Presenter: Cherié Page, Ph.D. & Judy Beckett Copyright © 2014 All Rights Reserved

The objective for this presentation is to offer therapists, administrators, and others working in the field of EAAT ideas for types of programs and groups that can be created, and what agencies can be partnered with when working with Veterans and their families utilizing EFP and TH.

The most important thing we as providers can offer Veterans is respect.

Veterans and military families require their own "cultural competence.“

For those of us working with Veterans, it is important that we are up to date with current research in order to become competent in understanding this particular culture.

Listen more, talk less; allow there to be silence as it can be just as healing.

Treat them as adults who survived war, not fragile children.

Be aware and prepared that working with Veterans can present some unpredictable moments that if approached by licensed professionals and knowledgeable staff with non-judgment, quick-thinking, and flexibility, can become powerful healing moments.

As a professional it is critical to be willing and able to go to the “edge,” but not “go over” therapeutically.

Do not do this work alone, be part of a team to strategize, consult, and work together.

Many Veterans report not returning to a program due to staff talking down to them, feeling “babied,” or structure of the sessions and feeling “held back”

Avoid questions such as “what’s the worst thing that happened to you over there?” or “have you ever killed anyone?” or “are you glad to be home.” These questions can be triggering and make Veterans feel even more “different” that they already do.

Make sure volunteers are properly trained.

Be Semper Gumby!

DreamPower offers Horses for Warriors. for OIF/OEF/OND combat Veterans and has been operating since 2009.

Veterans participate in EFP with licensed or pre-licensed therapists, as well as mounted and unmounted TH.

The sit-down portion includes: a check-in, an opportunity to ask/receive support from fellow Veterans and/or a discussion about a specific topic, such as positive coping skills or sobriety, and a check-out.

The second part of the group is geared towards horsemanship, in which Veterans can choose to groom, ride, lead, or lounge the horse of their choice. If they choose to sit and just be this always allowed.

A new and exciting aspect that has been added to Horses for Warriors is eye movement desensitization and reprocessing (EMDR) as a means help treat PTSD.

In mounted EMDR a Veteran is lead by a horse handler and works with a licensed and trained therapist to bring to mind a negative cognition (thought/emotion/image) related to a traumatic event. With the negative cognition in mind, Veterans receive bilateral sensory input from the movement of the horse while engaging in talk therapy.

EMDR allows Veterans to process through unresolved trauma so that the intense impact of the trauma can be “loosened up;” allowing the Veteran to live life more freely.

The impact of trauma not only impacts Veterans but their families too. Therefore, you can offer an support group for spouses/partners of Veterans.

Caregiver retreats have also been offered by Cornerstone Therapeutic Riding Center.

Confidentiality is key. Make sure the Veterans and spouses have adequate space between them. We have found that if they can hear one another, it can interrupt the therapeutic process.

Spouses can meet in various locations: bring chairs in the hay barn or an empty stall, or meet another covered area like a gazebo or observation deck. The group can also take a walk around the property.

Some beneficial topics: mental, physical, emotional self-care, boundaries, assertiveness training, stress reduction, mindfulness, developing and sustaining relationships, and self-compassion.

Another good way to expand your program for Veterans and their families is to offer a group for children and/or teens of Veterans.

This group can be either a strictly EFP or TH, or they can be a blend.

We have found that Veterans are very grateful to have a space for their children to receive therapy as well.

With children and teens there is more of an opportunity to be creative and have fun with expressive arts and horses.

Many of the topics used for the spouses group can be utilized and or modified to fit a children/teens group.

Oftentimes Veterans are searching for something fun to do with their family.

We have found that a Veteran/Military Family Fun Day is fantastic way to attract many Veterans and their families to your program.

Cornerstone Therapeutic Riding Center offers Welcome BBQ’s.

Some things to consider: How many people can be

accommodated? What activities do you want to plan? Do you wish to have food? Do you want to ride or not?

Partnering with homeless shelters that house Veterans is another way to extend your services.

The peaceful outdoor setting allows Veterans to escape from the chaotic, crowded, and usually over-stimulating environment of the shelter where they have the space to explore difficult emotions and learn skills to self-regulate during times of stress.

Veterans are able to explore their triggers and create a relapse prevention plan, begin realize their communication style and how it may impact their personal lives, and share their life stories in a safe space.

This group can be flexible in scheduling where meetings can occur once or twice a month or on a 4- or 6-week basis.

This can be accomplished through learning how to groom and lead, learning non-verbal communication, and horse behavior.

Veterans graduating from the shelter are encouraged to attend the “graduate group,” where they volunteer their time as well as connect with other Veterans.

Key element in partnering with agencies is developing a relationship with an agency and/or its employees so that they will refer Veterans to your program.

Bringing in a flyer for your Veteran group is a good way to spread awareness of your program. In general, a person or company needs to hear your program name at least three times before they remember it, therefore, contact you.

Be aware that different Veteran populations present different issues. For example, Vietnam Veterans often have physical issues that may interfere with riding. OIF/OEF Veterans may also have physical limitations as well impulse control issues.

Veterans can be one of the most difficult and often times mystifying populations to recruit and make stick; so be patient and persistent!

It is estimated there will be 260,000 homeless Veterans this year. Staff are usually open to partnering as they are looking for additional resources and activities for their Veterans to participate in. Check out National Coalition for Homeless Veterans to connect to resources for your community

The major obstacle of working with homeless veterans is their medical fragility that stems from years of being on the streets. While they want to get on the horse and ride or walk around the arena their health can impede this desire. Therefore, plan mounted and unmounted activities accordingly.

Community mental health centers that offer services to Veterans and their families and is a great place to start. Examples: Catholic Charities, Give an Hour, Disabled American Veterans.

Some Gave All- The Joey Graves Foundation is a Gold Star family and was created in honor of their son who lost his life in Afghanistan.

DreamPower hosted a Gold Star Families for A Day, where the goal of the day was to have fun, relax, enjoy fellowship, food, and horses.

Wounded Warrior Project is another great organization to partner with to offer a day at the ranch/barn for Veterans and their families. It should be noted that they will only partner with Premier Accredited Centers.

Operation Freedom Paws, a non-profit has partnered with DreamPower to offer psychotherapy services during training and at the ranch.

Operation Freedom Paws trains veterans with disabilities to train their own service dogs.

Take a look in your community and think outside the box because there are many types of non-profits that offer services to Veterans. Consider how and what your program can offer and receive.

Family crepe paper races Ranch survivor Challenge Learn to rope Learn how to tie knots Learn to groom horses Learn to lead horses

through obstacle course Allow children to ride Family three-legged races Egg races Fun art projects

Walking races with miniature or full-size horses

Mounted/unmounted HALT (Hungry, Angry, Lonely, and Tired)

Pair with a professional licensed therapist to offer mounted EMDR

Mounted meditation/labyrinth walk Mounted/unmounted obstacle course

aimed at addressing triggers and a plan of action

Expressive Art, i.e. painting horses, decorating horse shoe in honor of loved one, writing one take away from the day they want to carry as they reach their goals.

• One crucial aspect we have learned in working with Veterans and horses is planning NOT to plan.

• Rather allow there to be space for them to “just be” and for us to be present for them.

• They may not know what they want or how to ask for it but they do know they want to feel heard, free of pain, and present, and what better place to do that than in the presence of a horse!

Ideas for Activities

Establishing a relationship with and learning to care for horses provides a calming experience where Veterans can be comfortable and present in the moment; as Veterans can be prone to high levels of anxiety this can be particularly important for their overall well-being.

Through working with horses, a

sense of security, trust, self-mastery, increased hope for their future, self-worth, and increased well being can be developed and can transfer to their everyday life, their families, and their communities.

Websites http://www.mentalhealth.va.gov/communityproviders/. This is a Community

Provider Toolkit for providers working with veterans and military personnel and their families.

http://maketheconnection.net/. A website that has resources for Veterans, family, partners for therapy, jobs, transitioning from the service.

http://www.afterdeployment.org/ - Wellness resources for the military community http://maketheconnection.net/ - Shared experiences and support for veterans https://www.militarykidsconnect.org/ - online community for military children (ages 6-

17) http://www.ptsd.va.gov/ - National Center for PTSD resources http://www.nap.edu/openbook.php?record_id=13499&page=1 - Returning Home

from Iraq and Afghanistan: Assessment of Readjustment Needs of Veterans, Service Members, and Their Families (2013)

http://www.woundedwarriorproject.org/ - Wounded Warrior Project http://www.pathintl.org/resources-education/path-intl-equine-services-for-heroes -

PATH International Equine Services for Heroes

FACEBOOK PAGES DreamPower Horsemanship California Statewide Collaborative for Military and Families Healing Combat Trauma Operation Freedom Paws Women Veterans of California BOOKS Down Range: To Iraq and Back by Bridget C. Cantrell and Chuck

Dean (2005) Counseling Military Families: What Mental Health Professionals

Need to Know by Lynn K. Hall and Mary Edwards Wensch (2008)

Walking the Way of the Horse: Exploring the Power of the Horse-Human Relationship by Leif Hallberg (2008)