Terry Lewis quoted on DrKoop.com
Healing on Horseback
Riding Provides Unique Alternative to Therapist's Office
Jill Max
drkoop.com Health Correspondent
Anyone who's ever loved a pet knows that relationships with animals can be very satisfying. Horses are no exception. But in the right hands, horses can do much more than provide pleasure and a bonding experience. They can also be used in psychotherapy, allowing patients to work through their problems in unexpected ways.
Like standard psychotherapy, equine facilitated psychotherapy can be used for a wide variety of disorders, ranging from behavioral and mood disorders to substance abuse, trauma and psychotic disorders. There are certain elements that are common to both, such as taking a history, setting goals, and getting to know the patient. But equine facilitated therapy gives patients the opportunity to do something they can't do in a therapist's office. They get to ride, groom, lead or just stand next to a horse. For some, that can be a powerfully healing experience.
Something Else to Focus On
The difference between therapy in an office and therapy with a horse starts with the first visit. Often the time spent getting to know a patient is significantly reduced, according to Terry Lewis, LCSW-C, executive director of Great Strides Therapeutic Riding in Damascus, Md., who has practiced both types of therapy. When dealing with children and teens, a lot of them are there because their parents make them come. "It's harder to get to know someone when they don't want to be there," she says. "Here, a lot of that is diffused because of the horse."
One of the biggest attractions about this type of therapy is that patients want to do it. "Motivation is probably the most underrated aspect of treatment with horses," says Maureen Vidrine, M.S., R.N., C.S., a clinical nurse specialist in psychiatry who is also an advanced therapeutic riding instructor.
Lewis said that unlike her previous practice in an office setting, no-shows at Great Strides are rare. In fact, equine facilitated therapy often works for people who haven't had success with other types of treatment. "I find that people who come to me have been to three different therapists," says Lewis. "They don't know what else to do."
Coming to a barn instead of a therapist's office is also a plus for some people. No one needs to know they're in therapy since they could simply be going for a ride. "For a lot of people who come from a clinical setting, when you get into a barn, it's very normalizing," says Michael Kaufmann, director of education for the North American Riding for the Handicapped Association (NARHA) and founding board member of the Equine Facilitated Mental Health Association (EFMHA). "That can be a mental shift that allows you to feel differently, act differently, think differently."
The horse also gives patients something else to focus on while they carry on a conversation. Many parents know that the best time to talk to a child is when you're riding in a car. "This takes advantage of that. It takes the intensity out of it and makes it a lot more relaxed," says Lewis.
A Horse is a Horse, of Course
Of course the main attraction in this type of therapy is the horse. But the horse is more than just a docile bystander in the process. "The horse isn't just a prop," says Kaufmann. "Horses are truly participants. They're looking for interaction and in tune with what's going on."
Horses are very sensitive to body language and can point out inconsistencies between our verbal and nonverbal communication, explains Vidrine. Because of this, patients need to be clear in communicating with them. For people who have trouble with assertiveness or decision-making, directing a horse can be valuable practice for what they need to do in their lives.
But communication doesn't have to be through words. Many times children don't have language sophisticated enough to express what they're feeling, says Boo McDaniel, M.Ed., a NARHA certified master instructor, co-founder of EFMHA and executive director of Horse Power in Temple, N.H. By interacting with the horse in a way that isn't self-conscious, they can get deeper into the therapeutic interaction, she says. For instance, if a child learns how to make the horse stop, that can be used as an opportunity to explore how to tell a person to stop doing something, too.
Actions Speak Louder Than Words
A lot of equine facilitated psychotherapy centers around activity, such as grooming or riding. This can be very important for certain conditions. For instance, for ADHD, Lewis said that moving from one activity to the next helps keep the person's attention. For someone who is depressed, the activity associated with the process can be healing. "Physically moving is hard to do if you're depressed, but it helps," says Lewis. "The physical act of moving and doing something different can help move people through depression."
"The sights, the smells, the sounds of the horse farm have tremendous power," says Vidrine. "You don't necessarily have to ride the horse to have tremendous benefit."
Of course sometimes patients do ride and the rhythm can be relaxing. "It helps people connect with parts of themselves that they haven't been able to get in touch with," says Lewis. Sometimes she is able to challenge patients by testing where their frustration level is and then talking about it. It's different from an office setting because by the time they get to the office they're removed from the problem, but at the farm they can deal with the situation in the moment, she says.
Grooming is another activity that can be healing. "There's a rhythm to brushing, a rhythm to the horse's breathing," says Vidrine. "It's sensory input. It feels like we're rechoreographing neural pathways."
Grooming is also good for children with ADHD because they're very impulsive, and planning the order in which they have to do things is useful, said Lewis. "When you do something and you succeed, there's a level of confidence in you that you own," she says. "You can transfer that to the real world."
Almost all of these activities involve touching the horse, one of the most powerful aspects of equine facilitated psychotherapy. "It is usually less threatening for folks to develop an attachment with an animal than with a person, particularly if they've been victimized," says Vidrine. "We hope that that attachment will eventually generalize to humans." This is particularly true with children with autism, who have trouble forming attachments. It's easier for them to talk to, be interested in, and want to touch an animal, she says.
"For kids or people who haven't been touched appropriately, you can wrap your arms around a horse. It's hard for a therapist to do that," says Lewis. "It's something that in an office, it's really hard to provide."
It's hard to imagine how stroking and petting a horse wouldn't be good for just about everyone. But to some people it can be more than that. "The horse may be the first friend some of these people have had," says Lewis.
What to Look For
If you're looking for an equine facilitated psychotherapy program, Vidrine has these words of advice:
* Look for a NARHA member center. NARHA can be reached at 1-800-369-RIDE or www.narha.org.
* Make sure the person doing the therapy is legitimately practicing psychotherapy, has at least an M.S., and is credentialed in your state.
* Make sure the therapist is extremely familiar with horses and has a lot of expertise or is working with someone who does, preferably a NARHA certified instructor.
* Check to see if the horses seem happy and well cared for, and that the farm has adequate green pastures.
If you're thinking about starting any kind of program that involves horseback riding, get a checkup first. Horseback riding can cause problems to the back, buttocks and sciatic nerves. Start slowly, build up gradually, and stop at first sign of injury.
drkoop.com
Date Published: 6/25/01
Date Reviewed: 6/25/01
Great Strides Therapeutic Riding, Inc. --- www.GreatStrides.org