Running head: SATISFACTION EQUINE THERAPY Perceived Satisfaction with Equine-Assisted Therapy: A Qualitative Study of Family Narratives

The present research represents the satisfaction that parents feel with equine-assisted therapy. Equine-assisted therapy is, according to Funk and Smith (2000), the use of horses as a therapy technique that improves the well-being of individuals in all of the following areas: social, cognitive, psychosocial, and physical (2000). Themes were coded from publicized material that contained accounts of parents whose children participated in a specific equine-assisted therapy program in North Carolina. Each testimony was coded for themes that were similar in nature to those that were represented in other accounts as well. Themes that were found were organized into categories and related to satisfaction and equine-assisted therapy. There were four main categories that were represented in the data that were, Connection, Developmental Gains, Socioemotional Gains, and Personal Gains. There were also 22 specific themes that were represented in the data that were collected. Satisfaction was represented by the current research with each theme that was found in the testimonies. SATISFACTION EQUINE THERAPY 4 Perceived Satisfaction with Equine-Assisted Therapy: A Qualitative Study of Family Narratives Hippotherapy and equine-assisted therapy is not considered a new topic in history, but has been rapidly increasing since the 1960s. Granados and Agis (2011) conducted research in order to determine the areas of improvement that make children with special needs feel better with the use of hippotherapy. Part of their research included discovering the history and origins of using horses as a means of therapy. Granados and Agis found that therapy with horses could be dated back to the time of Hippocrates, who was the first to call riding horses therapeutic. He called riding the “healing rhythm. ” Chassaignac was the first to recognize that using horses for physical therapy was valuable because of the noted improvement of the rider’s balance, strength, supple joints, and morale. The more common hippotherapy and equine-assisted therapy have been growing across Europe, Canada, and the United States since the 1960s. Modern treatment has a wide range of goals that include physical, psychological, cognitive, social, behavioral, and educational goals. The goals of modern centers are to holistically improve the child’s life through each of these avenues (Granados & Agis, 2011). All and Loving (1999) defined using horses as a means of therapy in two ways, hippotherapy and therapeutic riding. Hippotherapy is a treatment used for improving posture, mobility, and balance that is obtained by an individual riding a horse. The horse’s movement directly causes movement of the rider’s hips that simulates walking. All and Loving defined therapeutic riding as an all-around benefit to an individual, that uses the recreational aspects of horseback riding as therapy. The notable difference between hippotherapy and therapeutic riding is that hippotherapy is conducted by a SATISFACTION EQUINE THERAPY 5 licensed physical therapist and the rider typically rides without a saddle in order for the therapy to be more physically demanding. The horse’s movements more directly cause the rider to move in ways that improve posture, movement, etc. (All & Loving, 1999), whereas therapeutic riding is considered by Funk and Smith (2000) to be the use of horses and riding to improve all aspects of a person’s well-being (Funk & Smith, 2000). According to Sterba (2007), horseback-riding therapy is instructor-based and modeled after what the instructor believes to be the most fitting between the horse and rider. The instructor’s job is to pair horses and riders based on both sets of abilities and then train the horse further to suit what the child or rider needs. The therapies used by the instructors are based mainly upon the instructor’s knowledge of the child’s impairment and then the therapies are made individually for each child to be able to improve the child’s overall posture, movement, and skills. Five out of six studies showed improvement in the gross motor function of the participants through the use of hippotherapy or horseback riding therapy (Sterba, 2007). The overall lack of large populations for these studies is apparent and essential in order to conclude that both hippotherapy and therapeutic riding are beneficial. Granados and Agis (2011) also concluded that children with special needs benefit from hippotherapy physically, psychologically, socially, and educationally. Some basic physical benefits are balance, increased muscle control, strength, stability, posture, gross motor functions and increased energy. Psychologically, hippotherapy was beneficial in growing self-efficacy, self-esteem, growing trust, security, respect, and self-control. From the social aspect, children with special needs seemed to improve in their ability to create and foster relationships and were able to gain reporting skills in the eagerness of telling SATISFACTION EQUINE THERAPY 6 about their riding experience. In some of the activities that are involved with hippotherapy, games are played and instructions are given that involve reading, math, and recalling information in order to complete the activity. Through practicing this type of therapy, children were able to grow in the educational aspect of their lives (2011). Benefitting Disabilities Therapeutic Riding or equine-assisted therapy is used to treat a wide range of disabilities. Elliot, Funderburk, and Holland (2008) stated that some of these disabilities include autism, spina bifida, learning disabilities and Down syndrome (Elliot, Funderburk, & Holland, 2008). Cerebral palsy (CP) is a disability where equine-assisted therapy is used for a great amount of treatment, physically, socially, and cognitively. Stranger and Oresic (2003) claim that CP is a disability that affects the social, cognitive, and physical functioning of an individual who has been diagnosed with the disability. The abilities of these individuals to provide for themselves, be socially acceptable, and be easily mobile are impaired in an individual with CP (Stranger & Oresic, 2003). Many different styles of treatment can be used to try to improve all three areas that are affected by CP in individuals, and equine-assisted therapy is one of them. Stranger and Oresic (2003) also suggested that equine-assisted therapy be used as a treatment for individuals diagnosed with CP because of its benefits to posture, mobility, and balance, along with the emotional support that the therapy provides (2003). Bertoti (1988) specifically did research regarding the postural changes in children diagnosed with CP using equineassisted therapeutic riding as treatment. Her study resulted in the support that individuals with CP showed improvement in weight shifting, balance, rotational skills, and posture control, as well as decreased spasticity. Specifically, 8 out of 11 children had improved SATISFACTION EQUINE THERAPY 7 posture at the end of the equine-assisted therapy treatments and numerous improvements were shown on the posture assessment scale that was used in this study (Bertoti, 1988). In 2011, Zadnikar and Kastrin wrote about the effects of hippotherapy and therapeutic horseback riding on children with CP. The main focus of this article was to overview the data collected from various sources that have tested in some way the functioning improvements or lack thereof of individuals with CP. Zadkinar and Kastrin found that the populations were too small and too diverse for each study to make a prevalent difference in what the study was focused on achieving through either hippotherapy or therapeutic horseback riding. Both were able to improve the daily living of the participants, but the measurement was hard to obtain and compare because of the wide range of participants (Zadnikar & Kastrin, 2011). There are many other areas of need that can be met through the use of equine assisted therapy and some include the elderly population, at-risk teenagers, substance abuse, speech impediments, violence, and specifically women. Equine-assisted therapy is not limited to treating individuals with mental or physical disorders and that are considered to have a handicap of some kind. Macauley and Gutierrez (2004) investigated the effects of hippotherapy on children with language learning disabilities. After a questionnaire was administered to the parents of the children that participated in the therapy, all concluded that there was an improvement toward the therapeutic goals in speech and language after the use of hippotherapy. The observation was made through the questionnaire that having willing participants did make a difference in the outcome (2004). At-risk teenagers can also benefit from therapy using horses as tools to reach these individuals that are struggling socially and psychosocially in their environments. SATISFACTION EQUINE THERAPY 8 Studies done by Bachi, Terkel, and Teichman (2011) and Burgon (2011) emphasized the therapeutic environment that allows these adolescents to get away from their usual surroundings and be treated holistically through the horses, riding, and surroundings. According to Chalmers and Dell (2011) and Schultz, Remick-Barlow, and Robbins (2007), the psychosocial benefits of equine-assisted therapy can be beneficial as well to children who have been exposed to violent backgrounds and adolescents who are participating in substance abuse. Specifically, two types of individuals that can also be positively affected be equine-assisted therapy are the elderly and women. Araujo, Silva, Costa, Pereira, and Safons (2011) did a study that involved the elderly and the postural control that was gained through the use of equine-assisted therapy. In 2009, Froeschle conducted research that studied women and how they were empowered by the use of horses as a career therapy. There are many ways in which people can benefit from equine-assisted therapy and hippotherapy that are n