Animals, Horseback Riding, and Implications for Rehabilitation Therapy

Journal of Rehabilitation,  July-Sept, 1999  by Anita C. All,  Gary L. Loving,  Laura Lee Crane

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Historically, animals have played an important role in peoples' lives. Domestication of animals began over 12,000 years ago and continues today (Jorgenson, 1997). Approximately 53 million (56%) households in the United States (U.S.) in 1994 had a companion animal and more than half of these 53 million households had more than one animal (Albert & Bulcroft, 1988; Beck & Myers, 1996; Sable, 1995). U.S. households own more dogs than any other pet, but the number of dogs and cats has been found to be declining, with ownership of birds, small animals, reptiles, and freshwater fish increasing. Two percent of U.S. households owns an average of 2.54 horses. People living in households with pets tend to be younger than the general population and people living in households with children more commonly have dogs, cats, or other small mammals (Beck & Myers, 1996). Gammonley and Yates (1991) reported that most Americans will own a pet during their lifetimes and that animals serve not only as pets but also as working companions for persons with disabilities.

The earliest recorded use of animals in health care was by Florence Nightingale in 1860. Nightingale (1969) observed that "a small pet is often an excellent companion for the sick, for long chronic cases especially" (p. 103). She suggested that a person confined for years to the same room might enjoy and find pleasure in the presence of a caged bird. York Retreat in England, in the late 18th century, was the setting for the first recorded therapeutic use of animals. York Retreat incorporated small animals in its treatment of individuals with psychiatric problems. This intervention occurred in an attempt to decrease the use of drugs and restraints (Netting, Wilson, & New, 1987; Willis, 1997). The first extensive use of animals in a therapeutic setting in the United States occurred from 1944 to 1945 in Pawling, New York. Patients, recovering at the Army Air Corps Convalescent Hospital, were encouraged to work at the hospital farm. Since then animals have been used in many therapeutic interventions (Jorgenson, 1997).

Funding for studies that involve animals has been elusive. Lack of funds and mostly descriptive studies with small samples have contributed to a lack of generalizability of findings. It is often difficult to convince human service professionals of the value of using animals as a therapeutic modality; their use has frequently been met with skepticism and reluctance. This article will review the use of animals in the therapy of persons with disabilities and the implications and issues that arise for rehabilitation professionals.

Review of Literature

The vast amount of material published about Animal-Assisted Therapy (AAT) has focused on animals that are commonly pets and are easily transported to facilities and persons desiring this therapy. Scarce research was found on therapeutic horseback riding or hippotherapy and its effects on persons with disabilities. This review of literature focused on the most common types of interventions used to influence some of the effects of disability and poor health. Outcomes for these alternative therapeutic modalities have also been presented. The review is divided into two major sections. The first section focused on interventions and outcomes with animals other than horses and the second section focused on interventions and outcomes of therapy with horses.

Interventions Using Animals

Animals as an intervention have been utilized on many levels from pediatrics to geriatrics, acute-care facilities to outpatient rehabilitation/community care, and from prevention to healing. Intervention is based upon the idea that the human-animal bond can be utilized as an integrated holistic approach to the care and rehabilitation of individuals and their families with chronic illnesses and disabilities. Interventions using animals are divided into four categories: Pet Visitation, Animal-Assisted Therapy, Hippotherapy, and Therapeutic Horseback Riding. Each of these interventions and its reported outcomes is described in this section.

Pet Visitation

The simplest form of pet-assisted therapy has been pet visitation, focused on fostering rapport and initiating communication. Barba (1995) and Savishinsky (1992) suggested that animals have a range of positive effects. These effects included: (a) fostering socialization, (b) increasing a withdrawn person's responsiveness and animation, (c) giving pleasure, (d) enhancing morale, (e) fulfilling needs to nurture and be nurtured, (f) enhancing the treatment setting, (g) reducing dependence on psychotropic medications, and (h) helping to keep individuals in touch with reality by providing forms of sensory stimulation. In this type of intervention, the animal initiated contact and the individual determined the direction of the visit. Frequently, social interaction increased because the pet became a topic of conversation. Zisselman, Rovner, Shmuely, and Ferrie (1996) reported that no accepted standards for administrating pet therapy existed. Recently, Hines and Fredrickson (1998) reported that the Delta Society has developed standards of practice that define the role of animals in therapeutic programs. These standards provided differentiation between programs that incorporate animals for entertainment or generalized benefits, animals-assisted activities, and animal activities that are used to cause a prescribed effect on specific individuals. Standards of practice also identified areas of concern such as: (a) animal selection and husbandry, (b) credentials and training of professional and voluntary personnel, specific requirements for protocols and processes operation, and (c) specific directions for recording data that may affect future programs (Hines & Fredrickson, 1998).