Hippotherapy module 6 EN

1. SpecialisedVET training on Hippotherapy for
professionals working with children with
intellectual, emotional, physical and psychomotor
disabilities
2019-1-TR01-KA202-074547

3. 6.1. Particularities of hippotherapy
6.1.1. Special characteristics of horses
6.1.2. Environment
6.1.3. Relationship - horse and the rest of the team
6.2. Role of each team member during emergency situations
6.2.1. Person in charge with riders safety
6.2.1. Emergency situations interventions

4. • Horse Assisted Therapy (HAT) has some particular features that differentiate it from
other recovery therapies.
• It is a therapy that takes place in different conditions - in an unknown environment
for the rider, usually outside
• The team has a multidisciplinary team with 2 to 3 persons.

5. • Therapists working with children with special needs are psychologists or psychotherapist, with at
least 3 years of experience in working with children.
• This is an important feature and should be a selection criteria for those using the horse as a
therapy tool.
• They have to know as many ways as possible how a child can react and to have experience in
dealing with crisis situations.
• The way children react (positive or negative reactions) will have an impact on the horse and will
change his reactions.
• At the very beginning of the therapy the therapist is required to check if safety measures are met.
This is the first and main task that has to be taken into consideration.
• In HAT, there is a team working.
• A therapist specialised in working with children with special needs,
• a horse - leader qualified to work with horses, and
• co - therapists or volunteers.

6. • Most important particularities of HAT are:
• therapeutic relationship – triangular relationship
• interaction – a very different one from that in a therapy room
• In the recovery process HAT can represent following:
• a way to sustain a therapeutic process – to master
• a form of complimentary therapy – psychical or physical affection - to correct or to
integrate unhealthy posture
• a self sustained form of therapy – specific therapeutic objectives (cognitive, speech
therapy, spatial orientation, motricity)

7. • The relationship between patient and therapist:
• It is built on cooperation.
• It is focused on a problem.
• It addresses the individual differences of the client but it targets also a better quality of
life (communication, learning abilities, decision making, etc.) and to a less extent a
personality change of the client.
• It is an eclectic one (it integrates and applies principles and strategies specific to more
than one theoretical approach and it does this according to the problem and the life style
of the client).
• It is formative (it does not aim ”to cure” but to prevent those maladaptive behaviours and
to help learn new strategies that might facilitate a more efficient adaptation to life
situations).
• It helps identify own resources to make adaptation to the environment easier.
• It is informative, as it offers to the client all the necessary information to take informed
and responsible decisions.
• It is supportive, it offers to the client the right frame to express feelings, inner struggles
and dilemmas s/he has about her/himself, the world, the past, the future and the present.
• It is focused on here and now. It only addresses briefly the past, only to get a better
understanding of the present.

8. • It is a process that validates ones own resources.
• HAT can also influence in a positive manner the state of mind, the cognitive,
behavioral and communication abilities for all ages.
• Patients that can benefit from HAT can have a diagnostic such as: cerebral palsy,
multiple sclerosis, developmental delay, stroke, heart attack, ASD, speech
impairment.
• HAT helps with balance by getting better timed reflexes and an improvement of ones own
body perception.
• The muscles are stimulated which leads to a better alignment of body parts and together
help obtain a better posture.
• Stimulates the flexibility and mobility of joints. Increases muscle strength and
coordination and the reflex answer times.
• Cardio-respiratory functions become stronger.
• Digestion and blood flow are getting balanced.

9. • An improved speech and communication ability is obtained by correction of posture
which engages the diaphragm - in charge with producing and sustaining sounds.
• HAT stimulates vestibular receptors.
• HAT Increases sensory perception.
• HAT improves the socialization function by interacting with the animal and team
members.
• Hippotherapy addresses emotions, thoughts, and behaviours that hinder the optimal
development and adaptation of a person to the requirements of life:
• posture has an important place,
• expressing emotions and non - verbal communication are highlighted,
• behaviours and actions are considered, speech is less important,
• it focuses on here and now, it is about how a person talks, behaves and creates relationships in
here and now.

10. • In HAT the therapeutic relationship has more members (child, horse and therapist).
• Following the instinct, we can conclude that the relationship between the horse and the
child is the most easy one to create. And it will be the first bond.
• We must take into account the first time the child will be sitting on the horse. That will be
all new for him.
• The therapist should have a first contact with the child near the horse. Creativity, ability
and experience of the therapist will play an important role here.
• Once there is a relationship between child and therapist, then you can start building a
relationship between the child and the horse.
• At this moment it is recommended to use techniques that do not imply riding the horse.
• Seldom the child will sit directly on the horse. This technique is fully accepted, but not
used that much.
• Some of the actions aimed to help the child to get used to the horse are the following:
• walking the horse in front of the child, eventually with another person riding the horse,
• sensory stimulation, caressing,
• getting to know the horse by brushing him.
• The child with special needs can have some difficulties regarding information integration.
• The above mentioned is a reason to position the child on the side of the horse, parallel
with the saddle and not directly in front of the horse.

11. Start by positioning
the child on the side
of the horse, parallel
wiht the saddle and
not directly in front of
the horse.

12. • The eyes and the breath of a horse will produce extremely strong sensations. This
is why the recommendation is to start on the side.
• By caressing we direct the child to the tail.
• It is important to have contact with the tail because this moves while walking and if
the child does not know where the movement comes from s/he might get scarred.
We have to bring the child to see the eyes of the
horse. A small child, close to the horse will only see
the horse’s legs.

13. A special attention must be dedicated to the
relationship child-horse as this relationship is
extremely important for this therapeutical process.
In some situations the child will display a very
strong emotional distress when separating from the
parent. When this is the case than all this actions
might be difficult and have no result because the
distress is so strong.
If this is the case than it is recommended to put the
child directly on the horse once the relationship
with the therapist has been established.

14. Mounting on the horse can take place in following ways:
1. The child is sitting by her/himself, the therapist is close to the child, having
visual contact and touching her/him.
Caressing or holding her/his hand, a soft tap on her/his foot or her/his back
following the movement of the horse will ensure the child that s/he is safe. In the
short time we will notice that s/he settles and becomes curious.
2. When the distress is too strong, we can use the mothering technique:
For this to be used safely, the therapist must know to ride.
It can only be used with small children that can be held in the arms.
If the child is bigger than the therapist on the horse, the therapist will be under
too much pressure and the therapist will not be able to handle safely the child. In
this case the mothering technique is not recommended.

15. The mothering technique
whereby the therapist is on the
horse, holding the child in
her/his arms and will seatt the
child looking forward at a later
moment.

16. • The first contact is the key to the entire therapy.
• This moment has to be treated with high importance.
• Each person has hers/his own rhythm in getting to know the horse. It is important to be
aware of this and to act accordingly.
• The relationship is important and the first meeting between child, therapist and horse is
very important.
• Normally, getting close to such a big animal is a difficult moment for us all.
• It is recommended that the first contact with the horse is made trough activities such as:
grooming and caressing and other activities performed from the ground.
• The child gets to know the horse and learns some safety rules: horses are being
approached from the side and gently mounted on.
• Activities performed from the ground could be: walking the horse in the manege,
grooming, talking and touching the body parts of the horse.

17. Getting to know the horse. Identifying his body
parts.

18. • The first step in HAT is finding balance.
• During the first sessions the vestibular stimulation is very intense also due to a poor
balance.The poor balance will enhance a much more intense movement.
• The movement of the head must be observed very attentively at this point.
• Taking this into account, no matter what therapeutic objective we have in the long term,
we will look at the present moment. This means we will choose that horse that will help
the child obtain a balanced position and the least intense vestibular stimulation.
• The second step in HAT is to obtain the best position possible of the rider on the
horse.
• By best position we mean a close as possible position to the natural sitting position.
• Taking this into account the body is split in two parts: upper part (hip, torso and head) and
lower part (legs).
• In order to maintain a correct position of the rider while the horse is walking, the therapist
must stabilize her/him on the horse.

19. • People with special needs have, no matter their diagnostics, less anatomic
positions.
• In children with cerebral palsy we can find unhealthy positions of the spine that can
be corrected with HAT.
• Imagine the human body as an interconnected system. If one segment is blocked, then
this will transmit blockages in all other parts of the body.
• When one of the segments is corrected, than all other segments will align in a correct
position.
• A correct position can be obtained only when each segment of the body is mobile and
can move independently from the other segments.
• Aligning the segments of the body by correcting the riding position means transmitting
correct impulses. It is the first step to conscious awareness of the body which leads to
controlling the body.

20. • In his natural environment the horse is a herd animal. Thus he is always searching
for the alpha figure. This is why between a horse and a human, a hierarchy must be
established whereby the human must be the alpha character.
• The horse needs to be led and it is very important that, from the beginning, the
roles are correctly established.
• Those working with horses, even therapists and volunteers must have knowledge
about the behaviour of these animals. They also must know how to identify the
different states of mind of the horse.

21. • The horses can have a very strong reaction. They also are very communicative and
can be educated by establishing a routine and a predictive life.
• Cognitive abilities of the horse are similar to those of a child aged 18-36 months.
• Horses are sensitive to touch and pain.
• They communicate with eyes, ears, tail, posture and nostrils. They also can make
specific sounds.
• They get bored when they have to live in narrow spaces and develop bad habits.
• It is important to know the personal history of the horse before it joins the team.
• A race horse, for example, might react to certain noises specific to the racing
environment. This would be extremely difficult to handle in the framework of a
therapy.

22. • The horse’s coping
mechanism differs from
horse to horse. This is one
reason why not all horses can
be used for therapy.
• They answer differently to
pain, fear, discipline and
surprise.

23. • For example, a race horse might wish to go in gallop when hearing a sound similar
to the start in a race.This is not an uncommon sound in a natural, free environment.
• The way horses communicate are different and are a very important element in
their interaction with humans.
• Horses are powerful animals that can get easily scared and their reactions can be
dangerous.
• Horses need a leader to follow. They need a leader to copy his emotional
responses.

24. • Sensory system of a horse:
• Hearing:
• Is very fine.
• The ears are shaped to locate, funnel, and amplify sounds.
• The ears have the form of a funnel.
• Eyesight:
• Horses have a binocular vision with very large eyes.
• They are the first to detect possible danger.
• Horses have a very good peripheral vision.
• They have a blind spot in their rear and in front of their forehead.
• Tactile:
• The reaction to tactile stimuli is variable.
• Their sensitive areas are: the head, the sides and their feet.

25. • Therapy horses are being tamed using
natural horsemanship techniques. It is
based on the relationship between the
horse and the trainer, and based on a
reward system.
• Dressage by punishment is not
recommended as it is more difficult to
implement while leading the horse
from the ground.
• The relationship between leader and
horse must be based on trust and not
on power.

26. • The dressage method used must combine principles and procedures with the
order in which they are used.
• They can change following the aim, the time and place.
• Any dressage method relies on the law of associations.
• To learn a new movement is possible when this new movement is associated with
an already known action. Each new action is introduced while relaying on an
already known action.
• In time, the new element becomes a custom and can serve as an aid to introduce a
new action.
• Also the conditional reflex, better known as conditioned response, is one of the main
dressage techniques.
• To built on it you must have the horses attention.
• It is important not to forget that originally the horse was a prey. He can not trust and
gets very easily scarred.

27. • A horse is very curious and can learn very fast.
• Negative events will stick to his mind immediately.
• It is important to obtain a reduction of emotional reactions.
• Dressage means, first of all, adaptation.
• For dressage and teaching of the horse, the trainer must have a consistent
knowledge and experience in working with horses.
• Usually it is pursued by an equine specialist.
• During dressage the horse must learn:
• the three walking paces,
• to properly walk on both sides,
• to walk faster or slower,
• to act calm during individual and group activities.
• He must also learn to walk the three paces while being longed. He has to know to
work on a longe on both sides. He must recognise signals from the longe, the
training whip and from the posture.

28. • After the initial training the horse must have a rhythmic and relaxed walk, no matter
which type is chosen (walk, trot, gallop).
• Special dressage for therapy horses: once the basis dressage has been pursued,
therapy horses must undergo a special program in order to be suitable for therapy.
• While learning the new techniques, it is important to use frequently repetitive
confirmation. A ritual must be established so that the horse can feel safe.
• Therapy horses must learn to be more resilient and to remain calm while they are
being groomed, equipped or during therapy sessions. Sometimes they must get
used to work in not so comfortable situations.
• They must get used to different ways of being mounted and with the movements
and tools used during this.
• Therapy horses must be used to work on different ropes and longes (lead rope,
bridle, longe, long bridles, double longe).

29. • The horse must listen also to the volunteers.
• Therapy horses must be used to act immediately when on the longe, especially
when training in the field of special psychopedagogy. When the therapist is
longing the horse, he has to communicate with the rider and can not give verbal
commands to the horse. Thus the horse must be able to answer to commands from
the longe and the whip.
• Horses must be trained to accept riders that have a stiff or uncomfortable position
due to different diagnostics. He must be able to find balance and to continue
walking, no matter what or how the posture of the rider is.
• Therapy horses must get accustomed to all tools, toys and other equipment used
during therapy. They must get used with the place where they work and with all the
stimuli (visual, acoustic, tactile) that might show up. A therapy horse has to get used
to the unspecific touch from the child, to screams, to uneven and uncontrolled
movements, to have a lot of people around (children and adults).
• Natual horsemanship has to be used to teach therapy horses. The Pat Parelli and
Tellington methods are recommended.

30. • Therapy is a very demanding activity for horses. It is therefore very important to
know the signs of a burn out. Among those, but not limited to, are following signs:
• ears stiffly back while being mounted and/or equipped,
• refuse to leave his box,
• runs or shies away.
• From the point of view of physical and psychological health, the horse must live in
an environment that is as close as possible to his natural habitat environment.
• He will be more calm and happy if he lives with other horses and has access to grassland.
• A horse that is not allowed to leave the stable will be tense, less curious and less attentive.
He will also receive less stimuli.

31. • In HAT, the environment is extremely important.
• It can offer a lot of advantages but also quite a few disadvantages during therapy.
• The more the environment is a known one, the more the horse will behave in a proper
way.
• Usually, therapy takes place in a very controlled environment. Sometimes walking
outside the manege can have real benefits.
• It is thus very important that the team knows the environment pretty well and the horse
must be accustomed to it.
• Even if there will be elements that can not be predicted, it still is important to forecast as
many as possible.
• It is also mandatory that the team knows very well what each member needs to do in a
crisis situation.
• The team must be permanently attentive to what is happening on the alley, in order to
react to changes.

32. Advantages
• The different than usual environment where the HAT takes place, as well as the simple
presence of the animals can help the child to stay more focused, to try eye contact and
increase his attention capacity. All these are important aspects for a successful
therapeutic process.
• The HAT brings the child in a new environment and forces her/him to absorb as much
information as possible from the new space. Constantly exercising this will increase the
child’s focus and attention.
• Because HAT does not take place in a closed environment, the child does not perceive it
as being a mandatory therapy.
• The child perceives this activity as a joyful one. S/he is identifying the activity with the
horse and sees the therapist as a binder between him and the horse.
• Eye contact can be made as the child has nowhere to go.
• As it takes place outside it offers a lot a therapy instruments that can be found in nature:
• leaves
• pinecones
• different sounds – the sound made by the walking horse
• the therapist can get creative and has a lot of possibilities to offer to the child new activities.

33. Disadvantages
• The therapy takes place in an environment that cannot be controlled.
• Safety comes first and sometimes this means working on fewer therapy objectives
to maintain safety.
• The HAT is practiced usually outside of urban areas and this means more time is
required to travel to and from them.
• Therapy sessions are depending on the weather. Low/high temperatures and bad
weather are not suitable for a session. Loud sounds made by the wind might scare
the horse.

34. • The horse and the team members form a system.
• This system must function well in order to ensure an efficient therapy session.
• The horse must be connected and listen to the horse leader.
• The horse leader must permanently see the ears and eyes of the horse in order to be
aware if he gets scarred.

35. • A horse's left side is the customary position to lead
a horse.
• You can stand so that you are either even with your
horse's head or about halfway between his head
and his shoulder.

36. • Leading the horse
from the back

37. • Correct position at the platform

38. • Correct walking position.
• Head of the horse must be
almost parallel to the
horse leader shoulder.
• Horse leader must always
see the eyes and ears of
the horse.
• Do not wrap rope on the
hand.

39. • Leading rope should be vertically aligned to the
horse.
• The distance between the horse and the leader
should not be bigger than 30 cm.

40. Do not hold the lead rope by it’s closing
mechanism as any movement of your hand will be
transmitted to the horse.

41. Do not use a large rope as it can be stepped on by
the horse, as well as by the horse leader.

42. • Do not pull the horse behind you.
• The horse leader has no control over the horse
and can not see any of his reactions.

43. • HAT is a high risk activity because:
- the working space is a large one,
- you work with an animal weighing 300 to 500 kg,
- you can not totally control working conditions,
- unexpected situations can occur (a loud noise, weather conditions – thunders), etc.
• Before starting a therapy sessions safety measures have to be met.
• This is why all team members must know and follow the safety procedures.
• If there is a member who does not know the rules or who acts differently from the
team, the resulted situation will be difficult to control and could have unwanted
consequences.

44. • The person responsible with the safety of the rider will be defined before each session,
taking into account the following:
• How many people take part in the session?
• Which equipment is being used?
• How high is the rider?
• How much does the rider weigh?
• Usually the person in charge with the safety is the one walking behind the horse leader.
• When there is only one therapist, s/he is in charge of the safety of the rider.
• When there are volunteers and co-therapists, then the responsible person is the one
behind the horse leader.
• The lifting techniques for the rider and the person in charge to do this will be discussed
at the beginning of each session.
• These things must be defined at the very beginning of the therapy session so that in an
emergency situation everyone knows exactly what to do.

45. • In an emergency situation, if the horse has an unusual reaction, then:
• the horse leader should push the horse as far as possible from her/him;
• by doing so, the rear part of the horse will shift outwards and will create an arch;
• this arch will ensure a safety zone for the child.
• The person in charge with the safety will encounter two situations:
• If the child has his feet in the stirrups, then the team will make everything possible to hold
the child on the horse until the feet are released from the stirrups.
• If the child does not have the feet in stirrups, then the person in charge with safety will lift
the child from the horse, constantly protecting her/his head.

46. The European Commission's support for the production of this publication does not
constitute an endorsement of the contents, which reflect the views only of the
authors, and the Commission cannot be held responsible for any use which may be
made of the information contained therein.
https://www.hippotherapy-training.eu/
https://www.facebook.com/HippotherapyProject/
https://www.hippotherapy-training.eu/elearning/?lang=en
https://play.google.com/store/apps/details?id=com.hippotherapy.mobile
https://apps.apple.com/app/id1526453884