clinical and Neuroimaging Evidence
Body of Abstract
Posttraumatic stress disorder (PTSD) is a prevalent and highly debilitating disorder, impairing social, occupational, and other important areas of functioning. Despite the development of several psychotherapies and pharmacotherapies for PTSD, research has shown that more than one-third of treated PTSD patients never remit. Many others avoid or reject treatment altogether. Military veterans have shown even weaker treatment effectiveness, higher dropout rates and are frequently critical of current treatment approaches.
As many patients with PTSD avoid or proven refractory to standard treatments, a host of complementary and alternative PTSD treatments have arisen and spread widely. One such treatment, equine-assisted therapy (EAT), is being increasingly used for a wide range of physical and mental health conditions, including but not limited to, PTSD. EAT enthusiasts believe that horse-human interaction experiences during therapy can potentially foster emotional and behavioral changes in patients, as these interactions offer a platform for eliciting thoughts, feelings, and behaviors related to patients’ lives outside the treatment. Furthermore, horses are especially advantageous for this process as they are naturally hypervigilant and highly sensitive to verbal and nonverbal cues, potentially providing patients with immediate feedback during horse-human interactions, which, in turn, enable patients and their therapists ample opportunities to enhance emotional awareness, reflection, and attunement to thoughts, behaviors, and patterns of communication.
While gaining popularity and exuberant proponents over the years, there have been no comprehensive treatment manuals of how to deliver EAT, nor has there been sufficient safety, feasibility, and efficacy research of EAT. To address this gap, our group at Columbia University Irving Medical Center in New York (https://www.columbiapsychiatry.org/research-clinics/ptsd-research-and-treatment-program), has recently developed and manualized a group EAT for PTSD (EAT-PTSD) comprising eight 90-minute weekly group sessions and then evaluated its safety, acceptability and efficacy. In addition, we have conducted a nultimodal brain imaging study to examine whether EAT-PTSD is associated with beneficial brain changes over the course of the treatment. I will review progress and barriers in treatment development for PTSD, discuss promise and limitations of previous EAT research, and present clinical and neuroimaging findings from our EAT studies. Future directions in the field will be discussed.
Linking Horse and Human Brains
Body of Abstract
Horses have a remarkable ability to aid human therapy. Lay people often assume this is because therapy horses endure years of specialized training to do their work. In fact, good equine-assisted therapy doesn’t require a unique individual animal, nor does it demand extended periods of education for the horse. Beyond a calm temperament and positive experience in the human world, all that’s required is an equine brain.
With background as a brain scientist and a horse trainer, I have developed brain-based horsemanship over many years. This work is described in my book Horse Brain, Human Brain, which was published in English in June 2020 and is being translated into five foreign languages at this time. Because all horses have brains, my approach to training horses and their handlers can be used effectively in all breeds and equestrian disciplines. Doing so increases safety, improves performance, speeds training, protects equine welfare, encourages mutual trust, develops brain-to-brain communication between prey and predator species, and creates stronger horse-and-human teams. It also explains why so many equines are perfectly suited to support human therapy.
What is it about their brains that makes horses so good at equine-assisted therapy for humans? In this presentation, I’ll introduce some of the reasons:
Horses have no prefrontal cortex and therefore cannot judge their human handlers
Horse-and-human communication depends on nonverbal body language
Horses learn and respond quickly in “pure” form with little emotional baggage
Horses have little to no categorical perception and therefore notice small details
The horse’s primary emotion is fear, as is common to wounded human psyches
Methods that calm equine fear also help control human fear
Successful horse-and-human interaction requires mutual trust built over time
Horses’ size and power requires humans to abandon techniques involving force
During the talk, I’ll explain how each of these items affects human wellness and aids in many types of therapeutic intervention. I look forward to seeing all of you there! In the meantime, you can learn more at www.janet-jones.com.
One Health as Framework for Animal Assisted Interventions
Body of Abstract
In the last few years, One Health has become an important framework for animal-assisted interventions (AAI) and awareness regarding the animal's health and welfare within these interventions is growing. One Health recognizes the inextricable linkage of humans, animals and their environment and is defined as any adden value in terms of human and animal health and wellbeing. Thus, from a One Health perspective, ethically justifiable AAI should generate an added value in health and wellbeing for humans as well as animals and avoid any suffering in both.
Although the animal is an essential part of this intervention, the body of research looking at the effects on the animal is scarce compared to research investigating effects on clients. In this talk, I will give an overview of the current research addressing these effects on animals involved in AAI. The main focus lies on horses but I will also include results from studies with different species and compare it. Finally, I will discuss implications for practice and propose a One Health research framework for future AAI research to ensure that the interdependencies between human and animal health are taken into account. Future research addressing animals should not only focus on stress reduction but also on positive welfare indicators to identify conditions that might provide benefits to animals participating in AAI (Hediger et al., 2019).
Scientific Frameworks to Guide Welfare, Training, and Handling of Horses in Therapy and Education Services
Body of Abstract
Practitioners who include horses in therapy and education services, or who provide adaptive riding lessons, have a professional responsibility to use best available, scientific information to guide understanding of equine welfare and the training and handling of horses. While not all of these services constitute healthcare, the concept of evidence-based practice, used in human medicine, can serve as a helpful reminder to allow scientific information to inform decisions in these areas. There are, at times, conflicts between common practices in the general horse sector and practices arising from the scientific study of welfare and equine behavior. Those providing professional services where horse interactions are incorporated must choose scientific information about horses to inform their actions. This in order to safeguard both participants and horses in their services. Multiple frameworks exist to assist practitioners in ethical and efficient decision-making about behavioral issues that may arise during therapeutic or educational sessions, and for equine welfare in general. In this presentation, recent welfare guidelines from HETI and IAHAIO will be discussed, along with useful frameworks from equitation science and science-based animal training approaches for formulating ethical plans of action for handling and training of horses in therapy and education services.
What's in a Name? Sociological Insights on Creating and Unifying Terminologies
Body of Abstract
When one tries to account for what animal-including care practices are, the first difficulty is to find the right words. Journalists experience this quite often when they use terms such as « animal therapy », « animal-assisted therapy », « animal assisted activities », « zootherapy », « animal mediation » (in France), « hippotherapy », « therapeutic riding », as if they were the same exact practices. For an outside observer, the profusion of terminology can be very confusing. However, this diversity in terminology reflects the complicated history of including animals in care practices. Since the 1960s, these practices have attempted to adopt specific names, reflecting the desire to create a particular professional identity. An identity that would reflect both a way of conceiving human care and a way of conceiving the specific role of animals in this process.
In my doctoral dissertation in sociology (Michalon, 2014), I traced the history of animal-including care practices and tried to understand how these practices reflected a profound change in human-animal relations. I analyzed the emergence of such practices as a social endeavor to legitimate marginalized ways to interact with animals, because they demonstrate that caring and personalized relationships with animals can have a positive and lasting effect on human health. Here, health is seen as a strategic tool to provide legitimacy to new ways of seeing animals, valuing them and interacting with them. I tried to grasp the social construction of animals as persons and the social dynamics of the benevolence towards animals, and what part played animal-including care practices in that process.
Looking at the evolution of the distinctive terminologies proposed to designate these practices is a good way to account for these social dynamics. In this lecture, I will describe this evolution in the two social universes: the anthropocanine universe and the anthropoequin universe. Dogs and horses are indeed the species most used in animal-including care practices. Focusing on the Anglo-American world, France and Europe, I will describe a similar process : the more animals are involved in practices labeled as “therapy”, the more they are seen as unique, singular beings, the more their personhood is acknowledged and valued. Each creation of a new terminology thus corresponds to a new stage in the joint affirmation of a new form of care for humans and a new relationship with animals, which both value personhood (human and animal).
Then I will adress the relationships between the anthropocanine universe and the anthropoequine universe, as an example of how the desire to unify terminologies sometimes comes from actors "peripheral" to the group of practitioners and only partially meets their professionalization needs. I will explore how the pet industry leadership has led to defining dog-including care practices as "standards" applicable to other species, including horses. This is best illustrated by the fact that practices involving dogs are generically referred to as including "animals", without mentioning the species; whereas practices including horses always mention the equine species in their terminology. In this case, the unification of terminology could thus be interpreted as a vector of "caninization" of human-animal relationships. Without denying the interest that practitioners may have in unifying their terminology, the question that must be asked is: who drives the unification and who benefits the most from it?
Background / Aims : At HETI’s 16th International congress through member feedback at the Open Forum and Education Round table that there is a pressing need for an International database of current terminology utilized as well as further clarity and understanding in current terms used.
Methods : In 2018-2021 HETI developed a taskforce that designed the questionnaire and helped to process the data in several linguistic and cultural groups. The main themes for the questionnaire were the following:
1) International Location
2) Education and Training Qualifications
3) Current terms utilised to describe the services you offer
Results : Since the beginning it has been clear that as a member organization HETI must hear the voice of the members and respect cultural differences. In order to support research and development of our services, we need to develop an understanding of terms used and hopefully develop a glossary of terms to categorize the services provided.
This will bring added value to gaining governmental support and hopes to add clarity for researchers around the world.
This work also aims to highlight both the commonalities and discrepancies in international terminology coupled with an overview of the expansive breadth of terms used worldwide in order to generate active reflection amongst practitioners around the world.
Conclusions : During the process of analyzing and classifying the information, we realized the importance of the influence of the close link that exists between culture and language.
Thinking from the bases of neurobiological functioning that language is the structuring of thought and how one thinks naturally and spontaneously in his “mother” tongue not in another, even when we handle a good level of the other language.
To the difficulty of finding words or expressions that represent the same with respect to the use of the terminology applied in assisted therapy with equines in all its breadth and variability is added the subjectivity that is intrinsic in the cultural characteristics of the different regions of the world (and even in different regions within the same country) the languages and their possible variations at the time of translation. Even the subjectivity and personal experience and training of the person who translates and analyzes the information is another variable to take into account.
This aspect is an important point to consider since it could be taken into account as one more variable when classifying the terminology and when thinking very well if we really refer to the same things when we use this or that word. In the Forum we are presenting the findings.
Karina Arrieta, Equine instructor and psychomotorist, Uruguay
Roisin BRENNAN, Psychologist, HETI executive director
Nicolas Emond, Equitherapist & Psychologist
Sanna Mattila-Rautiainen, Researcher, PT, HETI President, Finland
Maike Schubert, OT, England/ Germany
Yulia Slepchenko, PT, Russia
Alexia Stergiou, PT, Greece
Gabriela Volpe, Equine instructor and psychologist, Uruguay
keyword : Terminology, International, Questionnaire
Optimal Terminology for Services in the US that Incorporate Horses to Benefit People: A Consensus Document
Body of Abstract
Background / Aims : The purpose of this presentation is to present the process and findings for optimal terminology in the United States that incorporate horses and other equines to benefit people. This was a US based initiative to gain consensus among organizations and individuals involved in equine-assisted services regarding terms and definitions for the industry in order to address the serious problems in the U.S. that unclear and imprecise terminology has generated.
Methods : A diverse multidisciplinary consortium of individuals, including representatives of relevant national organizations, participated in an inclusive, systematic, and comprehensive 2-year consensus-building process. This process included a survey built upon existing published terminology, a professionally facilitated summit, and multiple revisions based on gathered feedback.
Results : The consensus-building process culminated in the identification of 12 specific services that relate to three broad areas of professional work: therapy, learning, and horsemanship. These results were endorsed by a large majority of the summit group as well as Boards of Directors of organizations involved in the industry. The final paper has been published in the Journal of Alternative and Complementary Medicine.
Conclusions : Terminology recommended for adoption in the U.S. clearly describes and distinguishes 12 distinct types of services. Terminology recommended for discontinuation was found to be ambiguous, misleading, no longer useful, or to have adversely affected stakeholders. It is hoped that all recommendations will prove useful and serve to enhance the professionalism and viability of specific identified services. It is also hoped that improved precision and clarity in terminology for naming specific services will advance their future scientific development and reliable measurement of effectiveness. Not all terminology-related challenges were resolved, however, and new challenges will likely arise as services continue to evolve and diversify. In addition, the focus was for the U.S., as expanding it beyond that scope was not feasible at the time. Significant impacts, if any, of the terminology recommendations herein merit ongoing monitoring and the question of optimal terminology merits revisiting in the foreseeable future as well as future alignment with global terminology.
keyword : equine-assisted activities and therapies, hippotherapy, therapeutic riding
Horse Riding Simulator with Virtual Reality for Rehabilitation of Children with Cerebral Palsy
Body of Abstract
Cerebral palsy (CP) is a group of non-progressive but not unchanging disorders of movement and posture due to an insult or anomaly of the developing brain. Children with CP frequently have muscle weakness, abnormal muscle tone, impaired motor control, and dysequilibrium, which cause abnormal posturing and poor balance control.
The evidence has accumulated that equine-assisted activities and therapy (EAAT) improve motor performance, balance, and gait in children with CP. However, there are cases where access to EAAT is difficult, varying from region to region. In such cases, an alternative is needed, and horse-riding simulator (HRS) may be one of the answers. It is reported that HRS is less effective than EAAT. One possible reason is the different quality of sensory system stimulation, besides just using the actual horse. If HRS is combined with various postural challenges that can increase somatosensory stimulation, it is expected that similar effects to EAAT will be elicited.
Virtual reality (VR) is a technology that provides a sense of presence in a real environment with the help of 3D pictures and animations formed in a computer environment and enables the person to interact with the objects in that environment. VR use in physiotherapy and rehabilitation has increased significantly in the last ten years. VR provides an opportunity for active learning, intrigues and encourages the participant, and ensures motivation. It enables performing difficult movements in a secure environment. Therefore, VR could be used in combination with HRS to make children feel like they were riding on horses and to enhance the therapeutic effect of HRS by providing multiple directional challenges for them.
Based on the contents described above, HRS with VR was planned and developed, and then the study was conducted on the effect of HRS with VR. School-aged children with CP, gross motor function classification system level I-IV were included in this study. They received the exercise on HRS equipped with a head-mounted display and controllers. Each session consisted of 30 minutes and was conducted twice a week for a total of 16 times. After the intervention, the participants showed improvement in balance, gross motor function, especially walking and running ability, and motor performance. Before and after the intervention, body composition analysis was performed using InBody. Body fat mass and percent body fat decreased, and fat-free mass and skeletal muscle mass increased after the intervention. No adverse events such as fall, VR sickness, or pain were observed. All children in the study were satisfied with the intervention.
In conclusion, HRS with VR may be suggested as an effective therapeutic approach for the rehabilitation of school-aged children with CP. The EAAT is the best intervention for promoting gross motor function of children with CP. However, a HSR with VR can be a good surrogate for EAAT when EAAT is not available.
Rehabilitation and Therapy with Horses in Virtual Reality
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Games allow us to explore both fictional and factual knowledge through immersive and emotionally engaging experiences as an act of interactive storytelling. For a designer, game is a way to interact and have dialogue with players - from getting players to understand the game to having them play the game in a way designer have intended them to do. Communication between designer and the player is one of the core elements of gameplay, which consists of conveying the information in more than one way. Unlike in other medium of creative industries – multiple elements convey the information to the viewer through visual and audio effects, emotion and anticipation of the performers, composition and dynamic point-of-views. In games, viewer is an active interactor with that environment, making impact through actions and received feedback from these actions. Therefore, composing a game as a medium of entertainment carries more depth in its dialogue with the audience/players. This is why game design approaches are widely utilized in other industries and professions besides the entertainment industry, allowing the individual approach and interpretation by each player to pursue own “journey”.
With aim to provide the best possible support in the modern society, there is growing need for utilizing diverse expertise, integrating the best practices from technological and humanitarian achievements, in a form of gamified solutions that enable inclusive content-sharing worldwide. Through gamification, we are able to merge the commercial games playability value and interactive storytelling practices with the specific needs of the professionals in their own fields, creating unique content for increasing engagement and motivations of the final users.
Development of virtual reality (VR) environments is great part of gaming technology evolution especially in its use outside of entertainment industry. It allows interactive simulations for learning and training practices while creating a safe space for individuals to explore and solve variety of challenges. Interacting with the virtual world is memorable and intuitive with richness in movement. The game world now includes own view and body movement, just like in real life. In creating meaningful, immersive, and intuitive user experience in VR, one of the main focuses are on the player’s ability to make meaningful choices. Enabling free body movement and gestures have huge importance in creating these choices, especially in cases of trauma, fear, and anxiety. Therefore, VR technology is widely used by professionals in education, healthcare, and therapy to support specific needs of each student/client based on unique set of challenges that one needs assistance with. Virtual therapy setup contains carefully designed practices and share of information which are given to the player in forms of visual, audio and interactive clues that pursue act of “discovery” which affects personal motivations.
In this paper I will focus on the opportunities for utilizing VR technology in creating horse therapy tool through interactive storytelling practices, providing a case study in which game design can be transformed to these new application areas for use by healthcare and wellbeing professionals. To pursue systematic changes in our society by creating safe, inclusive, and diverse environment for nurturing individuals’ unique views, we must focus on the education and utilize diverse expertise that would challenge the direction of innovation towards the desired goal. This is how and why gamification design practices can provide the building blocks in achieving this goal.
Communication between horses, equestrians and society
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Equine trade operates as a part of society and thus arises the need to communicate within. There are three levels in which active communication in needed: first local, second other operators and institutions in the trade, and third the society outside the trade. Communication enables establishing and further developing the environment in which it is possible for the equine trade to share value with the society. Communication is the key to effective influencing.
In all communication apply the same rules and principles, public affairs not being exeption. It is justified to argue, that the higher the level of operation, the greater the need to follow the principles and ethics of good communication. The principles come from the broadened emphasis of empathy, the willingness to try to see things from a point of view of a person, or a certain, identified stakeholder group. Common obstacle is to assume that the counterpart has the same knowledge on the subject than a specialist or an insider.
Empathy is about willingness to broaden the mind and thus be objective when looking at the equine trade, especially inside the trade. It is necessary to change the perspective when operating in different levels of influencing. A common, often unconscious obstacle in communication is being defensive. It often comes from fear and insecureness. In this context it is usually the fear of losing something we view as an advantage or established good. It is important to develop the skill to recognize this pattern of behaviour to to be able to step back from defensive subjectivity and step forward to constructive objecitivity. Rather than hold on, prefer allowing development. This concerns also the networks we build: the need to include, not exclude. The principles of good communication are openness, respectfulness and constructiveness.
One of the most important actions is identifying key stakeholders. It is with the key stakeholders that a communication system is established to enable exchange of information. It is to be respected that communication is always a two-way street. Although the matters discussed are of great importance, at the end of the day it is about people talking to people about the things that matter the most to them. That in itself is a solid foundation on which to build and a comforting thought.
Once the key stakeholders are identified, the next step is to develop a network. Usually there are several active networks between different operators. There usually is also a connection between the networks. This connection is important thus we need to be able to identify which network is the right one to further discuss the matter at hand. In public affairs, impacts and actions of a federation are on governace level.
Through regulations, rules and legislation comes the licence to operate. The closer the activity is to the core, that being the local community, the more specific the subject and the more impact the action tends to have on the community. On the community level the results of influencing are more swift than on the governance level. Local activity, events and everyday action at the stables is in itself a form of influencing and as such a very important part of public affairs it being the most visible action in the community. On local level there are operators and participants. Customers and spectators take part on activities the different operators provide. It is the operators that establish the image of the trade. A local operator is always a representative of the whole equine trade. It is on the local level that the significance of positive image matters the most. It is also important to acknowlege that the image has to be equal to the actual activity. Thus it is utmost important to make sure that the quality of the action is of high standard including sustainability and responsibility. Every action is a piece of a bigger picture. The pieces move and every move impacts and changes the possible outcome.
Local actions help the the work of a federation and vice versa. The federations need to be active, showing willingness to interact and take part in conversations and further establish the networks between the national federations and institutions.
Communication is about continuity, recognizing and finding unity, maintaining the connection and regularity. It is both formal and informal. Especially on a local level informality helps making the connections. There is always an interest that can be furthered with common actions. It is to understand that influencing is a work that is done together, a teamwork where teams are agile and versatile depending on the matter at hand, or the subject that needs to be issued. Maintaining the networks, it is easier to recognize whether the matter is to be discussed on a local, or on the federation level. Communication is a skill that enhances the ability to note issues and make decisions on which would be the right operator to take action in the matter.
Networks can and should be further developed. A network keeps growing every time when we have the chance to include people into our activities. Propably the most important stakeholder group is the one that includes all the people who has had no contact or experience with a horse. It is with that part of the society that we insiders and experts have to be most subtle, discreet, open and constructive in communication. We are all in this together, facing the rapidly changing future. Through communication we make sure that the equine trade plays a positive part in this change.
Children with Cerebral Palsy in Equine Arena
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This Clinic to Arena session for cerebral palsy(CP), specifically for clinic setting, will focus how to enroll the children with CP. We will discuss Indication and contraindication of equine assisted activities and therapies (EAAT), clinical outcome measures (gross motor function, gait, balance, cardiorespiratory function, attention etc.) in children with CP. Further effects of EAAT based on the cooperation with the Samsung Equestrian Team over the past 20 years.
- EAAT Indication/contraindication
- Clinical outcome measures
- Evidence based review of EAAT based on our clinical trials
To run the EAAT program, it is important to build good relationships with your local arena. EAAT has been used to improve gross motor function, muscle asymmetry, posture, balance, gait, and cardiac autonomic function in children with CP. In addition, EAAT itself is a kind of participation-focused therapy and leisure activity.
Children with Cerebral Palsy in Equine Arena
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This Clinic to Arena session for cerebral palsy, specifically for arena setting, will focus how the ‘classes’ for the children with cerebral palsy had run with insights from our team, including medical doctor, physical therapist, and riding instructor, and also family members of the children. Our center has been running the program since 2001, and has been modifying the program to be beneficial to whom those who get on a horse/ pony. Because of the language differences, our program can be translated into the similar work as “therapeutic riding” or “equine assisted activities” and “hippotherapy” or “equine assisted therapy”. The program how we came up will be covered in depth in the session.
- Processes for program
- Assignment to the “Therapeutic riding” or “equine assisted activities” and “hippotherapy” or “equine assisted therapy”
- Children with Cerebral Palsy in riding setting
With many years of experiences, I came to conclusion that there aren’t the correct ways to do our works, but only the best trials to do for each one of the individuals on a horse/ pony.
Exercise-based Oncology Rehabilitation in Breast Cancer Survivors: Therapeutic Horseback Riding as an Option
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Breast cancer is the most common female cancer in the world. Breast cancer patients have the unique characteristics than other cancer types because there are many different treatments for a long period of time. Research on exercise across the cancer care continuum underscores numerous recommendations for its integration into comprehensive disease-management strategies. Randomized controlled trials have strengthened the basis in efficacy data for exercise in oncology. Exercise provides a large volume of health benefits to patients during and after cancer treatment by reducing treatment-related symptoms, improving functional status and quality of life, and lowering the risk of disease recurrence. Although exercise is regarded as safe and beneficial for individuals with cancer, promoting exercise for this population is complex. A patient-centered pathway is needed that can guide oncology and care professionals in the efficient assessment of an individual’s condition and enable personalized referrals for exercise interventions that promote physical activity. Therapeutic horseback riding is known to have the advantage of combining physical activities with psychological benefits. It has been reported that therapeutic horseback riding will significantly improve aerobic capacity, body composition, strength, and QoL. Although there are still many limitations, horseback riding can be one of the good exercise modes recommended for breast cancer patients.
Breast Cancer Who Am I Now? – Using Equine Assisted Therapy to Heal the Emotional Wounds of Breast Cancer
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The physical and psychological impacts of this life changing disease often leave sufferers with presentations of Post-Traumatic Stress Injury (PTSI), emotional withdrawal, anxiety and depression.
Brenda TANNER, Founder of Equine Encounters Australia (EEA) has developed an immersion-style, group program to help sufferers deal with the residual psychological and emotional wounds. The program is designed to offer participants the opportunity to explore their thoughts, behaviours and emotions without any external influences. Activities are carefully graded to disturb the homeostasis, developing the individuals’ ability to remain regulated, whilst staying with the ‘discomfort’ of the unknown, whether emotional or situational.
Equine Assisted Activities Therapy isn’t about training a horse or riding –It’s a triangulated relationship which incorporates a qualified therapist, a horse(s) and the participant(s). Through a series of interactions and activities with the horse, the therapist supports the participant to slow-down, learn to recognize and reflect on their patterns of behaviour, observe their thoughts and notice their somatic response. Part of the therapists’ work is to help the participant create greater un-bias awareness and notice what’s happening for them in the moment, by observing what’s happening in the connection with their horse – literally, bringing their pre-frontal cortex on line and quietening the limbic response. External focus allows the participant to regulate and slow down to where they can separate ‘what if’s’ from the ‘what if it doesn’t’, which in turn allows choice.
In the therapeutic context, horses can be used to allow the participant to project their emotions/feelings, or used as a metaphor to create situational or relational awareness – It’s the work of the therapist to know how and when to use these different techniques.
EEA programs incorporate a number of therapeutic modalities into the Equine Assisted Activities; Relational Gestalt, Narrative Group work and Mindfulness.
The Man o’ War Project: Equine Assisted Therapy for PTSD
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Equine-assisted therapy (EAT) for post-traumatic stress disorder (PTSD) has attracted great interest despite lacking scientific evidence, a treatment manual, and a standardized protocol. Our group of experts in PTSD and EAT has developed an 8-session group EAT treatment protocol for PTSD (EAT-PTSD) and administered it to military veterans to assess therapeutic effects (see https://mowproject.org ; Arnon et al., 2020).
I will describe the development of a first of its kind treatment manual, which was applied to a sample of American veterans with PTSD. Protocol safety, feasibility, and acceptability were assessed by reported adverse events, treatment completion rates, and self-rated patient satisfaction. Data on PTSD, depressive, and anxiety symptoms and quality of life were collected pretreatment, midpoint, post-treatment, and at 3-month follow up. No adverse events were recorded. Most patients completed treatment, reporting high satisfaction. Our data also showed a significant decrease in clinician-assessed PTSD and depressive symptoms from pre to post-treatment and 3-month follow-up. Limitations and future directions will be discussed.
Clinic to Arena
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The second portion of Clinic to the Arena will be presented from a therapeutic horseback riding coach's perspective and will focus on lesson plan topics, skill progression, instruction theories, and mindset that will optimize the effectiveness of the coach’s role in facilitating therapeutic horsemanship (groundwork and riding), Equine-Assisted Learning, and other Equine-Assisted Services (formerly EAAT).
Participating in activities with horses and experiencing the horse-human partnership can not only be a wonderful way for an individual to heal from past traumas but to also build resiliency and spark personal development that will positively impact their future. One’s time and interaction in the arena or barn with a horse can have both immediate and lasting impact on their overall wellbeing and give them tools to face life with renewed strength and perspective.
Come discover tools and techniques that can be implemented while partnering with our wonderful equine co-workers to provide healing and decompressing activities that can bring normalcy and stability to the lives of those who have experienced multiple critical incidents, are battling PTSD, or are overcoming other traumatic experiences.
Equine Assisted Training for Children with Attention Deficit Hyperactivity Disorder
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Equine-assisted activity and training (EAAT) is known to improve the clinical symptoms in children with attention deficit hyperactivity disorder (ADHD). In addition, EAAT is also known to be associated with body balance and gait. We assessed the improvement of the clinical symptoms and gait balance in children with ADHD. In addition, we also found that the improvements of clinical symptoms would be associated with increased brain connectivity within gait balance circuit.
Twelve ADHD children and 12 age and sex matched healthy control children were recruited. In all children, clinical symptoms of ADHD was assessed with Korean ADHD rating scale and gait balance was assessed by the difference in the center of pressure (COP) as well as the difference in plantar pressure between the left and right foot during gait. All imaging data were acquired using a 3.0 Tesla Verio MRI scanner. Functional connectivity between the vermis of the cerebellum and all other regions of the brain was assessed. Horse riding training in current study was designed as a four week (3 times per week, 70 minute sessions).
After four weeks horse riding training, ADHD children showed improved K-ARS scores (z=3.18, p<0.01) while there was no changes in K-ARS scores in healthy children. Both ADHD children (z=2.84, p<0.01) and healthy children (z=3.02, p<0.01) showed improved depressive scores. During 4 weeks horse riding training period, the difference of plantar pressure between left foot and right foot has been decreased in both healthy control group (z=2.24, p=0.03) and ADHD group (z=2.28, p=0.02). After four weeks horse riding training, healthy control children showed increased brain connectivity from cerebellum to left occipital lingual gyrus, fusiform gyrus, right and left thalamus, right caudate, right precentral gyrus, and right superior frontal gyrus. However, ADHD children showed increased brain connectivity from cerebellum to right insular, right middle temporal gyrus, left superior temporal gyrus, and right precentral gyrus as well as decreased brain connectivity from cerebellum to left inferior frontal gyrus.
Horse riding training may improve clinical symptoms, gait balance, and brain connectivity which control gait balance in ADHD children. In ADHD children with deficit within fronto-cerebellar tract, the changes in brain connectivity would not be perfect as the changes in healthy children in response to horse riding training.
The Journey from School Exclusion to Acceptance at Equine College
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This case study will look at a 10 session family group equine assisted play therapy intervention
with a 16-year-old girl with Tourettes syndrome.
It will detail the session content and rationales for the chosen treatment plan which was flexible
due to the changing presenting needs of the family.
There are multiple issues within the extended family and there have been many interventions
from Children and Adult Services over the years with limited success.
The family reached crisis point when the girl lost control of her Impulses which resulted in her
being long term excluded from school.
As many of the children and young people we work with have intergenerational and interfamilial
family problems we invariably work with the whole family to effect change.
So the focus is not on the youth as the issue and the ‘problem’. we look at the whole system so
it’s a positive change effect model NOT a blame or scapegoating model.
Our philosophy is that if you are the only one that’s expected to change and no one else does
then change will not be sustained and problems may even get worse.
The sessions included girls mum, (she was a single parent) her grandmother and her
over the sessions, we focused through the voluntary involvement of the horses on the issues the
family thought they needed to address.
The end result was that the family are now much more cohesive.
The girl is now a volunteer on our programme.
she is engaging in education and has been accepted into equine college to undergrad level due to
begin September 2021
Effects on Research Design and Outcomes from Conceptualization of the Horse in Human Services
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The Outline for the meeting:
- Follow-up from EFP Meeting in Dublin, 2018
- Current Program Issues [from attendees]
- How can HETI help?
The welfare forum features panelists Katy SCHROEDER (USA), Heta RAUTIAINEN (Sweden), and Terri BROSNAN (Ireland) in a moderated discussion on issues and opportunities for equine welfare when horses are incorporated into therapy and education services. Key discussion topics include current guidelines, competencies, and frameworks for the welfare of the horse as well as areas of risk. The interconnectedness of health and welfare of the horse, the practitioner, and the participant as well as the need for science-based information in this area are emphasized.
Terminology Forum – Abstract
Moderators – Sanna Mattila Rautiainen and Roisin Brennan
Session Overview :
The terminology forum will provide a space for active reflection on some of the key points highlighted during the plenary terminology session. A small panel will discuss aspects in relation to terminology within the international context.
It aims to be a space to explore suggested next steps moving forward, for example how can HETI assist with this important topic in a way that respects and balances culture, diversity, language and tradition together with the future of the industry as a whole including areas relating to research, funding and provision of services.
The research forum includes two short presentations on research-related topics with an opportunity for questions from the audience. Debbie SILKWOOD-SHERER (University of Central Michigan, USA) will speak about research methods and their use relative to human-horse interactions, and Nina Ekholm FRY (University of Denver, USA) will speak about effects on research design and outcomes resulting from issues related to conceptualization of services and the role of the horse. In addition, representatives from the Ann Kern-Godal’s Memorial Fund for Horse-Assisted Therapy, the Horses and Human Research Foundation, and the HETI Journal: International Research and Practice will share resources for researchers.
The round table discussion will focus current topics in the field of Occupational Therapy related to those who incorporate equines into treatment programs. Discussion topics will include: the importance of terminology and scope of practice, OT support of the adaptive riding instructor, and mental health needs and services with the help of the horse amidst a pandemic. A short introduction will be followed by a lively moderated discussion and a question/answer session.
Keywords: Occupational therapy, terminology, practice, mental health
The round table discussion will focus on the links between practice, education and research in Equine Facilitated Physical Therapy (EFPT) based on experiences from two years of European collaboration. A short introduction will be followed by panel discussions on how to create the links between practice, education and research. The discussion will be based on questions and comments from HETI members and from the networking experiences. The aim of the round table discussion is to inspire physiotherapists to professional development in open minded groups of international collaboration.
Keywords: Physical therapy, education, practice, research, links, Equine Facilitated Physical Therapy
announced how to improve KEAD(the Korea Equestrian Association for Disabled) activity(competitions for national, educate superior competitor and coach, promote the health of the disabled, defend their rights, promote a healthy leisure life in Para-Equestrian etc.)
Panels discussion(improving KEAD activity)
Background / Aims : We are presenting our work on ERASMUS Project, which is aimed to extend and develop the competencies of educators and to compare current Partners Education offered in the field of Equine Facilitated Interventions. The Association of Finnish Equine Facilitated Therapies acts as a coordinator, with partners Festina Lente from Ireland , The Polish Hippotherapeutical Association from Poland, Lapo Association from Italy and The Federation of Horses in Education and Therapies International.
One aspect of this project is to identify and develop a set of desirable qualifications which professionals should have in order to demonstrate competency in this field of work. In order to provide successful and safe interventions the provider needs competencies in their field of profession,as well as equine related training and qualification.
Methods : We had our 1. Transnational Meeting in Finland, Ypäjä Equine College Ltd 15-18.11.2019 to get to know each other and plan our project work together. Originally, a couple of face to face ‘Learning, Teaching, Training’ Workshops in Finland and Ireland in 2020 were planned, however, the global Covid pandemic required us to change to online teamwork through zoom after our initial meeting.
Results : We are presenting our preliminary result in the form of an illustration which shows the aspects of Equine Facilitated Interventions within the four categories, Psychology, Education, Sport and Medicine. This illustration enables us to compare the existing practices through detailed information, while avoiding terms and labels, which are not clearly and consistently defined within the global field of EFI. Furthermore we are providing examples of competencies for the service providers within the different categories.
Conclusions : We are inviting a discussion at the end of the presentation
keyword : Equine Facilitated Interventions, Competencies, Best Practise
1.Domestic leisure activities and consumption trends
2.Current status of the domestic and foreign equestrian industry
3.Analysis of major policy projects related equestrian industry revitalization
4.Discussion on the development strategy of equestrian industry
5.Development plan of equestrian industry
An Introductory Survey of Volunteer Administrators in Equine Assisted Service (EAS) Organizations
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Background / Aims : Volunteer Administration is a relatively new industry, which when viewed specifically through the lens of Equine Assisted Services (EAS) showcases a unique role that has little information or data to support forward growth and evolution. One of the limitations is the lack of accepted standards of operation or recommended guidelines specific to the EAS industry with regards to Volunteer Administration. This survey aims to begin the process of data collection through which to provide guidance for the creation of EAS Volunteer Administration industry standards.
Methods : Through weekly meetings and discussions with volunteer administrators in the EAS industry, lists of common questions were generated and combined to form the basis of this first survey. The survey had 38 questions, containing a mix of questions which included structured and unstructured responses. The survey was proofed and trialed by industry colleagues and was launched through the PATH Intl. newsletter in January 2021 and subsequently shared on social media in an effort to increase the response rate.
Results : One of the goals of the survey was to collect generalized data such as the number of volunteer administrators, volunteers and participants at each center. The data collected is useful in starting to understand ratios which might inform best practices. With 61 respondents, the data also provided insight into Volunteer Administrator salaries, volunteer trainings offered and additional job duties that volunteer administrators have. This information helps create an outline and overview of the guidelines for volunteer administrators in Equine Assisted Service (EAS) organizations.
Conclusions : This industry data while limited, provides a look into where additional data may lead to the development and creation of industry best practices and the management of volunteers and volunteer administrators at EAS facilities.
A Digital Knowledgebase for Equine Assisted Program Research – Is It Time?
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Background / Aims : Through a series of meetings between HETI and HHRF (Horses and Humans Research Foundation) it has been recognized that there are very real barriers to advancing research in the field of equine assister programs and services that include having access to completed research. This lack of access to and awareness of existing research contributes to preventing or slowing the rate of progress when it comes to incorporating the fruits of research into equine programs.
We are investigating the possible models for knowledge sharing and will present our findings to the conference attendees. We will propose possible models for knowledge sharing and options to consider going forward.
Methods : Members of both HETI and HHRF are researching the area of digital repositories with the aim of presenting the findings to the membership of HETI for discussion, evaluation, and further action. We will also conduct a survey of HETI membership and HHRF supporters regarding their views on the nature and type of knowledgebase they would support.
Results : The outcome we look for will be to form an action committee composed of members of HETI and HHRF to determine the best model for a shared knowledgebase as well as the best business model to support such a repository going forward.
Conclusions : Filling the great gap in access to research results will
• enable researchers and practitioners to build on the findings of existing research,
• enable researchers to create larger scale projects with greater participant numbers,
• and will help to promote the ability to turn research results into knowledge that can be applied in programming across the world.
keyword : research , knowledgebase , collaboration
Analysis of The Therapy Equine Certification Program in The Czech Republic
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Background / Aims : This work aimed to analyze The Therapy Equine Certification Program (Program) of The Czech Equine Facilitated Therapy Association for equines and ponies enrolled in Equine Facilitated Therapy (EFT). The Therapy Equine Certification Program is the only requirement for adequate training, and personality profile for equines registered in Equine Facilitated Physical and Occupational Therapy (EFPOT) as well as Equine Facilitated Psychology and Equine Facilitated Learning (EFP/EFL). Only equines older than five years in the year of their certification can undergo the Program. The Program evaluates equine conformation, movement mechanics, specific factors, and acquired training suitability for clients. Every equine reaches the final number of points (on a scale of 1 to 10) for each factor.
For this analysis, we collected data on The Therapy Equine Certification Program results from the years 2011 – 2020. We hypothesized the following:
1.1. Type of the equine conformation affects its movement mechanics. The breed also determines movement mechanics.
1.2. EFPOT equines have more significant leg stride than EFP/EFL ones, and scapular position determines the leg stride.
1.3. Equines being prepared for EFP/EFL will reach higher marks for their ability to cooperate with a human than EFPOT equines.
1.4. Equine´s age at the time of examination has an impact on the final mark. Equines older than 8 years will reach better results than younger ones (5-7 years).
Methods : Statistical data analysis was performed in UNISTAT 10 (Unistat Ltd., UK). We used a generalized linear model, Pearson correlation and corrected for multiple comparisons using Scheffle and Tukey-B post-hoc tests.
Results : Ad 1.1. We analyzed marks for type, an average of marks for conformation and marks for movement mechanics. The last ones were correlated with marks for length and shape of the back and loins. Adequacy of the equine conformation was described as a mean value of the equine linear description. As expected, marks reflected the type, average of marks for conformation and marks for movement mechanics correlated with the pedigree. Ad 1.2. We also confirmed the effect of the scapular position on the results of the movement mechanics. Equines undergoing preparation for EFPOT reached higher marks for the movement mechanics than equines enrolled on EFP/EFL. Ad 1.3. Equine´s ability to cooperate with a human is key preparation for EFP/EFL. We assessed the difference between equines undergoing preparation for EFPOT and EFP/EFL and found better ability in the latter group. Ad 1.4. In line with our hypothesis, we showed that the equine's age has a significant effect on the examination results.
Conclusions : assessment of equine readiness, equine movement mechanics, personality- character
The efficacy of Equine Assisted therapeutic exercises in gross motor function and performance in children with Cerebral Palsy
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Background / Aims : To evaluate the efficacy of the equine-assisted intervention in children with cerebral palsy, in terms of gross motor function and performance as well as whether this improvement can be maintained for 2 months after the end of the intervention.
Methods : 31 children with cerebral palsy participated. The study lasted 28 weeks. The equine-assisted intervention lasted 12 weeks and took place once/week for 30 minutes. Gross Motor Function Measure, Gross Motor Performance Measure, Gross Motor Function Classification System, and Wechsler Intelligence Scale for Children were used for the evaluation of each child’s physical performance and mental capacity.
Results : The results showed statistically significant improvements in total Gross Motor Function Measure and in all subcategories (p<0.005), also in total Gross Motor Performance Measure and all subcategories (p<0.005). These Gross Motor Function Measure results remained present two months after the last intervention.
Conclusions : Equine Assisted Intervention improves the motor ability (qualitatively and quantitatively) in children with cerebral palsy, with clinical significance in gross motor function.
keyword : cerebral palsy, equine assisted activities and therapies, gross motor function, gross motor performance
Physical Therapy Incorporating Equine Movement: Kinetic Interactions between Children with Cerebral Palsy and the Horse
1 Physical Therapy, ROCK (Ride On Center for Kids), USA 2 Mechanical Engineering, Texas A&M University, USA
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Background / Aims : Physical therapy treatment incorporating equine movement is recognized as an effective tool to treat functional mobility and balance in children with cerebral palsy (CP). To date, only a few studies have examined kinematic outputs of the horse and a participant when mounted. In this pilot study, we examined the interaction between the horses and children with CP during physical therapy sessions utilizing equine movement to better understand the effectiveness of this type of treatment.
Methods : Four children with CP received eight physical therapy sessions incorporating hippotherapy as a treatment intervention. Functional mobility was assessed using the Timed Up and Go or the 10m Walk Test. Inertial measurement unit sensors, attached to children and horses, recorded movements and tracked acceleration, angular velocity, and body orientation.
Results : Results of the functional tests showed modest improvements over time. Sensor data, using the kinetic sensor measurement device, revealed that the children’s movements (quantified in frequency and temporal domains) increasingly synchronized to the vertical movement of the horse’s walk, demonstrated by reduced frequency errors and increased correlation. The findings suggest that as the sessions progressed, the participants appeared to become more familiar with the horse’s movement.
Conclusions : Since the horse’s gait at a walk mimics the human gait, this type of treatment may provide individuals with CP, who have abnormal gait patterns, an opportunity for the neuromuscular system to experience a typical gait pattern. The horse’s movement at the walk is consistent, cyclical, rhythmical, reciprocal and multi-dimensional, which can facilitate motor learning. Thus, the increased synchronization between horse and the mounted participant suggests that physical therapy utilizing equine movement is a viable treatment tool to enhance functional mobility. This study may provide a useful baseline for future work.
keyword : Cerebral Palsy, Physical Therapy, Equine movement
Effect of Equine-Assisted Activities and Therapies on Cardiorespiratory Fitness in Children with Cerebral Palsy: A Randomized Controlled Trial
Yoonju NA, Jeong-Yi KWON* (firstname.lastname@example.org ), MinHwa SUK 1 Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea 2 Department of Physical education , Seoul National University of Education , Korea
Body of Abstract
Background / Aims : To determine the effects of an Equine-assisted Activities and Therapies (EAAT) program on cardiorespiratory fitness in children with cerebral palsy (CP).
Methods : This study was a single-blinded parallel two-arm randomized controlled trial with 1:1 randomization to the EAAT or control group. Interventions: The EAAT program was conducted for 40 minutes twice a week, and the whole program duration was 16 weeks (a total of 32 lessons).
Results : Changes in the Clinical Global Impression-Severity scale and Clinical Global Impression-Improvement scale scores were not difference between the groups after the intervention. The Gross Motor Function Measure-66 (GMFM66) score increased in both the EAAT and control groups, and the difference between the groups was statistically significant (p<.05). The Pediatric Balance Scale (PBS), Timed Up and Go test (TUG), and 6-minute walk test results improved only in the EAAT group, and the difference between the two groups was statistically significant (p<.05). After the intervention, resting heart rate (HRrest) was significantly decreased in the EAAT group compared to the control group, and the difference between the groups was significant (p<.05). The EAAT group was only affected by the change in HRrest (p<.0001). The EAAT group was not affected by the change in the GMFM66, PBS, and TUG results. There was no difference in the amount of physical activity (PA) before and after the intervention in both the EAAT and control groups.
Conclusions : The present study showed decreased HRrest in children with CP after completing the 16-week EAAT program. This improvement was not explained by improvement of motor capacity, but by the intervention. In addition, the EAAT program (a participation-focused therapy) did not induce changes in PA in ambulatory children with CP.
Development of an ICF based assessment tool for the measurement of equine assisted interventions: a multi center evidence based approach
bel STOLZ*, Vera TILLMANN, Volker ANNEKEN Research Institute for Inclusion through Physical Activity and Sport, German Sport University, Cologne, Germany
Body of Abstract
Background / Aims : Equine-assisted interventions are carried out in large numbers worldwide. Their assessment and documentation vary greatly depending on scientific discipline and country; therefore systematization and comparison of results obtained is still difficult. Standardized documentation and valid scientific evaluation could contribute to determine therapy aims and effects objectively, reliably, and validly. Within the ‘PED Study: Horse, Evaluation, Documentation’, an ICF-based assessment tool is being developed in close cooperation with experts from the field of therapeutic riding and the German Curatorship for Therapeutic Riding (DKThR). The aim of the study is to develop within two years (1 September 2019–31 August 2021) a practicable and valid tool in the common language of the international health system of the World Health Organization (WHO) to adequately record therapeutic effects and document the course of therapy in a prospective longitudinal targeted manner.
Methods : A pilot assessment tool was developed on the basis of five focus group discussions with 21 experts from the field of equine-assisted therapy. It is differentiated into a global module and four sub-modules for hippotherapy, individual and group therapy, and traumatherapy. Items for the pilot tool were constructed on the basis of the gained qualitative data linked to the ICF classification system via Cieza et al.’s (2005) linking rules by two independent assessors. Based on a sample of 116 participants, first results regarding item construction (item analyses, difficulty, discriminatory power, explorative factor analyses) were obtained. Also, practical applicability was evaluated. Subsequently, the tool was modified and reduced in scope. The revised tool is currently being tested in a longitudinal practical approach in 24 locations in Germany (01 August 2020–31 March 2021). Statistical procedures to be tested are confirmatory factor analyses and other inferential statistical analyses due to the psychometric criteria validity, reliability, and objectivity on the basis of larger sample sizes.
Results : First results of the explorative factor analysis show a three-factor solution for the global module which explains 78.2 percent of the total variance. Bartlett and KMO tests previously indicated suitability for the factor analysis (chi-square (378) = 3530.46, p < 0.000; KMO = 0.923). Formed factors were psychosocial functioning, motor functioning, and mental functioning, including a total of 28 items of the initial 37. Scale reliabilities were in the excellent range (α = 0.96; α = 0.96; α = 0.95, respectively); the reliability of the total scale was α = 0.98. For both sub-modules individual and group therapy, explorative factor analyses yielded support for a two-factor structure. Sub-module reliabilities were also in the good to excellent range. Further results of confirmatory factor analyses are expected in spring 2021 and can be presented at the conference.
Conclusions : The results provide strong support for a targeted and economic assessment of equine-assisted therapy via the indicated scale structure of the developed global module and submodules. Items can be related to international health-related domains of the WHO. The developed assessment tool is subsequently prepared for the German-speaking practice as an app, to be used prospectively as a standardized assessment tool for systematized documentation and evaluation of equine assisted interventions.
Teaching Very Low Functioning Children with Developmental Delays and Complex Needs how to Ride
Sarah NEWMAN, Nancy PASCHALL* (Nancy@HalterSC.com) HALTER Program, Healing and Learning Through Equine Relationships, USA
Body of Abstract
Background / Aims : Children with developmental delays who also have other challenges can be the most difficult children to engage and teach. This session will focus on keys to successfully working with children who are extremely challenged/disabled. Successful outcomes are the result of 1) thorough assessments; 2) well-defined lesson plans with measurable objectives; 3) building a team of volunteers who work closely with each child to implement the lesson plan; and 4) great communication between the instructor and the volunteers. The goals of this session are that the attendees will have new knowledge of how to better engage and teach the most challenging of children.
Methods : This is a virtual presentation that will include videos demonstrating the key points of assessment, lesson planning, volunteer engagement and communication. Attendees will have plenty of time for questions and come away from this session with new ways to work with children with extreme delays and challenges.
Results : The attendees will learn important aspects of assessing potential participants for their programs that will help determine what the participants need in terms of support to learn riding skills, and life skills. The most developmentally and physically challenged children/people are rarely the focus of training for therapeutic riding instructors, and therefore many instructors do not feel prepared to teach them. This can create frustration on the part of the riders, the instructor, and the volunteers. Attendees will leave this presentation with new perspectives and tools that can be implemented immediately. This will improve the outcomes for developmentally delayed and extremely challenged/disabled children and decrease the frustration of the volunteers and the instructor.
Conclusions : People with extreme developmental delays, intellectual challenges, and other challenges such as autism, visual impairments/blindness, hearing impairments/deafness, non-verbal, and mobility challenges can be the most difficult people to teach to ride and learn basic life skills. The presenter, a pediatrician, has over ten years experience teaching people with the most severe of disabilities. Training for instructors rarely focuses on this population. This presentation will help attendees learn how to improve the outcomes for these riders and decrease the frustration of teaching them. Because measurable outcomes can be very difficult to identify for this population, the assessment process and developing meaningful measurable outcomes are stressed in this presentation. This presentation helps keep lessons as real learning experiences instead of pony rides.
HOW We Teach Matters! Optimize communication and cueing to enhance learning and focus in the arena.
Saebra PIPOLY* 1 Owner/Founder, Hoof Falls & Footfalls, LLC, USA 2 Advanced TRI, CTRI, ESMHL, Instructor Mentor, RTRI Faculty/Evaluator, PATH Intl., USA 3 Instructor- Therapeutic Horsemanship, Equine Business, Isothermal Community College, USA
Body of Abstract
Background / Aims : What makes a “great” instructor?
Is it an art has been honed over years of experience and trial and error?
Is it a science to how and what is to be said during lessons?
Is it both?
As instructors we want to ensure our students not only have fun and stay safe during lessons but also progress in their equestrian skills to the best of their own unique abilities. But how do we progress them? How do we do our part in helping our students with wide ranges of physical and cognitive abilities reach their fullest potential? How do we help them achieve independence? Is there really a method that works with every student?
Methods : There is a method. And this method works with students who have wide ranges of physical, cognitive, and emotional abilities.
How we present information and format our cues as instructors can greatly enhance how our students focus, process, and retain the information being taught. This is the key to them making progress towards more and more independence. To put it bluntly….HOW we teach and communicate can make or break a lesson and our student’s journey towards independence and true learning.
Results : Attendees will develop a better understanding of the following topics and how it applies while teaching in the arena: the difference between performance and learning, different types of learning, limits of our student’s focus, externally vs. internally focused cues, and the components of quality cues.
Walk away with the “formula” and method for great cues and communication that you can immediately apply in the barn or arena next time you teach. This formula can instantly enhance how you teach and interact with your students. You may be surprised how a few changes in your wording and “how” you say things can drastically impact your lessons and students in a very positive way.
Conclusions : nformation presented is adapted from and backed by information in the book "The Language of Coaching- The Art & Science of Teaching Movement" by Dr. Nick Winkelman. Additional research articles relating to learning, cueing, and attention will also be discussed.
This presentation strives to take this invaluable information from The Language of Coaching which is geared towards mainstream sports and translate it into examples and practical applications directly related to professionals in the EAS industry.
keyword : Instruction theory, Learning, communication
Hippotherapy for pain syndrome in the immediate postoperative period after knee endoprothesis in women.
Oksana KUZMINA* 1 Rehabilitation department, RIM medical centre, Russia 2 Department of hippotherapy, Platan & Co Equestrian Club, Russia
Body of Abstract
Background / Aims : Communication with animals helps to cope with psychological and social difficulties. The indisputable advantage of horse-assisted rehabilitation for orthopedic patients is its ability to replicate the biomechanics of human gait without axial load on the legs. Consequently, hippotherapy helps to minimize rehabilitation time by restoring the muscle corset of patients after surgery before they start to walk with a full load. Currently, the following difficulties arise during the rehabilitation of women after total knee arthroplasty: debilitating night pain in the knee joint, significant limitation of movements in the knee joint, long-term partial (up to 50%) limitation of the axial load on the leg when walking after surgery.
This study aims to develop the method of hippotherapy for such patients and to evaluate its effectiveness. The study achieved the following objectives: to identify the causes of pain, to identify specific osteopathic dysfunctions that can lead to pain in these patients, to form a rehabilitation plan with the help of a horse, to evaluate the effectiveness of hippotherapy compering to other methods of rehabilitation.
Methods : This paper presents results of the study of 30 women after knee arthroplasty, aged 52 to 78 years, who complained of nocturnal pain in the knee joint and lower leg that was not relieved by pain medications. At the beginning and at the end of the study the following measurements were taken: the volume of the thigh, knee joint and lower leg; temperatures locally; range of motion in the joint; data on concomitant diseases were collected. During the examination osteopathic dysfunctions in the pelvic and lower extremities were assessed, patients completed the VAS, Bristol knee score, Oxford-12 item knee score. Statistical processing of the data obtained was carried out using the "Statistics 10.0" program.
Results : It was revealed that the use of hippotherapy increased the range of motion by 2 times, there was a significant decrease in the edema of the operated limb, the level of pain decreased by 25%, the quality of life of patients improved by an average of 3 times.
Conclusions : The study showed that the likely cause of night pain in the area of the knee joint and lower leg, the development of edema of the lower extremities, dysfunction of the tibiofibular membrane, shortening of m. biceps femoris in female patients is gynecological pathology. The course of hippotherapy is aimed at restoring the function of the pelvic diaphragm and the elasticity of the ligamentous apparatus of the pelvis, which creates conditions for the adequate functioning of the pelvic organs. Relaxation of m. biceps femoris and popliteal muscles leads to elimination of the fibula dysfunction and restoration of the dc\tibiofibular membrane functionality. All the above lead to a significant reduction in swelling and night pain, early restoration of range of motion in the knee joint, which makes it possible to accelerate recovery of patients and improve their quality of life.
keyword : Hippotherapy, knee endoprothesis, post surgery rehabilitation
Influence of equine facilitated psychological support on the psychological wellbeing of healthcare workers during the initial phase of the COVID-19 pandemic in Italy
Michela RICEPUTI, Aurora SOTGIU, Annalisa ROSCIO* (), Denise VAGNINI, Federica FACCHIN, Sara MOLGORA, Emanuela SAITA, Umberto MAZZA 1 Maternal and Pediatric Department , Child Neuropsichiatry Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy 2 Amici del Centro V. di Capua” Association, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy 3 Department of Psychology, Università Cattolica del Sacro Cuore ”, Milan, Italy 4 Mental Health Department, Clinical Psychology Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
Body of Abstract
Background / Aims : The COVID-19 emergency had a great impact on the psycho-physical wellbeing of healthcare workers (HCWs)1 and several studies underlined high rates of fatigue and mental health issues among them2-3. Given this scenario, this research aimed to assess the psychological wellbeing of different categories of HCWs (doctors, nurses and healthcare assistants) at a hospital in northern Italy, and to study the psychological outcomes equine facilitated interventions vs. other types of supportive interventions or no intervention
Methods : This cross-sectional study was conducted in May 2020 at a public hospital located in northern Italy. To be included in the study, eligible participants had to be aged ≥18 and fluent in Italian. Given these inclusion criteria, 175 HCWs were included in this research. Participation was voluntary and all the HCWs involved in the study returned signed consent form.
Self-report questionnaires were administered, at the end of interventions, to all the participants to collect (1) demographic and workplace data, (2) information about whether the HCWs were involved in equine therapy, or other types of interventions, or didn’t participate to any intervention, (3) symptoms of anxiety (Generalized Anxiety Disorder Scale [GAD-7])5 and depression (Patient Health Questionnaire [PHQ-9])6, (4) perceived stress (Perceived Stress Scale [PSS])7, (5) professional quality of life (Professional Quality of Life Scale [ProQOL])8, and (6) post traumatic growth (Post Traumatic Growth Inventory [PTGI]).
Statistical analyses were conducted using SPSS (25). Descriptive statistics were obtained to examine participant psychological wellbeing according to the cut-offs scores of the scales, as indicated by the literature. Anxiety, depression, perceived stress, perceived quality of life and post traumatic growth were included as dependent variables in a Multivariate Analysis of Variance (MANOVA) to investigate the psychological outcomes of equine facilitated psychological support vs. other types of interventions vs. no intervention.
Results : All the scales had a good internal consistency (α>.70) and an approximately normal distribution.
As defined by conventional cut-offs, 36,6% (N=34) HCWs reported moderate to severe levels of anxiety and 31,4% (N=55) HCWs reported moderate to severe symptoms of major depression.
The MANOVA revealed a significant effect (p<.05) of the support interventions on psychological outcomes of HCWs F(7,163)=2,360; p=.025. Univariate F-tests showed a significant effect (p<.05) on post traumatic growth F(2,168)=6,149; p=.003 and post hoc analyzes (using a Bonferroni correction) pointed out that in HCWs who participated at the equine facilitated intervention(N=53) there was significantly greater post-traumatic growth (M=43,19; SD=23,82) compared to those (N=57) who didn’t participate in any intervention (M=27,95; SD=20,93).
Conclusions : Equine facilitated psychological support were found to be interventions that positively influence the quality of life, containing post-traumatic stress symptoms and favoring the development of resource and resilience aspects in subjects following a traumatic experience.
This study can contribute to explicate the mechanisms by which equine facilitated interventions may be effective in the treatment of trauma. However, it has limitations especially with regard to the lack of pre-intervention data collection and the non-random assignment of participants to groups.
keyword : health workers, equine facilitated psychological support, COVID 19
Case study: The Equine Therapy Assistance Program in Skills Development in Addiction.
Claudia MOTA*, Sarti ALINE, Mitiyo MENDES 35, Instituto Passo a Passo, Brazil
Body of Abstract
Background / Aims : This study aims to present a case that deals with the treatment of an individual in Equine therapy, using the Equine Therapy Assistance Program in Skill Development (PAEDHA) methodology for Addiction in the context of groundwork with free horses.
Methods : the project has been approved by the Research Ethics Committee of Universidade São Francisco (CAAE: 17152019.0.0000.5514); the participant signed the Free and Informed Consent Form (TCLE, in Portuguese), assuring us that his case could be published. The participant of this research was a 36-year-old male, a member of the therapeutic community specialized in addiction in a countryside city in São Paulo state, who is undergoing re-entry into society. The approach of this study was qualitative of the exploratory descriptive type. There were five 50-minute sessions; the first one was on anamnesis, while the others took place in the setting (arena and indoor horse track) at an equine therapy center. As the PAEDHA approach was used, throughout the sessions, some materials have been included in the setting in order to act as symbolization elements (a big ball, sticks, hay, a drum and a whiteboard), and sessions have been divided into three phases: warmup - when the participant would share their complaint or issue to be dealt with; the activity itself, when he relate his issues with the elements on the track and the horse dynamics, when the process and , by means of analogy, compare what happened on track to their primary issue.
Results : The approaches used matched the participant’s projection, their latent content; some metaphors/symbolizations were the naming of horses, challenger, happiness, and isolation, which enabled him to be in contact with his subconsciousness and imagine them. Throughout the sessions, the participant searched for his happiness, a topic raised by himself. In the session before the last one, he made an important move for his psychoeducative and therapeutic process, where the facilitator stands in a position for the participant to think about “what movement I should make to find happiness?”; the participant has an insight and says: “it depends on me”. In the last session, there was a rescue of all previous sessions; he managed to give other names to the horses according to his progress/development, such as: happiness, calmness, and provocative. For him, the negative aspects are also present and needed for his development process.
Conclusions : The psychoeducative and therapeutic process has enabled him to be in touch with the latent aspects, which led him to use psychoactive drugs; with that in mind, the creation of such demands has helped rebuild his purpose for life in search of his own happiness in simple things, like bonding with his daughters again. This case study has shown the possibility of a treatment using the PAEDHA strategies in the context of a free horse, which, through dramatization, enables the creation of content that is not accessible to the consciousness.
keyword : PAEDHA, Chemical Addiction, Equine Therapy
Effects of horseback riding for preventive care on the quality of life, the physical function, and the mental health of community dwelling elderly
aho KAWABE*, Rika MIURA, Aiko KOJIMA, Naomi ESASHI, Yasuhiro NAKAJIMA, Toshiaki TANAKA 1 Department of Horse assisted therapy, Non-Profit organization Piskari, Japan 2 Department of Product System, Industrial Research Institute, Hokkaido Research Organization, Japan 3 Department of Physical Therapy, Faculty of Health Sciences, Hokkaido University of Science, Japan 4 Institute of Gerontology, The University of Tokyo, Japan
Body of Abstract
Background / Aims : The effects of horseback riding on the physical and mental health of the elderly have been shown. However, there are few reports on the effect of horseback riding on the quality of life (QOL). The aim of this study was to investigate the effect of horseback riding on the QOL of the elderly and the relationship between their QOL, motor function, and psychological stress.
Methods : The participants were 13 community-dwelling the elderly who consented to participate in the study (mean age: 87.0). The horseback riding program was offered once a month in 2019. The horse was led by the leader and the walking speed of the horse was 110m/min for approximately 15 minutes with the side-walkers. The evaluation of the study used the health-related QOL (HRQOL) using the Japanese version of the MOS 36-item short-form health survey (SF-36) and the six items (the 5m walking time test (5MWT), the one-legged stance test (OLS), the functional reach test (FRT), the grip strength (GS), the timed up & go test (TUG) and the sit and reach test (SR)) of the motor function at the beginning and end of the program period. Moreover, the salivary alpha-amylase activity (sAA) was measured to assess psychological stress at before-after a riding session. Data were analyzed using the paired t-test to compare between the beginning and end of the program period and before-after a riding session. And multiple linear regression models were used to determine which factors were associated with the HRQOL. The p-value was used significance level of 0.05.
Results : The results indicated that the social functioning (SF) from the SF-36 was higher than 50 score of the Japanese national norm value at the end. Motor function evaluation showed significant improvement in the OLS and the GS, however, the TUG significantly increased time at the end of the program period. The value of sAA was significantly decreased after a riding session comparing to before a riding session. Multiple linear regression analysis revealed the higher PCS at the beginning was significantly associated with the TUG and the OLS, R2 = 0.84. The higher PCS at the end was significantly associated with changes in the sAA before-after a riding session and the OLS, R2 = 0.78. The higher RCS at the end was significantly associated with the number of horseback riding and the 5MWT, R2 = 0.90.
Conclusions : It may be related to the improvement of SF score in the SF-36 that horseback riding provides the elderly the opportunity to participate in society. In addition, horseback riding may contribute to the facilitation of muscle activation of the trunk from the data of OSL then it may lead to the improvement of dynamic standing balance stability. In conclusion, the results suggested that horseback riding may increase opportunities for social participation, improve dynamic balance, which may help maintain and improve the HRQOL.
keyword : quality of life, preventive care, elderly
Effect of hippotherapy on functional capacity and stomatognathic system in older adults
Edneia Corrêa de MELLO*, Lígia Maria Napolitano GONÇALVES, Isabela Hallak REGALO, Paulo Batista de VASCONCELOS, Elaine Cristina Soares LEITE, Christiane Maus MARTINS, Octávio BARBOSA NETO, Edmar Lacerda MENDES, Simone Cecílio Hallak REGALO, Selma SIESSERE 1 Department of Basic and Oral Biology, School of Dentistry of Ribeirão Preto, University of São Paulo,, Brazil 2 Department of Clinical Coordination, Vassoural Riding Therapy Association, Pontal,, Brazil 3 Department of Sports Science, Federal University of Triângulo Mineiro, Uberaba,, Brazil
Body of Abstract
Background / Aims : Functional capacity is an indispensable parameter to assess the health of the geriatric population, as it can detect a possible risk of falls, a significant cause of morbidity and mortality in these individuals and future dependence to perform daily activities. The molar bite force and the pressure of the tongue and lips are important indicators of the performance of orofacial functions: chewing, sucking, swallowing, speech and breathing. The imbalance of the stomatognathic system, in addition to compromising the performance of orofacial functions, can have an impact on postural balance, involving the other muscular chains in the body. Therefore, the improvement in functional performance, including the stomatognathic system, resulting from the application of therapeutic approaches, is a topic of great interest in clinical studies with elderly people. The present study aimed to investigate the effect of hippotherapy on the functional capacity and the stomatognathic system of older adults.
Methods : To this end, 16 individuals, aged 60 to 79 years, voluntarily participated in a three-month Program of moderate-intensity hippotherapy twice a week, on non-consecutive days, for 40 minutes each session. The benefits of hippotherapy can be optimized when exercises combined with riding are introduced, as directed throughout the Program adopted in this study. The evaluations were carried out pre- and post-Program. Functional capacity was analyzed using the following instruments: Berg's Balance Scale (BSE); Functional Reach Test (FRT), Timed Up and Go (TUG), Six Minute Walk Test (6MWT), 30 Second Sit to Stand Test (30CST), Arm Curl Test (ACT) and Sit and Reach Test (SRT). The stomatognathic system was evaluated using the Iowa Oral Pressure Instrument (IOPI), an instrument used to measure the pressure of the tongue and lips and the digital gnatodinamometer Kratos, used to measure the maximum molar bite force. The data were tabulated and submitted to statistical analysis (p ≤ 0.05) using the GraphPad Prism® software (version 5.0, San Diego, USA).
Results : There was a significant gain in postural control (FRT p=0.0431), in mobility (agility, balance) and in physical conditioning (TUG p=0.0011; 6MWT p<0.0001), in the strength of the lower limbs (30CST p=0.0302), upper limbs (ACT p=0.0100) and tongue pressure (IOPI p=0.0087).
Conclusions : Our data allow us to conclude that regular participation in a moderate-intensity Hippotherapy Program promotes an improvement in the functional capacity and performance of the stomatognathic system of older adults.
Development of a device for retaining good posture of elderly people
Rika MIURA*, Maho KAWABE, Aiko KOJIMA, Naomi ESASHI, Atsushi MITANI, Norio KATO, Yasuhiro NAKAJIMA, Toshiaki TANAKA 1 Horse assisted therapy, Non-Profit Organization Piskari, Japan 2 School of Design, Graduate School of Design, Sapporo City University, Japan 3 Physical Therapy Faculty of Health Sciences, Hokkaido University of Science, Japan 4 Graduate School of Health Sciences, Hokkaido University of Science, Japan 5 Product System, Industrial Research Institute, Hokkaido Research Organization, Japan 6 Institute of Gerontology, The University of Tokyo, Japan
Body of Abstract
Background / Aims : The Nonprofit organization Piskari, has been offering horseback riding to elderly people as therapy for 15 years. The results of posture analysis during horseback riding have shown that many elderly people have pelvic posterior tilt, resulting in unstable postural balance due to increased trunk sway and difficulty maintaining the correct riding posture. For this reason, there is a need for equipment that can maintain good posture during horseback riding. Here, we manufactured a trial device to reduce kyphosis in elderly people during horseback riding, and we verified the results of the device.
Methods : The subjects were four early-stage elderly people (mean age 68.8 years) who were independent for activities of daily living (ADL) and able to horseback ride unassisted at about the level of canter. The device used was a wedge made of urethane, which was inserted between the saddle and the buttocks. Three types of wedge were manufactured, with inclination angles of 3º, 5º, and 7º. Video cameras were used to film the posture of subjects in the frontal plane and the sagittal plane while riding a horse led in a straight line at a walk, and the movement of joints was analyzed by Dartfish 9.0 motion analysis software with sampling frequency of 60 Hz. The joint measurements were the neck angle, knee angle and spinal column angle. Each joint angle was measured without the wedge and with each of the three wedges, and the mean of the four subjects was calculated for each of the four conditions. The mean of five strides was used for each condition as one trial. For the statistical analysis, comparisons between four conditions for the joint angle was performed by means of a one-way analysis of variance and multiple comparisons test, with the level of significance set at 5%. In addition, qualitative motion analyses were performed. All subjects were given a full explanation of the details of the experiment in advance and gave their consent to participate (the University of Tokyo Ethics Committee approval 20-209).
Results : The subjects all showed slight posterior tilt when horseback riding with no use of the wedge. The differences in mean values for the four subjects when not using the wedge and when using each of the three wedges were compared. Neck movement was lowest with the 5º wedge, followed by no wedge (0º). Movement of the spinal column overall was lowest with no wedge (0º) followed by the 5º wedge. Knee joint movement was lowest with the 5º wedge. Upper and lower spinal column movement was lowest with the 5º and 7º wedges.
Conclusions : The results of qualitative motion analysis show that with the 5º wedge, there was a change in posture during riding from pelvic posterior tilt to pelvic anterior tilt and the spinal column maintained an intermediate position between flexion and extension. The elderly participants showed the least movement in the joints with the 5º wedge, suggesting that they maintained a sitting posture with good limb position that may lead to the acquisition of good postural stability.
keyword : elderly people, assistive device, prevention of care
A proposed study to shift TheHorseCourse proven equine-Assisted intervention to VR platform for large-Scale reach
Harriet LAURIE*, Dr Xun HE, Dr Ann HEMINGWAY, Dr Fred CHARLES, Ben LAURIE 1 CEO & Founder, TheHorseCourse, United Kingdom 2 Dept of Psychology, Interdisciplinary Neuroscience Research Centre, Bournemouth University, United Kingdom 3 Dept of Medical Sciences & Public Health, Bournemouth University, United Kingdom 4 Dept of Creative Technology, Interdisciplinary Neuroscience Research Centre, Bournemouth University, United Kingdom 5 Principal Software Engineer, Google Research, United Kingdom
Body of Abstract
Background / Aims : TheHorseCourse (THC; Thehorsecourse.org) ReStart is a highly effective equine-assisted intervention supporting those with mental health or behavioural issues when talk-based treatment is ineffective (Hemingway, A; J 2019, 2(2), 236-246; https://doi.org/10.3390/j2020017)
The role of highly trained horses in THC is to provide accurate feedback as the participant is coached through tasks. The horses are trained to kick a ball, free jump, etc in response to subtle body cues and the emotional stance of the unmounted handler. The horses’ reactions show the participant if they are too anxious, too aggressive, unfocused, communicating poorly. Success is achieved only when the participant provides calm self-leadership and thus functional behaviours are reinforced.
Despite being a highly effective intervention, the scaling of this programme is limited both logistically and economically by the high level of horsemanship skills the THC Facilitators require. For several years, THC has been exploring VR-based solutions to scaling their innovative programme. Until now unavailable, is the technology which would allow THC to replace the highly-trained horses in a meaningful way. A VR programme relying merely on narrative or user-specified responses would be poor . It is important to have a feedback loop, based on the ‘inner life’ of the user. Through experiments with Bournemouth University, THC has ruled out ‘Emotibit’ as inadequate (a wearable sensor for galvanic skin response). New work by Google’s Amber project (Honke et al, 2020; arXiv:2010.15274) shows real promise – a wearable EEG known as “the showercap” which has shown to correctly assess anxiety in real time. We propose to build upon the work of the Amber Project in order to scale THC.
Methods : Pilot study: Firstly, the Amber Project’s established protocol will be replicated with THC participants. Secondly, an assessment of whether measurable change is “visible” via the showercaps during key moments of the intervention will be conducted.
Following a successful pilot study, we will develop a highly-scalable intervention which takes place in a VR gamified context in which the horses’ behaviour is determined by the data generated by the users’ showercap in real time.
Lastly, the VR programme will be robustly evaluated by external academics before large-scale rollout.
Results : A digital approach has opportunities for improvement as the horses’ moods and distractions can be eliminated. Conversely the loss of some ‘real life’ aspects of the horse such as touch and smell may be detrimental. We hope for broadly comparable impacts.
THC is highly effective with those displaying multiple complex needs. Should efficacy prove to be somewhat compromised by the digital shift, there is still potential to support millions of people at a lower level of need. Therefore, at worst the digitalisation of THC can be viewed as early intervention or a preventative resilience building measure.
Conclusions : The potential for this cheap and accessible mental health intervention is vast, providing a much-needed response to a sweeping mental health epidemic. The digitalisation of THC seeks to capture the healing power of horses whilst dramatically increasing its availability and therefore impact on society.
VR in Hippotherapy for Children with Cerebral Palsy
Siena LEE* High School, Asian Pacific International School, Korea
Body of Abstract
Background / Aims : I accompanied students with disabilities to receive hippotherapy for years. Most of the kids were diagnosed with cerebral palsy (CP); the notable symptoms of this disorder are lack of balance, poor social responsiveness and joint attention (i.e. coordinating attention on the same topic/object with another person), and difficulties in motor coordination. Hippotherapy has shown a 30% improvement in posture, 80% growth in coordination, and 50% rise in balance, sociality, and confidence.
Despite the advantages, access to hippotherapy is limited both environmentally and monetarily. Moreover, since the children often lack social and emotional abilities, it is hard for them to optimize 30-minute lessons and require much time and effort until they mount a horse. There have been previous efforts to replicate the physical experience of hippotherapy through VRs, but there have been not many trials incorporating the VRs to support social and emotional training. Thus, this study focused the design of the VR on the social and emotional aspects of hippotherapy. The hypotheses are as follows: a. The VR will enhance the social/emotional responsiveness and joint attention of children with CP. b. As a result of the above, the effectiveness of the actual hippotherapy lessons will be maximized.
Methods : VR Design A VR program (using UNITY) was developed to incorporate the social and emotional constitution of hippotherapy to assist children with CP. It simulates hippotherapy lessons emphasizing interaction with horses during, before, and after lessons. A Head-Up display was used to higher immersion. The implications formulated the program to be engaging, interactive, and educational for the children. Experimental Design Subject of Experiment The experiment was conducted at a horseback riding center in Kyung-Ki, Korea. The investigation was directed over 1 lesson every week for 3 months for 12 children with CP who were new to hippotherapy. They were separated into experimental and control groups with the former incorporating VR. Experimental Method During each lesson, the total number of responses to the instructor, interactions with the horse, and initiations of communication were recorded. The given actions signify a student’s joint attention, concentration, and attempt to communicate. The children were also given a three-point Likert Scale questionnaire after the completion of the session to determine the child's comprehension of the horse's body language, fundamental social skills, and awareness of horses as sensitive entities capable of sharing emotions.
Results : The observation showed that the children in the experimental group displayed an increased frequency of behavioral performance compared to the children in the control group. Also, the outcomes of the Likert Scale questionnaire presented greater learning in those who used VR.
Conclusions : The results indicate that the VR program designed in this study was effective to enhance various emotional and social abilities such as joint attention, communication, and emotional sharing of children with CP. This experiment additionally proved that the VR program could be an efficient supplement to further support the children’s growth in hippotherapy lessons.
Nancy PASCHALL* 246, Horses and Humans Research Foundation and Healing and Learning Through Equine Relationships, USA
Body of Abstract
Background / Aims : Despite the intense need to increase the amount of peer-reviewed research in Equine Assisted Services and that many centers would like to conduct research, centers/programs and practitioners are generally unaware of what it means to be ready to conduct research. This presentation helps centers and practitioners understand what needs to be in place prior to conducting research so that the research projects do not overly stress the capacity and operations of the Equine Assisted Services Center. The primary presenter has developed a "Research Readiness Checklist" based on the experiences of having been involved in several center-based research projects. Meeting these "standards" will help centers to truly be ready, or, alternatively, decide other ways for their organizations to reap the benefits of research. All Centers will be encouraged to develop valid outcomes measurements that contribute data to support the field of Equine Assisted Services.
Methods : A presentation (virtual) of the factors to consider for centers, programs, and practitioners prior to engaging in research. The Research Readiness Checklist, which was developed by the current President of the Board of Directors of the Horses and Humans Research Foundation will be presented and reviewed. Plenty of time will be available for questions.
Results : This presentation will give attendees a tool that they can use to assess their readiness to be a part of research. By using this tool, attendees can look objectively at their center or their program and see if they are ready to take on the additional tasks and burdens that come with initiating a research project. The long-term results of this will be that centers and practitioners will be prepared to implement research projects and not be surprised by the stressors that come with implementing a research project. This will lead to equine assisted service centers, programs and practitioners being ready to become involved in research and thereby increase the amount of research on equine assisted services.
Conclusions : There is a critical need to empirically demonstrate the effectiveness of Equine Assisted Services across diagnoses, the severity of conditions, ages, genders, and the variety of services such as therapeutic riding, interactive vaulting, therapeutic carriage driving, equine facilitated learning, equine facilitated psychotherapy and hippotherapy (Occupational, Physical, and Speech Therapy). Concurrently researching the impact that providing these services has on the equines is essential and ethically responsible. Without increasing the evidence Equine Assisted Services may lose support to organizations and services that can demonstrate measurable outcomes or the lowest overhead expenses as opposed to the greatest impact. Therefore providing a tool such as the Research Readiness Checklist will help centers, programs, and practitioners make sure they are prepared for the additional burden that comes with undertaking a research project. This should lead to more organizations that have the capacity to implement research projects and thereby increase the number of research projects investigating the impacts of equine assisted services on participants and the horses.
keyword : research, readiness, tool
Body of Abstract
Background / Aims :
Group-Housing of horses – a potential source of social stress?
Denise V. HEBESBERGER*, Jacob C. DUNN , Dawn HAWKINS, Claudia A.F. WASCHER 1 Behavioural Ecology Research Group, Department of Life Sciences, Anglia Ruskin University, Cambridge, United Kingdom 2 Biological Anthropology, University of Cambridge, Cambridge, United Kingdom
Body of Abstract
Background / Aims : From an equine welfare perspective, group-housing of horses is recommended as it allows them to regularly socialise and thereby fulfil their social needs. This recommendation also applies to horses that are taking a role in equine-assisted interventions. So far, little is known whether agonistic interactions among group-housed horses constitute a source of social stress. Therefore, we aimed at assessing whether agonistic interactions among horses cause a stress response and whether affiliative interactions facilitate a calming effect.
Methods : We measured the heart rate of 15 group-housed horses during 596 spontaneously occurring agonistic and 416 short affiliative interactions such as sniffs, touches, and head rubs, and 37 grooming events when ranging freely in their fields. For comparisons, heart rate was also measured during behaviours of similar physical activity, such as standing and locomotion. The horse groups have been established at least a year before data collection commencement and comprised different breeds. The horses under study were used for equine-assisted therapy, riding and vaulting lessons, and hacking. This study received ethical approval from Anglia Ruskin University and followed ISAE** and ASAB*** guidelines for conducting research with animals.
Results : The most frequent interactions were mild threats which corresponded to a heart rate increase of 1.56 ± 1.09 (median ± IQR) beats per minute. Thereby, heart rate did not differ from walking, a behaviour of similar physiological activity level (Wilcoxon signed-rank test: n = 14, V = 0.241, p = 0.241). Only around ~1% of all agonistic interactions were of high intensity, which facilitated a heart rate increase of 23.05 ± 18.32 (median ± IQR) beats per minute. Due to the low number of occurrences, only descriptive statistics are given. During short affiliative interactions, the mean heart rate did not differ from standing, a behaviour of similar physical activity (Wilcoxon signed-rank test: n = 14, V = 0.211, p = 0.286). However, the mean heart rate during grooming was significantly lower (~8%) than during standing (Wilcoxon signed-rank test: n = 8, V = 26, p = 0.046, r = -0.53).
Conclusions : These findings showed that agonistic interactions mainly were of low intensity in established horse groups and did not induce a significant stress response. High-intensity agonistic interactions were rare. However, as they corresponded to a pronounced increase in heart rate, we recommend horse owners to regularly monitor the behaviour among group-housed horses. Frequent occurrences of high-intensity aggression could have negative welfare implications, and a change in group composition or husbandry routines should be considered. Short affiliative interactions did not affect heart rate; however, the lower heart rate during grooming indicated a calming effect. This finding suggests that allowing horses to engage in mutual grooming may promote relaxation and positive welfare.
** International Society for Applied Ethology
*** The Association for the Study of Animal Behaviour
keyword : Social interactions, heart rate, socio-physiology
Building Relationships in Equine-Assisted Activities: Overlaps and Differences in Horse and Human Friendship Strategies
Emily KIESON* Research, MiMer Centre, Sweden
Body of Abstract
Background / Aims : Equine-Assisted Activities and Therapies (EAAT) often emphasize the importance of horse partnership and welfare and often incorporate relationship building skills into therapeutic activities. Many of these activities involve restraint, training, or riding techniques that rely on principles of learning theory as opposed to research in pro-social behaviors in horses. In order to determine the interspecies social characteristics of such partnerships, we need to better understand how horses develop and maintain social bonds, how those strategies overlap with human interactions, and how these processes are and are not utilized in EAAT.
Methods : Two separate research projects were used to gain a basic assessment of horse affiliative strategies and the perception of human interactions by horses. The first study involved 200 horses housed in large two large pastures and socially-stable environments. The study involved video footage of horses under low and moderate stress conditions to assess affiliative behaviors between horses and pro-social strategies between chosen companions. The second study assessed the behavioral responses of a small herd of 11 horses to specific interactive strategies of humans in their pasture environment over a course of 8 consecutive visits to determine preference for individuals and interactions.
Results : The results of the first study support the idea that chosen proximity, mutual movement, mutual exploration, and mutually respectful communication play an essential role between favored conspecifics. Behaviors vary depending on context, but the types of communication within individual pairs remains consistent and mutual respect and reciprocation is always part of engagement. In the second study, horses demonstrated fewer stress behaviors during interactions that did not involve physical contact or that were mutually agreed upon by both horse and human.
Conclusions : The findings of these studies suggest that horses rely on communication strategies that are developed between two individuals and that each interaction must allow for each participant to voice willingness or objection, whether between two horses or a horse and a human. The findings can provide greater insight into how we interact with horses in EAAT programs if our actions and activities align with our goals of greater equine welfare, partnership, or relationship skill training. Such findings can also serve to provide more context into improving our understanding of equine social behavior in herd environments in order to improve their social environment with other horses.
Perception of the client’s voice by horses involved in Equine Facilitated Physiotherapy
Magdaléna ŠÁMALOVÁ*, Jitka BARTOŠOVÁ 1 Department of Ethology and Companion Animal Science, Czech University of Life Sciences Prague, Kamýcká 129 165 00 Prague - Suchdol Czech Republic, Czech 2 Department of Ethology, Institute of Animal Science, Přátelství 815 104 00 Prague - Uhříněves Czech Republic, Czech
Body of Abstract
Background / Aims : The aim of the study was to test the hypothesis that vocalization of the client during the Equine Facilitated Physiotherapy (EFPT) influenced physiology and behavior of the horse.
Methods : In total, 4 experienced horses from the EFPT center Caballinus were successively exposed to three different playbacks of a voice of a client during a simulated EFPT unit: the playback with negative emotional valence (negative playback/NP), positive emotional valence (positive playback/PP), and with silence as a control. The client was represented by an experienced rider in order to eliminate the confusing effects associated with the client. Heart rate was measured by Polar Team2 sensors while the physical activity was monitored using the Endomondo LLC mobile application which recorded the total time of the ride, distance [km], and speed [km/h] using GPS. Horse behavior (ears position, neck position and body reaction) was observed during EFPT unit.
Results : Horses expressed higher speed when exposed to NP compared to PP (4.38 ± 0.11 km/h vs. 3.98 ± 0.11 km/h, p=0,05; LSMEANS ± standard error) and increased the heart rate (64.59 ± 0.52 bpm vs. 58.66 ± 0.51 bpm, p < 0,0001). The frequency of conflict behavior (ears backwards) also tended to be higher when listening to NP than PP (12.24 ± 0.96 vs. PP: 11,19 ± 0,96, p=0,08). On the opposite, positive playback tended to slow down the horse's speed and it significantly reduced the heart rate compared to control (3.98 ± 0.11 km/h vs. 4,28 ± 0,11 km/h, p < 0,05).
Conclusions : The results suggest that horses are capable to recognize emotional valence in the voice of the clients, however the voice may be acoustically uncomfortable anyway. The positive valence of human manifestations had obviously calming effects on the horse, while the client’s negative emotions induced frustration even in experienced therapy horses. There is a wide range of other behaviors and characteristics of the client that may affect the horse during EFPT. Therefore, we will focus on other factors, such as the physical instability of the client or behavior of the handler in future.
Horses Healing the Wounded Warrior: A Qualitative Inquiry of Equine-Facilitated Psychotherapy in Treating PTSD for Female Veterans
Dr. Rebecca WARA-GOSS* Founder/Executive Director, LMFT, Ph.D. , Eudaemonia Equine Connections, Inc., USA
Body of Abstract
Background / Aims : Posttraumatic stress disorder (PTSD) is a major concern for military veterans in the United States and current research on women’s experiences in the military and the effects of their postmilitary PTSD are limited. Currently, there are a variety of evidence-based and alternative treatment options for veterans with PTSD, and one alternative treatment option includes equine-facilitated psychotherapy (EFP). EFP is a form of animal-assisted therapy (AAT) that integrates the human–animal bond as part of treatment and recovery. The purpose of this exploratory study was to explore in-depth experiences of the horse–human relationship in EFP with female veterans to elucidate how the horse–human relationship may assist in reducing impacts of PTSD. The research question was, “What is the lived experience of EFP in female veterans with PTSD?”
Methods : The research was designed as an exploratory qualitative inquiry study that utilized semi-structured interviews with 10 female veterans.
Results : The findings from this study included six theme groupings with a total of thirty-three themes found. The most significant themes common to five or more participants included: Emotional discomfort with the horse, Spiritual experience with the horse, Experience of safety with the horse, Visual contact with the horse, Emotional connection with the horse, Beneficial impact of therapy, Increased connection with others, Reduced anxiety, Reduced withdrawal, EFP advocacy for others, and Delayed awareness of PTSD.
Conclusions : Through exploring the nature of the human–animal bond in EFP, this research revealed invaluable insights into the potential healing power of horses and alternative mental health treatment options and served to honor women’s experiences in the military. In addition, this qualitative study provided an opportunity to gather rich detail and general information as to the effects of EFP for sufferers of PTSD.
Effects of Equine-Assisted Learning on Firefighters’ Psychological Stress: A Pilot Study
Dahye SHIM, Tae Woon JUNG, In Kyung LEE, Gumran PARK, Yun Jae PARK, Jeong Yi KWON, Yun-Hee KIM* () 1 Physical and Rehabilitation Medicine, Samsung Medical Center, Korea 2 Equine Industry & Sports, JeonJuKiJeon College, Korea 3 School of Equine Scienc, Cheju Halla University, Korea 4 Department of Horse Management, Sorabol College, Korea 5 Gyeonggi-Do Equestrian Federation, Korea
Body of Abstract
Background / Aims : Firefighters are highly vulnerable to the Post Traumatic Stress Disorder (PTSD) since they are frequently exposed to traumatic incidents in their work environment. However, they are weakly applicable to traditional hospital or office-based forms of treatment. In this context, an Equine-Assisted Learning (EAL) program was undertaken for firefighters in South Korea. The aim of this pilot study was to explore the feasibility of field application of the EAL program, to identify its safety and efficacy in psychological terms, and to generate evidence for future confirmative studies for general use of the program.
Methods : 60 firefighters participated in an eight-week Equine-Assisted Learning (EAL) program consisting of 16 sessions: six sessions of ground activities and 10 sessions of riding activities. The ground activities were designed to allow firefighters to learn how to deal with horses and to enhance their life skills by developing relationships with horses. Before starting the program, the Trauma and Psychological First Aid training was provided by a professional in order to effectively deal with possible psychological crises. The Korean versions of the Posttraumatic Diagnosis Scale (PDS-K), the Center for Epidemiological Studies Depression Scale (K-CESD), and the Difficulties in Emotional regulation Scale (K-DERS) were used for measurements. The study procedure included a pre-test and a post-test for a single group of 60 firefighters.
Results : Participants were divided into two groups according to level of posttraumatic stress symptoms (PTSS): the PTSS risk group and the PTSS non-risk group. Results showed that PDS-K (p < .001), K-CESD (p < .001), and K-DERS (p < .001) scores were significantly reduced in the PTSS risk group. Moreover, in the PTSS risk group, there were greater improvements with significant group x time interactions: PDS-K (F= 23.576, p=.001***), K-CESD (F=6.757, p=.012*), and K-DERS (F=6.094, p=.017*). Significant reduction was also found in all sub-scales of PDS-K: re-experiencing, avoidance/emotional numbing, and hyperarousal.
Conclusions : This study showed that EAL is effective in improving firefighters’ PTSD, depression, and difficulties in emotional regulation. Also, our results showed greater improvement in psychological stress in the PTSS risk group than in the PTSS non-risk group. These findings suggest that EAL is effective in relieving PTSD and PTSD related symptoms in firefighters who have levels of PTSD that are subsyndromal or more severe. Lastly, this study as the first EAL pilot study successfully conducted in South Korea verified the feasibility, safety, and psychological efficacy of EAL. This is meaningful in that the results of this study support the general applicability and efficacy of EAL across cultures.
The Effects of Equine Assisted Learning on Improving Stress, Health and Coping Among Quarantine Control Workers in South Korea
Sunju SOHN*, Taewoon JUNG, Yun Jae PARK, Jeong-Yi KWON, Jihyeong JEONG 1 Dept. of Social Welfare, Cheongju University, Korea 2 Dept. of Therapeutic Riding, JeonjuKijeon College, Korea 3 Gyeonggi-Do Association for the Disabled, Gyeonggi-Do Association for the Disabled, Korea 4 Dept. of Physical & Rehabilitation Medicine, School of Medicine, Sungkyunkwan University, Korea
Body of Abstract
Background / Aims : Foot-and-Mouth Disease (FMD) and Avian Influenza (AI) frequently occur in South Korea, resulting in high levels of occupational stress among quarantine control workers who are forced to partake in massive killings of livestock. This study explored the usefulness of Equine Assisted Learning (EAL) in improving the psychological and emotional functioning of these workers.
Methods : A total of 51 FMD/AI control workers participated in 16 sessions of an EAL program, facilitated by therapeutic riding professionals and trained horses.
Results : Results showed significant changes in their level of stress, coping style, and overall quality of life related to health, most notably increased vitality, enhanced emotional and social functioning, greater problem-solving and less social avoidance after EAL participation (pre stress M = 17.8, SD = 4.41, post stress M = 14.9, SD = 4.2, p<.001; pre depression M = 44.2, SD = 6.9, post depression M = 35.8, SD = 6.2, p<.001).
Conclusions : Usefulness of equine assisted activities and the association between greater stress coping ability and improved functioning in various areas of life are consistent with previous research findings. Implications for EAL application are discussed.
keyword : Equine Assisted Learning, stress reduction, quarantine control workers
Reconstruction of children’s perspectives on horse-Assisted interventions: Work in progress
Annika BARZEN* Rehabilitation and curative education, University of Cologne, Germany
Body of Abstract
Background / Aims : In this presentation the research progress of a cumulative dissertation from the University of Cologne (Germany) will be summarized. In this project four scientific articles have already been published to prepare the main survey, which will be carried out during the year 2021. The focus of this PhD-project lies in the reconstruction of children’s perspectives on horse-assisted interventions in order to supplement existing results from the research field. The research interest is dedicated to a research desideratum, since the children’s perspective has hardly been scientifically considered in this context. In order to understand what is relevant for children about horse-assisted interventions, they themselves are included in the empiric part so that they can explain their own relevances. This opens up a new perspective on existing research results, which offers a deeper understanding of the effects of horse-assisted interventions and also includes the possibility of evaluating the practical implementation.
Methods : How children perceive horse-assisted interventions is to be worked out with the help of open guided interviews and grounded theory. The open attitude should prevent the results from being influenced by assumptions. The coding methods from grounded theory are used to evaluate the interviews and a circular process of data collection and analysis is followed. Furthermore, drawings of the children of themselves in the stable are collected and analyzed in order to offer a further means of expression in addition to language. In published papers, the methodological considerations have proven themselves in a pilot project with three children at-risk. Based on the empirical data, research priorities could be set for the main survey.
Results : Until now the main findings from the published empirical articles show the relevance of mastering challenges with the horse for the surveyed children. Through the challenges with the horse and the support from the riding instructor there arise different learning situations wich allow the child to experience their own self-efficacy.
Conclusions : The findings from the previous work are used for the main study with the aim of specifying and expanding the results that have already been published. The qualitative methods of analyzing children’s interviews and drawings will be applied again. Around 20 qualitative interviews and drawings should be conducted with children at-risk from 7-14 years who have been participating in a horse-assisted intervention for at least 2 months. Children from 2-4 institutions will be interviewed. In order to obtain further background information on the respective intervention, the implementing personnel are also asked to fill out a questionnaire.
keyword : Equine-assisted-intervention, children's perspective, grounded theory
When Children Encountering Animal-Assisted Education - A Case Study in Taiwan
HaoJu HSU, Jannette Wei-Ting Wang GUTIERREZ * (email@example.com) 1 Department of Sociology and Social Work , Fo Guang University, Taiwan 2 Department of English Language and Culture, Tamkang University, Taiwan
Body of Abstract
Background / Aims : The phenomenons such as "grandparenting," "single parenting," or "latchkey child" are increasing in Taiwan society. Meanwhile, child-caring or upbringing is no longer by parents only. It is often outsourced to after-school programs provided by child daycare, torturing centers or other talent classes in the market. However, there are difficulties in obtaining such services for rural communities with relatively few resources or hard to afford for middle-down families. On the other hand, more and more children are described as having "attention deficit hyperactivity disorder(ADHD)," "emotional management difficulties," or "learning disabilities" in the school. These children often lead to low motivation, achievement, confidence, or difficulty in interpersonal relationships. After seeing the needs of children in the local area (Nanhua community, Hualien county), the Taiwan Child Development Association Equine Assisted Education Center cooperates with the local community to promote the "long-term community empowerment program" (hereinafter referred to as the Long-term Program). Through multiple and rolling revisions of equine/animal-assisted courses, it accompanies local children in their after-school time and hopes to empower them in the long term.
Methods : This study uses qualitative methods to conduct in-depth interviews with coaches of equine-assisted courses, primary caregivers(parents) of children and other key participants (e.g., primary school teacher). The main focus is the experience of the "Long-term Program" from 2013 to 2019 and the effects on children. Furthermore, the researcher entered the field as an observing-participant during the first semester of 2019. Template analysis is adopted in the data analysis strategy.
Results : The impacts of Long-term Program on participated children (at least joined for a whole year) include four aspects as below:
1.Ability enhances: children's ability to observe both people and animals is improved and expression skills. Some children develop their leadership, showing a sense of empowerment at the interpersonal level.
2.The formation of positive self-esteem: children have positive development in their concepts of "achievement," "sense of competence," "autonomy," "self-efficacy," "self-affirmation," and "self-expectation" to enhance children's sense of power at the individual level.
3."Character building": Children demonstrate essential core values of personal characters, such as "responsibility," "self-discipline," "respect," "caring for others, animals and environment." The respondents observed the display of characters from courses of the program, school classes, or private family time.
4."Enhancement of interpersonal relationship": animal-assisted education plays the function of "social support" and "social catalyst" to reflect and assist children to regulate their self-emotions and moderate social emotions, as well as improve social skills, effective communication, or cooperation in a group. Children likewise increase a sense of belonging to the Equine Assisted Education Centre and their community. These include the sense of empowerment at the interpersonal and community level.
Conclusions : As an external resource to provide free services for children and their families, the "Long-term Program" is not only a benefit from animal-assisted education; it is also a community effort to help families, sharing their burden of raising children. It responds to the needs of local families in order to stimulate or furtherance children's development.
keyword : animal-assisted education , children development , community context
Systematic Review and Meta-Analysis of Benefits of Equine-Assisted Interventions for Children with Autism
Nina FISCHER VON EDELAU* School of Population Health, Curtin University, Australia
Body of Abstract
Background / Aims : Despite not being considered evidence based treatments and not being included in treatment guidelines, intervention approaches using horses in a therapeutic setting (equine- assisted interventions; EAIs) have rapidly gained popularity for children with Autism Spectrum Disorder (ASD), due to their promotion in popular media and their increased availability as part of a shift to self-determination in health care and self- managed funding models and disability insurance schemes. The aim of this study was to determine benefits and effectiveness of EAIs for children with ASD by assessing the existing research literature against a combination of guidelines for evidence- based/ empirically supported treatments, examining study quality and risk of bias, and estimating effect- sizes through meta-analytical procedures.
Methods : A narrative review of existing literature and a meta- analysis were conducted following the Preferred Reporting Items for Systematic Review and Metanalysis (PRISMA) guidance, with the final database search being concluded in November 2019. An inclusion based approach considered all possible quantitative studies examining goal oriented, structured therapeutic interventions and activities where horses played a central part for children up to the age of 18 years with a diagnosis of ASD. Studies were reviewed narratively based on intervention, participant and study characteristics and assessed for methodological quality and risk of bias. A selection of studies that captured the most common outcome variables on well- established outcome measures were further analysed through random effects meta-analytical procedures.
Results : A total of 44 studies from peer-reviewed journals and academic dissertations were included in the narrative review. For outcome domains of ASD symptom severity, social skills and problem behaviour, the emerging evidence suggested that EAIs could be considered as probably efficacious treatments. In addition, meta-analytical procedures confirmed that EAIs had a medium effect on ASD symptom severity (g = 0.413, 95% CI [0.153, 0.673] p = 0.002) and social skills (g = 0.423, 95% CI [0.212, 0.634], p < 0.001). However, methodological weaknesses like lack of randomisation, inadequate blinding and lack of standardised intervention protocols were identified in this review. Studies also failed to conceptualise and test possible underlying mechanisms of change.
Conclusions : Despite results being encouraging and indicating that EAIs provide a range of benefits and demonstrated an effect on ASD symptom severity and social skills, the current study further confirmed ongoing areas of methodological difficulties that should be addressed in future research. Future research should also give consideration to how different treatment components relate to therapeutic outcomes and how therapeutic effects could be maximised.
Cognitive Behavioral Therapy and Hippotherapy - possibilities of a common path
Magdalena PIKUL* Therapeutic and Sports Stable at the Special Educational and Care Center in Wierzchosławice-Dwudniaki, Poland
Body of Abstract
Background / Aims : The aim of the presentation is to provide basic information about Cognitive Behavioral Therapy (CBT) and to determine conditions that must be met for any form of influence (including hippotherapy) to be considered as psychotherapy. Psychological benefits of hippotherapy are explained on the basis of the Bowlby’s Attachment Theory, the Self-Determination Theory of Motivation by Deci and Ryan and the Ellis Model. The results of own research are also used. Subsequently, techniques and mechanisms of CBT which, to some extent, may be present during hippotherapy, are explained. The following issues are discussed: work with non-adaptive thoughts (through cognitive restructuring), behavioral activation, the role of experiences related to pleasure and reward, mindfulness training and emotional regulation. Various mental disorders were referred to, including depression, anxiety disorders, obsessive compulsive disorder.
Methods : Literature analysis analysis of research reports
Results : Hippotherapy and other equestrian activities can constitute a source of psychological benefits that can be explained by the mechanisms described in Cognitive Behavioral Therapy. In Horse Assisted Psychotherapy, it is possible to use CBT techniques such as: work with non-adaptive thoughts, behavioural activation, engaging in activities related to pleasure and reward, mindfulness training and emotional regulation.
Conclusions : So what are the possibilities of a common path of hippotherapy and CBT psychotherapy? First of all, Horse Assisted Cognitive Behavioral Therapy: conducted on the basis of a specific paradigm by a psychotherapist who, because of conceptualization, decides to enrich his work by adding activities with horses. Secondly, activities conducted by a hippotherapist or a riding instructor in cooperation with a psychotherapist, in accordance with his recommendations. Thirdly, it would be worth for hippotherapists working on other goals (e.g. related to physical improvement) to have knowledge about mental functions and, based on it, influence the motivation and general well-being of the patient. All these interventions need reliable research to verify their effectiveness. In addition, they should be used by people who understand the need to adapt the methods of intervention to a particular patient and circumstances. It is also worth noting that an additional possibility of a common path is using the theoretical and empirical background of CBT as a source of knowledge helpful in explaining the phenomena observed in hippotherapy.
Promoting safety in HAT for Complex Trauma: an application of Integrative Model of Human Animal Interactions through case study
Charlène LECONSTANT*, Elisabeth SPITZ Health Psychology, APEMAC, Université de Lorraine, France
Body of Abstract
Case : A growing number of researches suggests that Horse Assisted Therapy (HAT) is a promising and evidence-based intervention for the treatment of trauma and stress-related disorders. These so-called alternative or complementary interventions to standard trauma treatments are particularly aimed at patients who do not respond to conventional exposure treatments. However, in addition to studies showing the effectiveness of HAT in reducing post-traumatic stress symptoms, it remains to be understood and objectified by which therapeutic processes these benefits are gained. As of now, a consensus seems to be emerging that the beneficial effects of HAT in the treatment of trauma stem from its ability to facilitate the development of a sense of security in the patient. This process occurs through the horse-patient interactions in the natural and experiential setting offered by this form of therapy. Current recommendations for the treatment of trauma include exposure therapies. In this context, the stabilization phase described by Janet has long been considered a prerequisite, even a preparation of the patient for the treatment of traumatic memories. However, studies now show that the stabilization and safety phase would be effective and sufficient enough to achieve a reduction in post-traumatic stress symptoms. Since researchers now agree that the therapeutic benefits of HAT are mediated by the horse-patient interactions, we suggest that it would be useful to further investigate the processes by which patient/therapist and horse communicate and interact. The Integrative Model of Human-Animal Interactions (IMHAI), which we built, provides a conceptual framework for the study of interspecies interactions and aims to model the main emotional processes involved in human-animal interactions. This model was developed using theoretical contributions from three disciplines deemed fundamental to the understanding of interspecies interactions: neuroscience, psychology, and ethology, with the goal of providing a transdisciplinary approach on which practitioners and researchers can build and collaborate. IMHAI is based on the work of Jaak Panksepp, founder of Affective Neurosciences, particularly the seven primary emotional systems common to all mammals; and the Stephen Porges’ Polyvagal theory, highlighting the role of the autonomic nervous system in social and defensive behaviors. These two theories have the advantage of being common to both humans and animals and are largely part of existing theoretical frameworks for understanding trauma and its treatment. The perspectives offered by the application of the IMHAI applied to HAT for the treatment of complex trauma will be discussed through clinical cases. The case reports will present the psychological evolution of patients admitted to the aftercare center for the treatment of concomitant Substance Use Disorder and Post-Traumatic Stress Disorder, with concrete and practical examples of the use of IMHAI in HAT for the treatment of complex trauma.
Trauma Sensitive Equine Assisted Mindfulness (TS-EAM) for Cancer Patients with Post-Traumatic Stress
Katarina LUNDGREN* 224, MiMer Centre/Lund University, Sweden
Body of Abstract
Background / Aims : As a trauma sensitive mindfulness instructor, an equine assisted growth facilitator, a cognitive science student and an educator in the field of equine assisted interventions, also being a trauma survivor, I have worked through why mindfulness and experiential therapy and learning with horses did not always work the way they these interventions were supposed to. It intrigued the researcher in me, and I dove into studies of mindfulness, experiential learning and therapy with horses, as well as trauma and dissociation. The result of these studies and my own experiences of trial and error, moving through my own trauma therapy and mindfulness instructor trainings, is a 10-week program we (MiMer Centre) call TS-EAM – Trauma Sensitive Equine Assisted Mindfulness. We have received a small grant from the Kern-Godall Foundation in Norway, to set up a study group and to do a pre-pilot to explore how we can adapt this program to help cancer survivors with
Methods : In both traditional mindfulness methods and EAP/L the goal is to help clients become more present. In my studies of TSM (Treleaven, 2018) I found the theoretical framework I needed to explain my own experiences of why this often does not work. What works is instead to break down what presence is and how to get there, into smaller steps. Presence is necessary to be able to work with and integrate trauma, but presence is also what is triggering to a dissociative person, or any traumatized person. Dissociation, as well as trauma induced anxiety, needs to be handled with care and respect. It has often been a lifelong strategy to handle adverse experiences.
We currently work with these steps in our 10-week TS-EAM program (they will continuously be evaluated):
In the Norwegian study we have gathered a reference group with cancers survivors, experts on cancer, mindfulness, and equine experiential learning and therapy, to help us build a tailormade TS-EAM program for cancer patients struggling with post-traumatic stress. The reference group will go through the 10-week program and give us their feedback. This is the first step towards doing the full study we have in mind.
We are also preparing a Swedish study using our 10-week TS-EAM program for young girls at risk.
Results : Due to Covid the Norwegian study has been somewhat delayed. We will continuously report how our work is progressing, and HETI 2021 is the first time we bring these several years of prepatory work to the public.
Conclusions : Building good programs is a slow process. Merging different modalities is a delicate work, 1+1 does not equal 2. Bringing TSM together with EAL/EAP looks very promising. If it gives the results we predict, TS-EAM will be a good intervention to help trauma survivors develop tailor-made mindfulness toolboxes to reach more presence and better quality of life. It can either be offered as a standalone intervention, as a preparation or supplement to trauma therapy.
keyword : Equine Assisted Mindfulness, Trauma Sensitive/Informed, Cancer
TheHorseCourse reduces domestic violence & abuse incidence by 51% – How? A close look at the method behind the evidence
Harriet LAURIE*, Dr Ann HEMINGWAY 1 CEO, TheHorseCourse, United Kingdom 2 Public Health, Bournemouth University, United Kingdom
Body of Abstract
Background / Aims : Domestic violence is rising and the COVID pandemic has only made matters worse.
Recent findings from Bournemouth University show that the work of TheHorseCourse, an equine-assisted charity in Weymouth, UK, with ‘Troubled Families” resulted in a 51% drop in incidence of domestic violence and abuse (DVA) over a 12 month period whereas the control group showed an increase of 17%. This study showed efficacy with an experimental group of n=268 and a control of n=10569, results were statistically valid, with a significant difference level of p<0.05.
The lead academic and the founder and CEO of the charity explore and reflect on materials illustrating how this was achieved by the equine-assisted programme, ‘The ReStart’.
Methods : A variety of data sources feed into this reflective process:
Methods will be illustrated by video clips of real participants* engaging and being coached through the same equine-assisted exercises that were employed with the families in the DVA study referred to above
Diagrams and written materials describing the ReStart programme. The ReStart is delivered on 5 consecutive days, 2 hours per day with 1-to-one facilitation of horse interactions which take place primarily on the ground (unridden) using halter and rope, or at liberty. To an onlooker, tasks might look like circus tricks – kicking a giant ball or mounting a pedestal, but the participants are taught to communicate clearly and effectively with the horses using their focus, energy and intention rather than pulling on ropes or pushing the horses.
The equine-assisted processes embed core skills such as self-calming, assertiveness, focus and planning, which are built rapidly through action-based learning with skilled facilitators and highly trained horses. The ReStart is unusual in that it relies heavily on teaching these skills through rehearsal in a task-based context with the horse, and actively avoids a talk-based approach.
anonymised case notes for five representative families in the study
written and/or video reflections from the group of facilitators employed in the study
written and/or video reflections from the families who participated in the study
* All video footage and photographs will have appropriate consent, or can be blurred in accordance with conference preferences. All case notes will be fully anonymised.
Results : Reflections on the ‘active ingredients’ of the intervention, the journey of change and how it is experienced by the participants.
Conclusions : Typically, DVA interventions are talk-based and focus on both psycho-social skills and specific risks and triggers for abuse. This study suggests that an action-based non-DVA-specific intervention could be as or more effective than existing talk-based programmes. This is an important opportunity for future practice both in DVA services and in the Equine Assisted sector.
keyword : DVA, Domestic violence and abuse, equine-assisted
Therapeutic Riding (TR) for Children with Different Diagnosis Categories
Anne BARNFIELD*, Andrea CAREY, John MITCHELL 1 Department of Psychology, Brescia University College, Canada 2 Fowler-Kennedy Sport Medicine Clinic, University of Western Ontario, Canada
Body of Abstract
Background / Aims : The effectiveness of Therapeutic Riding (TR) physically is well known, and more recently effects for psychological issues have begun to be investigated. There is now much evidence for beneficial psychological effects of TR (and other activities involving horses) for those with Autism Spectrum Disorders (ASDs), but there has been less research into outcomes for other special needs. This study builds upon prior research by more specifically investigating the psychological and emotional effects of TR with children from different diagnosis categories.
This study was run to investigate the psychological and emotional effects of TR for children with a variety of special needs. It was anticipated that analyzing results by category of diagnosed disorder would show whether certain disorders, or particular aspects of any disorder, were specifically affected by participation in TR
Methods : The study used a within subjects design of pre-treatment versus post-treatment comparison, with measures at four time points across three courses of TR sessions. A convenience sample of children with diagnosed special needs, enrolled for TR sessions, were recruited via the local TR centre, SARI Therapeutic Riding. Participants were subdivided by diagnosis into three groups: Autism Spectrum Disorder, Developmental Disability, “Other” (e.g., Down syndrome, Fetal Alcohol Spectrum Disorder – FASD).
Participants engaged in three sets of 10, weekly, TR sessions. Data was collected through parental questionnaires and researcher observational checklists. Parents completed an adapted version of the “Camper Growth Index – Parent Survey” (CGI-P; acacamps.org), modified for use with weekly TR sessions, at pre-course and post-course time points (four in all). Parents could add written comments regarding the TR sessions and outcomes at the end of the questionnaires. The researcher completed pre-, and post-course checklists, adapted from the ACA Camper Growth Index – Observational Checklist (CGI-O). All measures were scored on 4-point Likert scales ranging from 1 (strongly disagree) to 4 (strongly agree).
Resulting data was subject to quantitative analysis of parental questionnaire responses and researcher observational checklist scores. This quantitative data was analysed with within- and between-factor ANOVAs. Qualitative data (parental survey comments) was also examined, giving more in-depth information on the participants’ experiences.
Results : Due to the low numbers in diagnostic categories other than ASD and the large number of participants with an undisclosed diagnosis, participants were divided into two categories for analysis: ASD and Other. For all participants, improvements in scores on pre- versus post-session measures were found. Significant improvements were seen in positive identity constructs such as self-esteem, however results for other constructs were more variable. Some other domain categories approached significance (Leadership, Positive Values and Physical Skills), but none of these other domain categories showed statistically significant effects. Findings regarding the ASD group were in line with other studies, with significant improvements for the ASD group in self-esteem and in peer relationships.
Conclusions : Although further research in this area, with larger participant groups, needs to be done it can be concluded that TR is a beneficial activity for children in all diagnostic categories, with particular social-emotional benefits for those with ASDs.
Novel Adaptive Riding Intervention for Youth with Anxiety: Fidelity Outcomes
Lauren SEIBEL*, Dana SEAG, Fei GUO, Meghan MORRISSEY, Robin PETH-PIERCE, Mary ACRI, Emily HAMOVITCH, Sarah HORWITZ, Kimberly HOAGWOOD 1 Child and Adolescent Psychiatry, New York University School of Medicine, USA 2 Public Health Communications Consulting, LLC, USA 3 Child Development Institute, Canada 4 Population Health, New York University School of Medicine, USA
Body of Abstract
Background / Aims : Rates of anxiety are increasing, and half of children with anxiety do not receive needed treatment (Whitney & Peterson, 2019). Novel treatments are needed to expand the availability of and facilitate engagement in treatment. Equine-assisted services have shown promise in improving children’s mental health issues, including anxiety. However, there are currently no manualized, evidence-based, equine-assisted services that have been rigorously studied for youth with anxiety (Latella & Abrams, 2019). The purpose of this study is to examine fidelity of delivery of “Reining in Anxiety”, a novel adaptive riding intervention for youth with mild to moderate anxiety. Reining in Anxiety is a ten-session, manualized intervention that combines evidence-based practice components found to be effective for treating youth anxiety with progressive horsemanship skills (Acri et al., 2019). The intervention was designed to be delivered by Professional Association of Therapeutic Horsemanship International (PATH)-certified therapeutic riding instructors (CTRIs), who are trained in teaching horsemanship and understanding disabilities, but typically do not have any formal mental health training.
Methods : A pilot trial of Reining in Anxiety was conducted in a random sample of 41 youth (ages 6 to 17) with mild to moderate anxiety and their parents. Children were assigned to either the intervention group or control group (standard adaptive riding group). Three PATH CTRIs were trained in Reining in Anxiety, and two actually facilitated groups (one instructor was trained as a back-up in case of primary instructor absence). The instructors received a 3-day in-person training from a licensed, master’s-level mental health professional who was also PATH-certified (and co-developer of the intervention). Instructors received implementation supports and weekly supervision throughout delivery of the protocol. Fidelity assessment entailed raters using a yes/no rating of the delivery of a standard checklist of key elements for each session. In the first semester, fidelity checks were conducted on 100% of the sessions. Because the fidelity in the first semester was so high (98.7%), we conducted fidelity checks on 20% of lessons in the remaining semesters.
Results : Fidelity of individual sessions ranged from 93.3% to 100%, with a mean rating of 98.7%. Separate analyses of fidelity by instructor showed: Instructor 1 addressed 98.1% of the elements across the 10 sessions (range 88.9%-100%) and Instructor 2 addressed 99.7% of the elements (range 98.0%-100%). For 34% of the sessions for which fidelity was assessed, a second research team member rated the sessions. Inter-rater reliability was excellent, k=0.92.
Conclusions : These fidelity data confirm that the intervention was delivered as intended and attained a very high level of fidelity (98.7%), well beyond the threshold for high fidelity (e.g. > 80%) established in the literature (Garbacz et al., 2014). This pilot study is the first to demonstrate fidelity of delivery by PATH CTRIs of an adaptive riding intervention built upon evidence-based practices for treating youth with anxiety. The successful delivery of this intervention has important implications for expanding access to community-based mental health services beyond traditional mental health settings, potentially helping to address the gap between the need for and use of evidence-based youth mental health services.