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Equine Facilitated Learning

When a child breaks a bone or has chronic ear infections, there is a clear and standard course of treatment that care providers can prescribe. However, when a child faces mental health issues, there is no “one-size-fits-all” approach to healing and wellness.

Behavioral experts have found many types of experiential therapies can help a child through his or her psychiatric diagnosis. One of the most successful has proven to be animal therapy, specifically horses which can have a calming and therapeutic effect for children with behavioral and psychological challenges. This type of therapy is known specifically as equine facilitated learning (EFL) and The Division of Child and Adolescent Psychiatry at Cincinnati Children’s has developed an EFL program for our children admitted into our Residential Treatment Center struggling with mental and behavioral issues.

The EFL program began in 2004, partnering both a Certified Therapeutic Recreation Specialist (CTRS) and an equine expert. Through the years, Cincinnati Children’s has added a small barn and riding arena on our College Hill Campus. This on-site presence allows children who may not be safely transported in our community the opportunity to engage and benefit from this fantastic program. Children meet with a CTRS and a horse expert twice a week for six weeks as they work side by side to build their skill with their horse and confidence in themselves. In the beginning the therapy focuses on building a relationship with the horse through grooming and basic ground work. By the end of the six weeks the kids have the opportunity to ride their horse and even participate in a trail ride.

Through the course of this program, kids gain insight into their own situations by discussing their feelings and behaviors while working with the horses. The intent is to apply those learnings to other areas of life. Non-verbal communication, assertiveness, creative thinking, problem solving and leadership are among the many skills participants develop throughout the course of program. As one of our patients shared following a session, “It’s pretty hard to not feel important when you are on a top of a horse”.

The program’s primary focus is utilizing an alternative treatment that improves self-esteem, builds healthy relationships and teaches effective communication with an emphasis on being assertive. In the beginning, kids are often hesitant, anxious, and scared; by the end they are confidently riding, showing off their newly acquired skills to their friends, family and our staff. From a program “graduate”: “I walked into the program being terrified of horses, and I thought I was going to get hurt, but horse therapy has been one of the most helpful things since I’ve been here.”

Many of the kids in the program form special bonds with their horse, and begin to identify similarities and differences that exist in their relationships with significant people in their lives – and apply those realizations. One patient shared this sentiment, “I learned that you have to build trust with your horse by not giving up on it.”

Anecdotally all of those who are involved in this program believe that we are properly using these resources to improve the outcomes in the children and families we serve. To provide objective evidence, Cincinnati Children’s has initiated pre and post program outcome measurements to further validate this program’s impact. While it is still early in that data collection, initial cohorts show an average improvement in participants’ self-esteem score of 58%!

We are proud of the work we do and are motivated to continue our work through this EFL program. We look forward to continuing to measure our progress- one child at a time- and are excited by the potential implications this program has in improving the mental health for our children and the functioning of our families.

Equine Facilitated Learning
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