So what is “equine therapy” anyway? To get a basic primer, you can start with Part 1. In light of recent changes, we've decided to write Part 2. The industry leader, the Professional Association of Therapeutic Horsemanship (PATH) International, is currently working on revising terminology and definitions for the field so some of the specific terms used in this post are subject to change. This blog post will specifically address the use of the term "therapy" and the difference between therapy services and therapeutic activities as currently defined by PATH Intl.

On June 6, 2019, PATH Intl. released a statement regarding use of the term “therapy” in describing and advertising programs for equine assisted activities and therapies (EAAT). In the spirit of greater transparency and more accurate representation of services within the field of EAAT, PATH Intl. stated that only programs providing services recognized as therapy by the medical community and facilitated by licensed healthcare providers may use the term “therapy” when describing their programs and activities. This distinction is crucial in order to understand what types of services are out there and how to decide which type of service will best meet your (or your client's) needs.
 
So what does this mean for the consumer? Well, here are a few questions to ask to figure what the best service is for you and how to find someone who can provide it.
 
Questions to Ask Yourself:

1. What am I looking to get from this service?
2. Are my goals recreational or clinical? That is, do I want to learn about horses and riding or do I want to experience clinically significant mental or physical health changes?
3. Do I want a service that may be covered by insurance?

 
Questions to Ask a Potential Provider:

1. What specific services do you offer?
2. What are your staff’s qualifications?
3. Are any staff members licensed health care professionals? If yes, what license(s) do they hold?
4. What happens in a session/lesson?
5. How will this benefit me?

Here's a quick snapshot of the different types of activities versus therapies and what you can expect from each:

With her big blue eyes and braided blond hair, Katie* bounded out of the car and ran towards the barn. Her aunt yelled after Katie to slow down and wait for her to catch up. Katie burst into the barn like a tornado asking everyone she saw where the horses were.  After a quick introduction to her counselor, Katie made her way down to the play area for her very first session with the miniature horses.

Katie approached the horses much like her entry into the barn – an uncontrolled ball of energy. Startled by Katie’s approach, the horses immediately ran to the other side of the play area. Katie ran after them. Despite the counselor’s efforts to help Katie understand that the horses were frightened by her running, she was frustrated and angry when the horses didn’t want to play with her. In a huff, Katie settled down to play in the sandbox instead.  As she grumbled about the horses being “mean” and ran her hands through the sand, Katie began to relax. A few minutes later, the horses made their way back to Katie and allowed her to pet them.

Prior to living with her aunt and uncle, Katie had a difficult life. Although her mother had tried to provide the very best for her daughter, she had her own struggles. From the time Katie was a baby, her mother would park her in front of the TV to keep her quiet. As Katie got older and became bored with the TV, her mother would yell and scream and even hit Katie. To provide Katie with a safe and secure home, the state awarded her aunt and uncle custody when Katie turned six.

As a result of Katie’s early life trauma and neglect, she had difficulty regulating her emotions and would often become aggressive when upset. She struggled to make friends and didn’t understand why the other kids didn’t like to play with her. As Katie’s time in play therapy progressed, she gradually began to see how her behaviors influenced the horses’ responses to her. Soon Katie began to use the horses’ behaviors as “clues” for understanding her own feelings and behaviors. As her empathy towards others developed, Katie made her very first best friend at school.

​Katie’s story is not unique. As many as 20% of youth suffer from a mental health disorder. Most of these children go untreated, avoid treatment, and drop out of treatment prematurely. With an improvement rate of 90%, our evidence-informed services can be life-changing not only for the child but for the entire family. It is crucial that at-risk youth receive needed mental health care in order to grow, thrive, and become happy, healthy, and well-adjusted.

*Client names and details have been changed to protect client privacy.

Many different children come to us for play therapy. Some children come because they’ve experienced trauma and need a safe place to process their experiences. Other children find themselves feeling sad or worried much of the time. Many of these children struggle in their relationships with friends, family, teachers, and others. While some children may act aggressively, others may hide their true feelings. In order to help children struggling with these issues as well as many others, we use Equine-Partnered Play Therapy. By integrating miniature horses into play therapy, children are able to learn ways to feel happier with themselves and in their relationships with others. Read on to get a closer look at the top 3 things children can learn by playing with horses.

1. Empathy
In order to successfully work with horses, a child must first have empathy. That means the child must be able to understand someone else’s feelings from that person’s (or horse’s!) perspective. Sam came to play therapy to work on reducing his anger and improving his social skills. He frequently bullied and taunted other kids at school and, as a result, did not have many friends. During the first few weeks of play therapy, Sam would often try to startle or “trick” the horses and was confused when the horses moved away from him and wouldn’t let him get close. Over time, Sam began to see that his “bullying” of the horses influenced their response to him. Sam began to notice that the horses responded differently when he approached them calmly and quietly. Over time, Sam was able to connect the horses’ behaviors to their likely feelings. When Sam startled the horses, he surmised that they might feel scared. However, when he approached them calmly, they felt safe. Sam’s parents saw similar changes in his interactions with his classmates and he started getting invitations for playdates.

2. Confidence
As horse people all over the world will tell you, a horse can tell right away whether or not you’re confident around them. In order to convince a horse to allow you to be the leader, you must feel truly confident in what you want and what you’re telling the horse to do next. Jenna came to play therapy because she often felt very anxious around her peers. Jenna rarely spoke in school for fear of saying the wrong thing and being made fun of by her classmates. Over the course of play therapy, Jenna gradually became more confident in her ability to lead the horses. She learned that in order to walk the horses (instead of the horses walking her), she would need to decide what she wanted to take the lead in showing the horse. As a result, Jenna’s confidence grew enabling her to start raising her hand in class and take on leadership roles in small group projects.

3. Self-Control
Many children struggle with the ability to control themselves when faced with strong emotions and difficult situations. Oftentimes, the feelings can be so overwhelming that children don’t always have the internal resources to manage these feelings, which can result in tantrums and outbursts. Jason came to play therapy to work on his disruptive behaviors and tantrums, often in response to frustration or being told “no.” Jason was very interested in the horses and tried to find ways to integrate them into much of his play. Despite Jason’s best efforts, the horses did not always play along – at least not the way Jason wanted them to. While at first Jason would get mad and call the horses “stupid,” over time Jason began to notice that the horses often moved away when he became frustrated. He learned that in order for the horses to feel safe, he would need to be calm. Jason began to catch himself when becoming upset and use coping skills to calm both himself and the horses, allowing them to continue their play. Jason’s parents soon noticed that Jason began taking “time-outs” for himself to calm down and was able to express himself more clearly and calmly rather than throwing a tantrum when he did not get his way.
Equine-Partnered Play Therapy is a unique model for counseling young children.

If you’re interested in learning more about our services for your child, please feel free to call us at 682-334-3784.


For mental health and/or equine professionals interested in facilitating EPPT: We periodically schedule EPPT trainings. Check out www.equineconnectioncounseling.com/trainings to attend our next training!

We are contacted frequently by other mental health and equestrian professionals asking, "How do I become an equine assisted counselor?" It is exciting to hear from so many people who are interested in joining the field. However, the question isn't simple to answer. There are many different avenues one can take to becoming an equine assisted counselor. But there are a few qualities a practitioner must possess in order to be successful in EAC!

1. A collaborative spirit.
EAC is a team effort. Unlike traditional office counseling where it is just the counselor and client, EAC incorporates at least one other participant: the horse. Sometimes, that means a whole herd of colleagues in a session. The EAC counselor has to be able to pay attention to what the horse is doing because the horse is providing valuable feedback to the client. An EAC counselor also must respect the horse's authenticity and autonomy. By becoming a team with your equine therapy partners (and any human therapy partners like a certified equine specialist), EAC counselors will be able to enhance the session for their clients. 

2. Flexibility.
Flexibility is important when working with horses because they often don't feel the need to comply with your agenda. Did you or your client have a plan for how to spend your session? Chances are, your equine therapy partner will have a different idea. EAC counselors have to be willing to sacrifice the original plan in order to attend the client's needs in the here-and-now. Getting caught up what the client is "supposed" to be working on also discounts the horse's agency and can cause you to miss out on some valuable reflective opportunities for the client.

3. An open mind.
EAC is unlike any other type of mental health therapy. We don't talk the whole time, we brave the bugs and the elements, and we consider these huge, four-legged critters to have almost as much input about the process as the two-legged critters do. Sometimes your team's interpretation of what happens in session will be different. The client's perception of the horse's behavior may not align with yours. In those moments, it is imperative to keep an open mind and be willing to let the horses and your clients affect you as much as you might be affecting them.

Think you have what it takes to become an equine assisted counselor? ECC plans to offer training in REPC in the future--keep your eye out for more information when it becomes available!

Equine Connection works with dozens of kids and teens each week. A huge part of our work with the under-18 set is working with parents and other significant adults in the child's life. Our goal is always to support parents to raise resilient, confident, well-adjusted people. There are many things that horses can teach us about kids and parenting. Horses are sensitive creatures just like kids are. It is important to interact with them in certain ways to make sure they have positive experiences.

Consider this scenario: Mom enters the kitchen to find her young son, Chris, climbing on the counters in order to get to the cookies up there. Concerned for Chris's safety, Mom tells him to get down off the counter and sends him into a timeout. As Chris is walking to his room for timeout, he yells "I hate you!" at his mom.

So what can horses teach us about how to deal with situations like this one? Here are just a few things...

Choose your battles. Horses have a distinct hierarchy in their herd that helps to keep this rule in place. If horses get into fights about non-essential things, they may be too tired to stand up for themselves when it really counts. Similarly, parents may find that children are less resistant (and that you are less exhausted) by letting the little things slide while providing consistent consequences for the bigger things. Let's go back to Chris and his mom. When Chris yells at his mom, she becomes angry and yells back at him. Instead of continuing to his room and timeout, Chris starts yelling at his mom even more. If Mom had focused on the primary concern--climbing the counter--instead of engaging with an angry child, chances are Chris would have gone into timeout without much additional resistance and thought twice before climbing on the counter again.

Be a thermostat, not a thermometer.​ A thermometer changes according to its environment, while a thermostat can change the environment. In other words, be as calm as you want your child to be. It is common knowledge that a nervous human often makes a nervous horse. When working with horses, it is important for the person to remain calm even when the horse becomes excited or scared. Horses, like kids, will look to you for leadership. If the leader gets upset about something, there must be something to be upset about, right? Chris becomes more upset when his mom becomes angrier. Instead of rising along with your child's temperature, remain calm the way you want your child to be. It will then become easier for the child to calm down again.

Use the least amount of pressure necessary... It's tempting to want to come down hard on kids in order to "fix" their problematic behaviors, but this often contributes to resentment, resistance, and defiance rather than consistent changes. A horse doesn't move another horse by suddenly kicking out as hard as they can. They'll start by applying the least amount of pressure possible and increase it only if they don't get the reaction they want. Kids benefit from this concept also. For example, Chris's mom told Chris to go to timeout and gave him the opportunity to do it himself. She could have physically picked Chris up and carried him to timeout straight away, which may have upset Chris even more and led to additional conflict. By letting him walk himself to timeout, Chris's mom gets the response she wants with minimal effort.

...and remove the pressure when they do what you want. Keeping constant pressure on a horse can cause them to feel overwhelmed, confused, and defensive. They might even start to push back, trying to get the pressure to go away. Chris has already received the consequence of timeout. If Mom continues to yell at him about climbing on the counter or yelling at her while he sits in timeout, she keeps the pressure on him and he will probably continue to feel angry and resentful. Or, she might tell him not to climb on the counters every time he comes into the kitchen after that. However, that doesn't give Chris the opportunity to learn to manage his own behavior. It also doesn't recognize when he does manage his behavior and resists climbing the counter for the cookie.


What are your thoughts about what horses can teach us about parenting?

The notion of horses being able to help humans heal and grow has been gaining more and more recognition in recent years. You may have noticed that there are an awful lot of terms being tossed around out there to describe various forms of equine-assisted activities and therapies. But what do they all mean? Read on to find out!

Equine-Assisted Therapy (EAT): A broad term referring to services provided by a licensed health professional that incorporates horses into the therapy process. Practitioners are often required to have a graduate degree and are regulated by a state board. Examples of EAT include equine assisted counseling/psychotherapy and hippotherapy.

Equine-Assisted Activity (EAA): Refers to services provided by a non-licensed professional that utilizes the inherent therapeutic benefits of being around horses to enhance non-clinical activities. Facilitators are not regulated by a state board and are not required to have a degree in their field. Examples include therapeutic horseback riding, therapeutic vaulting, and therapeutic driving. Equine assisted learning is also considered to be an EAA.

Equine Assisted Counseling (EAC) or Equine Facilitated Psychotherapy (EFP): EAC and EFP fall under the heading of equine-assisted therapy. It is a clinical service that incorporates horses into mental health therapy and is provided by a qualified/licensed mental health professional. For example, the ECC counselors are Licensed Professional Counselors or graduate-level interns working under supervision of a licensed counselor. Other examples of credentialed professionals that can provide EAC/EFP include: licensed psychologists (PsyD), licensed clinical social workers (LCSW), licensed marriage and family therapists (LMFT), and psychiatric nurse practitioners (PMHNP). The goal of EAC/EFP is not to teach riding or horsemanship but rather to address specific mental health goals through interaction with horses.
* Licensure credentials and requirements vary from state to state, so it's important to do be familiar with what mental health professionals are qualified to do in your state.

Hippotherapy: This term is often incorrectly used to describe all forms of equine-assisted activities and therapies, but actually refers only to the use of horseback riding/equine movement in physical, occupational, or speech therapy. It is provided by a licensed physical, occupational, or speech therapist. The goal of hippotherapy is to use the horse's movement to promote functional improvements in sensory, neuromotor, and cognitive functioning. To learn more, visit the American Hippotherapy Association website.

Therapeutic Horseback Riding (THR): THR is an equine-assisted activity that adapts horseback riding lessons for individuals with disabilities. It is a non-clinical, recreational service with inherent therapeutic benefits. Many people have seen in videos of THR on the internet but often mistake it for hippotherapy, its clinical cousin. Unlike hippotherapy, THR is not facilitated by a licensed professional. Rather, it is taught by instructors that have been specially trained and certified to adapt riding lessons for people with disabilities. Its goal is to teach people how to ride a horse with considerations made for their disability. THR instructors are not regulated by a state board and most certifications do not require a degree.

So what's the difference between a license and a certification, anyway?
Even for people who work in the industry, the differences between professional licenses and certifications can be hard to grasp. At the most basic level, licensed professions are regulated by the government while certifications are offered through independent organizations. That means it is illegal to say you are providing certain services if you are not licensed by the state (think "practicing medicine without a license"). While both licensure and certification exist to protect consumers, certification is usually easier to obtain and not necessary for practice.

For example, although we highly recommend that a therapeutic riding instructor be certified by an organization such as PATH International, it is not legally required for someone to be certified to teach riding lessons to people with disabilities. It does, however, provide more confidence that the riding lessons will be safe and suitable for the riders. On the other hand, it is illegal for someone without a license to practice equine assisted counseling because mental health counseling is a field regulated by state laws. 

Here is a brief breakdown of the differences between licensure and certification:​
LICENSE:

• Supervised by a state licensing board and subject to specific laws governing legal practice
• Often requires at least a bachelors degree (most mental health licenses require a graduate degree)
• Considered mandatory to work in certain fields such as medicine and mental health

CERTIFICATION:

• Supervised by a private organization
• May not require a specific educational degree
• Does not provide legal authority to practice in a specific field
• Considered voluntary to demonstrate competence in a profession

We hope that this has clarified some of the confusing aspects of this growing industry. Still confused? Ask your questions in the comments below!


Definitions have been adapted from PATH International.

"The horse will teach you if you'll listen."  -Ray Hunt

You'd be hard pressed to find an equestrian who doesn't believe they've learned a lot simply by being around horses. But whether you are an experienced horse person or have never seen a horse up close, there are many things about life and living that horses can teach us. Here are five lessons we learn from our equine therapy partners over and over again.

1. Be Authentic
The dictionary defines authentic as being real or genuine. Humans learn to hide many things inside because of messages we've internalized from our families, friends, and society at large. Constantly hiding our true selves and our experiences can lead to physical and emotional stress. Horses, on the other hand, do not know how to be anything other than who and what they are. They also understand authenticity--it is uncomfortable for a horse to encounter a human who is not being genuine because it is difficult for a horse to gauge how safe that person is to be around. Horses teach us that it is healthy to always be who we truly are.

2. Be Present
Horses aren't very concerned about the past or the future. They don't think in terms of their next meal, they think more along the lines of, "I'm hungry right now." Much of the emotional stress that humans experience has to do with dwelling on what happened before and what might happen in the future. Attending to our here-and-now experience can be powerfully healing. You may have heard the practice of being present referred to as mindfulness. Mindfulness is an important tool in recognizing and managing emotions, something that many clients who struggle with depression, anxiety, or trauma identify as an area of struggle. Horses are always in tune with the present moment so that they can keep themselves comfortable and safe.

3. Let It Go
This idea goes hand-in-hand with being present. Horses are focused on the present moment, so if right now includes a dangerous situation, the herd will immediately react in order to keep everyone safe. Once that danger is past, however, horses have the ability to return almost immediately to their previous state of calm. They don't worry about the next time the bear might come out of the woods or what they could have done differently the last time they encountered a bear. This ability to let it go sets a great example for those dealing with trauma and anxiety.

4. Say What You Mean and Mean What You Say
Have you ever had a conversation with someone that makes you wonder how sincere they are? Horses might not be able to speak, but they are still master communicators. Horses are deliberate with everything they do. In the herd, this keeps other horses from being confused about what is going on and therefore maintains safety. It's difficult for everyone to be secure if they have to second-guess whether their herdmate actually means it when they say that bear is on its way to eat them. For people who struggle to communicate effectively, it can be a challenge to ask a horse for what they want. Horses will respond if we communicate clearly and assertively (note that we didn't say "loudly").

5. We're Better Together
Horses are herd animals. Everything from their physical safety to their emotional security depends on having other horses with them. Humans are also hard-wired to be in relationships and we can gain a lot by having a support network. However, humans have a tendency to withdraw from their social supports when dealing with life's challenges. Horses' relationships with each other become more important during times of stress and danger. They know that having someone at your back can make all the difference. For people, a "herd" can consist of family members, friends, co-workers, and professionals (like teachers or therapists!).

Have you learned any important lessons from horses or other animals?

There are many different models for practicing equine assisted counseling (EAC) out there--different practitioners working with different types of clients tend to have their favorites based on their individual beliefs of how counseling works. It's probably no surprise that the ECC counselors are partial to practicing Relational Equine Partnered Counseling (REPC), the model of equine assisted counseling developed by Dr. Sheade. We've discussed the benefits of EAC and REPC for our human clients many times (here, here, and here) but the animal lovers in us also enjoy seeing the positive impact this mode of therapy can have on our equine therapy partners, as well. Here are a few of the key elements of REPC and how they benefit the horses we work with:

1. Horses have the capacity to be self-directed.  There are models of EAC that encourage the client to establish dominance over the horse as a way to practice assertiveness, leadership, or communication (think the horse scene in the movie 28 Days). In REPC, we view the horse not as a thing to be controlled or influenced, but rather as a sentient participant whose actions, reactions, and experiences are just as valuable to the therapeutic process as the client's and counselor's are. Most of the time our horses are at liberty in their own pastures and can choose what they do or do not want to participate in during session. If a horse chooses to follow a client around the pasture, they do. If a horse wants to walk away from a client, they do. If multiple horses want to approach a client during an emotionally charged moment (it's happened!), they do. The horse has the opportunity to freely express his or her reactions to clients genuinely and authentically. REPC respects the horse's autonomy in terms of behavior and feeling. This can be very different from other equestrian activities in which horses are trained to do as a human asks and act according to human expectations. REPC gives horses the opportunity to have a say (and be in heard) in communicating what they want (or don't want) from their interaction with clients. Clients are encouraged to approach the horse as someone they are in a relationship with (much like our spouses, children, coworkers, teachers, etc). This approach enables both the horse and client to strive towards collaboration, compromise, and mutual understanding - all the ingredients of a healthy relationship.

2. Structured activities are de-emphasized and session content is allowed to develop organically. Some forms of EAC rely on specifically structured exercises that work with the horse as a metaphor for life's challenges. Others have a step-by-step course of activities designed to encourage the client's assertiveness and problem solving skills. Because REPC is relationship-focused, clients may develop skills in all the things listed above, but ​the goal is to develop insight and emotional regulation as opposed to completing an activity. For therapy horses, this can make every day new and different. Horses that work mostly in an arena with riders on their backs can become bored and irritated with their job just like people do (imagine going to work to perform the same exact tasks over and over every day). The organic, adaptable nature of REPC can provide mental stimulation and keep horses from getting bored. The certified equine specialists that co-facilitate EAC sessions with the ECC counselors also work with our partner Wings of Hope's riding program. Many of them have shared seeing positive changes in horses' stress levels and behaviors in riding lessons since they began partnering with ECC.

3. All sessions are conducted on the ground. With riding and other strenuous physical activity off the table, there are many horses that might otherwise be simply "put out to pasture" that can continue to work and be interactive. For example, ECC works with horses owned by our partner organization, Wings of Hope, which offers therapeutic riding lessons. Horses that work in their riding program must be calm, physically sound, and difficult to scare or upset. Our partnership has given new purpose to horses that have become unsuitable for that work--for example, older horses with physical problems that make riding them unsafe. By partnering with ECC for the counseling program, the horses can remain at their caring home and Wings of Hope can be confident that these special horses continue to do what they do best: support the growth and healing of those working to overcome life's challenges.

*The world of equine assisted counseling is growing and developing quickly. The variety of methods and modalities gives practitioners a lot of control over their practice and clients a lot of choice in how to approach the healing process. While those of us at ECC are a little biased--alright, a lot biased--towards REPC, we always encourage therapists and equine professionals interested in getting involved with EAC to find the approach that fits for them. We are always excited to offer consultation and training to professionals seeking to enter the industry.*

What other benefits do you think EAC/REPC might have for horses? If you are already involved in the EAC field, what changes have you noticed in the horses you work with since beginning your practice?