Title

An Introductory Survey of Volunteer Administrators in Equine Assisted Service (EAS) Organizations

Body of Abstract

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.  

keyword : volunteer, volunteer management , volunteer administration

Title

A Digital Knowledgebase for Equine Assisted Program Research – Is It Time? 

Body of Abstract

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  

Title

Analysis of The Therapy Equine Certification Program in The Czech Republic 

Body of Abstract

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  

keyword :

Title

The efficacy of Equine Assisted therapeutic exercises in gross motor function and performance in children with Cerebral Palsy

Body of Abstract

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

Title

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

Body of Abstract

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

Title

Effect of Equine-Assisted Activities and Therapies on Cardiorespiratory Fitness in Children with Cerebral Palsy: A Randomized Controlled Trial

Yoonju NA, Jeong-Yi KWON* (jeongyi.kwon@samsung.com ), 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. 

keyword : Equine-Assisted Activities , Cardiorespiratory Fitness in Children, Cerebral palsy

Title

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. 

keyword : quantitative assessment, factor analysis , digitalization

Title

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.

keyword : complex challenges, multi-handicapped, teaching strategies

Title

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  

Title

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

Title

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

Title

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  

Title

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

Title

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. 

keyword : equine-assisted therapy, postural balance, elderly

Title

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

Title

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. 

Discussion: 
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.  

keyword : virtual reality, equine-assisted, anxiety

Title

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.  

keyword : VR, Cerebral Palsy, Social/Emotional Responsiveness

Title

Research Readiness in Equine Assisted Services 

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

Title

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Body of Abstract

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Title

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  

Title

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. 

keyword : Horse-Human Interaction, Affiliative Behaviors, Interspecies Relationships

Title

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. 

keyword : equine facilitated physiotherapy, stress, welfare

Title

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. 

keyword : Female veterans, Posttraumatic stress disorder (PTSD), Equine-facilitated psychotherapy (EFP)

Title

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. 

keyword : Equine-assisted learning, Posttraumatic stress symptoms, Firefighters  

Title

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  

Title

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  

Title

When Children Encountering Animal-Assisted Education - A Case Study in Taiwan 

HaoJu HSU, Jannette Wei-Ting Wang GUTIERREZ * (jannettegutierrez@gms.tku.edu.tw)
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

Title

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. 

keyword : Autism, Equine- Assisted Interventions, Systematic Review 

Title

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. 

keyword : psychotherapy, cognitive behavioral therapy, emotional disorders

Title

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. 

keyword : Complex Trauma, Primary Emotional Processes, Safety

Title

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):  

1. Introduction 
2. Mindful Gauges 
3. Safety 
4. Resilience 
5. Inner Awareness 
6. Self-Compassion 
7. Belonging 
8. Presence 
9. Mindful Attunement/Attachment 
10. Integration 

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

Title

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

Title

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.

keyword : Children, Therapeutic Riding (TR), Diagnosis categories

Title

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.

keyword : adaptive riding, youth anxiety, fidelity