The Horse as Therapist
By Ingrid Edisen

Do horses help physically and mentally handicapped people? Yes, say the therapists who work with such folks. And all of us “horse people” already recognize our creatures’ special healing and grounding qualities. Horses don’t care what you look like or how many degrees you hold. They just live in the moment.

Some therapists use the horse as a partner to help clients. However, do not err and use the term “hippotherapist,” explained Donna Stoffa, a physical therapist in Austin. She noted that one must be a licensed therapist in a recognized field-such as psychotherapy, physical, occupational, or speech therapy—who may choose to use the horse as an element of the therapy. Several lay people also help with impaired people-many of them serve as team members known as “sidewalkers” whenever a client is on a horse.

One large organization that serves as an umbrella for handicap riding programs is NARHA which stands for North American Riding for the Handicapped Association. A.W.A.R.E. in San Marcos operates as such a program.
There are other ways the horse can be used. Psychotherapist Leslie Moreau who owns Legends Equestrian Therapy in Boerne, is one of the few people in the United States who uses horses in Equine Facilitated Psychotherapy. She specializes in troubled youth and young adults-emotionally disturbed/mental health challenged teenagers-who may have been kicked out of other outpatient therapies. Many of her clients are labeled juvenile delinquents and have criminal records. Moreau maintains an efficient operation that pairs her four horses with clients on a one-on-one basis so the client has to deal with issues right there in the moment with the horse as a patient participant. As her brochure states: “Riding is a metaphor for life. The horse is a sensitive unconditional partner who accepts the client as he is, but who does not lie for him. The horse mirrors the client’s emotions, both aware and unconscious, allowing the therapist access to unspoken information....” n Georgetown, a Level III Centered Riding® Clinician builds self awareness in “typical folks.” Her lessons bridge over to the therapeutic realm. Centered Riding® focuses on riding from one’s core balance-the same balance many of us left behind as we grew out of toddlerhood.

Most of us think of handicap riding programs like that found in A.W.A.R.E. Sherry Ross, an accountant, and her husband became active volunteers with A.W.A.R.E. because of their original and continuing involvement with Special Olympics and because of their son’s volunteer activities. The program has 13 horses to assist its clients who suffer from mental retardation, cerebral palsy, autism, head injuries, developmental delay type disorders.

“Funding is a problem for us,” Ross noted. “We have a very tight budget and we do charge a fee. A lot of our clients live in group homes or come from very poor families. Even our families with two incomes often have such high medical costs, their finances are limited for therapies such as therapeutic horseback riding.”

Donna Stoffa knows full well about the budgets incurred with handicapped riding programs. She spent several years forming a board and getting an instructor NAHRA certified, but was amazed to find that to be realistic, their operation would have to charge approximately $150 to $200 per ride to cover the overhead. She directed me to the EQUEST website which represents probably the largest and most successful handicap riding program in the state. EQUEST, in the Dallas area, is a non-profit like many handicap riding programs. It maintains an equine “workforce” of 33 horses. And it keeps a high profile in the fundraising arena. Sadly, Stoffa, with 30 years of professional physical therapy experience had to step back from her well-intended idea. She showed me the core reference books for handicap riding programs: a series of books by Barbara Teichman Engle entitled Therapeutic Riding Strategies for Rehabilitation.
Ross explained the huge involvement necessary for their program in San Marcos. “Keeping a good volunteer pool is another problem. In a smaller town like San Marcos it is hard to find [enough] daytime volunteers....” Twice a week A.W.A.R.E hosts group classes for one school district that helps ten children. This larger group is broken into two sets of five students. Minimally, this requires eight volunteers-with 12 being a better number. “

Stoffa remembers the rescheduling she had to do if the weather did not hold for a session. She needed three volunteers or sidewalkers per session; so every schedule change meant four phone calls.

Much discussion with a client’s family, therapists, and teachers is done before any riding is done, Ross explained. The folks at A.W.A.R.E. are very patient and careful with their special charges and helping them get over “the fear factor.”
“If I act excited about them riding and tell the other riders to look and see what so-and-so is accomplishing and how special they are, I can get them hooked. On the other hand, I had a child last year and it took me a month to get him to do more than touch the horse...At the end of two months his favorite words were ‘go fast,’”Ross said. Of course, she also mentioned that at times a client’s perception is not necessarily a realistic one as some “have no survival instincts.” That’s how important it is to have a well-trained and closely supervised staff. Still, “the success stories are the rewards,” she said.

Meanwhile in Boerne, Leslie Moreau works with youth usually ages 12-25 who have severe social and mental health problems. These are the kids who have “bombed out of other therapy programs,” she explained. Many of them have been in and out of multiple hospitals and may be on medications and have criminal records. Yet, there on a wall in her barn is a sign: Barn Chores: sweep, clean tack, poop scoop, move hay... Her clients have to do barn chores just like everybody else. She teaches them how to handle, clean, tack up the horses and ride them. But the riding is not even the end result.

What she excells at is pairing a kid with a certain personality problem with a horse of hers that may have an “issue” of its own. As Moreau relates, “I have given my horses diagnoses based on their personality idiosyncrasies that both mirror as well as compliment the diagnoses of the kids.” By doing this, the child ends up having to work on something that is critical to his or her problem in the outside world. During the Saturday morning sessions I saw, she had two well-trained assistants who worked with her closely as they focused on their clients in one-on-one sessions.

A teenaged girl, on probation for beating up other kids at school, had to ride a cool, calm Begium draft horse in the dressage arena. The horse must have weighed close to 2,000 pounds. The girl was about 5 foot 2 inches. The client was knowledgeable about riding horses as previously she’d already had two years of hunter/jumper experience. Ask him trot, Moreau urged. The client kicked and clucked for at least two full rounds. Moreau quietly explained to me that she was not going to give the girl a whip for two reasons—she wanted the girl to deal with the frustration of getting the calm horse to step up into a trot and “you don’t give an aggressive person a weapon.” Once the pair got going, the draft horse then decided he’d experiment and tried to take a few steps out of the arena and head back to the barn. Moreau and her assistant guided the pair back on track but it served as a testing ground for the client whose frustration mounted while managing the phlegmatic beast.. Moreau uses precisely that setting to get to the client’s core problem. The moment the client reverts to old behaviors when dealing with the horses serves as an instructional point.

Another client, a boy with many physical problems, and who is legally blind rides a special Arabian that Moreau bought specifically for him. A bay, Bailey is a head tosser for anybody else, but once the boy mounts him and despite the jerky and extreme movments he makes from the saddle, the horse stays steady as a rock. It is as if the horse understands he needs to take care of the rider. The client then had to guide the horse in and out of trees to the round pen while he was lightly, verbally assisted. Not once did anyone grab the horse’s bridle or reins; the boy had to do all the work. Then, in the round pen, the client was allowed to trot and walk while an assistant and Moreau both supervised. Again, the horse stayed true to the course, operating largely off their verbal cues with no lunge line or whip necessary. I was amazed to find myself agreeing with Moreau that in the near future the pair would be allowed to canter in the round pen. The boy’s balance, while not perfect, was solid enough to give credence to the idea. Yet, if one were to see him navigate on the ground, with his halting, tipping movements, one would think otherwise. Moreau told me that this particular client had been with her for five years. As a youngster, he’d learned he could manipulate the adults around him via tantrums, etc. but after many sessions of “time outs” when he’d first started at Moreau’s he’d come this far and I was floored. One could appreciate the length of time it’d taken for Moreau to “raise the bar” slightly each time this client had been with her until now he was up to such a challenge.

Satori Stables’ Lynn Larson who teaches Centered Riding®, does not call herself a therapist but the quality of her instruction leads the student to visceral body knowledge. Better balance begets better harmony between the horse-rider pair; better rider balance is shown by improved movement on the horse’s part immediately. But how does one regain learning one’s balance? She gives the client such tools by way of information about anatomy, exercises and visualizations that can be used easily while riding. Rather than finding oneself worrying about the activities of one’s day, a student ends up focusing on three main centers of balance, in sequence as one aligns the spine. A riding session becomes almost like a Zen meditation. All of the techniques, which draw on Feldenkrais, Alexander, Tai Chi and others, can be used to enhance any riding discipline at all levels. One can also use them in non-riding situations, too. Even onlookers can see the client’s improved body work reflected in the horse’s comfort and relaxation.

Here’s how to contact the folks mentioned in this article: A.W.A.R.E. is listed in the NAHRA website under Texas operations; Leslie Moreau at legends@gvtc.com or (210) 885-8696; Lynn Larson maintains a website at Satori Stables or (512) 869-7903; Donna Stoffa at Dstoffa@yahoo.com.

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