Introduction
Solution Focused Brief Therapy(SFBT)is a primary strength-based therapy, begun by social worker and family therapist Steve de Shazer and his partner, social worker, Insoo Kim Berg from the Milwaukee Brief Family Therapy Center (1993). Solutions are created from the conversations of therapist and clients when the clinician asks the client for exceptions to their presenting problem issue/problem saturated stories, as well as several other techniques. The focus and purpose of the model is to seek change and is an empowering theoretical perspective that encompasses ascertaining helpful resources clients have implement from their working knowledge of life issues. SFBT is different from other models, such as problem-based, in one major aspect: the goal is to help the client identify what has worked in the past, not by viewing the issue/problem from how it may have evolved, but rather seeking exceptions to when the issue was not present. SFBT focuses on the present and future. What is also an important consideration of this strengths based model is that it is evidence-based, thus making it a prime model accepted for treatments and insurance reimbursement (Franklin, Trepper, McCoumn, and Gingerich, 2011).
Problem based, such as the tenets of the Mental Research Institute (MRI) in the 60’s and 70’s, formulated brief therapy to provide short- term work with clients by examining their language, purposes of behaviors and actions, and remediating the problems. The SFBT model evolved from many of the tenets of problem-based therapy, except, from a positive view. De Shazer’s (1985) principal premise of “Problem talk creates problems. Solution talk creates solutions,” guides the model. For example, consider a client who is riddled with anxiety about attempting to write a paper for school. SFBT would help the client examine how, when, or where the anxiety evolved and possibly create a paradoxical intervention to continue the worrying for a specific time, with the solution being the client realization of how much time was consumed. This strength-based model would ascertain what the client does when not worrying, when success occurred prior, and how the worry may be useful. One of the core beliefs is that the negativity serves the client in a positive manner. Helping the client reframe provides strengths the client can add to their repertoire for solutions. For example, consider the client that worries. Asking the client how the worry is helpful generally initiates a response of, “It is not!” Asking the client, when it was useful to worry about getting papers done results in responses such as, “When the worry kept nagging at me, I finally got it finished. “
SFBT credence is that the client is the expert about their life, thus the therapist’s primary function is to aid the client by providing a framework that is embedded with positive co-constructive solutions. The steps that provide the formulation are designed to use language that is positive. The techniques specifically focus on (a) assessing prior solutions, (b) here and now and future-centered rather than past-centered, (c) embedding and adding compliments to clients’ attempts, (d) clients using more of what has been successful, and (e) helping co-create goals that are linguistically positive (de Shazer, 1985). The focus of questions asked is intended to help clients think about their internal resources as solutions.
Questions such as, “When was the most recent time when this (goal/desired outcome) happened?” The imperative use of language continues with questions such as “What is a small sign of change?” as well as asking scaling questions, such as, “From 1 to 10, where is the issue/problem now and where would you like it to be?” SFBT also creates and embeds compliments with clients such as “How did you get through that so well?” Perhaps the most useful question and technique is called the “miracle question.” The inquiry has a “purpose to shift the conversation quickly and easily into the future when the problems (that brought the client to therapy) are gone,” (de Shazer, 2000). Questioning “what needs to be different ” seeks to help the client develop a goal. Strength based positive words are aimed at the overall creation of solutions as possibilities. Metaphorical tools and attending to how the client uses language and helping them replace negative with positive, creates change. For example, the metaphor of the glass being half-full is a much more powerful embedding linguistic tool for change than the glass being half-empty. Or consider “remembering something” rather than “don’t forget,” or the opposite of fear/worry is calmness and confidence. The powerful use of positive language is key to the strength based solutions in a relatively new treatment modality.
Equine-Assisted Psychotherapy
Equine-Assisted Psychotherapy (EAP) is designed to be effective in a brief therapy model. The application of metaphorical properties includes the equine’s behaviors as well as the client’s verbal and nonverbal behaviors. Strength based models, such as Solution Focus, accomplish the goal to help clients co-create solutions.
SFBT for Equine-Assisted Psychotherapy provides the structure necessary for the therapist with the tools to assess the client’s strengths. Metaphorical questions related to the client’s interactions in relation to the equine behaviors assist the client in discovering their perceptions of what occurs with the equine. For example, a client enters the arena and is asked to approach an equine. The equine backs up as the client approaches. Asking the client what is happening with the equine, the responses will be directly related to the client’s internal perceptions. “He backed up because he does not like me,” or “I think he wants me to come closer,” for example.
Equine-Assisted Psychotherapy, with a strength-based model, provides a backdrop that is designed to be interactive and experiential and begins with the smells and sounds of a barn. Coupled with this are large animals. Equines are very unique due to their size and power. Even though they are big, people of all ages are often drawn to them. Equines are herd animals of prey, therefore they are reactive to the sounds, views, and emotions around them.
This characteristic of equines provides the opportunity for mirroring feelings of clients. For example, if a client is anxious and wringing their hands, the equine may be moving and darting in the field or standing still with eyes and head moving side-to-side. Equines react to people in the here and now. The saying, “Don’t let the equine know you are afraid because they will be also,” accurately describes the relationship equines can have with humans. The opposite can also be equally powerful.
Each session is designed to provide an experiential, hands-on activity that helps the client create solutions. Tasks of intermingling with equines are noted by the counselor. It is the meaning or interpretations that clients give to the interactions with the equines that provide information to the counselor to help clients change behavior. Utilizing a strength-based approach grounded in brief therapy and solution focus, Equine-Assisted Psychotherapy provides the venue for change.
This chapter discusses a brief review of the literature regarding the evolution and effectiveness of Equine-Assisted Psychotherapy. The types of clients benefitting from this SFBT strength-based approach will be examined. The organization of a treatment plan will be presented that encompasses (a) how to choose the equine, (b) working with clients that are not comfortable with equines, (c) designing the semi-structures activities for the sessions, and (d) four key properties of change. The chapter will then review four clinical cases: a child with severe anxiety, an at-risk oppositional defiant youth, an adult with Aspergers, and a couple with a pending divorce and depression. Additionally, the chapter concludes with the recommendations and challenges for practitioners.
Evolution of Equine–Assisted Psychotherapy
The foundation of Equine-Assisted Psychotherapy is rooted in the past during eras whereby animals, such as dogs, cats, birds, and so forth were utilized as “pets” and noted to create changes in people’s emotions in a positive manner. Egyptians, Greeks, Romans, and others utilized animals therapeutically (Pitts, 2005; Kruger, Trachtenberg, & Serpell, 2004). According to Parshall (2003), the earliest known anecdotal case utilizing animals for treatment of mental health disorders was in England in 1699. Noted specifically were interactions with cats, dogs, even rats, which brought about a relief of depressive symptoms (Parshall, 2003).
Another key case for Animal-Assisted Therapy was noted in the late 1940s with returning World War II veterans. Specifically, dogs were used to help returning soldiers ameliorate emotions for what we would now call Post Traumatic Stress Disorders (Marshall, 2007; Parshall, 2003). The next important case representation of using animals to assist in mental health was noted by Boris Levinson, a clinical psychologist, who in 1961 shared a case from his practice. At an American Psychological Association conference in New York, Levinson described the facts of a session in 1953 that was a complete accident of fortune. The doctor was working with an autistic child who was, at the time, nonverbal. Inexplicably, the doctor’s dog pushed the therapy office door open and walked up to the child, who began to become animated and spoke for the first time (Morrison, 2007 & Parshall, 2003). This incident led to the beginning of research studies, conducted by Levinson of how animals, specifically dogs, can be used as therapeutic tools (Levinson & Mallon, 1997). Levinson’s research that Freud had also used his dog in therapy as well was reportedly discussed as well.
Following Levinson’s work, the North American Handicapped Riding Association (NAHRA) was established in 1969 with the purpose of providing services for the handicapped by implementing a team approach called Hippotherapy. NAHRA is now known as The Professional Association of Therapeutic Horsemanship International (PATH, Intl). The intended outcome of the therapy is to provide multiple remediation such as speech and language, occupational, and physical therapy to increase neurological functioning. The child is placed atop an equine and there are two assistants, who walk along, one on each side. Another person leads the equine. The primary purposes of Hippotherapy are to provide growth and development for neuromuscular difficulties and/or increase receptive and expressive language skills. Research has begun to note that not only do children gain muscle control and communication skills, but they also exhibit improved self-esteem ( De Guitis, 2003; Glasow, 2006).
Equine-Facilitated Therapy (EFT) grew out of the Hippotherapy field. EFT was designed to help children with learning challenges acquire riding skills with support. Research (Ewing, MacDonald, Taylor, & Bowers, 2007) also reports increased self-esteem and as well, improved academic skills. The results of having one’s body engaged in a sensory motor activity, for example, helps realign organizational skills for example. The movement of riding literally moves one’s body side to side and the vestibular movement becomes a pathway for helping riders concentrate and focus. Academically, the result is increased attention.
Vaulting is another faction that was developed by NAHRA. Vaulting is described as conducting gymnastics off the back of an equine. Studies of vaulting have also noted increased self-awareness and self-esteem in clients (Vidrine, Owen-Smith, & Faulkner, 2002). Eventually, the use of equines as a means of support and increased mental health led to the evolution of formalized therapy with the use of equines, called Equine-Assisted Psychotherapy (EAP) in 1999 (Frewin & Gradiner, 2005; Taylor, 2002).
The term Equine-Assisted Psychotherapy was coined by Greg Kersten, founder of the first organized certification group, named EAGALA (Equine-Assisted Growth and Learning Association) in the late 1990s. Kersten grew up on a farm with many equines and noted, after the loss of his father that the equines on his farm became important to him as emotional support. Kersten reportedly began to spend more time with equines and less with people. He began to notice the equines’ nonverbal interactions in the herd. The use of equines without riding was a unique premise which filled Kersten with awe. He began to study their communicative behaviors. Specifically, Kersten noted that the equines seem to detect and respond to emotions. He stated that the time he spent with the equines were emotionally healing as well as providing a glimpse into the empowerment of the animals (Kersten & Thomas, 1999).
The use of equines for emotional growth is noteworthy as equines are predisposed to either flight or fight within the herd. One of the more therapeutic behaviors of equines includes mirroring the experiences of humans (McCormick & McCormick, 1997). For example, if a client is angry, the equine will often take off running. If the client is sad, the equine is often observed hanging its head. These interactions help create a therapeutic moment for the client. The therapist observes and can ask, “What do you think is happening that the equine’s head is lower?” Kersten utilized his learning about the therapeutic encounters between equine and man while working with incarcerated individuals. He introduced a program using equines within a judicial system. Inmates interacted by grooming and even conducting some organized activities but did not ride. Again, the interactions were therapeutic.
Years later, Kersten partnered with social worker, Lynn Thomas, and the Equine Assisted Growth and Learning Association (EAGALA) came to fruition in 1999. The organization certifies both clinicians and equine specialists by providing training in Equine-Assisted Psychotherapy and Equine-Assisted Learning. To date, Mr. Kersten has started another certification, Observation and Knowledge (O.K). The effectiveness of Equine-Assisted Psychotherapy has grown and there are numerous people implementing programs for all areas of mental health disorders (Kakacek, 2010a, 2010b, 2014 Kruger & Serpell, 2006; & Trotter 2006).
Effectiveness of Equine-Assisted Psychotherapy
Equine-Assisted Psychotherapy (EAP), while relatively new as a legitimized treatment modality, continues to grow as a new therapeutic strength-based treatment. Studies have been generated by mental health professionals with a variety of applications. Results indicate positive changes in the lessening of mental health symptomology and disorders (Kakacek, 2007; Kruger & Serpell, 2006; Holmes, Goodwin, Redhead, & Goymour, 2012, & Trotter, 2006). Decreased depression, increased focus, decreased anxiety, and increase of positive self-esteem are a few of the results from EAP.
Clients Benefitting from EAP
The variety of clients benefiting from EAP traverses all diversity areas (age, gender, sexual orientation, religion, education, disability, and social economic status). The youngest client on record has been documented at three years old, and the oldest in their 80s. The preponderance of EAP has no boundaries in terms of the various clients (Kakacek, 2007; Kruger & Serpell, 2006; Holmes, Goodwin, Redhead, & Goymour, 2012, & Trotter, 2006).
The majority of mental health issues also can gain from this treatment. Eating Disorders, Depressions, Anxiety, Body Dysphasia, Post Traumatic Stress Disorders, Sexual Abuse, Physical Abuse, Substance Abuse, Aspergers and so forth are some of the most treated using equines therapeutically. Additionally, transitional issues, divorces, growth and development, and teaming benefit as well. The overall benefit for clients is based on their goal and desired outcomes. (Kakacek, 2007; Kruger & Serpell, 2006; Holmes, Goodwin, Redhead, & Goymour, 2012, & Trotter, 2006). The equine is certainly a partner in the change process, as is the therapist who attends to clients’ needs while also listening to their language and observing the behaviors of the equine.
Process of Change
The overall theoretical presence in EAP is strength based. Solution-Focus Brief Therapy is utilized by this author. The process of change contains (1) the elements of organizing a session, which includes a unique environmental setting and choosing an equine, (2) assessing the client’s physical and emotional needs for working with equines, (3) designing the semi-structured activities, and (4) implementing the four key properties of change (Kakacek, 2008, 2010a, b, 2014).
Organizing the Session
Sessions begin with a collaborative decision as to whether to begin inside the indoor arena or outside paddock or arena. The decision is dependent on goals and desired outcomes of the client. A brief question of asking “What brought you here today?” begins the strength based solution model. During an initial session, the formalities of opening a session are replete with observational data for the therapist, as the client(s) are given a tour of the facility inside the arena and then to the stalls inside and /or equines outside. A brief introduction of the equines is made. Any equine history, however, is omitted at this time. Due to the experiential nature of EAP, it is key that clients make their own discoveries or label the equines as deemed important to the client. For example, working with incarcerated juveniles, the group is very quick to state who is, in their perception, the “toughest equine or leader.” Experiential work is paramount for significant metaphorical change to occur. For example, one client chose an equine that he identified as “sad” and discussed thinking the equine liked him because they might be alike. He further identified the sadness asking if the equine had been “beaten.” This resulted in his revealing the same in his life. Then the equine history was disclosed. In this example, the equine had been rescued by animal rights activists and had a history of being whipped by its previous handlers. In the client’s view, the identification with an equine with a shared a history began the process of change, as resiliency became a theme.
During EAP, brief discussions often ensue with clients revolving around choosing an equine(s) to work with for the session. Equines available are those that have relationships with humans and each other. Like humans, equines exhibit different behaviors based on their needs. For example, if one day a particular equine appears to be more in need of physical space due to behaviors such as “kicking out,” that equine is not among those able to be used that day. Interestingly, the discussion of isolation often comes about when a client chooses an equine that, for all purposes, is “off- limits” for various reasons. Separation issues may indeed become the entire session, as a client may process the metaphorical aspect of the equine being apart as they describe their own feelings.
Assessing Physical and Emotional Needs
When considering the issue of physical safety, both the equine and the client need to be considered. As a therapist with equine experience, physical safety when working with equines is paramount at the beginning of a session. Clients are asked what part of the equine they might need to be aware of for safety. The word safety is used as a strength-based term rather than negative wording such as “watch out for or get hurt.” The discussions are often full of revealing information as to how the client perceives their own environment for safety. Secondly, the demonstration also peruses the client’s nonverbal stance with the equine. Do they have boundaries? Do they watch their feet? Are they aware of the equines’ nonverbals? Likewise, the client’s behaviors are noteworthy in that the equine must be respected as well. Following a brief discussion and demonstration with the equine, therapy continues.
Assessing the client’s emotional needs revolve around talking about what brought the client to therapy as well as exploring their goals. Checking the nonverbals with the equine also lends to assessing the client’s emotional barometer. The client’s proximity to the equine and the touch, as well as the equine’s response is full of quiet, subtle nonverbal messages from both. Using a SFBT model, the counselor can talk about what the client’s internal resources have been for prior problem resolution. This interaction often paves the way for the semi-structured activity to take place. For example, a client, Jane, once shared wanting to feel more confident in developing friendships in high school. She specifically and repeatedly talked about how “scary” walking in the hallways was because she was fearful people would not speak to her. We talked about times when this was not the case, and she was able to have the confident feeling she desired. This all occurred while she was confidently petting an equine, who was looking at her and not moving.
Semi-Structured Activities
Semi-structured activities in Equine-Assisted Psychotherapy are uniquely designed utilizing their strengths to achieve their goals. The activities can be as simple as watching a herd or an equine or brushing. Activities can include props such as poles, cones, or ropes and can occur inside or outside the arena. The aforementioned client, Jane, was working with an older mare who was generally quiet, although sometimes her arthritis made it difficult for her to move (and the client did not know this fact). The client was instructed to take the props into the arena and construct a path similar to a hallway in school. Poles were carefully placed and a bend was made in the path. Jane was then instructed to move the mare through the path. The client cautiously took the rope and began to walk. Quite predictably, the mare started to walk and when she came to the bend, she stopped. At this point, the client began to shed tears. By asking “What do you think the mare needs most right now? What works for you?” the client opened up and was able to search for prior times of success in school. Processing positive language, Jane was able to extrapolate what she tells herself to be successful. Jane began to give the mare positives, “You can do this! You are fine!” and the mare walked around the bend.
Four Key Properties of Change
Metaphorical constructs are the primary mechanism utilized for change (Kersten & Thomas, 1999; Irwin & Weber, 2001 Lyddon, Clay, & Sparks 2001; Karol, 2007; Kakacek 2007, 2010a,b, 2014 ; Kakacek & Ottens, 2008). Four prime target areas in EAP facilitate metaphor: (1) using metaphors to explain a equine’s behavior (“What is the equine running away from?”); (2) analogous language to discuss props or tools (“What does the halter mean to the equine and what is your halter in life?”), (3) clients relating life lessons learned (“What does it mean that you walked to get the equine over the obstacle?”); and (4) clients inferring lessons learned in coping (“When we work through our obstacles, we succeed.”) (Kakacek & Ottens; p. 19, 2008).
Equine Behaviors
Metaphors used to discuss the equines behaviors can lead to a rich exchange between the client and therapist. Referencing the client in the path and asking what happened with the equine or simply asking what is going on with the mare, opened the discussion with the client to talk about the mare being afraid and shy. Next, asking “Is that how it is for you? developed a commonality of the two and as bridged an intervention solution for the client.
Analogous Language
The props used in equine- assisted therapy can also lead to solution tools. The client, when queried about the bend in the path, reported that was where her locker was located at school (the turn in the hallway) and where the fear grew. Coupled with the notion of a locker was the fear of the mare to move as well. Asking “What is the bend to the mare and what is your bend?” resulted in the client sharing about her locker and relating to the fears of the equine as well. The use of isomorphisms were a tool to help the client use the equine as a “mirror” of her emotions.
Additionally, the simple haltering of the equine and attaching a rope can lead to a full session in the experiential components. For example, the previously discussed client, Jane, put the halter on in such a way that worked to attach a rope and also was not “the correct way.” The focus in EAP is not helping the client accomplish a task; rather it is the client experiencing their own success. The strength based model focuses on the client’s perceptions and the therapist continually reframes and compliments the client in even the smallest of tasks. This basic component of EAP also helps the client “think out of the box,” as there are no wrong or right ways to complete tasks. Rather it is about the process. Helping the client talk about how they decided where to put the halter on the equine is data for understanding how the client makes decisions. For example, this client placed the halter on “backward” and was frustrated because the client felt it was “wrong.” This led to the client talking more about other times she felt she had done something wrong and how the school anxiety had manifested.
Relating Life Lessons
Through her time with the mare, Jane was able to explore feelings of inadequacy in attempting to make friends in the school. She related the haltering to the struggle to walk in the hallways and make eye contact with peers. The client then practiced walking the mare through her “hallway” in the arena. This occurred while the client told the mare, “It is okay and you are safe. Nothing is scary here.”
Coping Lessons
The client was able to leave the session with a new goal of remembering how she was able to de-escalate the equine’s “anxiety” by being positive. Thus, Jane worked on transferring the practice skill to the actual school hallway. The role playing, albeit isomorphic, was paramount for change. She reported in a subsequent session to being able to walk calmly and look at one peer. As she continued to practice the skills learned in the arena, new coping skills emerged and were validated.
Case One: Sue
The client, an eight-year-old, presented with anxiety and was described by her parents as having difficulty with excessive worrying. The worries had been present for about four years and impacted her daily functioning. The triggers to her anxieties were unknown. The session was outside with two miniature equines or “minis,” both of which were mares. One mare was dark brown, and one was white in color. Interestingly, the minis, like the client and accompanying parent, were mother and daughter. This became an important fact when processing at the end of the session.
The session began with Sue choosing to work with the dark mini, Grace. The client chose her by stating,”She seems lonely and a little nervous,” (the mare was mirroring the client). I asked, “Is that like you today?” The client responded, nodding yes and then in a hushed tone shared about issues at school with a friend. She indicated that she worries about the friendship and not knowing how to communicate that with the friend. I asked, “On a scale from 1 to 10, where is your worry at? ” Using scaling to assess she responded an 8. Grace had walked up to the client, which the client attributed to Grace liking her and feeling safe, even though she was afraid. I asked the client if she thought Grace needed some help. She responded a resounding, “Yes!”
Next, I asked her to use the props nearby to build something that might represent Grace’s fears. The client carefully took two poles and made a jump with cones at the ends. There were two mud puddles, and the client cautiously built the obstacle up to the puddles. I asked her to move Grace over, around, or under the obstacles. The goal was to help her uncover her own way to get “over” fear or worry. She carefully put a halter on Grace and, although it was done incorrectly, this does not matter in EAP. It is the process of problem-solving that adds to the richness of the experience and keeping with a Strength Based model. While figuring out the halter, the client asked her mother once to help, and the mother told the client she was “fine.”
After the halter was on, the client attached a lead rope and with encouraging words to Grace, began to move her toward the obstacle. Meanwhile, Grace’s daughter, Snowy, began to follow the client and Grace. I asked the client what Snowy was doing and the client responded, “Oh, she wants to have help, too, but she has to wait and be patient. I can only help Grace now.” The pair approached the obstacle and the client, still encouraging verbally, also began to nonverbally pat Grace as they walked. The client chose to have Grace walk over the obstacle. In doing so, Grace’s back legs touched the pole while going over it. The client was very verbal telling Grace she had to do it (walking over the obstacle) until she did it “just right.” The walking continued for another 10 minutes with Grace still knocking her back legs on the pole. During this time, Snowy had walked away from the obstacles.
I reflected that doing this perfectly was important to the client. The client nodded “Yes,” quite emphatically. Using isomorphism I asked, “What do you think Grace thinks?” The client replied, “That she needs to keep working and will get it right.” Establishing a goal for the session I asked, “What else might she need to accomplish the goal?” The client replied , “I just have to tell her she is doing good all the way.” The client’s internal needs were revealed. Thus, the client increased positive comments and the mare finally did walk over the pole without touching it. I asked, “Are you finished with the goal?” The client replied, “Grace is, but maybe Snowy should do it, too.” Snowy was not haltered and had no lead rope, and amazingly just walked up and stepped over. Immediately afterward, Grace walked up to the client’s mother and just stood beside her.
Processing began with inquiring what the client thought the rope and halter meant to Grace. She replied it was a way to “help and guide her.” Extrapolating the experience with the client, I asked, “What guides you?” The client stated that her parent was her guide. More processing followed and then the discussion turned to the obstacles:
Therapist: Tell me about the obstacle you built. What do the poles mean?
Client: A way for Grace to get over her fear of new things.
Therapist: I noticed you were telling her she was doing good and touching her when you were walking her. You were also smiling. What do you do to get over new things?[Exception to the rule.]
Client: I tell myself I will be okay. Mother tells me too. Mostly I just try but get really scared.
Therapist: I wonder what you were thinking to do with Grace to help her.
Client: That she could do it and needed to do it without thinking too much.
Therapist: Did it work for her?
Client: Yes, but only after many times trying.
Therapist: And you helped her try every time. You believed in her.[Complimenting the client.]
Client: Yes but she needed to do it right.
Therapist: So you have a part, too, that keeps trying. And does that lessen your fears?
Client: Yes! Like Grace.
Therapist: If you were to give Grace a secret message to remember it is “ok to try,” what would you tell her? [Metaphor to explain equine behavior.]
Client: It’s ok to try and sometimes bumping a little is ok.
Therapist: I am wondering what would happen with the same message if you were able to tell yourself that inside, right now.
Client: Ok. I can do that.
Therapist: Tell yourself that as you go over the poles.
The session concluded with the client working with Snowy and Grace together. The client laughed and even jumped the puddles with the mini equines. To remind her of her strengths, I cut off a little of Grace’s tail for the client to keep in her pocket when she felt she needed to be brave. In the following sessions we continued to work on strengthening her confidence and self-esteem. The client worked with bigger equines, cleaned hoofs, and brushed the equines all over their bodies. She was able to take control, literally, of a “bossy” male (gelding) pony. This was in response to the issue with the friend that she initially presented. Upon learning that Grace was the mother, the client’s parent also walked away with new information to be helpful in the home environment. There was a renewed effort to focus more on what the client COULD do. We concluded the session with a scaling question and the “fear” and “worry” had dropped to a 4. We also reframed the words “fear” and “worry” to “can do it.” Focusing on strengths that the client can accomplish using equines as therapeutic tools and enriching the experiences with rich metaphoric extrapolations, is inherent in SFBT.
Case Two: Jim
Equine-Assisted Psychotherapy is an excellent model for at-risk adolescents. For eight years I had the pleasure of working with groups of incarcerated youth on a weekly basis. The power of the interactions and the use of Strength-Based Counseling has been rewarding. A study conducted early in the treatment indicated that recidivism rates were lower when at-risk youth participated using the equines (Kakacek, 2009).
The mere size of the equines and the power displayed has always impacted the youth by engaging their respect and cooperation with the animals. Sessions were something the group looked forward to attending. The creation of the obstacles weekly fit dynamics and needs that the staff from center described weekly as well. All the boys that attended the EAP sessions exhibited some changes in behaviors. As with all counseling and readiness for change, some clients exhibit change more than others. One youth, in particular, was able to develop keen insight about himself and his needs to strengthen his future.
The group had been attending for 10 sessions. One youth was getting ready to be discharged home and thus, leave group. These times were always emotional for the boys as they had come to identify with an equine with which they attributed similarities. The youth described in this final session came to the group with a history of involvement with gangs and drugs. During Jim’s last session, rather than have the boys create their obstacles, I directed them to build a community by making a box on the ground with poles. At the same time, as typical in sessions, the equines are free to engage with the youth. The boys indicated they were ready to begin and they were instructed to stay within their community boundary. They were also told that the four equines needed to “stay clean and avoid entering the community.” Slowly, buckets of grain and a few piles of hay were added to the “community.” Jim took control of the exercise and helped direct his group members to work at not letting the equines get “high” or “steal food.” He, in particular, was speaking in a gentle quiet voice to the equines to “follow the rules.” [strength based]. Eventually he indicated that each member should do their part and toss the food out of the community. “We have to keep this clean now. We have worked hard,” he said. [inferring lessons learned].
Processing with Jim after the session, I asked what the grain and hay represented to him. Much as he said during the exercise, he indicated that that item represented drugs to him. I then queried, “What part of this exercise will be useful to you when you exit?” (A small, embedded command that, indeed, it WOULD be useful as well as strength base future). Jim said he realized how hard his mother tried to help him (with the same gentleness) and, that he needed to stay away from peers that were part of the problems and move toward positive role models. The we discussed his strengths:
Therapist: What will you take away from equine therapy?
Client: That I can make good decisions and I can stay in school. I want to go to college.[Extrapolating changes with equines for own life]
Therapist: Suppose tomorrow morning you wake up and life is just the way you want. What will you be saying, doing, and feeling? [Miracle question]
Client: That I am smart, staying in school, and feeling proud that I know how to deal with feelings now.
The last time I heard about this youth, he was in school and working hard to accomplish his goals. The client reported:
If people are having problems in their lives, they should go to equine therapy to get in
touch with their inner selves and to relieve stress. Once they leave there, they’ll have smiles on
their faces. Most dudes like to be tough, but on the inside, an equine opens up one’s weakness
and brings out the softness.”
Case Three: Bob
An adult with Aspergers, age 62, came to EAP to learn how to improve relationships with people in general. The client reported he was no longer in a relationship and wanted to figure out how his previous diagnosis of Aspergers could be managed. The first day, Bob chose to work with a short stout equine called a Halflinger. The client indicated having owned equines in the past and riding horses.
The client hesitantly and methodically haltered the equine, touching the gelding only when necessary. Bob attached the rope to the halter and began to walk with the equine from one paddock to another. While walking, we discussed the parts of an equine to be aware for safety. The client also began to talk about how he believed Aspergers is displayed in people by noticing that they (those diagnosed with Aspergers) “just think differently.” Bob went on to explain that he did not conceptually understand terms such as love or friendship. The client also spoke about how co-workers would say “Hello” and Bob did not understand what the client was to do in such cases.
The client appeared frustrated verbally and was not aware of the equine’s behavior at this time. The equine moved into the client’s space, bumping into him. Bob jumped back and said, “I get it! I need to be aware of people in my space and say something! Like hello! Did you make the equine do that to me? This is really amazing!” [Using metaphors to explain horse behavior and relating life’s lessons learned.]
The process continued and we discussed how he could begin to notice others and respond. This was a tremendous learning experience for the client. The equine, according to the client, helped him understand that people, like the equine, expected an interaction and would be “pushy” if it was not reciprocal. [Metaphor to explain equine behavior.]This event began the growth and development for the client as a metaphor for change. He was eager to use the equine again and eventually developed a relationship with the animal. One day, while the client was processing his “feelings ” he began to laugh and reached out to pet the equine. This seemingly simple gesture and acknowledgement of laughter led the client to self-discoveries of a variety of emotions. [Client infers lessons learned]. Then I asked a miracle question. “I am wondering if after a good sleep tonight, you wake up in the morning and something is new and the frustration is replaced with new thinking, what might those thoughts be?” Bob replied, laughing, “That I can know what laughter is and how to know a little more about how to be with people, like I did Buddy (the equine)!” [Client inferring lessons learned and future goal positive goal.]
Case Four: Mike
Counseling couples is always a delightful, intriguing experience for me. The dynamics are so rich, and I enjoy the prospect of helping client couples uncover their strengths. Sometimes didactic or office visits are not as impactful, or strength based. Thus, I choose to use the environment of a field full of equines to help clients search for their strengths.
This was particularly true for a client who was recently separated from a partner. The client was struggling with depressive symptoms and wanted to be able to communicate with his partner in an effective manner. The prior session in the traditional office setting did not yield a positive outcome, as the symptoms continued and no change was noted by the client.
Mike came to the session at the stable and indicated no equine experience except one whereby he took a ride on an equine and had difficulty stopping or controlling the animal. Already, I had a metaphor about how the client had seemingly “no control” with the partner that had left. I chose not to dialogue about the metaphor, as I wanted the session to flow without interruptions, and quite frankly, with a view of equines grazing in a field, I knew more interactions would be plentiful.
Mike and I walked into the field. I asked him what he needed the most today and he replied, “To figure out how to communicate better with my partner.” As we walked into the field with four mares, three fillies, a pony gelding, and a very old gelding who stood away from all the other equines, I instructed the client to choose an equine with which to develop a relationship. The client, having no awareness of the equines, chose a mare that almost never approaches people. The client began by asking, “What do I do?” I responded by directing the client to do whatever he thinks will help he and the equine today. The client replied that he wanted to have the equine come to him. The client then began yelling at the equine to “come here!” The equine looked at the client briefly and trotted away. The client, walking fast with his hands on his hips and using an adamant voice, attempted a few more times. Noticing the frustration, I asked, “How’s it going?” to which he replied, “She doesn’t like me!” I asked the client what he thought the equine did to indicate dislike for him, and what he would do next. He responded by stating the equine was just like his partner–walking off and not listening. [ Metaphors to explain horse behavior and described the problem.] I asked the client to think about a time when his partner walked toward him, and to specifically recall was he was doing, saying, and feeling. [ Searching for exceptions to the problem and using the equine for analogous language.] The client said, “Well, I will try a different way.”
The client quietly, with hands at his sides, gently spoke to the mare. As he slowly approached, the mare came towards him and he was even able to touch her. The change in the client’s demeanor was rewarded by the mare through this experience. The client became teary-eyed when he stated he knew what would work with his partner. We spent the rest of the session processing the strengths of the client and practiced these in the field. I know that most work comes between sessions, and the following is a letter from Mike a few days later:
Interesting experience and very eye- opening. I learned a lot about myself today and perhaps help me to be able to love and respect my partner in a whole new way. At least I discovered that I never learned or knew. Met a bunch of very smart and intuitive equines. My favorites are Rashada and Hercules.
At first, when I approached Rashada, she ran away. I learned with that with a change in the tone of my voice she accepted me! However, that did not last. She was closer to me but when I spoke in that tone she walked away. By opening myself up, not speaking and being patient in my approach she again let me come close. Wow, things change quick!
I realize by taking it easier and with more patience I was able to approach old man (equine ). By being in my partner’s face and not having any patience in many situations ,I was pushing my partner away. Trying to pacify my own emotions with things will happen. 53 years of not having patience and always trying to fix. I understand, but I am scared, I do not want to continue to be the “old man.” Makes me think about Casey (equine. Why was he alone? He was wise with his choice of area to munch. Was he just comfortable with himself? Or did he just need some “space”?Why was the crazy male equine [ Barry] given such a hard time by the females? Was he impatient and wanted everything his way? And then learned quickly it does not work that way? Why didn’t I closely watch out for the piles of crap? Why? Why wasn’t I scared of the equines? Last time I was near a equine, I was hurt??? How was I able to let a equine nuzzle up to my chest and why did she?
[Metaphors about equine behavior, client relating lessons learned and inferred.]
Mike has continued working on the positive strength based outcomes from the session with the equines. He was able to modify communication to explicitly walk with quiet intention. Mike is able to have a positive outcome with his partner now.
Summary of Cases and Strength Based Model Applications
Each case briefly described both SFBT model techniques and the four prime areas for change used with the clients. Each session was a tiny glimpse into how using equines is a wonderful tool. Much like the pondering journal of the last case synopsis, the sessions are full of numerous interactions that clients can reflect upon for growth.
Clients’ changes using strength-based models are reflective in the positives that occur with the use of the metaphorical constructs and of the use of equines. The clients are more externally focused on the equine, and thus both verbal and nonverbal expressions flow freely. The solutions or mere interactions are a powerful tool for clients, from simply brushing an animal to moving the animal through an obstacle.
Recommendations for Practioners
The field of EAP continues to grow and is exciting to practice! I still use my traditional office and always have the option of using equines. Insurance covers EAP, when billed as mental health therapy. I have found that most clients prefer to use the equines at some juncture, if not for all sessions.
When considering a practice in EAP, I recommend professionals have some equine experience. I began having an equine-experienced person with me. Now I have extra people with equine experience when I am conducting a large group or family sessions. It is advisable to have an extra set of eyes making sure the equines and people are physically safe. I also attend to the emotional safety of people during those times. In the above cases, I worked alone for three of the cases. I have conducted sessions with groups of 20 for supervision and did have two assistants in the field, one with equine experience and the other, like me, having both equine and a clinical mental health license.
Summary
Philosophically, I have always gravitated toward strength-based counseling interventions. When combining EAP and strengths-based strategies, understanding the questioning skills of SFBT is key for successful sessions. Also, having experience with paralanguage is paramount to a successful session. Practicing nonverbal language is essential as well as observing the nuances in equines. Finally, learning how to extrapolate the metaphors for change is crucial and, for me, as a clinician. the most enjoyable aspect. It is essential to pay attention to your co-therapist (the equine) and share some joy that comes with being a part of the change process. Happy Trails!
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