EQUINE THERAPY: ACHIEVING WELL-BEING WITH A CENTURIES-OLD TOOL

Transcription

1 EQUINE THERAPY: ACHIEVING WELL-BEING WITH A CENTURIES-OLD TOOL Diego Coira, MD, FAPA Rafael Coira, MD, JD Margaret Grady, MSN, APN, C Dana Spett, MSW Abigail West, Columbia School of Social Work, MSW Candidate September 2018

2 DISCLAIMER None of the presenters have any financial interest in the subject matter that will be discussed in this presentation. The patients discussed in this presentation have been disguised so that their identities are protected.

3 HIPPOTHERAPY Hippos Greek word horse Treatment with the help of a horse

4 HISTORY Hippocrates 400 BC Europe 17th Century prescribed for: Ø Gout Ø Neurological disorders Ø Low morale North America 1960s Ø NARHA 1969 Ø PATH International 2011

5 HISTORY Liz Hartel Denmark Ø 1943 Ø 1951 Ø 1952 Polio Norwegian Physical Therapist Silver Medal Helsinki Olympics Grand Prix Dressage

6 GERMANY World War I World War II Ø Veterans Rehabilitation

7 CERTIFICATION PATH EAGALA AHA

8 HORSES Any Breed Ø calm Ø even tempered Ø gentle Ø usually older horses

9 POSSIBLE THERAPEUTIC VALUE Cerebral Palsy Multiple Sclerosis Autism Depression Anxiety PTSD ADHD Alzheimer s Disease

10 BENEFITS Mood Cognition Balance Social

11 EQUINE ACTIVITIES Ground Work Riding Driving Vaulting

12 OUR EXPERIENCE Two Years Data Collection Over 50 patients Diagnosis Ø Depression Ø Anxiety Ø PTSD Ø Alzheimer s Disease Ø Autistic Spectrum Disorder Ø Substance Abuse

13 FUTURE PLANS Research Ø Randomized Clinical Trials Ø Depression, Anxiety, PTSD, Alzheimer s, Substance Abuse, ADHD Program Development Ø Equine Facilitated Psychotherapy Ø Teaching Mindfulness through the horse Ø Wellness Program at the Farm

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15 USING HORSES TO HELP PEOPLE

16 VIDEO

17 PHYSICAL BENEFITS

18 POSTURE BEFORE AND AFTER

19 POSTURE BEFORE AND AFTER

20 WELL-BEING

21 POSSIBILITIES

22 Mindfulness Through the Horse Margaret (Midge) Grady, MSN, APN, C

23 OVERVIEW Concept of Mindfulness Learning Mindfulness Through the Horse How Nature Supports Well-Being

24 MINDFULNESS IS Mindfulness means paying attention in a particular way: on purpose, in the present moment and non-judgmentally. Jon Kabat-Zinn Researchers consider the term Mindfulness to be synonymous with Awareness. (Miller, Fletcher, and Kabat-Zinn, 1995)

25 WHY IS MINDFULNESS IMPORTANT? How we use our mind changes our brain. Our innate power to change is based in mindfulness. Being aware allows us to choose a response rather than simply reacting out of habit.

26 MINDFULNESS EXERCISE

27 HORSES THE IDEAL MINDFULNESS PARTNER By their instant and accurate response horses reflect our thoughts moment to moment. Being safe and developing a successful partnership with horses requires being in the here and now with relaxed concentration and attention to body awareness. Horses, Mindfulness and the Natural Environment (Ch. 6) P. 155

28 VIDEO

29 VIDEO

30 MINDFULNESS THROUGH HORSES 2.0 THE BENEFITS OF NATURE Biophilia Hypothesis: suggests that humans possess an innate tendency to seek connections with nature and other forms of life. Nature is always in the present. Studies show that being in nature or even viewing scenes of nature, reduces anger, anxiety and stress. There is evidence that spending time in nature has both physical and mental health benefits.

31 THERAPEUTIC VALUE The ability to choose your response to stress Greater productivity Greater creativity Enhanced resilience Improved relationships Improved sleep Symptom relief from pain, stress and anxiety Help us to tune into other with greater empathy

32 WRAP UP Human beings have an innate ability to be mindful. Our ability to change is based in our awareness. Greater awareness allows us to choose a response. By their instant and accurate response horses reflect our thoughts. Being in nature provides greater opportunity to practice mindfulness.

33 QUOTE Horses, living truly in the moment, invite us to put aside our insecurities... and meet them with authenticity and simplicity.

34 Case Studies Rafael Coira, MD, JD

35 CASE 1 70 year old man married with 3 children and 6 grandchildren retired, diagnosed with Alzheimer s Dementia 5 years ago. Initial presentation included memory loss, confusion, paranoia, skin picking, hallucinations and aggressive behavior. Treatment: 1. Risperidone 1mg po bid 2. Supportive and Family Psychotherapy 3. Equine Therapy 8 week program

36 CASE 1 (CONTINUED) Patient responded well to Equine Therapy. Benefits: 1. Improved Balance 2. Improved Cognition and Mood 3. Reduced Aggressive Behavior Family requested to continue Equine Therapy. Two Years Later: Reduced Risperidone. No aggressive behavior, paranoia or hallucinations.

37 CASE 2 20 year old woman with diagnosis of Generalized Anxiety Disorder. Presented with symptoms of excessive worrying, cognitive distortions and generalized anxiety. Treatment: 1. Lexapro 20mg daily 2. Valium 5mg daily 3. Individual CBT We Added: 1. Equine Therapy 8 week program

38 CASE 2 (CONTINUED) Patient s symptoms improved significantly. She then completed 16 more weeks of equine therapy. We were able to reduce Lexapro and Valium gradually over 12 months. She is currently off medications.

39 Thank you

40 SOURCES American Hippotherapy Association, Inc. (2006). Hippotherapy Treatment Principles Level I (2nd ed.) Fort Collins, CO: American Hippotherapy Association, Inc. American Hippotherapy Association, Inc. (2011). Level II Hippotherapy Treatment Principles (1st ed.) Fort Collins, CO: American Hippotherapy Association, Inc.