Hippotherapy (our signature treatment technique) and therapeutic/adaptive riding (which we do not do) are extremely different, yet both have their place. So, what exactly are you looking for?
Hippotherapy vs. Therapeutic/Adaptive Riding
- Hippotherapy is a one-on-one medical treatment because it is integrated into physical, occupational, or speech therapy. It concentrates on a certain set of patient outcomes. A doctor’s prescription is required, and therapy is often covered by health insurance, depending on your insurance policies.
- Therapeutic/adaptive riding is a recreational activity that has been modified to meet the requirements of people with disabilities. It usually takes place in semi-private or group sessions, with the main objectives being to improve riding abilities, establish confidence and relationships, and improve emotional well-being.
If you’re looking for a therapeutic or adaptive riding instructor or facility, you’ve come to the right place. Those who are members of the Professional Association of Therapeutic Horsemanship (PATH) International are recommended.
How much does equine therapy cost the patient?
Due to the advancement of Friedreich’s ataxia, I thought my horseback riding days were ended until I discovered Therapeutic Riding of Tucson (TROT) in Arizona.
I’m nearing the end of my second 12-week session at TROT, and despite having a neuromuscular condition at the age of 33, I’ve observed that therapeutic riding has provided me with numerous benefits.
Although majority of the TROT riders are children with cognitive problems, I’d like to raise awareness of the physical and emotional benefits of therapeutic riding and hippotherapy among individuals with neuromuscular disorders.
Therapeutic riding vs. hippotherapy
Many people confuse therapeutic riding and hippotherapy, although there are significant differences between the two.
Therapeutic riding’s main purpose is to teach people with impairments how to ride a horse. Most riders improve their riding skills and become more independent as they continue to ride.
Hippotherapy is a type of therapeutic riding that is always done by a registered physical or occupational therapist (PT or OT).
According to Susan March, program manager and physical therapist at Bit-By-Bit Therapeutic Riding Center in Parkland, Fla., hippotherapy is a therapeutic technique that employs the horse as a tool to focus on specific goals such as increasing balance, coordination, head control, and fine motor skills.
“Some people require the expertise of a therapist because their bodies are incapable of simply taking a standard riding lesson,” explains Sharon Gilbert, office manager for the American Hippotherapy Association (AHA) in Fort Collins, Colorado. The therapist’s purpose is to assist clients in transitioning from hippotherapy to regular therapeutic riding lessons.
A therapeutic riding center and its instructors should be certified by the Professional Association of Therapeutic Horsemanship International, or PATH Intl., to assure the highest standards and the safety of the riders (formerly the North American Riding for the Handicapped Association).
It’s critical to work with an OT or PT who is professionally trained in hippotherapy and registered with the AHA if hippotherapy is being used. Furthermore, therapists must be certified by PATH International or be accompanied by a certified staff member. Some therapists go above and above to earn the title of hippotherapy clinical specialist, a title that denotes a high level of expertise in the field.
Therapeutic riding sessions can be done quietly or in groups, although Gilbert emphasizes that hippotherapy sessions are always private.
Therapeutic riding and hippotherapy are both done in an arena, on the grounds of the center, or on the trails. Riders with higher experience can also weave through barrels or cones, or step over ground poles, in both events.
A individual therapeutic riding session costs $40-$75, while a group session costs $30-$75. Scholarships, both full and partial, are frequently available; inquire at the riding facility for additional information.
Hippotherapy sessions cost roughly $80-$115 per session, however some health insurance companies will cover it in full or in part. Medicaid will cover the cost of hippotherapy in some states, such as Florida. Scholarships may be available as well.
Before the ride
The first step is to have a physician fill out a medical release form before beginning therapeutic riding. Riders must next be assessed by a therapeutic riding instructor, who will assess their strength, balance, and ability to sit on a horse.
Instructors must decide how much help riders will require while riding and how much they can perform on their own. After that, there will be a test ride for further evaluation.
Some states and insurance companies demand a physician’s prescription before beginning hippotherapy. Even if a prescription isn’t necessary, the doctor must nonetheless fill out a medical release form.
March, who is registered with AHA and has worked at Bit-By-Bit Therapeutic Riding Center for 10 years, explains that hippotherapy necessitates a more in-depth evaluation in which therapists examine each individual’s strengths and weaknesses and build a personalized treatment plan. Therapists create workouts based on this information, she explains.
Special horses, saddles and reins
The horses used in therapeutic riding and hippotherapy have been carefully chosen for this type of activity.
“Mary Vardi, a PATH Intl.-certified therapeutic riding instructor with TROT who has been active in therapeutic riding for more than 20 years, says, “I’m usually looking for a horse that has a very peaceful nature sound and not spooky.”
“He must be able to move well, with a good walk and trot, and he must be responsive but not too responsive.” Vardi normally selects horses for the program between the ages of 8 and 15.
Therapeutic riding teachers pair horses with people based on the horse’s size and width, temperament, and walking and trotting speed.
The style of saddle used is determined by how much support riders require. A western saddle, for example, provides greater support than an English saddle, which demands the rider to exert more control and balance.
According to Cheryl West, program manager and PATH Intl.-certified head teacher for the American Therapeutic Riding Center in Sand Springs, Okla., “a range of modified saddles are available at various therapeutic riding centers for people who need even more support.”
Adapted saddles may include front handle bars or high backs to accommodate riders with severe trunk control challenges, according to West.
Surcingles, which are leather or nylon harnesses that go from the rider’s front to the horse’s rib cage, are sometimes used by riders. Surcingles usually have one or two handles on top and are supported by a western saddle pad.
To offer the rider more movement during hippotherapy, therapists typically employ a surcingle and a western pad.
A selection of reins is also available at some therapeutic riding centers. Because riders can slip their fingers through the loops, looped reins can sometimes assist riders who have difficulties grasping the reins.
When the horse is ready, it is escorted to the mounting ramp, where the rider awaits. The rider is hoisted onto the saddle or surcingle by an overhead lift, where he or she is centered and the stirrups are adjusted.
Sessions may include a small group of participants, depending on the disability and the amount of support required: the rider, the specially chosen horse, the therapeutic riding instructor or therapist, the horse leader, and two side walkers, who are usually volunteers who walk alongside the horse offering support to the rider.
Emotional benefits
Therapeutic horseback riding and hippotherapy are both enjoyable ways to spend time outside. Therapeutic riding can be a very social activity because it can be done in group sessions.
Mastering the skills required to control the horse can boost self-esteem and provide a sense of empowerment for therapeutic riders. Therapeutic riders and hippotherapy customers may build confidence as they watch their progress over time.
“Camille Levy of Tampa, Fla., who has myotonic muscular dystrophy and uses both a power and manual wheelchair, says, “I’m able to feel more comfortable on the horse and not so worried that I’m going to fall off.”
For the past three months, Levy, 49, has been riding with Bakas Equestrian Center in Tampa. “It’s assisting me in learning to turn the horse around the poles, which I previously couldn’t do. It makes me happy, and that’s all that matters to me.”
Levy says she’s excited to compete in the Special Olympics equestrian competitions and win ribbons for barrel racing.
Trey Lovell, 23, of Perryville, Ark., values hippotherapy so much that he has driven three hours once a week to Beyond Boundaries in Ward, Ark., for the past three years. Lovell, who has Duchenne muscular dystrophy and uses a power wheelchair, says spending time with his horse, Comanche, is something he looks forward to.
Physical benefits
Therapeutic riding and hippotherapy provide several physical benefits, with some of these benefits occurring even while the horse is not moving. According to West, who has been instructing with the American Therapeutic Riding Center for five years, simply sitting on the horse stretches the adductor muscles of the thighs. Riders with tight muscles are occasionally started on a narrow horse and eventually progressed to bigger and wider horses.
The majority of the physical benefits, however, are due to the horse’s mobility.
“The horse often does the majority of the labor,” West explains. “The majority of the muscles in the rider’s body will be worked simply by the horse’s movements, including key muscle groups in the legs, arms, buttocks, torso, and neck.”
Riders are taught to maintain an erect stance against the horse’s movement, stretching their stomach and back muscles in the process. The rider’s muscles are required to contract in order to rebalance since the horse’s motions constantly put the rider off balance, she claims.
Many riders gradually require less trunk support from side walkers, and some become more self-sufficient while riding.
“I’ve seen kids who ride without side walkers, who have been doing it for a long time and are doing pretty well, and I know that I’ll get there, too,” says Levy, who has improved her balance in just three months of riding.
Levy initially sustained herself by “hanging on for dear life” with the saddle horn. She can now hold the reins in one hand while resting the other in her lap.
Trey Lovell’s OT at Beyond Boundaries, Alicia Hammerle, says she tests her clients’ balance by changing the horse’s direction or the rider’s position on the horse. The rider’s balance is shifted to one side to the other, forcing them to employ their trunk muscles to sit up straight.
“That can help strengthen their trunk control so that they can balance better for functional activities like reaching for a glass on the table or sitting up straight while brushing their teeth when they’re not on the horse,” adds Hammerle, who is registered with the AHA and certified by PATH Intl.
Lovell weaves Comanche through cones and does figure-8s in the arena as part of his balance exercises. He also focuses on his dexterity by practicing grasping the reins.
“With Trey, I’ve observed a huge improvement,” Hammerle says. “He was able to sit up on his own for a brief time on his bed not long after riding with us, which he couldn’t do before he started riding.”
Her suggestion to those who have been doing hippotherapy but are no longer able to do so for various reasons is to continue working with a therapist in a clinical context to progress any functional gains they may have achieved.
Finding a facility
Alternatively, call the American Hippotheray Association at (877) 851-4592 or go online to “Hippotherapy” and select “Find a Therapist” or “Find a Facility.”
Happy trails
TROT has been a great experience for me, and I plan to ride for as long as possible. Therapeutic riding not only brings back fond memories of my father and me horseback riding together, but it also helps me gain strength both on and off the horse.
More Fun with Horses: Therapeutic Carriage Driving
For people who desire (or need) to manage the horse while sitting in their wheelchair or on the carriage seat, driving a horse-drawn wheelchair-accessible cart or carriage is a popular pastime. The goal for therapeutic driving students is to learn to use the reins and their voice to drive the horse and carriage.
“It’s a two-dimensional movement versus the three-dimensional experience of riding,” Bonnie MacCurdy of the National Center for Equine Facilitated Therapy in Woodside, Calif., adds. “While learning a new and fascinating skill, a person can work on goals of flexibility, strength, posture, and range of motion.”
In order for driving pupils to use the reins, they must sometimes be modified. Therapeutic riding centers sell rein adaptations, but some driving instructors, like MacCurdy, prefer to construct their own.
For example, MacCurdy created a bar to link the reins for steering with one hand for drivers who can only use one hand. She’s also made loops in the reins to make it simpler for driving trainees with a weak grasp to hold the reins.
According to MacCurdy, who is seeking her therapeutic riding and driving certification with PATH Intl., carriage driving instructors also have a set of reins and can assist students as much or as little as they require. A driving session normally involves three to five volunteers.
Therapeutic driving is offered by a small number of PATH International-affiliated therapeutic riding centers. They can be found on the PATH International website (under “Find a Center,” select “Driving”) or by calling PATH International at (800) 369-7433.
The cost of therapeutic driving sessions is normally around $50 per session, although scholarships may be available; inquire at the riding center for more information.
Horses are incredibly perceptive to the emotions of humans, which is why these animals are effective in therapy.
Horses are able to recognize human facial expressions and prefer to approach happy faces over hostile ones. Horses are extremely sensitive to changes in human expression and emotion as a result of this sensitivity, and horse therapy is becoming a more popular avenue for emotional and physical healing as a result of this sensitivity. Hippotherapy and equine-assisted therapy are two prevalent methods of horse therapy, however they have significant differences.
Equine-Assisted Therapy vs Hippotherapy
Both therapies use horses, but they focus on distinct aspects of total wellness. Equine-assisted therapy is a type of therapy that involves patients caring for horses in a stable setting. Hippotherapy, on the other hand, is a type of physical therapy in which the patient rides a horse to improve his or her physical condition.
The occupational therapy, speech-language pathology, and physical therapy components of this horse-riding therapeutic practice are all referred to as hippotherapy.
Equine-assisted treatment addresses mental health issues such as those linked with alcohol, opiate, or cocaine withdrawal. Patients can address the emotional and mental health concerns linked with their substance use disorder by caring for horses with a mental health practitioner present. Horses’ emotional intelligence aids patients in gaining self-confidence, overcoming obstacles, and establishing long-term emotional foundations for long-term sobriety. Equine-assisted therapy has been demonstrated to promote mental wellness and even alleviate the symptoms of mental illnesses.
Finding Treatment Solutions
At Banyan Detox Boca, we provide a wide range of mental health and addiction treatment options. Equine-assisted therapy is used in our Boca drug treatment programs to help people overcome their difficulties.
If you or someone you love needs guidance in recovery, contact our treatment team by calling 888-280-4763.
- The Effects of Equine-Assisted Activities and Therapy on Resting-State Brain Function in Attention-Deficit/Hyperactivity Disorder: A Pilot Study (NCBI)
Who benefits from equine therapy?
Equine Therapy is usually part of a larger therapeutic strategy, aiming to supplement more traditional treatments that are appropriate for the case. Equine therapy sessions should always be led by a qualified Equine-Assisted Therapist who has had both specialist equine therapy training and traditional mental health training.
When a horse and a client meet, it is common for suppressed emotions to be released, allowing them to be processed and healed. “I continue to wonder at how a horse may act in a certain way that culminates in the presentation of a critical issue for a client,” says equine therapist Nancy Jarrell. It’s as though the horse is already aware of the past.”
People benefit from EAP in a variety of ways, according to a recent article in Psychology Today:
- A better knowledge of the necessity of assertiveness and good limits
- Learn to go beyond of your own negative, self-centered thinking and care for another species.
Children with cerebral palsy, behavioral tics, motor control disorders, and coordination impairments, as well as adults of any age with decreased mobility, can benefit from certain equine-assisted therapy.
Equine Therapy has also been proved to be effective for people suffering from eating disorders such as anorexia and bulimia. Individuals learn to better manage their emotions and communicate their sentiments in a more positive manner as a result of the therapy. Riding and caring for horses boosts self-esteem and reduces anxiety, as well as addressing negative body concerns.
The horses they deal with offer unconditional acceptance to the majority of participants in Equine Therapy.
How effective is equine therapy?
“Horses and people have striking similarities, according to Dede Beasley, M.Ed., LPC, an equine therapist at The Ranch who grew up riding horses. She’s also had a private practice for 30 years, counseling individuals, couples, and families. “Horses, like people, are social creatures with herd dynamics that are strikingly comparable to the family structure.” Equine therapy is a hands-on method to experience change at The Ranch’s rehabilitation center in Tennessee. It encourages people to take a fresh look at themselves and the world around them. With the help of horse therapy, people who have struggled to make progress or fulfill their treatment goals have made considerable strides. Many of the advantages of equine therapy have been proven via research. It lowers blood pressure and heart rate, relieves tension, and alleviates anxiety and depression symptoms. Equine therapy is also beneficial to persons who are suffering from addictions or mental illnesses. Horses are better at teaching a variety of life skills than humans are. This is the main advantage of employing equine therapy with those who are suffering from mental illness or addiction.
How do you bill a horse for therapy?
HCPCS #S8940 (Equestrian/Hippotherapy, per session), CPT #97139 (Unlisted therapeutic procedure), or just normal CPT#90847 were recommended as possible procedure codes in policy (Family Psychotherapy, with patient present, 50 mins).
What are the different types of equine-assisted therapy?
Equine therapy is a popular treatment option for a number of psychiatric, mental, and mood disorders, as well as addiction. There are various types of horse therapy that are used in clinics all around the world. Each has goals that are in line with the various client needs and situations being addressed.
Riding a Horse for Therapeutic Purposes
Therapeutic horseback riding is usually taught by a riding instructor or a horseman who teaches you how to ride and control a horse. It’s a type of exercise that helps people improve their coordination, balance, posture, muscle tone, confidence, and overall well-being. In addition to riding, the individual is usually taught how to work with the horse on the ground.
2. Horseback riding treatment
Hippotherapy is comparable to therapeutic horseback riding, but it usually includes the participation of an occupational therapist, physiotherapist, or speech and language therapist. The horse is led through numerous different gaits, tempos, cadences, and directions by a handler. The various motions of the horse force you to use various postural reactions, thereby strengthening the rider’s muscles.
Equine-Assisted Learning (EAL) is a type of equine- (EAL)
Participants in EAL programs have a greater sense of self-awareness as a result of their interactions with horses, which is vital for revealing patterns of behavior and allowing you to think in new ways. Education, professional growth, and personal development are the three main areas of focus in EAL. Participants develop confidence by learning how to deal with such enormous and powerful animals, as well as understanding how nonverbal communication affects people in their life.
Equine-Assisted Psychotherapy is a type of equine-assisted psychotherapy (EAP)
Horses are used in EAP to treat psychological issues. Therapeutic riding or hippotherapy are not the same thing. Although some programs include riding and vaulting, the majority of programs focus on groundwork with horses, such as grooming, feeding, and ground exercises. Horses are used by mental health practitioners to help their clients learn about themselves and talk about their thoughts, patterns, and behaviors. The purpose is to provide assistance in the areas of social, emotional, cognitive, and behavioral issues.
5. Treatments that aren’t widely used
Interactive vaulting, therapeutic carriage driving, and Equine-Assisted Activities (EAA), which include horse care, stable management, displays, parades, and demonstrations, are all examples of equine therapy.
What is therapy with horses called?
Hippotherapy is a type of physical, occupational, and speech therapy in which a therapist employs a horse’s natural movements to deliver graded motor and sensory input. A foundation is laid for bettering brain function and sensory processing, which can be used to a variety of daily activities. When using hippotherapy as a treatment technique, the horse’s movement is a means to a treatment objective, unlike therapeutic horseback riding (where specific riding skills are taught). Patients with neurological or other disabilities, such as autism, cerebral palsy, arthritis, multiple sclerosis, brain injury, stroke, spinal cord injury, behavioral disorders, and psychiatric illnesses, have all benefited from hippotherapy. For several of these conditions, the effectiveness of hippotherapy is unknown, and additional research is needed. We hope to provide information about hippotherapy that many clinicians and health care workers are unaware of.
Who benefits the most from equine therapy?
EAAT has been found to improve muscular tone, strength, and control, as well as increase range of motion, endurance, balance, gross and fine motor skills, stimulate cardio-respiratory function, and aid with coordination, sensory integration, and ambulation. Riding a horse is a particularly beneficial therapy for many people with illnesses that cause ataxia and/or stiffness of the arms and legs, such as multiple sclerosis and cerebral palsy, as well as one-sided paralysis and other asymmetry issues. Another significant benefit of riding is that the rider can get useful exercise while remaining relatively passive, as the horse’s movement moves the rider’s body. As a result, by gently moving, extending, and nourishing soft tissues in sync with the movement of the horse, riding can help reduce contractures associated with wheelchairs and various disorders.