So, how do you become a Hippotherapy Clinical Specialist?  First, receive your degree and state license as a OT, PT, or SLP.  Then begin your clinical practice in an area that interests you with excellent mentors.  Aim to become competent in your professional scope of practice.  During this time you should also begin or continue to focus on your own horsemanship career.  Take riding lessons, spend time grooming and handing horses, learn how horses think and react.  Take up horses as a passion, as a hobby, as a future career.  This is a good time to look for an AHA Level I course.  Take the course and study the manual afterwards.  Look for areas that you feel you have strengths and weaknesses.  Look at horses with new eyes; look at horses as your new co-workers.  Seek a mentor who is respected in the Equine Assisted Therapy field and look for opportunities to observe a variety of therapists treating.  If you are still motivated and excited, now is the time to look for a facility that will allow you to apprentice or begin taking clients.  Begin with clients that are well within your comfort zone, work closely with your mentor (in real life or though video mentoring).  After you have a minimum of thirty hours of hands on treatment, look for an AHA Level II workshop.  This workshop will improve your clinical reasoning and use of equine movement as your treatment strategy.  Go back to your caseloads and reassess your strategies and successes.  It is important to stay connected to others who are using hippotherapy as a treatment strategy and continue to grow your horsemanship skills.  If you have been treating for a year or more and are committed to becoming a Hippotherapy Clinical Specialist, then seek out the AHA HPCS Review course.  Give yourself six months after taking the course to study.  The course is an excellent way to see where your strengths and weaknesses are in relation to the HPCS exam.  After the course, commit to a study program or hook up with a HPCS study group.  Schedule to take your exam and if you are well prepared you can become Board Certified as a Hippotherapy Clinical Specialist.

First, you should expect some of the same things as you would expect when beginning therapy at any new facility.  Your child should receive a thorough evaluation by the therapist who will be treating him/her.  The therapist may appreciate other evaluations, but will still need to complete their own incorporating the special considerations that the horse brings to the treatment session.  The therapists will work on developing your goals, plan of care and discharge plan.  You will generally be expected to fill out a variety of paperwork and have a physicians form completed prior to beginning therapy.  Your state may require a prescription for Physical, Occupational or Speech therapy.

Second, you should expect that your child will be required to wear a safety helmet and may be required to wear a safety belt as well.  If the therapist/facility does not require helmets, strongly consider finding another facility.  In some states it is against the law for anyone under the age of 18 to be mounted on a horse without an ASTM/SEI approved helmet.  Some facilities provide approved helmets and others require you to provide a well-fitted helmet for your child.  Dress for the weather.  Some facilities may have an indoor (but not heated or cooled) area for therapy, while others have a fenced area where therapy takes place.  The general dress code is long loose pants (sweats or jeans, but not wind pants) and closed toed shoes.  Dresses, short shorts and sandals are generally not appropriate when hippotherapy is part of your child’s therapy plan.  Clothing contributes to a safe therapy session.

Third, you will need to understand horses and children.  The movement of the horse may take part of all of the treatment session.  The therapist will determine what length will be best for your child on that day.  Some days, your child may benefit from the horses’ movement for all of the session, while another day they may get a better session with the horses’ movement as only part of the session.  The horse will be matched for your child and the goals that you set with the therapist during the evaluation.  The things you should know about horses include facts such as horses are easily frightened; they do not like loud sounds, camera flashes or quick movements- especially behind them.  Noisy siblings, flash photography or rambunctious cheering may frighten the horse.  Always ask the therapist before taking a flash photo or offering the horse a treat.  Like a service dog, many horses are not permitted treats while working.

The treatment session is likely to include some time to review the day or previous week, put on the helmet and safety belt (a great time to work on fine motor skills) and transition onto the horse.  During the session there may be a designated place for you to watch the therapy session or a waiting room for you to relax in.  It is important to watch part of a treatment session or have someone videotape it if you cannot be there, so that you can ask questions about your child’s performance.  There is often a warm-up period that allows the horse and child to “sync” their movement together.  This time may be quiet and seem like nothing is happening, but this can be an important start to the session.  The horses’ movement is the main focus of the session, so the therapist will be giving directions to the horse handler about changing the way the horse is walking throughout the session.  Activities and games should not be the focus on the session, as these can be done in a therapy clinic or at a desk.  Rather, the session should focus on what the horse brings to the therapy session that the therapist cannot recreate in the clinic, home or school.  This does not mean that games or activities may not be part of your child’s therapy session, but that they are not the main focus.  A game may be incorporated to distract your child from the challenges of the horses’ movement.  An activity may be used in the session to encourage your child to be more social or say a new word, while the horses’ movement is preparing his/her body or engaging his/her sensory systems.  At the end of the session, your child will transition off the horse and may then complete some additional tasks or games.  After the horses’ movement has influenced your child’s body, sensory systems and emotions he/she may be most likely to complete other tasks, such as having a conversation, putting on her jacket or walking on a balance beam.  The therapist is likely to report back to you about your child’s performance and make suggestions for activities for you to complete with your child during the week.

Finally, your child will be discharged from therapy one day.  A discharge plan should be discussed with you during the evaluation.  If your child has enjoyed interacting with the horse, you may want to pursue an adaptive riding program to further your child’s interest with horses.

Adapted sports (sometimes called disabled sports) are organized sports for athletes with a various disabilities. While several sports have been specifically created for individuals with disabilities, many adapted sports are modified versions of mainstream sports such as basketball, soccer, baseball, etc. Adapted sports are divided into 3 broad disability groups: sensory, physical or intellectual disabilities; as a result some disability specific sports, like goal ball-a team sport designed for visually impaired and blind athletes- and wheelchair softball, have been created.

Adapted sports were created with the goal of providing individuals with disabilities opportunities to not only be physically active but to also provide participants with an environment that fosters a positive mental outlook and enhances self-esteem. Generally, these programs are offered to participants ages 3 and up; but some organizations offer more age specific programs as well.

Participating in adapted sports promotes physical health and wellness by increasing heart rate, facilitating muscle and helping to maintain optimal weight. These activities can also impact social and emotional wellbeing by providing interaction with peers, offering distractions from the stresses of daily life and providing individuals with a sense of personal accomplishment and satisfaction. In addition, the integration of adaptive sports into rehabilitation provides a unique and fun context for working on specific therapeutic activities and skills such as balance, coordination, fine and gross motor skills and communication.

With the number of individuals with disabilities growing, we are seeing more than ever the emergence of a special type of athlete. Adapted sports offer individuals with disabilities opportunities to be physically active with peers, learn and improve sports specific skill and concepts and help to provide a healthier lifestyle. For further information on adapted sports or to learn about programs in your area please go to www.ncpad.org or contact me at tamikarj@gmail.com.

Tamika Jones, M.Ed., CAPE

Dress for the job.  If you are going to be riding, make sure you are wearing clothes you can ride in- breeches for English riding and stretch jeans or pants for western.  Wear a shoe with a heel and half chaps if you are not wearing boots (tall boots or cowboy boots).  Ariat has some nice sneaker style riding shoes that are comfortable enough to stand and teach in or sidewalk and safe enough to hop on for a quick school.  Footwear is important and open toed shoes, sandals, heels or clogs are inappropriate.  If you are teaching all day, make sure you will be comfortable and presentable to parents and your students.  Riding clothes are acceptable for riding instructors.  Therapists should dress in a way that allows them maximum movement, ability to run, play and chase children and work around the horses safely.  All professionals should look neat and tidy on the job.

Dress for the weather.  Wearing layers always makes dressing for the weather easier.  Start with a good base layer in winter months, such as under armour or smart wool.  Fleece or insulated breeches are also nice.  Many people have trouble keeping their feet warn if they are standing and teaching.  I have winter Ariat paddock books and Mountain Horse tall boots and both keep my feet very warm.  I wear one layer of loose fitting socks.  Some people have good success with wool socks as well.  Vests work well to keep  your torso warm and providing good range of motion.  Turtlenecks are also a good option in you may have to go from inside to outside work throughout the day.  During warmer months it can be tempting to dress for the weather and end up to casual or unsafe when working with the horses.  Paddock boots or riding sneakers are still necessary and if you can wear them with shorts successfully- more power to you.  I, personally, cannot bear the look of paddock boots and shorts and therefore wear long pants throughout the summer.  I am able to do this through choosing light weight cotton pants (think scrubs).  Shirts should still provide coverage and tank tops or spaghetti strap tops do not provide a flattering or professional look.  If your center has logo wear then by all means stock up and wear that to work.

For interviews you should come dressed professionally for the job you are interviewing for.  If you are interviewing for a riding position, we like to see candidate wearing riding clothes.  If you are interviewing for a therapist position, we like to see someone dressed for the job, neat and workman like clothes, sensible shoes and minimal to no jewelry.  A therapist candidate should look like they are ready to get on the floor and play, groom a horse and assist a client during a session.  We prefer nicer wear then jeans and sneakers for an interview though.  Think khaki’s, button down shirt or polo and riding boots or sneaker.  Hair should be neatly tied back and personal grooming should be neat.  Put your best foot forward for the interview and present yourself as if you were already working in that position.

Each center may have their own dress code for staff and volunteers.  Presenting a professional image while being able to do the work that needs to be done is often more challenging then the business attire an office requires or the workers outfit on a construction site, but careful attention to your appearance is part of dressing for the job.

Do you say “time to go ride Goldie”?

Do the parents of your clients’ tell their children they are coming to “horseback riding”?

Do your administrators call your therapy sessions “lessons”?

All of these words impact our ability as therapists to get paid for the services we are providing!

I did it too- I told my young clients that we were going to “ride” their favorite horse.  I told myself I was being age appropriate, but after closer inspection I realized I was being lazy.  Clearly I wasn’t going to say “it’s time to go do therapy”, but I could certainly come up with something more accurate.  And I did.  I now say the following:

• time to go see Goldie
• time to play with Rex
• let’s go see Boots
• Molly is waiting for you
• get on Prince

During therapy sessions, I do not use riding terminology.  I use terms/words that children will use with their friends.  I use go for walk, run or fast for trot, and stand up for jumping position.  I do this both for the child and for those who may be observing our session- I am working on concepts that will transfer off the horse and away from our facility.  I want the language I use to be useful for the child throughout the rest of his/her day.  Have you considered this when working with your own clients?

I ensure that all my emails are titled Occupational Therapy.  If a child asks I tell them that I and an occupational therapist.  I remind my families from day one- evaluation day- that this is not horseback riding; it is therapy, and so should you.

Sooner or later one of your special needs riders will be interested in volunteering in your program.  How can you accommodate them while minimizing liability concerns?  What are some successful ways programs have included special needs riders as volunteers?

Program can choose to integrate riders into their existing volunteer program or design a program especially for riders interested in volunteering.  Both strategies have their merits and limitations.  Having riders volunteer in your existing program means that your special needs riders must meet the same criteria for safety and skills as your average volunteer.  Many programs need volunteers to help with office work, special events, landscaping and other tasks.  These may provide a “just right” match for the volunteer with a disability.  However many riders want to volunteer with the horses and lessons.  Can that rider with a cognitive impairment understand the safety concerns when sidewalking?  Can the rider with a mild physical impairment complete an emergency dismount?  These are important factors to consider when including special needs riders into your existing program.  Your program must balance both the desire and opportunity for people with disabilities to volunteers with your program with the safety needs of the riders in the lesson.  If a rider were to sustain an injury with a volunteer with a disability as the sidewalker what liability would your program assume?

Creating opportunities for riders to volunteer can be a way to mitigate risks.  Your program may decide to create a buddy or mentoring program for independent riders to mentor each other and provide encouragement and support.  This is an excellent way of involving riders with riders!  Your buddy program can help riders who want to volunteer their time by having them assist with grooming and tacking and then providing encouragement and suggestions to riders during the lesson.  This type of program has been used successfully with several adaptive riding programs.  Other programs for riders to volunteer may include programs focusing on horse care and maintenance.   Program volunteers and rider volunteers can learn horse care skills and provide these during volunteer hours.  Skills can include bathing, clipping, mane pulling, braiding, hand walking and hand grazing, carrot stretches and TTouches.  These skills are first provided to everyone under supervision and as groups progress they are allowed to do more of the horse care with minimal supervision.

What programs have you seen that incorporate riders as volunteers?  Are you a rider that volunteers at a PATHI center?

Why take fieldwork students?

Taking fieldwork students is service to the OT field and the field of Equine Assisted Therapy.  It allows me to refine my clinical reasoning skills by explaining my treatments and interventions to the student.  It allows me to see my clients in a new light- a student will often try things that I may have already dismissed and may have a totally unexpected result.  Taking students keeps me in touch with changing OT trends.

How does our fieldwork program run?

Our facility accepts both Level I and Level II students.

Our Level I student fieldwork is guided largely by the school assignments and the schedule of the student.  Some Level I placements require students to complete one week of 40 hours and others have students complete one day per week over the course of the semester.  Students are hands on throughout their placement and design an intervention for one client during their fieldwork.

Our Level II program is significantly more involved.  It requires the student to have prior horse experience.  The student must attend our volunteer orientation and training prior to fieldwork.  They complete forty hours per week for 10-12 weeks (depending on their school).  During this time they treat the OT caseload, co-treat with PT and SLP clients, do a consultation with an adaptive riding instructor and riding student, present on an OT topic to volunteers/parents/the public and complete an fieldwork project that is of interest to the student and benefits the facility.  The student is also videotaped during intervention at three periods throughout their placement.  Students come out of the placement with a strong foundation in movement and using equine movement as the primary strategy in treating a pediatric caseload.

I am happy to have helped another great OT-to-be in her career and hope to see many of my students in the field some day.  Keep looking for a guest blog post from my most recent student!