Horses Who Heal - Therapy Horses

Horses Who Heal

Therapeutic riding offers some 5,500 mostly older horses a second career - and a second chance. For the right horses, in the right hands, it's a pretty good living.

Standing at the mounting block waiting for his rider, Doc fidgets. It's the tenth week of a 12-week semester, and the big horse is beginning to display behavior that, while permissible when he's with his herd, is completely unacceptable in the riding arena. Tossing his head, he lips at his handler, tries to rub his head against her arm, and stamps his feet. Meanwhile Kea, a blind Appaloosa, placidly moves through the obstacle course, trusting his leader not to steer him wrong. He seems unfazed by the autistic child on his back, even though she periodically vents an ear-piercing scream that would have most horses dancing sideways. What makes one horse act out in a stressful situation, while another displays a Zen-like attitude? How high are the tension and anxiety in so-called therapeutic riding programs? Children, teens and adults with disabilities clearly benefit from the various activities and therapies that fall under this umbrella term...but what's in it for the horse?

The Horse-and-Human Bond
Historically, human beings have had a deep and abiding relationship with the horse, not just as a partner in our labors, but as an inspiration in art, mythology, music and poetry. In fact, our use of the horse as a work animal may be the most obvious yet least interesting aspect of the profound and lasting bond that we have shared with this fascinating animal.

The therapeutic value of riding was documented as early as 600 B.C. by Orbasis of ancient Lydia. It wasn't until 1875, however, that the first systematic study of therapeutic riding was reported. After prescribing pony riding as a treatment for a variety of conditions, French physician Chassaign concluded that riding was helpful in the treatment of certain types of neurological paralysis. He noted improvement in posture, balance and joint movement, and a striking increase in morale.

In 1946, following two outbreaks of poliomyelitis, riding therapy was introduced in Scandinavia. This movement was spearheaded by Liz Hartel, an accomplished horsewoman who was stricken with the crippling disease. After surgery and physical therapy allowed her to walk with crutches, Hartel was determined to ride independently again. Daily supervised riding sessions brought back her muscle strength and coordination. In 1952, she won the Olympic silver medal for dressage.

Presently, more than 600 therapeutic riding programs are member centers of the North American Riding for the Handicapped Association (NARHA), headquartered in Denver. Founded in 1969, NARHA establishes professional guidelines, safety standards, insurance provisions, and instructor and therapist training and certification for the growing field of equine-assisted activities (EAA) and -therapies (EAT).

For individuals with physical, cognitive or psychological disabilities, therapeutic riding can prove beneficial in several ways. They may experience increased strength and balance, improved body awareness, and enhanced self-esteem. The positive relationship that develops between a rider and her peers, horse, and therapeutic team presents opportunities for the development of trust and social growth.

The field of equine-assisted activities encompasses a range of equestrian programs.

  • Hippotherapy - a medical intervention whereby a licensed physical or occupational therapist uses the motion of the horse to conduct targeted therapy.
  • Therapeutic Riding - a specially trained therapeutic riding instructor teaches riding skills to a person with disabilities. While legally not a therapy, this activity can have profound and multiple benefits.
  • Equine-Facilitated Psychotherapy (EFP - experiential psychotherapy with horses. EFP is facilitated by
    a licensed, credentialed mental health professional working with an appropriately credentialed equine professional. This often involves horse training, grooming, and other groundwork (nonriding client/horse interaction).
  • Other equestrian activities offered for individuals with disabilities include driving, vaulting (gymnastics on horseback), and local, regional and even international competition opportunities such as the Paralympics.

The Source of the Horse
No matter the venue or the intent of the activity, the horse is at the center of it all. There are an estimated 5,500 horses active in therapeutic riding programs in the United States alone. These animals come to therapeutic riding from many different sources and with a wide range of backgrounds. Some have minor but debilitating physical ailments, i.e., lameness or allergies, that make them incapable of racing, jumping, dressage, driving, police work, etc. "Few people can afford to keep a horse who can no longer be used for his main purpose," says Stephanie LaFarge, Ph.D., senior director of ASPCA Counseling Services and a NAHRA-certified riding instructor. "But the alternatives are costly euthanasia, or worse: slaughter for the income to be realized from the horse's meat and bones. So horse-lovers desperately want to find a quiet, post-retirement occupation for their mounts." Other owners are unscrupulous individuals looking to unload an aging and/or what they see as "useless" animal on someone else. Either way, many of these owners turn to therapeutic riding programs as the answer.

"We look at about twenty horses for every one we accept into the program," says Kristin Elliott Leas, barn manager at High Hopes Therapeutic Riding in Old Lyme, Connecticut, and a NARHA advanced instructor. "Our first responsibility is for the safety of our riders, horses, volunteers and staff. And for that, we have to be very particular when choosing what sort of horse comes into our program."

A varied set of criteria is used when considering mounts for therapeutic riding. "When a horse is offered to us, we do a telephone screening first," says Sally Eaton, program coordinator at the Pacific Riding for the Disabled Association in Langley, British Columbia. "We ask if he has any bad habits. Is he likely to be scared by children or someone with a disability? We ask whether he has the patience of Job." Says Leas: "We check on the horse's prior training, how she was handled, what sort of work she's done in the past, what work - if any - that she's doing currently, and whether or not she's sound." Horses who pass the initial interview and, sometimes, a home visit, come in for a trial period at the facility. There they are worked and observed by staff and volunteers. Is the horse calm when being groomed, tacked and mounted? Does he interact positively with other horses? Does he work well with a leader and a sidewalker, or does he prefer an independent rider? Is he responsive to commands and tolerant of mistakes, or does he willfully disobey?

As a rule, horses who don't pass the trial period are returned to their owners. If the horse was part of the therapeutic program and is being retired due to age, infirmity or behavior, he may be adopted by an outside party. The adoption procedure is very selective. "We want there to be a good match between owner and horse," says Leas, "so we do a thorough background check, invite the prospective adopter out to meet and ride the horse, watch them together, observe whether or not the person wanting to adopt is horse knowledgeable, check references, and get details on where the horse will be living and how he'll be maintained. If the adoption goes through, then we check up on the animal periodically. We want this to be a match that will last a lifetime. If it doesn't work out, we'll take the horse back and try again." In general, therapeutic riding facilities do not have inappropriate horses euthanized, nor are they sold for slaughter.

Obviously, it is in the best interests of the facility to choose horses with care and maintain them in an excellent manner. While NARHA has criteria for this, none of it is mandatory and much is open to interpretation.

Not Exactly Easy Street
As for the horses who pass the test and enter a therapeutic program? Depending upon the facility, these animals may have to contend with one or more of the following stressors:

  • Having to override natural instinct or training in order to compensate for differences in every rider.
  • Riders who make loud or unexpected noises.
  • Uneven and sudden rider weight distribution from individuals with significant physical disabilities. This can cause a horse to feel off-balance and, over time, may injure its back.
  • Receiving mixed signals from rider and leader. A leader may request a halt by pulling back gently on the lead, but the rider (perhaps with uncontrolled muscle spasms) is pressing with his legs, indicating a wish to walk on.
  • Coping with different handling styles from a variety of volunteers, rather than the familiar consistency of one-on-one horse ownership.
  • Isolation, extended stall time, and limited turnout due to lack of space.
  • Poor herd dynamics, with one horse constantly being harassed by the others.
  • Lack of stimulation. Consistently being ridden by inexperienced riders can create boredom and lead to the development of bad habits.

"When looking at stress in therapeutic riding horses, we need to recognize that some of the same stressors they deal with are inherent in any equestrian setting," cautions Michael Kaufmann, director of education for NARHA and a former faculty member of the American Humane Association Horse Abuse Investigator School. "Being isolated in a stall for long periods of time is an unfortunate reality for many horses boarded at some of the finest recreational stables in the country." Much of this stress, Kaufmann adds, is not so much due to intentional neglect or abuse, but rather is caused by the practical management methods for equines that humans have developed and adopted over time.

Unfortunately, the law does not help much in defining what treatment of horses is detrimental to them psychologically, and does not even recognize the impact of stress. Indeed, many experts still dispute whether animals can feel significant stress at all. Put a rodeo stock contractor, a New York City carriage horse driver, and an Olympic rider in the same room with a staff member of an equine rescue group and they will have one lively argument over how each perceives and defines stress in horses. The equine disciplines represented by each are perfectly legal, and each has the potential for significant stress in the animals.

Most trained animal cruelty investigators shy away from making broad statements, preferring to look at individual animals and what symptoms they present. Unfortunately, these investigators' hands are often tied, as state anti-cruelty laws limit the protection of horses (and most animals) to the most basic provisions of food, water and shelter. The laws do little to define what type of housing, training and handling methods are in accordance with the actual behavioral needs of horses. The word "humane," while bantered about frequently in court cases, is often hard to define when applied to the treatment of equines. For example, there are many bits, whips and electronic training devices available at tack stores around the country that, while legal, would not be deemed humane by many horse experts.

Many riding centers monitor the therapeutic relationship so that the horse benefits as much as the client. At Green Chimneys, a long-established residential school for at-risk youth in Brewster, New York, the staff prevents stress by giving horses turnout time in pasture and trail-riding to make a cognitive shift from the ring. Psychologist Dr. Susan Brooks says, "We also pay close attention to nutrition. And if possible, we don't use bridles - only reins and halters. There's no yanking on the bit." In Boerne, Texas, psychotherapist Dr. Leslie Moreau works her horses only four days a week. How well the horse and client are working together is under constant evaluation.

Science Weighs In
Little formal research has been done on measuring stress in horses, but that may soon change, thanks to the efforts of Dr. H. Marie Suthers-McCabe, associate professor of Human/Companion Animal Interaction at the Virginia/ Maryland Regional College of Veterinary Medicine. In a pilot study to explore the physiological and behavioral markers in therapy horses, Suthers-McCabe examined eight horses used for a groundwork EFP program. Four participated in therapy sessions. Of those in the control group, one stayed in the stall, two remained in a turnout pasture, and one was used for able-bodied lessons. Blood was drawn before and after therapy sessions to measure the levels of cortisol (stress hormone). In this case, levels remained the same in the control group, with a slight individual variation from horse to horse. In the test group, one had decreased levels, one had increased levels, and two stayed the same. " Just because levels are elevated doesn' t mean that the work is inappropriate for the horse," says Suthers-McCabe. " A little stress is okay, but prolonged stress is a different matter. That can affect overall health by triggering immune suppression."

Suthers-McCabe hopes to continue her work by paralleling studies done by Johannes S. Odendaal (University of Pretoria, South Africa), and Richard Meadows and Rebecca Johnson (University of Missouri College of Veterinary Medicine), using precise methods to show chemical changes that occur in both humans and animals when the human/animal bond is present. Chemical indicators to be measured include cortisol, oxytocin (" happiness" hormone), prolactin (" bonding" hormone), endorphin (" warm feeling" hormone), phenylethylamine (" attention" hormone), and dopamine and epinephrine (" nerve transmitters" ).

" In order to understand what' s going on with horses, we need to measure for more than just stress," says Suthers-McCabe. " We need to measure for the other side of the equation, the " feel-good" indicators, the possible physiological proof that horses are enjoying their work. And, as always," she adds, " we must remember that horses are individuals' each is going to respond differently to a given situation. My ultimate goal is to find a way to help people notice stress in a horse without having to draw blood. We need to be able to note subtle things that indicate stress, so we can then determine, per individual animal, the appropriate length of therapy sessions, how often they can or should work, etc."

The Power of Observation
According to Leas, observation is the key. " There are no rules about stress in horses. They' re like people. They' re all going to feel stress from time to time, they' re all going to handle it differently, and what stresses one won' t bother another. I don' t know that we can realistically expect to avoid stress altogether. The best way to lessen it is to know your own horses intimately. Learn their normal behavior, so you' ll notice any changes. Horses communicate all the time, with their voices, bodies and breathing. It' s up to us to make the effort to learn to understand what they' re saying."

Leas suggests that stress in therapeutic riding horses may manifest itself in a number of ways:

  • Body Language - ears flattened to the skull, pursed lips, an agitated movement of the tail, showing the whites of the eyes.
  • Cribbing (mouthing on posts or rails), wind sucking, weaving.
  • A reluctance to move.
  • Biting or kicking at handlers, sidewalkers, or other horses.
  • Pacing in the stall or field.
  • Lack of appetite.
  • Turning off - becoming zombie-like, with no affect.

This last situation happened with Gopher. Pinned to the ground and nearly killed by another horse before coming to the therapeutic facility, Gopher vanished into himself - as if not to draw attention lest he be attacked again. With gentle treatment, careful schooling and a better diet, Gopher opened up, began to interact with his caretakers and the other horses, and had a successful therapeutic riding career. Not only that, but he continued his therapeutic career on his own when he retired from the center to become the mount of a young girl who was afraid of cantering. Under Gopher's patient tutelage, she is now a successful and confident rider.

Keeping Horses Happy

The following recommendations may not apply in every case, but these are some of the things to look for in evaluating whether or not therapeutic riding horses are receiving adequate care.

  • Is the horse suited to the specific task he's being asked to perform?
  • Do the horses receive adequate rest periods and/or vacations between periods of work?
  • Do the horses receive extra TLC through the care of interested and trained volunteers?
  • Is an equine trigger-point therapist and/or equine massage specialist involved in the program? (Some will volunteer.)
  • Do trained staff and/or volunteers school the horses to help maintain the animals' mental and physical fitness?
  • Do staff take the horses on trail rides or, if feasible,
    trailer them to a different location for physical and mental stimulation?
  • Are the horses maintained in as natural a state as possible? If prolonged turn-out time with the herd is not feasible, are they hand-grazed in groups so that they can interact with one another?
  • Does every piece of tack fit properly? Stress may be due to the pain of a rubbing saddle, a too-tight girth, or an inverted bit.
  • Are the horses scheduled for regular veterinary, dental and farrier appointments?
    Therapeutic riding facilities welcome visits from the public. They're happy to give a tour and answer questions, but please call in advance to set up an appointment. Many centers are so busy (some see over 200 riders per week) that unless you call first, there may be no one available to talk with you at the time.


Horses who do well in a therapeutic riding program generally enjoy their relationships with people. One such was Apple Jack - "A.J." - a 28-year-old Pony of the Americas. "He'd watch for his special friends," recalls Marni Adamson, one of his handlers. "Even before he heard your voice, he'd recognize your step and be at the front of the stall, nickering for some attention - and a treat if you had one." Adamson adds that the pony was completely unflappable. "Nothing fazed him. Not a sheet of plastic snapping in the wind, a child screaming, or a deer on the trail. He'd just turn and look at me as if to say, "Well, am I supposed to be scared of this or not?" And if I wasn't, then neither was he."

Some horses even seem to prefer the company of human companions over that of the other herd members. That's clearly true of Honey, a strawberry roan mare. Where she is intolerant of another horse's approach, she actively welcomes the presence of a known human coming out to visit and leaning against her while she grazes. She enjoys her work and is heavily focused on her riders and their needs when in the arena. "You can actually see her draw into herself, focusing all of her attention on her rider and the job at hand," says Patti Coyle, a NARHA advanced instructor who works closely with the mare. "If her rider leans too far to one side or the other, Honey will literally shift her weight in order to help them regain their balance, all without any prompting from her handler. Consequently, her riders adore her."

Preventing behavioral stress in horses is largely a process of self-regulation and awareness. In some centers financial pressures and lack of sufficient training in those working with the horses may lead to increased stress in the animals. On the other hand, the more fully humans appreciate what is required for equine comfort, the better able horses are to do those things that heal others so profoundly.

So is therapeutic riding good for horses? The answer is yes - and no. Like so many things, it is truly a matter of perspective - a perspective controlled by human caretakers. "I wouldn't stay in this field if it was damaging to the horses," says recreational therapist and NARHA advanced instructor Dawn Nelligan. "It's exploitive only if we take the attitude that we just want the horse to work, and it doesn't matter if they're sick or hurt or frightened or upset. If we say "Just do it, who cares how you feel?" then that's wrong." Says the ASPCA's LaFarge, "It would be ironic if the quiet, post-retirement occupation that a horse-lover sought for her mount turned out to be highly stressful." Ultimately, it is up to those to whom the horses look for care to make sure that they lead happy, healthy and, as much as possible, stress-free lives.

Author Note: Not all facilities that advertise therapeutic riding are accredited by NARHA or have NARHA-certified instructors. Anyone seeking a riding center specifically for therapeutic riding should inquire about NAHRA accreditation. Call NARHA at (800) 369-7433, e-mail, or log on to

Melissa Crandall, freelance writer, novelist and lifelong horse lover, resides in Quaker Hill, Connecticut. Additional reporting by Graham Hayman of Vancouver, British Columbia.

© 2002 ASPCA

ASPCA Animal Watch - Winter 2002

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