EMILY PRINS E-Portfolio

Summary of Literature Review and Needs Assessment

          Animal assisted therapies (AAT) are defined as the use and inclusion of animals in a trained professional’s, such as an occupational therapist’s, goal directed and planned therapeutic intervention plans that can help to promote a client’s cognitive, psychosocial, behavioral, emotional and/or or physical functioning (AAII, n.d.). AAT falls under the broader category of animal assisted interventions (AAI) which also includes things like animal assisted activities (AAA) and animal assisted education (AAE) (AAII, n.d.). Hippotherapy, as defined by the American Hippotherapy Association (AHA), refers to how rehabilitation professionals, such as occupational therapist, speech therapist, and physical therapist, utilize the movement of a horse as a therapy tool to meet client’s goals that target sensory, neuromotor, and cognitive systems to impact functional participation and outcomes of the client (Peterson, 2020). Hippotherapy is a form of AAT. Hippotherapy is not a stand-alone service, and best practice put forth by the AHA dictates that is done in conjunction with other therapy tools and techniques (Peterson, 2020). Program development models lay out a plan that includes planning, developing, implementing, and evaluating (Doll, 2010) a program. Specifically, Braveman (2001), cited four steps for program development that include a needs assessment, program planning, program implementation, and program evaluation.

In my personal needs assessment, contextual factors that I found for myself included that I wanted a hands-on experience at a site that allowed me to be comfortable and show my extroverted personality. I identified that I have knowledge gaps around horses, hippotherapy, and some personal barriers like my need to be detail orientated and not having as many guidelines structuring this experience. With the combination of my intrinsic factors (personality style, resilience, learning style), extrinsic factors and awareness of my additional learning needs I looked forward to learning more about hippotherapy and program development from an established site in St Louis!

            Initially, I was going in a direction for my project that would look more at the incorporation of groundwork into hippotherapy lessons. After being at TREE House for a few weeks I saw that they were already doing this, it just was not something that I had ever seen or heard of doing before! This caused me to shift and really think about what the site might need from me during my time here to benefit not only myself, but this organization and these clients. That is when I learned about the staff’s ideas for the living classroom, and my project took off from there.

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Goals for Capstone Project

      My goals for this capstone experience were to gain an exposure to hippotherapy sessions through observation of treatment planning and goal writing, learn and demonstrate safety and good judgement in clinical reasoning within hippotherapy and therapeutic riding sessions, gain an understanding of the financial aspects of running a site with hippotherapy with other services, grow my experiences and skill in leadership and management of a community agency nonprofit, and help with program development, either of an existing program or to make a new one. My capstone project came into play with my fifth goal for this experience, program development. My goals for the capstone project in general were to synthesize all the learning I had gained from my overall experience goals and put them into action on a program that my site either needed revamped or made completely new. I wanted to be able to research and do a mini needs assessment of my site, locate and find relevant research (OT, mental health, general therapeutic benefits) support for this program, help to secure funding through grants and fundraising, then present my ideas to all applicable parties at TREE House. Lastly, I also wanted to make sure that whatever I did and planned would be able to be sustained, so my goal was to be transparent about what I thought maintenance, upkeep, and staff needs would be to maintain this programming.​

         

Methods

          To better inform my capstone project and my learning needs, I used a variety of methods to prepare myself to begin the program development process. For my first goal of gaining an exposure to hippotherapy sessions through observation I observed over 50 hours of hippotherapy sessions at the barn (both PT and OT), I researched and learned treatment techniques and activities for sessions by speaking with OT professionals and listening to podcasts, I wrote example goals and example documentation for client cases at my site, and I planned an example session involving hippotherapy for an example client. For my second goal of demonstrating safety and sound judgement in clinical reasoning I discussed what to look for in sessions to mark improvement  and what outcome measures are used with therapy staff, I researched qualifications and trainings to be able to be a provider of hippotherapy and therapeutic riding services, I observed and discussed safety aspects of all involved (horse, client, instructor, volunteers) during sessions, I took initiative to successfully set up and then take safety precautions during all sessions I was involved with, I became formally trained in side walking and horse leading, and I completed an online meeting to explain the process of become hippotherapy certified.

 The third goal of learning more about financial aspects of running a site with hippotherapy and other services was achieved through observation and interaction with insurance, billing, and reimbursement for therapy services with the finance manager, keeping track of monthly costs of running the site (salaries, insurances, site upkeep), participating in the care of the animals with the equine manager, and participating in and helping to improve existing financial and networking systems. The fourth goal of gaining experience in management and leadership was achieved through several marketing focused activities like taking part in all marketing and advertising efforts with the marketing coordinator, learning about the hours of operation and when most clients are here in conjunction with staffing times, and asking/learning about the leasing of animals versus purchasing. Lastly for my firth goal I wanted to synthesize all the above information and methods to inform program development at my site. I wanted to do this by thinking about marketing efforts, funding, planning/executing, and scheduling/support staff.

           The actual methods of my project, the program development of the living classroom idea and the implementation of the sensory trail, happened via a few methods. First, I spent a few weeks researching all the different components of the living classroom including goats, chickens, llamas, sensory trail, meditation seating area, eco explorers’ program, a garden, and an adaptive fishing program. Throughout this research process I met with the program director and the chief program resource officer to get their input in the early stages of planning. Next, I started a grant to hopefully secure funding for the living classroom under general operating. Once the living classroom research was complete, I held a meeting with all full-time staff at TREE House to have an open discussion about what I had found, their ideas of the program, and their concerns as well. We addressed maintenance, who world be responsible for what, what to do in the off season, and which of the eight aspects we would like to shift to priority. Lastly, once it was decided that the sensory trail was easiest to continue forward, I organized a volunteer workday, complete with tasks sheets and supplies, and we started on the sensory trail revamp efforts. I along with other staff members spent several days on the sensory trail making the improvements so it can be open in time for the fall season. As part of my dissemination of this project, I also made a training and maintenance manual for all TH staff to refer to, that has detailed information about each sensory trail station and what each station can be used for, goal wise.

 

Results

Results from my first four goals helped to inform the results of the program development goal, and ultimately my project. The first goal of my experience and associated methods of achievement were important to my capstone project as they helped me gain an appreciation, understanding, and love for what hippotherapy can do for clients. The living classroom, and sensory trail specifically, are centered around hippotherapy. My second goal and methods were important to this process as they helped to reinforce that safety is always the number one priority. Safety of the rider and of the horse is always something that needs to be considered, especially when planning and implementing new programming. This knowledge helped to inform strategic choices about timelines in the living classroom, stations on the sensory trail, and even placement of future animals at TREE House. My third goal and methods helped me to keep in mind that my site in a nonprofit and mainly runs of grant funding and fundraising. I learned that you could have all the ideas in the world, but you need to make sure you can sell these ideas and create a vivid enough picture with your words to secure funding for it. If someone else does not believe in your vision like you do, then you’ll be stuck without the necessary funding to go forwards. This goal also helped me to learn about all the care and responsibility that being a horse owner entails. There is a lot of behind the scenes work and expenses that go into keeping horses and using them for therapeutic purposes. My fourth goal illuminated the need for staffing for new programs especially when compared with current staffing times and responsibilities. Without the necessary dedicated and motivated staff to run this new program I was proposing, it would not continue past my time here, and that is not a sustainable way to plan things. This goal also helped me to gain some skills in marketing my ideas and plans through written advertisement, photos, and video promotional advertisements on social media. Each of these results is documented within my deliverables on my eportfolio.

The overall results of the program development piece are that the living classroom is now something that was taken out of the waiting list the last two years and is moving forward with progress! I was glad that this project was something I could help with, especially because it was something that so many staff members had been wanting to progress but did not have the time to do so, like I did. The sensory trail is complete and ready for clients to start using. I created a sensory trail activity and maintenance guide that details all the new features of the trail, where they are located, how they can be used, and the upkeep of them. My hope is that this guide serves as a training manual for new therapist or returning therapist and staff and gets them excited and thinking about all the things they can do on the trail with their clients. The other components of the living classroom are planned and ready to go, pending donations for ADA accessible roads and ramps, and more funding. As a team, it was decided that goats would be the next best step for the living classroom so that is hopefully on the horizon for TREE House. What I think an important result of the sensory trail and living classroom program development that I did, is that because all the full-time staff, and some part time staff, were involved since the initial planning phases there was a lot of buy in for this project. Everyone from the executive director, facility manager, equine manager, program director, physical therapist, and chief program resource officer came out to help with parts of the sensory trail installation. I was happy to have this help and see so many of the staff members invested in this improvement for TREE House.

            The implications this project have for OT practice and my professionalism are tremendous. First, OTs at the site, along with other therapist and staff, will now be able to use the sensory trail with their clients to help elicit sensory experiences that clients may be seeking. This will help clients in their everyday lives, and give OTs another area they can address with their clients at TH. The living classroom will also have implications for OT practice at TH. OTs will be able to take their clients to all the 8 components and work on their therapeutic goals in new and innovative ways. OT at TH will not be the same now that these ideas are flowing, and the sensory trail is complete. Professionally, I can take this experience and use it as something to talk about in interviews and bring to more sites. I can’t wait to draw on my experiences here for my own career.

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Recommendations for Sustainability

          To maintain the sustainability of the sensory trail and living classroom a few things need to be done immediately, each year, and for years to come. Starting with the items that need to be done immediately, is establish a point person for the sensory trail. Between the full-time staff there needs to be one person who is going to be responsible for assessing the condition of the trail each year and making necessary recommendations for improvement. This person needs to take responsibility of the trail, how it looks, how things are stored, keep tabs of all the activities and stations and can filter feedback from the TREE House community about how it is going on the trail. This person would also be responsible for taking tarps off each morning, and ensuring they are in their right place each evening. We have a pretty good idea of who this will be, but that would be my main recommendation for sustainability purposes immediately. Next, each year there needs to be a volunteer workday or staff workday where necessary improvements are made, and the “season” is opened. After the winter months and going into the spring the trail will need to be mowed, refreshed, and cleaned. It would be a good idea to get volunteer and staff buy ins by having a workday for everyone to make these improvements! This way it gives everyone a chance to see what is on the trail, jog their memory of things to do, and then get back out there and use it again. Another yearly sustainability task would be evaluating the point person and if they want to continue doing this job. TH could see if there is any interest from someone else on taking this role, if it is too much for one person and another person needs to tag along, or if it can be filtered down to a smaller role for a volunteer. Each year another sustainability initiative would be to assess the activities and the usage of each one. Therapist and staff could be surveyed to see what they like about the trail and what they dislike, or would like to change and why. At season close this could be done so necessary improvements and new ideas have time to come to life before opening season again in the spring! For years to come, and each year efforts will need to be made to continue raising funds for the sensory trail maintenance, or budgeting for it alongside other expenses. If the sensory trail is left like it was at the beginning of this project, it takes a lot more time and money to fix it, rather than doing little fixes as it needs it along the way.

          Regarding the living classroom, I have similar recommendations or sustainability. It will be of the utmost importance to establish a point person for each of the components, especially for the animal-based components. Bringing on more animals to a site that already has 18 horses will put strain on the people and volunteers who care for those horses daily. There will either need to be more staff hired, or more volunteers brought on to make sure every animal is taken care of well. Like the sensory trail, the maintenance of each of the living classroom spaces will also need to be discussed. Having to mow, weed, and prepare more land each day will put a strain on the facility manager, so more volunteers or staff will also need to be hired to help sustain these programs at the living classroom.

Overall, the biggest take aways for sustainability of my capstone project, the living classroom and the sensory trail, are making sure there is adequate staffing power and keeping funds raised to support these initiatives.

 

References

American Hippotherapy Association . (n.d.). AHA, Inc. Terminology for Healthcare. Fort Collins, CO; AHA, INC.

Animal Assisted Intervention International. (n.d.). Animal assisted intervention. Retrieved from http://www.aai-int.org/aai/animal-assisted-intervention/

Braveman, B. (2001). Development of a community-based return to work program for people living with AIDS. Occupational Therapy in Health Care, 13(3-4), 113-131. 

Doll, J. (2010). An Introduction to Program Development as a Foundation for Grant Writing . Sudbury, Massachusetts ; Jones and Bartlett Publishers, LLC.

Peterson, A. (2020). What is Hippotherapy. American Hippotherapy Association. Retrieved December 6, 2021, from https://www.americanhippotherapyassociation.org/what-is-hippotherapy.