Healing Hooves and Soothing Whiskers: The Power of Animal-Assisted Therapy with Species Large and Small (Part 1)
If you’re on this site, chances are high that you’ve seen a therapy dog in action.
But what about a therapy horse? Or perhaps a therapy guinea pig?
Believe it or not, animal-assisted therapists are incorporating a variety of furry and feathery friends into their work and seeing the benefits of the human-animal bond on their clients young and old alike.
The Association of Animal-Assisted Intervention Professionals (AAAIP) recognizes many species as eligible for testing and certification, including dogs, cats, horses, rabbits, guinea pigs, domestic rats, birds, pigs, and llamas/alpacas. While some professionals opt to include other species as well, such as reptiles, hamsters and goats, the nine species listed are ones that AAAIP and its associated volunteer therapy team organization Pet Partners have recognized as relatively low zoonotic disease risk. There’s also enough research to support good welfare and recognition of affiliative behaviors in these particular animals.
Having owned quite a variety of animal species myself, I love the idea of expanding our view of what’s possible with therapy animals. But what does it actually look like having a miniature horse or a room full of guinea pigs helping a client in a therapy session? I’ve asked a few pioneering animal-assisted therapists exactly that, and here is what they offered…
In part one, we’ll delve into the details of working with equines, and in part two (out next week) we’ll discover the ins and outs of keeping guinea pigs in a busy clinic.
Animal-Assisted Therapy…With Hooves!
Miso the American Miniature Horse helps owner Marjorie Borreda of Le Petit Ranch provide animal-assisted therapy to clients of all ages.
Incorporating equine interactions within a therapy session—whether it’s for speech, occupational, physical or mental health therapy—can occur in a wide array of forms. Speech-language pathologist Kara Ingram partners with a therapy dog herself (@dooley.doodle.speech), but has colleagues who partner with horses at her facility. She explained there are three main ways in which an equine might be incorporated into work with clients:
· Hippotherapy, in which the movement of the horse is the primary focus. A horse is selected for a client based on its gait pattern and size of its barrel (i.e., width of the horse’s back), and the multidimensional movements and multisensory input helps organize a client’s nervous system. For example, a horse with a faster gait and more impulsion (muscular push through its legs) could help a child who needs to be more alert. There is a plan of care which dictates goal-directed interventions for hippotherapy.
· Animal-assisted therapy, in which the human-animal bond between client and horse increases motivation and provides meaningful contexts with a non-judgmental presence to target therapeutic goals (the same as the animal-assisted therapy with dogs featured across other articles in the Speech Dogs blog). Again there is a plan of care which dictates goal-directed interventions.
· Therapeutic riding, in which the focus is teaching actual horseback riding skills with adaptations made to accommodate different abilities and horsemanship skills. This is recreational in nature, though instructors and clients may choose to establish individualized goals.
(In a recent AAAIP webinar with Dr. Nina Ekholm-Fry, a leader in equine-assisted services, she discussed some recent changes to terms used to describe working with equines for therapeutic purposes. The terms used in this article differ at times from the more descriptive language she recommends (e.g., “speech therapy incorporating human-equine interactions”) but are readily recognizable at the time of writing and what all the practitioners I consulted used in our communications. If you’ve been in animal-assisted therapy very long, you’ll know there have been frequent shifts in terminology as the niche seeks to become more cohesive.)
Finding education for animal-assisted therapy with horses
Betty Tedford of Communication Reigns Speech, Language & Literacy, has been incorporating equine-assisted therapy since 2024. She also partners with two therapy dogs and sometimes has both a dog and pony within a session at different times and for different activities.
“I was raised on a farm and ranch in Northern California and was an avid member of 4-H and our local horse show and rodeo associations…showing horses starting at the age of 6 until I went to college. I spent a period of my life without horses while I was teaching in Southern California, but when my daughter was born, we sought out a rural lifestyle again. We have had horses ever since,” Betty shared.
“As soon as I began my graduate studies for communication sciences and disorders, I attended a Level One Hippotherapy course at the Shea Center in San Juan Capistrano that was taught by Ruth Dismuke-Blakely. She is a speech language pathologist and a pioneer in partnering with horses in speech and language therapy. The training was incredible, with clinical practicum and hands-on training with the horses. I began looking at the research and noting the efficacy of animal-assisted therapies.”
While Betty found the multi-day Hippotherapy course “phenomenal and solidly research-based,” she experienced challenges getting approval for a master’s research thesis on the topic due to a relative lack of research in the field with which to compare and consult. “Since that time (2013), that has thankfully changed.”
In 2024 Betty earned additional certification in Horse Powered ReadingTM and plans to hold summer intensive groups this year with an emphasis on receptive/expressive language and phonological awareness.
Betty Tedford and Tango the Shetland pony partner to provide animal-assisted speech therapy to children after Betty’s full-time job as a school SLP.
Marjorie Borreda started in the world of digital marketing before following her true passions for both animals and giving back, completing a 240 hour Animal-Assisted Therapy certification course in Switzerland and becoming one of the first AAAIP Certified Animal-Assisted Intervention specialists in Europe. In 2024 she opened Le Petit Ranch in Massachusetts, where she is importing what she learned working in Europe with a variety of programs for young and old alike.
Having always loved horses and riding as a teen, “when I started my animal assisted therapy journey, I was drawn towards practicing with horses,” Marjorie said. “However, after many falls while horseback riding when younger, I knew I woudn’t be very comfortable with therapeutic riding, being not a very confident rider myself. I was not sure how I wanted to partner with them, so I observed and interned with many colleagues and I got certified in different ways of working/ partnering with horses.
“I interned several times with a colleague who is bringing her pony into a nursing home and I was very impressed by how stimulated the residents were by the visit of the pony. They were remembering a lot of memories about horseback riding or pony rides while being a child and they were very much interacting with each other about the pony. I was also very impressed by how calm and interactive the pony was with the residents without the help of food or external rewards. This experience opened my mind to partnering with miniature horses or small ponies in order to be able to bring them to institutions.
“In parallel, I also studied and interned to become an Equimotricite facilitator which is a certification from Belgium focusing on how to leverage obstacle parcours to stimulate problem solving and gross motor skills for kids and adults with disabilities.”
Marjorie is especially interested in liberty work, in which you “connect [with the horse] with no rope or halter, just by breathing, cardiac sync and body movements…this opened my eyes to the type of therapy work I would like to do with them.” She also became a certified Horse Powered Reading facilitator in 2024, a method that combines educational activities with unmounted equine interactions. She’s looking forward to Animal Assisted Play Therapy certification soon as well.
Marjorie and Miso work a lot “at liberty” (without a halter or other equipment) to build the human-animal bond as part of the animal-assisted therapy they provide together.
Finding an equine partner for animal-assisted therapy
Both Betty and Marjorie partner with smaller equines, a Shetland pony and American Miniature Horses respectively.
Discussing how Betty found her partner Tango, she said, “Finding a pony with a solid foundation in groundwork and in the saddle has proven to be invaluable. Many ponies don’t have that foundation and have not been exposed to varied environmental stimuli.”
“We had a couple of quarter horses at the time that I was beginning to start my private practice, but they were my daughter’s reined cow horse and her breakaway roping horse and they had never been handled by young children. Because of this, I did not think they would be well suited for therapy work without additional training.
“I was looking for something smaller…I knew a really solid pony might be hard to find. One of the trainers we knew and respected was advertising a Shetland pony that had been trained by his son, and their young daughter was handling the pony as well. He had such a solid foundation and was very comfortable around kids and really seemed to enjoy people. We added him to our herd and he is an absolute gem and a perfect therapy partner.”
Tango often carries items needed for an animal-assisted speech therapy activity, such as the speech-generating device seen here, naturally drawing child clients attention to them.
Marjorie says that despite all her educational background around human-equine interactions, “It’s actually the love at first sight with Mini Mac and Miso who made it happen.
“I strongly believe that animals chose us and not the contrary. They just appear at the right time, in the right place, to connect with us and to teach us something about ourselves.
“I met Mini Mac and Miso when they were 8-months old. Everyone in the horse world told me that it was a crazy bad idea to buy young horses for therapy especially because I’m not coming from the horse world myself. But I did not want an experienced horse…I felt very comfortable with the idea of learning alongside them.”
Marjorie works with a horse trainer to learn about equine behavior and build her relationship with Mini Mac and Miso. “I am not teaching them anything special for therapy but I am focusing on working with them to make them comfortable, confident and interested in the human world around them (ie. wheelchairs, strollers, etc.) as well as exposing them to positive interactions with humans. I am also educating myself on horse behavior in order to be sure that I understand their signals and that I can offer them a setup where they feel comfortable at all times and they can make their own decisions in the most natural way possible.”
Since Marjorie has found her two equines to have very different temperaments, she is learning to adapt therapeutic activities to each horse. “Mini Mac loves to perform tricks and to learn. At two years old, he knows how to lay down, sit, dance, back up, etc., and he is offering all his tricks, willingly, to any human interested to ‘play’ with him. He is the first one to leave the pasture and go into the work arena.
A child grooms Mini-Mac, Marjorie’s other equine partner, as part of animal-assisted therapy.
“Miso is not a trick master but he enjoys being groomed and massaged and talked to. He is willing to connect with humans but he prefers to do it when he can see and smell his herd not too far away.
“For the moment, I don’t think any of them will be comfortable to be brought into an institution [as opposed to working at the ranch]. But horses live a long life (about 35 years) and they definitely mature slowly, so we just need to be patient and to be creative with who they are right now.”
Marjorie recommends anyone considering this work look at the work of Andy Booth, training focused on Liberty Work and breathing, and the books Let Horses Be Horses by Lesley Skipper, Teach Yourself Horse: Natural Horsw Management by Heather Simpson, and Horse Track Systems by Amy Dell.
Both Betty and Marjorie currently incorporate their equine partners into a relatively small portion of their overall workload. Betty works full time as a school-based speech-language pathologist and runs her niche private practice including therapy animals on the side.
“I do not bill insurance, but I provide clients with a superbill so that they can seek reimbursement. My equine-assisted therapy practice actually supports keeping all our horses. Honestly, that was my goal when I started. I wanted to make enough to cover the cost of our feed. I have done that and then some.”
She says Tango works about two hours a week with her, “but of that time, about 10-15 minutes per half hour therapy session are spent with direct client interaction, the remainder of our session he is usually happily grazing alongside us.”
Marjorie is taking it slow with Mini Mac and Miso, who are both still very young. “They have a training session with me of 30 minutes every 2-3 days to build our bond and learn stuff together and they have two, 30-40min therapy sessions with kids or adults per month for the moment.” At the moment, their animal-assisted therapy sessions are covered through donations received by Le Petit Ranch’s 501(c)3 non-profit, though they are also applying for grants.
Weather challenges when including horses in animal-assisted therapy
“Everyone I met who is working with horses were very adamant to anticipate bad weather when you build or choose a place for your therapy center in order to be able to practice all year long,” Marjorie shared.
“Having said that, as we are building our ranch, it was VERY expensive to have a real covered arena. So for the moment…in case of inclement weather I can do sessions either in the shed (grooming, breathing, reading, etc.) or in the classroom. I built a classroom big enough to welcome 5-6 kids easily and the mini can enter if interested. Later on, if we get enough funding, we will put money towards a covered space.”
Betty and Tango work together in Utah, also without the luxury of a covered arena. Instead they reschedule for rain but bundle up when it’s cold. “In the summer months, we schedule early in the morning and later in the evening to avoid the hottest part of the day.”
Some final thoughts about animal-assisted therapy including equine interactions
Betty identified many important points for anyone considering adding equines to their therapy work. “Seek training from respected professional organizations. Find and train experienced horse handlers and side walkers so that you can focus on providing the therapy. Be well versed in safety protocols, such as emergency dismounts, and practice with your side walkers and horse handlers often. Understand your horse’s body language and be ready to pivot when using them in a session. Understand the contraindications to providing hippotherapy for certain clients due to medical reasons.”
However, she’s found the extra effort has enlivened her practice in a myriad of ways.
“As a school-based SLP with a caseload of 70+ students who provides therapy in a tiny office with no outside light, coming home to an evening session where my clients and I are outside under the sky is a gift. Learning to better incorporate equine assisted activities and hippotherapy in my practice stimulates my brain and feeds my spirit. Witnessing the exponential progress clients make and sharing in their joy and enthusiasm as they engage with the horses is the most rewarding work I have ever done.
“My most favorite moments are the pivotal moments that seem to happen often in equine-assisted therapy: the moment when a client independently selects an icon on his AAC device while riding; the moment when a child with ADHD and executive functioning deficits maintains focus, and that moment lasts for an entire 30-minute session; the moment when a neurodiverse child who elopes in school when working on reading attends to print because the pony appears to be attending to it as well.”
Betty and a child engage with Tango and the therapy materials he carries as part of an animal-assisted speech therapy session. Being outdoors is one of Betty’s favorite parts of partnering with a therapy horse.
Marjorie added that’s it’s important to be “very comfortable with the unexpected. Horses are prey animals and they have a tendency to run away. They could be the most confident horse and get super scared of an unusual situation. It’s important for a therapist partnering with a horse to be comfortable with the unpredictability of horses.
“I feel like all of that makes partnering with horses extremely rewarding. If we accept to partner with them in a way that is the most natural for them (we don’t force them, we don’t break them, or we don’t make them do anything that make them uncomfortable or scared or defensive) and they choose willingly to partner with us, then we have something magical and very raw in their interactions.”
Like Betty, Marjorie has found her equine partners help her right along side the clients.
“Partnering with my miniature horses has taught me so much about myself. Working with them, especially them being so young, is definitely therapy for me first and foremost. I am coming from a world of 15 years of high productivity in big corporations, always focused on being busy, multi-tasking, rewarded for doing and not being….Having to learn everything about working with horses taught me to be in the present, to accept the unexpected, to let go of the control and more than anything to feel and be aware of my own emotions. They are teaching me to ‘be’ and also to be more attuned to others.”
Stay tuned for part two…animal-assisted therapy with animals on the opposite end of the size spectrum: Guinea pigs!
In the meantime, follow Betty Tedford @bjt_the_slp and Marjorie Borreda @le.petit.ranch.
If you’d like to learn more about animal-assisted speech therapy and partnering with therapy animals, check out the various resources on the Speech Dogs site!
