Equine-assisted therapy and therapeutic riding embraces the magic of human-horse bonds

Sep. 10—The healing qualities of animal companionship are hard to deny. From veterans suffering from post-traumatic stress disorder to people who have seizures, all kinds of people can get help from animals to cope with different mental and physical issues.

Emotional support dogs are a familiar concept to many, but medical professionals are also starting to turn to an outdoors animal for such treatments: horses.

Occupational or physical therapists use horses to guide clients through activities to provide what is known as equine-assisted therapy, equine-assisted learning and therapeutic riding. Therapy sessions can take place on the ground or on the back of a horse in a barn, ring, arena, along a trail and other locations.

"Therapeutic riding is for people with disabilities that want to just learn the recreation of horseback riding. So we teach horseback riding to those people in a safe setting," said Tamara Merritt, director of program innovation and research for Hearts & Horses in Loveland. "We have individuals with spinal cord injuries; we have individuals that have dementia, so a really wide variety of people who want to learn horseback riding in a safe area."

Hearts & Horses Therapeutic Riding Center, 163 N. Larimer County Road 29, offers programs that "enhance physical, cognitive and emotional wellbeing through equine partnerships." Founded in 1997, the organization's instructors are trained and certified by the Professional Association of Therapeutic Horsemanship International.

"Oftentimes, it's not just riding for those individuals, but there's also other therapeutic components," Merritt said. "There are just so many ways to help people."

Studies have shown that interacting with animals can decrease the levels of the stress-related hormone cortisone and lower blood pressure, reports the National Institutes of Health, NIH. Relationships with animals can also help relieve loneliness, increase feelings of social support and boost a person's overall mood.

"There's not one answer about how a pet can help somebody with a specific condition," explained Dr. Layla Esposito, director of the NIH's Human-Animal Interaction Research Program. "Is your goal to increase physical activity? Then you might benefit from owning a dog. If your goal is reducing stress, sometimes watching fish swim can result in a feeling of calmness."

Per NIH, researchers are also looking at how animals can benefit children's development by studying animal interactions with children who have autism, attention-deficit/hyperactivity disorder and other conditions.

"We're trying to tap into the subjective quality of the relationship with the animal — that part of the bond that people feel with animals — and how that translates into some of the health benefits," said Dr. James Griffin, a child development expert at NIH.

Equine therapy programs can help treat mental and physical conditions such as muscular dystrophy, spinal cord injuries, strokes, traumatic brain injuries, autism, cerebral palsy, Down syndrome and visual and auditory disabilities.

"A horse's gait is the closest thing that we have to our gait, so we pair up our clients and horses to utilize the horse's movement," said Taneal Behm, therapist and owner of Iron Horse Therapeutic Farm in Fort Collins. "So if we have a goal of walking, we will use the horse's movement to help accomplish that goal."

Behm founded Iron Horse Therapeutic Farm in 2013. She and her husband, Ryan Behm, own the 10-acre farm located at 5020 E. Larimer County Road 40. The farm is home to horses, farm cats, goats and a donkey named Bob. In 2017, Behm expanded to create Integrated Pediatric Therapy Associates in Windsor and Greeley to help provide interdisciplinary services for special needs families.

Equine-assisted therapy can help clients learn how to walk, practice balance, learn how to control body movements, assist with oral motor eating skills and more.

For example, placing a client backward on a horse can help with their swallow reflex, Behm added.

Equine-assisted therapy can be used on clients as young as 18 months up to all ages of adults.

"I see the power that these animals have in their ability to promote therapeutic outcomes. They can maximize progress and goals and build self-efficacy and self-confidence that these kids need," said Lindsey Messenger, lead therapist with Iron Horse. "I think that's a really special thing that I think can be hard to replicate in the clinic."

In addition to therapeutic riding and occupational and physical therapy services, horses can be used for emotional and behavioral support programs to help treat things like anxiety, depression, eating disorders, addiction and relationship issues.

Hearts & Horses offers Changing Leads, which is a program for at-risk youth, Riding in the Moment, designed for people with Alzheimer's disease, dementia and other forms of memory loss, and Hearts & Horses for Heroes, an equine-assisted therapy program specifically for veterans.

"A very therapeutic piece of horses is that they really show up with you right where you are in that moment. They don't hide anything. They don't judge you," said Kathryn Yuma, Development and Communications manager for Hearts & Horses. "They are really wonderful partners, especially on that emotional side."

For its Changing Leads program, the organization works with Boulder Valley and Thompson Valley school districts, and is working on collaborating with Poudre School District, to identify students who have social-emotional learning challenges.

"So maybe they have experienced some sort of childhood trauma, problems at home or they just have behavioral conditions," said Yuma. "We bring them out one day a week for eight weeks, and they are here for about six hours. They are paired up with a dedicated adult volunteer and horse for the eight weeks, and it's a very specialized curriculum."

As an approved job placement site for the Unique Services of Northern Colorado, USONC, Iron Horse Therapeutic Farm helps people with other types of disabilities find a place and purpose in the work sector. USONC is a part of the state's Division of Vocational Rehabilitation, which helps place people with disabilities into employment opportunities.

Members of USONC help keep Iron Horse running by cleaning stalls, feeding and watering animals and helping with a variety of other tasks.

"They work and get paid through the state of Colorado, and they come out here every day and clean and help," Voorhes said. "It's touched their lives and enhanced their lives. They are an amazing part of our time, and I don't think we could do it without them."

Iron Horse also offers farm-based occupational therapy where clients are introduced to other animals such as goats that helps clients learn how to socialize, self-advocate and work together.

"A lot of the patients we see start in the clinics where they get occupational therapy basics and fundamentals. When they are ready for their next set of challenges, we put them in place in an environment like this," said Iron Horse Clinical Director Stephanie Voohres. "Being around animals, a lot of kids just open up."

Horses used in therapy programs

Horses in many equine-assisted therapy and therapeutic riding programs are leased or donated to organizations.

Both Hearts & Horses and Iron Horse Therapeutic Farm have leased horses as well as horses the organizations own in their herd.

Horses that are leased to therapy programs provide a win-win for the organization and the horse owner.

Many organizations that use leased horses pay for the animal's care and boarding, which can be quite an expense for owners. Some organizations also cover veterinary care and farrier care, maintaining the horse's hooves.

"It's a really nice way for people to own horses without having the boarding costs. It's really been a mutually beneficial program," Behm said. "The horses get exercised daily, and we are able to use them."

Horses used in equine therapy are a variety of breeds that come from all different backgrounds including barrel racing horses, working ranch horses and show horses.

"There's a lot of misconceptions about therapeutic riding that I learned about when I came here. That the horses are older or kind of at the end of their life," said Kris Quine, Hearts & Horses Development and Communications director. "And that's not really true. They have to be athletes to be able to do the physical work. And what they take on emotionally from riders is quite demanding."

With the horses being used for therapy purposes and many patients being young or novice riders, horses used in programs have to have certain characteristics, movements, size and temperaments.

Horses leased to Hearts & Horses undergo a 90-day evaluation period, while Iron Mountain follows a 30-day evaluation period, before being released to participate in the therapy programs.

"It takes a very special horse or equine to really settle into the life of Hearts & Horses. During that 90 days we work with our training team on all the physical and verbal cues so that there is consistency," Yuma said. "If the horse does well within that 90 days and settles in, they are welcomed in as a member of the herd."

Both organizations also utilize miniature donkeys in their programs.

"They are really great for people who have adaptive equipment, whether that be a wheelchair or a walker. They are at that perfect level where they can rest their head in your lap and you can rub their ears," Yuma said. "They've been really amazing partners because if someone is intimidated by a 1,000-pound horse, getting them introduced with an equine like a miniature donkey is super helpful."

Struggles with insurance companies

Though a handful of insurance companies will cover equine-assisted therapy — often only approving a limited number of sessions — many other insurance companies do not cover any of the costs, requiring patients and their families to rely on grants, scholarships or self-pay to cover costs.

"Insurances are starting to recognize it more, which is really, really helpful. We've always led from the place of occupational therapy, and so that has helped us with insurance and navigating those battles," Behm said. "But it is so nice that they are becoming more accepting and understanding and seeing the benefits that it provides to people."

As with pretty much anything related to medical care, insurance companies require data showing how patients benefit from the medication, procedure or therapy before they will consider covering costs.

The same holds true for equine-assisted therapy and therapeutic riding.

"Our industry is working hard to standardize the terminology basically. We are working with Children's Hospital in Denver and Colorado State University to do randomized, controlled trials on the benefits of therapeutic riding," Merritt said. "And all of that helps inform the industry, helps inform medical professionals, helps inform insurance companies of the therapeutic components that are so valuable to what we do."

Hearts & Horses' partnership to study the effects of therapeutic riding on children with autism is funded by a five-year NIH grant.

"Children with autism in our industry are probably the biggest population that is served at centers all over the country," Merritt said. "So those families have figured out that something is working here. Something is helping these kids. It's amazing stuff."

The study will also examine physiological changes within children who ride the horses and compare them with a control group of kids in a classroom who interact with a large stuffed horse. Some of the data collected for the study includes heart-rate response, galvanic skin response, heart-rate variability and cortisol — all of which are markers of stress.

Data collected will then be examined to determine the differences between the kids who interact and ride actual horses compared to the kids that are in the classroom-only program.

"Being able to offer and treat people in different ways is just so important. Not all kinds of classic therapy works for all kids or adults," Quine said.

How to be part of equine-assisted therapy

Volunteers for equine-assisted therapy centers also receive numerous benefits from being around the animals. Volunteer opportunities include walking beside the horses, leading the horses on walks, working on the barn team or as a horse assistant and helping with property maintenance, special projects, weekend care, facilities care and administration.

Many equine-assisted therapy organizations offer opportunities for both individuals and groups.

Internships are a great way for those interested in pursuing a career in occupational and physical therapy to learn about this unique form of therapy.

"We partner with Colorado State University, and we usually host about five CSU occupational therapy students a year and around two students from PIMA for the Certified Occupational Therapy Assistant program," Behm said. "So we are really connected with our local schools in supporting future education and growth of students."

Northern Colorado equine-assisted therapy

To learn more about Hearts & Horses Therapeutic Riding Center in Loveland, go to www.heartsandhorses.org.

To learn more about Iron Horse Therapeutic Farm in Fort Collins, go to www.ironhorsetherapy.org.

Other organizations that offer equine-assisted therapy and therapeutic riding services in the northern Colorado area include:

* Colorado Therapeutic Riding Center, Longmont

* Triple T Haven, Ault

* Medicine Horse, Longmont

* HorseBuds, Inc., Greeley

* Front Range Hippotherapy, Longmont

* Unbridled Equine Assisted Learning and Counseling, Wellington

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