Back in the Saddle: Part 6 – Occupational Therapist

I didn’t intend to have a gap between posts in this series, but the past five weeks have been BUSY. Our older daughter graduated from high school at the end of May. This celebration was followed by the associated parties, end-of-the-year awards ceremonies, preparations for both girls to spend a week at Young Life Camp, an anniversary road trip with Travis, my mom’s move across town, college orientation, and an increase in my involvement as a volunteer at Cincinnati Therapeutic Riding & Horsemanship (CTRH). I chose to temporarily slide this series to the side, but it’s great to be back!

Throughout this series, I’ve used equine therapy as a general term, but Therapeutic or Adaptive Riding would be more appropriate for the activities described in the previous posts. You may also be familiar with equine-assisted therapy and hippotherapy. The terminology used depends on the focus of the specific activity and who is involved.

Hippotherapy is therapy to treat neurological, physical, cognitive, or communication deficits in which a patient (as one affected by cerebral palsy, stroke, autism, or multiple sclerosis) sits or lies on the back of a horse for the therapeutic effect of the horse’s movement.


Some of you may know there was a time when I worked as a Certified Athletic Trainer. I practiced alongside physical and occupational therapists in an outpatient orthopedic clinic while also providing medical coverage during high school and professional athletic events in the evenings and on weekends.

Many years later, while volunteering at CTRH, I heard there was a need for sidewalkers to help cover the hippotherapy sessions. I couldn’t wait to get involved, and I loved working with the two occupational therapists who had combined their love for horses and their passion for helping people as health care professionals. Please join me in welcoming Lauren Bosse to the blog.

Hello, Lauren. Thank you for talking with us today about hippotherapy from an occupational therapist’s perspective. Which came first, your occupational therapy (OT) degree or certification as a PATH Intl. Certified Therapeutic Riding Instructor (CTRI)? What led you to combine the two in this particular setting?

I was an OT first, then I started volunteering at Cincinnati Therapeutic Riding. It was a smaller organization at the time, very welcoming, and inclusive. I always loved horses and enjoyed working with people with special needs. 

PATH Intl. guidelines require an instructor to be present during hippotherapy sessions. I decided to become a CTRI so I could teach classes. In doing so, we could practice hippotherapy without needing another instructor present.

How do you design/plan a session? What does a typical session look like?

Generally, I follow the same pattern. We warm up and then walk around the perimeter of the arena. I incorporate some varied patterns in motion, then include an activity or two that might challenge the rider’s motion. The exercises also work on their fine motor, cognitive, and balance skills. Walking outside, around the property on horseback, is the best for motion on a varied terrain and helps with sensory integration.

What has been the most rewarding experience/memory since you’ve started your career?

My favorite part of the job is when a client really responds to therapy and has a great time riding. I see improvement in their balance, posture, and confidence. One mother said that her child would try out more of the playground equipment after riding. Another mother said her child was much calmer for the weekend after riding. It’s very motivational.

What is your least favorite part of your job?

Some riders don’t respond as well behaviorally or physically, and that can be challenging. 

From an instructor’s perspective, what benefits does hippotherapy offer a rider? A rider’s family?

Riders will show improved balance, posture, and breathing. Sometimes they may show improvements through speech, cognitive and sensory skills. They often have an increase in motivation. It’s empowering for that rider, and the family appreciates this. 

Do you have any tips or tricks you’ve found helpful when working with riders who may be uninterested, noncompliant, or scared and nervous?

Repetition of routine and activities usually helps so the rider knows what to expect after the first couple of sessions. We try to find toys or activities that are comforting and not overstimulating. Unfortunately, sometimes nothing works.

Is there anything else you’d care to share with readers?

I think there are great opportunities for research in this field that would encourage increased insurance coverage and allow more people to participate.

Yes! While hippotherapy/equine therapy is considered experimental and investigational by some insurance providers, I have witnessed riders gain a variety of physical, emotional, and social benefits through participation in such a program. Unlike traditional therapy sessions through which a patient works with a therapist, equine therapy and hippotherapy require a team of people to care for both the rider and the horse.

The enthusiasm and training of horse leaders and side walkers are key to the success of a session. We couldn’t do hippotherapy without them!

This is great, Lauren. Thank you once again for sharing your unique perspective. Next week, we will talk with the mother of one of the riders about the benefits of equine therapy from the family’s point of view. Thank you for reading!