Kate Twardzik, BA & Dr. Sandra L. Kakacek, Ed. D, LCPC
Sunlight shines on the day at the animal-assisted therapy in counseling at the farm. The smell of hay combined with the neighs of horses and dogs and cats wandering to greet clients as an animal-assisted session begins, has been replaced with no smells, but the sounds of the horse’s neighs and seeing the dogs and cats enter the ZOOM screen, have a new arena to begin therapy. The joy of reaching out to touch a horse and/or dog or cat has been recreated by the vision of the animal as the co-therapist reaches out to the animal as instructed by the client.
We all miss our time together and the gentle clop-clop of a horse walking in the barn aisle, as other horses are calling out “hello” to the client. The transition has been filled with a new wonder as we carefully have the client direct the session by first choosing, as we do in-person, which animal will help them in their goal. This article will describe the application of ZOOM sessions. Discussed will be the pragmatics of using ZOOM, the theoretical orientation, beginning of the session, middle of the session, closing a session, and a follow-up of a next session.
ZOOM
The platform of ZOOM utilized in Telehealth is a version that is HIPPA compliant. We know that this was a requirement waived due to the “stay at home order,” however, having the version to protect clients is always an extra measure taken. ZOOM is relatively safe-guarded due to password protection. The client is sent the link by this therapist, as is the human co-therapist at the farm. A simple click on the link, and the client enters ZOOM. The parent assures our clients are connected. The co-therapist uses her cell phone as she uses that at the farm to provide visuals for our clients. Our session then begins.
Theoretical Orientations
The theories utilized in our animal-assisted therapy, is overall brief therapy, coupled with cognitive-behavioral, solution-focus, and Adlerian. Cognitive -behavioral is widely used (Chandler, 2017). The addition of solution-focus brings a clear way of using rating scales and can be applied to the animal’s behaviors as well (Kakacek, 2016). Adlerian principles are utilized overall as a means of understanding the “arena” community and how all are merged in the session. There are also metaphorical tools integrated into each session. “There are four properties that help facilitate the behavioral/emotional changes using metaphors. One is attending to the horse’s behavior (what is the horse’s feisty behavior about?). Secondly, using analogous language referencing props during activity (what does baton with the ball at the end represent to you?). Thirdly, clients processing prior responses in their lives that were gleaned from the structured activity (what does it mean that the horse pulled you?). Lastly, processing with clients’ to metaphorically extrapolate the emotional and behavioral strategies and applications to utilize outside the “arena” (if you were able to move the manure bucket here, how will you move that in other areas of your life?)” (Kakacek & Ottens,2008, p. 19). A
Beginning of Sessions
The clients discussed in this article have received therapy at the farm, thus, they have familiarity with the animals utilized. One client, a 5 year old, will call out to the horses as the co-therapist walks down the aisle, stopping to see each equine, dog, and cat. The client then decides who she would like to “work” with. Recently, the client was working on separation anxiety, and chose a pony. It is always amazing that the animal a client chooses has similar patterns of behavior. This pony is very reluctant to be encountered by people. However, he does gravitate to this client. We encourage the client to speak to the pony as if she were in the stall with them. Quietly, she calls him to the “phone.” Gently, with each step, the pony reaches where the co-therapist is holding the phone. The pony’s nose stretches out to the phone, and the client begins to giggle. Thus, we begin the session.
Middle of Sessions
A 10-year-old client had developed a strong bond with the pony. Once the pony hears her voice, he begins to look for her and engages easily with our new challenge of bonding without a physical touch. We ask the client to show the pony their “homework” from the week prior. The client has been working on increasing confidence and independence to tackle a new beginning of changing schools. We direct the client to notice what the pony’s ears are doing. The client talks about the pony listening to her, as his ears are forward. The client wants the pony to be brushed then. We ask the client what to do to move the pony. The client provides directions for putting the rope on the halter and then says, “Come on, let’s walk to where the brushes are.” The pony stops in the aisle to eat some scraps of hay on the floor. We ask what is happening and she says the pony is distracted. We follow with, “Is that like you sometime?” The metaphor continues as the client discusses what distracts her from accomplishing new tasks to be independent. This extends to talking about the feelings involved when she is not achieving what she would like, both at home and at school.
End of Sessions
Meanwhile, during this time, the pony pulls back on the rope ties. We ask the client what the pony is doing. She responds with stating he is nervous and wants to go back to his stall. This enters processing, what she wants us to do when he is nervous. She talks about patting him and at the same time, tells him he is okay. Then she talks about what she does when she gets nervous. She has her own place at home, that is her safe place. The session closes with talking about how the pony was distracted and how she can also work on that as well for next session.
Next Sessions
The client that was distracted came to the next session and showed us her chart she was working on that was designed to increase her staying on self-care tasks. The chart showed some good progress, however, the need for consistency was needed. Therefore, for this session, we decided to choose to use the dog, Dolly, a rescued Saint Bernard, that also, of course, needs to work on not being distracted. Our session started talking about what Dolly needed. A chart was used in the session that was big enough that our client could see it. The chart was divided in different areas. The client was instructed to decide what Dolly could do to earn paw prints for success. The client also decided how many paw prints the dog needed to earn either playing with her favorite bone, brushing, or a treat.
The goal was to help the client focus on self-rewards and model what a chart completion looked like. The client first told Dolly to sit. Her voice was kind and gentle. She repeated it a few times. Finally, Dolly sat. We asked if Dolly should earn a paw print. Dolly earned her first one. Next, she asked Dolly to roll over. This took more prompts. We then asked does she get a paw print. The client said no that she did not listen the first time because she was distracted by another dog. Dolly finally did earn enough paw prints and was given a treat, as decided by the client.
We followed this with a new chart that was divided into 3 parts per day that the client would mark on her own if she completed self-care tasks. She also decided on a reward and is working toward the successful completion. The younger client is now working on identifying feelings. She draws a feeling face, holds it up for us to see and tells a time when she feels that way, as well as applying that to the pony or dog.
Summary
This brief article is a small snippet of how animal-assisted therapy in telehealth is being utilized. This offers us an opportunity to continue therapy with our clients and as well as engage the parent as needed. Follow-up phone calls are also conducted. The clients are tuned in to the animal’s behaviors and likewise, our animals know their voices. The joy of seeing the animals on ZOOM and having the clients be a director of the session is a sense of empowerment for us all. The arena for “change” continues.
Special Thank you to ERC Farms and Kate Twardzik, who is an amazing trainer of horses and owner of the sweet therapy dogs and cats. She is a rehab grad and works as an ABA registered tech. Her gifts continue to amaze us all.
References
Chandler, C. K. (2017). Animal-assisted therapy in counseling. 3rd Ed., Routledge: New York.
Kakacek, S. L. (2016) Equine-Assisted Psychotherapy: Applying Strengths-Based Solutions in an Arena for Change. In Handbook of Strengths-Based Clinical Practices, Edwards, J.K., Young, A., & Nikels, H.J. (Eds). pp. 192-206. Routledge: New York.
Kakacek, S. L. & Ottens, A. J. (2008). An arena for success: Exploring equine-assisted
psychotherapy. Michigan Journal of Counseling: Research, Theory and Practice, 35, 14-23.