Lessons In TR

Recently multiple equine organizations in the US have worked together to recommend an “optimal terminology” for working with horses in ways that benefit people in this country. Since this blog reaches quite a few people involved in the adaptive and therapeutic riding industry, I thought it would be important to share a summary of the words they recommend we use now. Even if you don’t have an adaptive riding program at your barn, it’s important to be aware of this in case it ever comes up at your barn so you can  direct people toward the right resources. I’m very excited they did this because for the past few years it’s become obvious that the industry’s terminology was changing and really needed some direction that everyone could agree upon (see my first terminology blog post for more). So without further ado, here is my summary!

WHY New Terminology Is Needed

The new recommendations for terminology to use when talking about services that incorporate the horse to benefit people in the US come from the following sources. (Ideally you’d read them yourself, but in case you don’t, I’ve made this post!)

• “Optimal Terminology For Services That Incorporate Horses To Benefit People: A Consensus Document” (all quotations in this post come from this document)
• PATH Intl’s Summary
• “Uniform Terminology Consensus Panel” (video explanation), or read a summary here

A new unifying terminology was needed because current terminology is unclear and many people use it to refer to different things, which can be unbeneficial for everyone involved.

• Unclear language can mislead consumers about what services you offer and therefore put your program at a liability risk.
• It can make it hard for consumers to find the services that best meet their needs.
• It prevents professionals from communicating with insurance providers about reimbursable services they can offer.
• It prevents researchers from creating a united body of research for specific services and therefore impedes scientific progress.
• The current unifying terminologies (equine-assisted activities and therapies, horse therapy, therapeutic riding as a unifying term, etc.) do not refer to anything specific and therefore are legally indefensible. Without a new unifying term, these words would continue to be used.
• Using a unifying terminology will help programs and organizations promote the industry together and improve consumer awareness.

Note: The document is focused on terminology within the USA, since there are bigger issues when aligning terminology internationally. For more info watch the video.

The NEW Terminology To Use!

TWELVE types of services were identified within THREE areas of professional work, with ONE unifying term used to refer to multiple services. These are the recommended terms.

1) Therapy = licensed therapy professionals working within the scope of practice of their particular discipline with specialized training to incorporate the horse into individualized therapy plans

• Counseling
• Occupational therapy
• Physical therapy
• Psychotherapy
• Speech-language pathology

NOTE:

• Therapy – only use this word when a licensed therapist is providing treatment
• Use Therapy-First Language – use this method when referring to any of the above, which means FIRST identify the therapy and then add the equine-related descriptor (such as “physical therapy using equine movement” or “psychotherapy incorporating horses”) because this language is very clear and rightly recognizes the equine as one of many tools a therapist can incorporate
• Psychotherapy – note that this used to be “equine-assisted psychotherapy” but now is recommended to be referred to as “psychotherapy incorporating horses” to keep consistency in this area of service

2) Learning = related to specially trained or certified professionals incorporating the equine into the broad area of learning in the following nontherapy services

• Equine-assisted learning in education = “engages people of all ages in learning processes that focus on academic skills, character development, and the promotion of relevant life skills such as problem-solving and critical thinking skills”
• Equine-assisted learning in organizations = “assists members of corporations, organizations, and other workgroups build effective teams and leaders”, may include things like executive coaching, team-building, group retreats, etc.
• Equine-assisted learning in personal development = “assists individuals and groups discover new ways to face life challenges and opportunities by developing skills in effective problem-solving, decision-making, critical and creative thinking, and communication”, may include personal coaching, wellness-related activities, etc.

3) Horsemanship = the area of equine services in which qualified professionals “demonstrate extensive competencies in adapting equipment, the equine environment, and teaching techniques to match the abilities and needs of participants who experience restricted participation in life situations”

• Adaptive equestrian sports = “prepares people with diverse needs to participate in events and competitions in equine disciplines”
• Adaptive riding or therapeutic riding = “may both be used to name and describe services that focus on skillfully adapting riding and making natural healthful benefits of riding and horses accessible to individuals and groups with diverse needs. Instructors…should have extensive expertise in riding instruction across the continuum of horsemanship skills, from groundwork to riding. Potential benefits may include physical fitness and improved cognitive, emotional, social, or behavioral skills.”
• Driving = “teaches individuals with diverse needs how to safely participate in driving activities with horses”
• Interactive vaulting = “engages individuals and groups with diverse needs in movements and gymnastic positions around and on horses and vaulting barrels”

The NEW unifying term:

Equine-assisted Services (EAS)

• This term is a type of shorthand or generalization to easily refer to multiple (2+) services from the above (for example when talking among professionals about common issues, or when training volunteers).
• Like in the video, I list this term under the other terms instead of above, because it is not meant to be an “overarching term” but rather a “unifying term” for the services.
• Even though any one of the above terms are a type of EAS, when you talk about just ONE type of service you should use the specific name (“adaptive riding” not “EAS).

Terms To NOT Use

The following terms were recommended for discontinuation of use due to the reasons listed earlier about unclear terminology. Unique reasons for each term are listed in the published document and I’ve included a note for each below.

• equine therapy, equestrian therapy, horse therapy, horseback riding therapy, therapy riding – “Therapy” in these terms wrongly implies that licensed therapists are involved, or that the horse alone makes it a legitimate therapy.
• equine-assisted activities and therapies (EAAT) – It is dated and doesn’t refer to the area of Learning, wrongly separates activities and therapies, and is legally indefensible.
• therapeutic riding as a catch-all term – Discontinue using this term to label any service that incorporates the horse or to imply that the riding is a type of legitimate therapy (as it has been used historically). However, it is a highly recognized term nationally and internationally so it may be continue to be used to refer to the specific service of therapeutic riding, or you may use the alternative of “adaptive riding”, either are ok.
• hippotherapy as a stand-alone treatment – In the US hippotherapy refers to when a licensed therapist uses equine movement as a treatment tool as part of an overall treatment plan, not on its own. Prescriptions and referrals are made to OT, PT, and SLP, not to “hippotherapy”.
• hippotherapist – There is no legally recognized licensed therapy professionals called a “hippotherapist”
• hippotherapy program/clinic – There are no “hippotherapy clinics” or programs, but rather therapy clinics that provide access to treatment within which equine movement is used.

A Few Things To Know

Who Endorsed the Recommendations

• The document and its terminology recommendations are endorsed by:
  • American Horse Council
  • Certified Horsemanship Association (CHA)
  • Horses and Humans Research Foundation (HHRF)
  • The Equine Experiential Education Association (E3A)
  • Professional Association of Therapeutic Horsemanship International (PATH Intl.)

Who Did Not Endorse the Recommendations

• The American Hippotherapy Association (AHA) agrees with the terminology but does not endorse the unifying term because:
  • they’ve found that unifying terms that link their services to those that aren’t recognized as therapy blurs the lines when working with insurance for reimbursement
  • it’s redundant and confusing to include them under a new unifying term when PT/OT/SLP are already identified as services under the health care industry
  •  the horse is one of many tools a therapist may use so it’s confusing to include them under the term “equine assisted” which sounds like the horse must always be used
• Instead of a unifying term, the AHA recommes using specific terms about the services you offer.

Regarding Recommendation Concerns

• In response to the above concern, PATH Intl included in an email published 2/1/2021:
  • “Because AHA’s communications combine the issue of incorrect representation and using the unifying term, Equine-assisted Services, some PATH Intl. members have expressed feeling torn between the optimal terminology recommended in the consensus paper and the response of AHA. Please know, misrepresenting the services you provide is an ethical issue, but using the unifying term, Equine-assisted Services, as outlined in the consensus document is not a misrepresentation. It is a way to reference multiple services you offer. The important message is that you are specific to the type of service, when you are talking about an individual service and that you don’t use the unifying term to reference a specific service.” Using the specific term protects you, your center, and the people you serve.

How to Respond to People Using Incorrect Terminology

• Be kind.
• Focus on helping them find the right term, because they might not know what they are asking for.
• Then get them connected with that service.
• For example, “Thank you for asking about our services. We don’t refer to what we provide as “equine therapy” because that is therapy for horses, but we do offer adaptive riding, which is riding lessons adapted to individuals with special needs, is that what you are looking for?”

Next Steps to Take

• Do a self-assessment of your term usage.
  • For example, do you use the term “therapy” appropriately? If “therapy” is in your program’s name but there are no therapy services or licensed therapists involved, then it misrepresents your services, opens up the potential for fraudulent practices, and may cause you to miss out on clients who are looking for what you do offer. If “therapy” is in your name but it just one of many services you offer, your name may underrepresent your programs.
• Make changes.
  • PATH Intl. stresses that there is time, it’s not expected to happen overnight, and they are there to help you if needed.
• Be especially clear in interviews and newspaper articles about the terminology you use, as journalists have often used the wrong terminology to report about programs.

Conclusion

I hope you found this helpful and instructive as to the language to use when talking about your programs! I’ve done the best I can to summarize it for you and trust that I’ve used the appropriate language to spread the word. However, I am not the expert on this, so if you have any questions about terminology I’d recommend calling the PATH Intl. office. 🙂 Have a great weekend!

****************

Note: This is not professional advice, this is a blog. I am not liable for what you do with or how you use this information. The activities explained in this blog may not be fit for every rider, riding instructor, or riding center depending on their current condition and resources. Use your best personal judgement! If you would like to contribute an activity or article, please contact me here, I would love to hear from you!