On the Ground

I was thinking about the things I really like about the EAGALA model. There are four principles to the model: there is a team approach, activities are focused on the ground, sessions are solution-focused, and follow a code of ethics. Sounds simple enough, and it is! The EAGALA model allows for a great deal of flexibility, and assumes the client has the best answers for themselves. This has proven to be true even with clients who struggle with cognitive or other disabilities. Today, I want to focus on the term 'On the Ground' because I think this one has more than one meaning. 

Recently, there was an interesting discussion on the EAGALA FaceBook page. One individual had comments about how she felt there should be rules about when and how the horses can be used in the sessions. There was a bit of debate about it, but for the most part, EAGALA practitioners supported the notion that the TEAM, following the CODE OF ETHICS, which includes the code of ethics from EAGALA and the Code from the therapist's credentialing body, make decisions 'on the ground'. We think of 'on the ground' as meaning non-riding activities, but there is more. It also means that the team makes decisions 'on the ground' to determine the safest course of action for everyone involved. This is where the flexibility comes in...

I and my equine specialist (ES) are familiar with the horses we use in our program. We know they have good days and bad, and we have even seen them need to call in sick for work on a particular day. These decisions are made by us, we don't need any rules other than those provided in the Code of Ethics. We depend on our animals for so much, and we couldn't do this model without them! They ARE a part of the team. 

That being said, I remember having one horse not feeling well, and seemed to be having gut problems. This mare had been working with a young woman for a few months, and I was concerned about what we might do, since we felt it necessary to call the vet out to have a look. I called the parent, and explained the situation. I asked if she felt her daughter could handle having the vet come out during her session. She said she felt it would be O.K. (The horse was not at risk of having to be put down). The young woman was able to observe and ask questions of the vet, for about 15 minutes during her session. 

I am sure there might be mixed feelings from the general public about this decision, but anyone who would speak out against trying this is certainly missing the purpose and beauty of the EAGALA model! As it turns out, this same young woman, who is usually very healthy and athletic, was experiencing some health issues that also had to do with her gut! If we had not offered the opportunity to do this unusual session, we would have taken away an opportunity for this youth to feel even more connected to her horse, realizing that she too struggled with health problems from time to time! This normalized the girl's situation as well!

In sum, if you can justify it, you can do it! The EAGALA model allows for individuals to learn and grow in a unique and beautiful way! Embrace it!

Body Activity

Recently, we did a really cool activity that could be really great for your teenagers who are dealing with issues such as body dysmorphia, or sexualized issues. You might even think of other ways to use it, so here goes!

Take your individual client out into a pasture. Ours is about 6 acres, but you could even use a really large area with forage or grass. Have the individual take their horse and show the team where their 'body' is in the grass or on the ground, as if they were lying down there. We didn't have the client label anything or put objects down to represent parts, but you could certainly try it! 


Once this is done, have the person take their horse for a 'tour'. You will want to think about what word to say. You may also want to label the horse, in this case, we labeled the horse 'guys', so that this client could take the horse around the body and decide what he could and could not eat along the way. The horse could represent bullies, friends, or others from their peer group. 



When they return, talk about what was observed, what they liked and didn't like. Did he eat? What was that like? Did you give permission for eating? Then have them go back and visit the areas they didn't visit before. Discuss what that was like. We found this to be a rather simple but powerful way to talk about ones' body, how the client views his or her body, as well as how they perceive others view their body and when and how they can/should be touched. Was pretty cool! Give it a try and let us know how it turns out!

As a really excellent follow-up, we did an activity that I saw many years ago where a flake of hay represents the body, and three buckets are filled with a bit of grain and each labeled with something the individual values (i.e. family, school, faith, friends, etc.) We then ask them to protect themselves and their values and see what happens! This one we did in the indoor arena. 

Putting these two together was really helpful! 

Help us save Braveheart!

Braveheart is a 1 & 1/2 year old miniature filly. She came here as a rescue with her dam and sire, and two of her brothers. One brother moved to Missoula to help out with an EAGALA program there, and the other stayed here in Helena, to be a project for 4H. When she got here, she was only 2 days old. The family had a crisis and had to move away immediately, and were looking all over to find folks to take their animals and give them a home. We don't take rescue animals, but in this case, we caved in. 

Such a little doll!

Braveheart was always friendly, and interactive. She was like a baby goat! She was so tiny. She was named Braveheart because she seemed to be fearless of people or things, despite her small size! After the family was here for a month, we started using them in therapy sessions. Braveheart was a natural. She was always interested in people, and would interact with them, and try to find out what they were doing. 

With her family people family!

On one occasion, a girl and her mother who were wanting to work with the horses less and less, were brought out in the arena where the minis were already roaming around. The family didn't know, but the mini's were there to help them re-engage with the horses again, so they could get back to work! Of course, Braveheart was the first to come over, and it was really meaningful to the young girl who was really touched by the little horse taking such an interest in her being there. It brought the family back to a better place. 

Braveheart was a 'big' help with other families with smaller children on the Autism spectrum. When the kids would come, they got excited about seeing the horses, but when they got close to a big horse, they got disconnected because they couldn't really see the whole horse anymore. When the mini's arrived, the children could run right up, hug and kiss them, look them in the eye, feel their breath on their little fingers, and we knew that Braveheart would not hurt them, she was happy to see them, and would whinnie and walk or run over to her new friends.

Such a good kisser!

In EAGALA, all of the work is done on the ground, it uses a lot of metaphor and relationship between the person and the horse, and the team helps the person look at things that went well, as well as anything that the person wish worked better. Often, the horse can represent other people or problems in one's life. Braveheart has represented friends, sisters, brothers, and children. She loves to play dress up, then roll all the clothes off. When families build a room or a space that represents something in their life with barrels and tarps and other materials, Braveheart is always the first to venture into the space and tour the area. On one occasion, she kept knocking things down, and the family was able to say that it reminded them of a sibling, and how they actually handle the situation in real life. At first, they thought how angry they get with the brother, but as they worked with the horse, they realized that they actually handle things well, and were working together. They felt a lot better about themselves when they realized this. 

This past summer, Braveheart started having problems with her legs. It was terrifying at first to see her dragging one of her legs. We found out from Dr. Deidre from Valley Veterinary Hospital that her knee caps weren't moving out of the way. We have tried several different interventions to include injections, oral medications, and physical therapy. Despite these efforts, she became worse. We had to start looking at the possibility that this horse might have to be put down. I couldn't imagine this scenario. Such a useful horse who has given so much to others, not even 2 years old yet, and has to be put down? Every time we made the decision as a team that we would put her down, she would do something to show us that she wasn't done. One leg or the other would look better. She would perk up and walk over to us. Sometimes she could walk or run! Earlier this week, when I was doing her PT, all I had to do is move the knee cap, and she lifted her leg up and down all by herself!

We decided to take her in and have x-rays done based on Dr. Deidre's conversations with other vets to see what might work. If there was no arthritis, and if she had grooves in her bones enough for that knee cap to move up and down, there was a surgery that might work. The results were good! She was eligible for the procedure! Then, she told us the cost. Between $3,000-4,000! I was very upset, and said that I just couldn't afford it. Dr. Deidre and Leah called back and said, "What if we do a fundraiser? Perhaps others in the community would be willing to help the little pony that has helped so many others?!"

I thought it was an amazing idea. The very next day (today!) Charlie Misra from Beartooth NBC came out and interviewed us, and the piece comes out on the new tonight! (Charlie, awesome job, looks great!) Leah has already had donations come in for this little filly, and I am just amazed at the hard work and dedication they are showing for her! I am not used to getting help like this, and I am absolutely humbled by what is happening. We made a terrible copy you can see above. As soon as a link is available on the NBC website, I will update the link!

Soon, we will announce the location of the official fundraiser, and we hope you can attend! Please help us support Braveheart so she can live a long healthy life and help others along the way! Please call Valley Vet at 406-442-0188 to make a donation today!

Horse Powered Reading

Fresh Steps EAP has a new program called Horse Powered Reading. This program can be offered on an individual basis, or in groups. Horse Powered Reading (HPR) was developed by Dr. Michelle Pickel of Cross P Ranch, who is a professor of Special Education at Concordia University, St. Paul. 

5 Key Reading Skill Areas:
Phonemic Awareness	Starts with infants, Kingergarden and into 1st Grade
Decoding	Can begin in Pre-School, and into grades 1 and 2
Vocabulary	Important both before and during school and at home
Fluency	Combining accuracy, speed and prosody
Comprehension	Not just literal, but the deeper meaning

The program combines the five key reading skill areas together with the four types of activities that can be developed using the EAGALA model. This is not psychotherapy, it is considered Equine Assisted Learning. We continue to require a therapist and equine specialist in every session because of the powerful nature of the model. 

Types of EAGALA Activities

Observation

Relationship

Movement/No Movement

Create

The horses in this case are used in many ways, to include (but are not limited to) acting as a reading partner, a character in a story, or a book, for example. Activities in groups include many pieces of play equipment that may have letters, parts of words, or complete words on them, such as cones, buckets, or balls. Each session starts with a lesson plan that describes clearly the skills to be taught or practiced, and continue with a flow during the lesson to accommodate the needs of the learners present. 

Body Dysmorphia

Body Dysmorphia is a fancy name for when a person thinks that their body is ugly.

http://en.wikipedia.org/wiki/Body_dysmorphia

As I look back, I look at old pictures of myself where I think I look really great! However, at the time of the photo, I did not believe that I looked good. I'm certain that telling someone when they are in the moment that they look good will not get through. It seems more like the negative comments have more weight than the good. Even those we trust implicitly cannot get the message through that we look good. Why? Because what matters most is what we think about ourselves. It is not about the fact that we look good or not, it is about other things, such as if we feel successful and fulfilled in our lives. This is not a common theme for young people, as they are struggling to become the complex adult they wish to be.

So, how do we get through to these young men and women? Consider Equine Assisted Psychotherapy. Feedback does not come in a judgmental form, heck, it doesn't even come from other people. There are many people across the US and abroad who are using EAP as a method for treating eating disorders and body dysmorphia (for example Selah House and Timberline Knolls).

Some of the symptoms a parent or guardian might see that are a serious cause for concern are:

• cutting on legs and arms
• excessive piercings
• tattooing
• eraser burns on legs and arms
• withdrawn
• binge eating
• no eating
• excessive exercise
• not eating with others
• hoarding food
• not touching food such as not touching food with lips when eating
• obsessive and/or compulsive behaviors around food or exercise

Often, people with these symptoms are difficult to spot, they are not necessarily judgmental of others with weight or other physical problems. They are, however, very judgmental about themselves.

An example of a session could be to observe several different horses with different weights or trouble maintaining or dropping weight. Is the individual's observation of the appropriate weight of the horse accurate? If they see the ribs of the horse, do they believe the horse is too thin? If a horse is obese, do they notice? This activity can be a gauge of what the person observes in the environment, and may be helpful later when it is time to look into the 'mirror'. Which horse do they think represents themselves the most, and what about that horse reminds them of themselves. Are these traits positive or negative?

Try a grooming exercise, and have the client observe all parts of the horse, looking for any differences in the way things look or feel as compared to other parts of the horse. Are the chestnuts observed? Are they viewed as normal, ugly, possible wounds? How connected to the horse can get client become, or are they more withdrawn and find it difficult to physically and/or emotionally connect with the horse. Who in their life to they touch? What is this touch like? What if they touch the horse with different parts of their body, such as, not with their hands, but with their knee, leg, shoulder, head? What is their perception of the horse's response to them? If the horse walks away, comes near, ignores them, picks at the ground for food? What is important is to find out what it means to the person, not what we think it might mean. These tools help us find out where our client is, where they are in their life, what they see, and how they see it. If these perceptions are skewed, better to let them see it on their own, be a guide, don't correct them, or you will only emphasize their belief that others are judging them.

I remember a great demonstration regarding body dysmorphia at the 2011 EAGALA Conference. They called it "The Beauty Pageant". They had a pony and a donkey and several suitcases full of clothing and accessories. Volunteers were asked to spend time with their equid, getting to know them, and then dressing them accordingly. They were then asked to walk their dressed-up equid around for a beauty pageant, and talk about their experiences.

Recently, we purchased some clothing and various articles from Goodwill, and have been using them with families. We are fortunate to have the miniature horses, which makes this much easier!

Recent Events

Mental health is much more complicated than is realized. Particular diagnoses do not necessarily mean that a person is unfit to carry a firearm. There exist laws to prevent purchase of firearms to youth, and therapists are always on the look for suicidal or homicidal ideation, but it is rarely seen. When it is, action is taken... immediately. 

Diagnoses could be considered labels. No one should be stuck with such a label, and no one should be treated differently because of that label. We call that ‘stigma’ and it is something those who work in the mental health community would like to eliminate. NAMI works on this particular issue. 

http://www.namimt.org/

Only a person who has committed a crime is statistically likely to be a repeat offender. We should not assume we know what a person will do based on their health or mental health, because we don't. Psychosis is caused by a variety of factors, and is often treatable, or goes away. Schizophrenia doesn't make a person aggressive toward others or not care about the well-being of others. 

Recently, we have seen two boys with Autism commit horrendous crimes. Youth with Autism are generally not aggressive, unless there is a disruption to their schedule, or if they are having difficulty communicating and become frustrated. What is often seen is an immediate destruction of property, swinging out, and often harming oneself because of anxiety and frustration. It appears to be more often seen in children/youth who are considered non-verbal. Try taping your mouth shut and your fingers together – you would become frustrated within the first day. These children live their lives in this manner. When episodes occur, they do not last long, and are certainly not including time to calculate a crime over days, weeks, or months. This suggests that this type of crime has a strong environmental element, which is the responsibility of the community to change. 

For another opinion on this important issue:

http://host.madison.com/ct/news/opinion/column/dr-kurt-newman-how-to-ensure-children-s-mental-health/article_a64d5a96-512c-11e2-8a67-001a4bcf887a.html

Make a Difference in Someone's Life

Recently, an old friend of the family, who I've known since I was a little girl, committed suicide. He left behind three beautiful girls, and I have been wondering how something like this happens. Overall, I don't know, but in this case, I had some ideas. 

My friend was always very popular, very charismatic, and well-loved. He was very talented, he could sing and play the piano very well, and we all enjoyed his playing and singing when he would share. Despite this, he didn't call anyone and ask for help. He could have called any one of hundred of people, but he didn't. Why not?

Perhaps because he was so popular, that it was difficult for him to sort through what was real and what was not. People who are famous or rich, or in the lime-light for whatever reason, seem like they have perfect lives, but I'm wondering if it's not all that great. 

I have a hard time determining who are the good guys and who is trying to take advantage of me and my family. No matter how old I get, I still get tricked from time to time. However, take the example of the famous person - there are apt to be more bad guys trying to take advantage of them than of me. On top of that, some folks may not mean to hurt another, but just want to ride on the coat-tails of someone who appears to be doing well. 

For someone who is popular or famous and suffers from mental illness, this can be very dangerous. Even with all our faculties we still have a hard time making good judgements and choices. When some of our abilities to interpret data are damaged or not working very well, we end up with the wrong responses in our behavior. This could be as innocent as thinking someone is our friend when they really aren't, or as serious as believing we are a burden to our friends and family. 

When someone pretends to be your friend, you feel pretty icky, but imagine thinking that the people who love you the most would be better off without you around? More than icky. 

If someone you know struggles with the question of whether or not you need them, remind them. If you have an acquaintance that seems different, say something. When you walk down the street, or go in and out of a business, hold the door for someone, smile, make eye contact, be nice. Those kinds of things helps people who feel lonely and depressed to question their decision about the world, and helps them see that there is good out there. You really can make a difference in someone's life. Please try at every chance you get.