Vol. 18 No. 2 Spring 2012

Professional Association of Therapeutic Horsemanship InternationalProfessional Association of Therapeutic Horsemanship International

COLLABORATION ISSUE

PATH Intl. Community Connections

Rehab Hospital CollaboratesWith Center

Hospice Teams UpWith Horses

Therapeutic Driving BuildsCar Driving Skills

Ensuring Excellence and Changing Livesthrough Equine-Assisted Activities and Therapies

COLLABORATION ISSUE

PATH Intl. Community Connections

Rehab Hospital CollaboratesWith Center

Hospice Teams UpWith Horses

Therapeutic Driving BuildsCar Driving Skills

Professional Association of Therapeutic Horsemanship International (PATH International) STRIDES is a ben-

efit of PATH International membership and is published quarterly (Winter, Spring, Summer, Fall). Non-mem-

bers can purchase a subscription for $34. International subscriptions are $54. No portion of this publica-

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International is not responsible for the return of such material. PATH International reserves the right to

reject, accept and edit unsolicited material. PATH International STRIDES is intended as a challenging infor-

mation exchange and communication opportunity for the field of equine-assisted activities and therapies.

The opinions, practices or products presented in STRIDES do not necessarily reflect PATH International

policy, imply PATH International endorsement or comply with PATH International standards.

Vermont Venture...28Hospice Teams Up...16 Rehab Hospital Collaborates...32

Subscriber List: Occasionally our subscriber list is made available to reputable firms. To beexcluded from this list, send your current address label and a note requesting exclusion to:PATH International, P.O. Box 33150, Denver, CO 80233.

Spring 2012

Features

On the CoverThe grand prize winner in the adult category for the 2011 PATH Intl. PhotoContest was sent in by Rocky Mountain College.The leader, Hollis Edwards,is working with volunteer J.J. Barney and rider Andrew Atkinson.

16 Hospice Teams Up With HorsesAn equine-facilitated psychotherapy program helps griev-ing children and adults heal from the loss of a close familymember. By Lisa Renae Nelson and Laura Strom

22 PATH Intl. Community ConnectionsThis members-only social networking site is opening upnew networking opportunities as it re-invents the waymembers are able to connect with one another.By Leif Hallberg

28 Vermont VentureHow four centers collaborated to form Vermont PATH Intl.Equine Services for Heroes to better serve veteransthroughout the state. By Liz Claud

32 Rehab Hospital Collaborates With CenterA groundwork program for participants with spinal cordinjuries promotes physical and emotional healing.By Terry Chase

38 Cart Driving Builds Car Driving SkillsLearn how therapeutic driving students can transfer theirskills to motor vehicle operation and how centers canpartner with driver educators and vocational rehabcounselors. By Susan Grant

Departments

Professional Association of Therapeutic Horsemanship International

Professional Association of Therapeutic Horsemanship International, P.O. Box 33150, Denver, CO 80233

Phone: (800) 369-7433 l Fax: (303) 252-4610 l www.pathintl.org l E-mail: pathintl@pathintl.org

2 President’s Letter

3 CEO’s Letter

4 Region Contacts

5 PATH Intl. Donors

6 Newly Certified Instructors

7 Accredited Centers

8 About Insurance: Collaborating With Other

Agencies By Debi DeTurk Peloso

10 News Briefs

12 Inspiring Stories: Making Love Visible

By Marge Tautkus Gunnar

46 PATHways: 2012 Standards Manual Changes

50 Press Box

51 Classified Ads

52 A Great Idea: A Win-Win County-Center

Partnership By Karen Karvonen

54 Book Ends

56 Calendar of Events

Spring 2012, PATH International STRIDES16

By Lisa Renae Nelson and Laura StromPhotography by Lisa Renae Nelson

In 2008, Sutter Care at Home inSan Mateo, CA, partnered withthe National Center for Equine

Facilitated Therapy (NCEFT) inWoodside, CA, to provide a daylongequine-facilitated psychotherapy(EFP) session for children grievinglosses of a close family member. Atthe children’s Horses & HealingWorkshop, volunteer therapists fromNCEFT helped the children learn togroom, touch and safely interact withthe horses. As they began to bond,

volunteers introduced the children toriding by first teaching them verbalcommands as they led them slowlyaround the ring and then quickeningthe pace in response to the children’scommands and comfort level.

Eventually, the children werebrought into a side-by-side positionwith each other, and the leader played“Simon says” using a powerful varia-tion of the childhood game so the chil-dren could express their feelings. Thecommands included sitting sideways

and then backwards on the horse, lay-ing supine and then laying forwardand thanking the horse. At the veryend, Simon asked the children towhisper a secret to the horse abouttheir loved one who died and sharesomething important with the horse.

The first session was so powerfulDuring an equine-facilitated psychotherapy

grief session for adults at NCEFT, participants

decorated and wrote prayers and messages

to their deceased loved ones on ribbons they

then tied on the horses’ manes.

Spring 2012, PATH International STRIDES 17

in creating a magical healing inter-vention for bereaved children thatSutter Care at Home (formerly SutterVisiting Nurses Association &Hospice) and NCEFT have completedsix workshops to date. Losses haveinvolved one or both parents, grand-parents and siblings and included sui-cides and ambiguous losses such asdisappearances. Participants haveranged from four to 17 years old.About 20 percent of attendees hadlost someone while they were inSutter’s hospice care; the balancecame from the community (referralsfrom other professionals, agencies,schools, Craig’s List, etc.)

The program was the brainchild ofJennifer Wilson, a Licensed Marriageand Family Therapist (LMFT) atSutter Care at Home. After hearingabout a program at a hospice in theMidwest that relied on the therapeuticpower of horses, she approachedNCEFT Executive Director GariMerendino, who was delighted withher idea. Soon, with the help of a per-son who volunteered at both places,Wilson wrote a grant and a successfulcollaboration was born.

Grief in Children

Merendino saw that grieving chil-dren are a very unique type of specialneeds child. “When the children cameto NCEFT, each was dealing withtheir own personal loss and trying tomake things normal again,”Merendino said. “It helped me realizehow we can make a difference in thelives of others even when we are notproviding hippotherapy or therapeuticriding. The Sutter experience hasopened our eyes to other opportunitiesto make a difference through ourwonderful therapy horses, dedicatedstaff and volunteers—a difference thatcomes one individual at a time.”

Children, especially those underthe age of five, are particularly vul-nerable to the stress of grief because

of the developmental stage of theirbrain. The pre-frontal cortex is notfully developed. Traumatic memoriescan be trapped in the limbic system,which stores emotion and memory. AUniversity of Stanford study docu-mented that trauma to childrenchanges the size and shape of thehippocampus and can interfere withmemory (Landou, 2009). In addition,grief is revisited with each newdevelopmental milestone a childreaches. For instance, a child maywish the parent could see him or hergraduate/win this award/go to theprom, etc.

The Diagnostic and StatisticalManual of Mental Disorders (DSM-TR-IV) states that a person can bediagnosed with bereavement for up totwo months after the death of a closeloved one; there is no mention ofgrief in children (APA, 2000, p. 740).After two months, a new diagnosis isneeded, such asdepression. Thisis in sharp con-trast to manyindigenous cul-tures, whichunderstand that afull year is need-ed for mourningalong with com-munity rituals.The year bringsanniversaries,birthdays, holi-days—and on allof those occa-sions the lovedone is grieved intheir conspicuousabsence.

Many peopleare familiar withthe stages ofgrief developedby Dr. ElizabethKübler-Ross:denial, anger,bargaining,

depression and finally acceptance(Kübler-Ross, 1969, p. 285). Thetrouble with this theory is that peopledo not seem to move through it step-by-step. One minute a person mayfeel a sense of acceptance about theloss, and then suddenly when the hol-idays loom and the loved one is notthere, the person may move back intoanger.

The latest research reported inTime Magazine by psychologistJanice Genevro on the quality ofgrief service “…increasingly indi-cates that grief is not a series of stepsthat ultimately deposit us at a psy-chological finish line but rather agrab bag of symptoms that come andgo and, eventually, simply lift”(Konigsberg, 2011).

William Worden’s theory of griev-ing, which is embraced by Sutter Careat Home, sees grief as a series oftasks or milestones we must achieve.

A child at a Horses & HealingWorkshop holds up a horse shoe she hasdecorated as a memorial to a close family member and then spelled outthe name of her loved one with alphabet beads.

18

Called the “Four Tasks of Mourning”(Worden, 2002, p. 27), it includes:1. Accepting the reality of loss; we

have to acknowledge that our lovedone has really died.2. Experiencing the pain or emo-

tional aspects of loss.3. Adjusting to an environment in

which the deceased is missing andhaving to change the way a persondoes things.4. Relocating the person

within one's life and finding aritual or ways to memorializethem. A person still has a rela-tionship with the deceased,and it is the counselor’s roleto encourage people to talkaloud with the deceased as away of accomplishing thistask.Worden says that these

tasks apply to everyone, butwith children we need to takeinto account their cognitive,social and developmentalstage (1996, p. 12). Childrenaround four to five years oldoften have magical thinkingand may believe they causedthe death. A child might sayor think, “You’re so meanbecause you won’t let mehave that toy. I wish youwould die!” Then if the parentor loved one does die, thechild may feel tremendousguilt and pain. Younger chil-dren, whose coping skills areless well developed than anolder child, may find it much moredifficult to adjust to the new environ-ment without the deceased. Forinstance, if mommy always read astory at bedtime, and now she is notthere, this can be incredibly painful.

Children’s Healing WorkshopThe goal for the children was to

touch on each of the four tasks ofmourning in a four-hour Saturday

workshop with the therapy horses atNCEFT. The children arrived at10:45 a.m. Parents and/or guardianswere encouraged to leave their childif he or she would permit the separa-tion, and if not, they found ways tostay in the background. A picniclunch was immediately served in alarge group of trees with participantssitting in a circle. A game helped peo-ple learn each other’s names.

After lunch the children went intoa private space, in this case a NativeAmerican tepee, with the leader andan assistant. The leader explainedhow each child was there for a specialreason that not all children share. Shetold them that having lost a loved onewas a bond they all had in common,and on this day they would do somesharing about their special person,ride horses and create an art projectas a memorial for their loved one.

The children were encouraged toshare as much or as little as theywanted and were told that helpers(bereavement counselor volunteers)would be willing to listen to whateverthey wanted to say throughout theday. Research shows that bereavedchildren are greatly helped by safe,structured group settings in whichthey realize that they are not alone intheir experience. The group size was

limited to six to eight chil-dren, and the ratio of adulthelpers was one-to-one tobe sure someone was avail-able for every child.Using a talking stick, the

group first shared who haddied (Worden’s first task).Next they talked aboutsomething they enjoyeddoing with their person(Worden’s second task). Fin-ally, they shared what theymissed about their loved one(Worden’s third task).The children received

instruction about how theywould interact with thetherapy horses and wereplaced in one of threegroups that rotated throughactivities. One groupgroomed and rode the hors-es; one played with goatsand the third one workedon decorating a horseshoeas a memorial (Worden’sfourth task) with glue,feathers, paint and glitter

and alphabet beads for spelling outthe name of their loved one.Sue Hobart, MA, the youth

bereavement coordinator at SutterCare at Home who took over the pro-gram when Jennifer Wilson left, says,“Horses have a magical attraction forchildren. They are capable of address-ing the spiritual aspect of grief with-out children needing to verbalize it.”She feels it is a natural way for chil-dren to experience the kinesthetic

Children who lost close family members participate in a daylong

equine-facilitated psychotherapy session between NCEFT and a

hospice, Sutter Care at Home.

Spring 2012, PATH International STRIDES

Spring 2012, PATH International STRIDES 19

aspects of grief because children areaware that horses are sensitive tohuman emotion through physical con-nection. In addition to suggesting thechildren talk with each other at theworkshop, she also suggested theywhisper a secret into the horse’s ear.In this way, the horse becomes a safewitness who cannot possibly exposetheir secret.In the closing circle, Hobart played

a game with the children in which theypassed a button on a string and made awish. Many children wished for every-one to feel better. One boy who lostboth parents said, “May everyoneexperience healing in your grief.” Atthe end of the day he expressed hisgratitude by saying, “Thank you somuch for making this day. This is areally special experience.”As the workshop closed, more

snacks were served and NCEFT pre-sented gold medals to each participantto honor their participation. At2:30 p.m. parents returned to pick uptheir children.Stephanie Amsden, MSW, a long-

time bereavement program coordina-tor who participated in the activities,had this advice for other agenciesconsidering such partnerships:• Secure funding.• Find a reputable facility to hostthe workshop.• Include a counselor skilled inEFP on the team.• Have plenty of trained volunteers.• Bring easy, fun food for lunchand snacks.

Adult Grief Session

After a second workshop forgrieving children in which Wilsonnoticed that the parents were lookinglongingly at the horses, she said, “Irealized that the program could beequally successful with adults anddecided to adapt the workshop tohave adults experience the magic ofthe horses.”

Lisa Renae Nelson, LMFT, whohas a private EFP practice and volun-teers at NCEFT, co-facilitated thefirst Adults, Horses and HealingWorkshop. The focus was to allowparticipants to explore their grief tothe level they felt comfortable, whilethey engaged in different equineactivities. Some individuals initiallyexpressed trepidation being aroundthe horses, but near the end of thishealing day, everyone was comfort-able touching and interacting withthem.Horses seem to uncannily reflect

back much of what is going on withina person. Frequently, interacting witha horse allows one a window intoone’s own inner psyche. It is ofteneasier to “hear” and accept lessonslearned from our equine partners thanfrom a fellow human. The equineactivities of the day were chosen toaid participants in exploring their feel-ings of grief and loss while finding aunique path to healing.The initial activity was reflective

work, first developed by BarbaraRector of Adventures in Awarenessand a former manager at NCEFT(Rector, 2011). The individual stands

silently in front of a horse; there is nophysical contact. If one is open to lis-tening in that space of quietude, wis-dom and insight are frequently experi-enced. One person reported, “I sawmy husband’s eyes looking back atme.” Another said, with tears in hereyes, “The horse looked so sad.”Richard Newton, equine TTouch

practitioner, taught participants howto perform TTouch, a form of calm-ing bodywork, on the horses, onthemselves and with each other to aidin alleviating negative emotions andstress (Tellington, 2011).In another activity, participants

had to navigate a horse through anobstacle course in the arena with theadded challenge of horse treats strewnthroughout the course (EAGALA,2011). Inevitably, the horse wouldstop at the treats despite each person’sefforts to complete the course uninter-rupted. Each response was unique asthey struggled, then accomplishedleading the horse away from the treatsto finish the course.This activity is rife with metaphor.

After the last person completed thecourse, the group explored how eachparticipant’s grief mirrored their arena

At the end of an equine-facilitated psychotherapy session for participants who have experi-

enced a loss, a horse gallops up a hill with a ribbon carrying one person’s message and

prayer for a deceased loved one.

20 Spring 2012, PATH International STRIDES

experience. One participant remarked,“…it gives a visual example of thegrief battles in everyday life and thetemptations that hold us back frombeing truly alive.” Grief is a powerfulforce that can hijack emotions,thoughts and functionality. Partici-pants were able to see and discusshow grief often detours their path inlife. They explored learning to acceptgrief as a natural process on theirjourney while not giving it the powerto derail their life.

One of the most moving activitiesat the end of the adult’s workshop isthe “Ribbons in the Wind” (Dawson,2007, p. 78). Other cultures believe insending spiritual prayers and mes-sages via the wind, e.g., prayer flagsin Buddhism. Participants meaning-fully decorated and wrote prayers andmessages to their deceased loved oneson ribbons. Silence enveloped all whowere there, and a sacred space wasnaturally created. They then tied theribbons onto the manes and tails ofthe horses, who were led beside agate outside a beautiful pasture withhills, grass and trees. In tandem, thehorses were set free. The ribbons flut-tered in the wind, releasing theprayers and messages to loved ones asthe horses ran up the hill and disap-peared into a grove of trees.

Participants were invited to sharetheir experiences. Many spoke aboutpersonal insights and finding ways toexpress and release levels of grief thatwere interfering with their lives. Theyshared how the horses and equineactivities provided a key touchstonein their healing from grief. Often,people need companionship andstrength from others to walk the pathof grief. One woman wrote, “Myloved ones are gone and I need to bestrong so I can live my life and learnto live with their memory instead ofhiding in a corner.”

Those who know horses acknowl-edge this hard-to-define healingelement they hold. The marriage of

grief counseling and EFP is a fairlynew and exciting concept for mentalhealth practitioners. Hopefully, thisrelationship will continue to grow asthe equine-assisted activities and ther-apies community reaches out to socialservice agencies and therapists intro-duce appropriate equine-facilitatedhealing methods within the profession.

Connecting with a horse in themidst of life’s storms can bring healingand hope in a unique and profoundway. Horses are natural healers, espe-cially when we humans share the reins.References

American Psychological Association.(2000). Diagnostic and statistical manual ofmental disorders-Text revision (4th ed.).Arlington, VA: American PsychologicalAssociation.

Dawson, M. (2007). Horses healing grief.Collierville: InstantPublisher.com.

EAGALA. (2011). Why horses? RetrievedNovember 22, 2011 from http://www.eagala.org/Information/Why_Horses.

Konigsberg, R. (2011). New ways to thinkabout grief. Time Magazine. RetrievedDecember 7, 2011 from http://www.time.com/time/magazine/article/0,9171,2042372-1,00.html.

Kübler-Ross, E. (1969). On death anddying. London: Tavistock/Routledge.

Landou, E. (2009). Posttraumatic stressmay harm kids’ brains. CNN Health.Retrieved November 14, 2011 fromhttp://articles.cnn.com/2009-12-09/health/ptsd.brain.kids.memory_1_ptsd-post-traumatic-stress-hippocampus?_s=PM:HEALTH.

National Center for Equine FacilitatedTherapy. (2008). Programs & Services.Retrieved October 22, 2008 from http://www.nceft.org/index_programs-services.html.

Rector, B. (2011). Learn about AIA.Retrieved November 22, 2011 fromhttp://www.adventuresinawareness.net/about.htm.

Tellington, L. (2011). What is TTouch?Retrieved November 22, 2011 fromhttp://ttouch.com/whatisTTouch.shtml.

Worden, J. (1996). Children and grief:When a parent dies. New York: Guilford Press.

Worden, J. (2002). Grief counseling andgrief therapy: A handbook for the mentalhealth practitioner (3rd ed.). New York:Springer Publishing Co.

Lisa Renae Nelson, MA, LMFT, the social skillsprogram director at NCEFT, has been offeringequine-assisted activities at NCEFT since2008. She also practices EFP at DreamPowerin San Martin, CA, and in her own EFP prac-tice, Tanglewood Center, inWoodside, CA.She can be reached at LRNelsonMFT@gmail.com. Laura C. Strom, MS, LMFT, abereavement counselor volunteer for SutterCare at Home in San Mateo, CA, specializes inissues of disabilities and trauma. She can bereached at LCStrom@gmail.com.