Questions about NARHA/ PATH certification, costs of hippotherapy versus therapeutic

[Tbrown28]

Oh gosh, I’ll try to keep this organized, my head is swimming with questions.

At present, I am teaching at small riding academy in Northwest Georgia. Mostly dressage, a little hunter eq. This isn’t my full time job nor my career, but I adore the kids I teach and the horses I work with. We’re relatively new to the area, only about 50 students enrolled at present, but we have a board of directors keen on expansion. I volunteered to research avenues into therapeutic riding, mostly because I have a keen interest of working with a range of anxiety and social disorders. I am very empathetic to PTSD, and in particular would love provide outreach to teens and returning veterans. I’ve got a real knack for keeping people and horses calm. I have several friends who have approached me, questioning me about therapeutic riding…and I dunno, feels like an avenue I need to investigate.

The little bit of reading I’ve done this morning is already daunting. While I understand the differences between TR and HT, I am pitching this proposition to a board of business men. Ergo, I have to ask, which is more lucrative? Which is a more feasible avenue to pursue starting from the ground up?

To my understanding in TR, the bare minimum of handlers in the ring must be two: a certified instructor, and a licensed OT, COTA, or PT, correct? And possibly handlers depending on the rider’s needs. Do handlers need to be certified as well? Or can they be adult volunteers? I understand at least one handler must be present for HT, but those are strictly one on one sessions.

PATH? NARHA? Are they the same? Are there other certification organizations? Cost wise, what am I looking at to pay for my certification? How do barns handle paying the therapist on site? Need to iron out all these pitches before I address my board friday. Any other useful tidbits or voices of experience would be greatly appreciated! : ) I’m not married to this idea, but it’s certainly an avenue I would like to investigate.

[betsyk]

Hi - there are no really quick answers to your questions, and I’m at work this morning and shouldn’t be typing a big long post anyway. You’ll learn the most and get answers to a lot of your questions by calling a couple of PATH (formerly known as NARHA) programs near you and asking if you can come visit and meet with their director. Watch lessons and hippotherapy, ask lots of questions. (bring chocolate or something nice for the person who takes the time to meet with you!) Read and reread all of PATH’s website first - most of the information is really there, it’s just a little obscure sometimes.

The process to certification of a program and its staff, from the ground up, is going to take several years and a whole lot of money. Investigate this like any other business plan and realize that most programs are nonprofits - they’re not in it for the money and most operate on a very, very tight budget just to survive. A for-profit model is a much less common way of doing things and will require more digging on your part to find others who have done it successfully.

[Tbrown28]

Yes the PATH website is a little obscure, which is why I was hoping for simplified answers from you fine COTH people. I did some research into this back in 2010, but I saw at the time it was impressively expensive for my budget and I was already enrolled full time in college. Now I am in a position to have a little more time and funding, and I can see a lot has changed since I did my initial research here. We are currently a 501 c(3) non profit, doing okay with our riding academy, but as you say it’s tough, and we have no met our financial goals for the last few quarters. I expressed in our last board meeting this was a long drawn out process, financially and time wise, but you know business men, they want numbers, charts, spread sheets and pie graphs. I’d like to hear from active centers that don’t mind divulging the cost of making their barns accredited centers, and overall how much instructor/ therapist certification cost through PATH intl. (because on the site now, I’m seeing roughly $600-$800? for instructor certification?) I swore when i researched this years ago certification was running upwards of $3000. You know, just curious : ) Thanks for the quick response while you were at work btw!

[charismaryllis]

haven’t been a member for years, but i can at least tell you that the outfit i volunteered for absolutely ran on volunteers. leaders and sidewalkers were all volunteer, mostly teen-aged. i think they hired a couple of muckers a few days a week, but all the rest of the horse care was done by volunteers. the barn would occasionally get a community service kid; they generally did painting/maintenance work. (well, except for the time one of my riding instructors got caught doing 80 in a 55 on his motorcycle and was sentenced to the TR barn; he shoveled LOTS of stalls for three weeks. )

i can also tell you that many of the clients at that barn had their therapy covered by insurance.

[equinekingdom]

I am recently PATH certified - in November 2012. Yes, certification cost is based on where you take your certification course. Find a stable locally that is hosting the clinic, it’s usually a four-day-long time, with actual certification being the last day.

First you have to become a member of PATH (sign up online), then you can sign up to become an instructor. Once you’ve started the process, you get the material, read it, then you have to take two online open book tests about their standards and whatnot.

After you’ve done your tests, you take your internship, so to speak, with a therapeutic riding program - you teach and learn under a mentor that is already a PATH certified instructor. I had it easy becuase I got to work with a place I already knew a lot of the people well becuase I’ve known/worked with the facility for a long time. The other place close by that I tried to contact refused to return my calls and ignored every attempt I made to build a relationship.

You have to have a minimum of 25 hours of volunteer teaching in, teaching at LEAST two people in a lesson - it MUST be group lessons. Private lessons don’t count, and you have to have a certified PATH instructor sign off on your hours. I ended up with something like 30 hours by the time I was done.

Once you’ve finished your hours, you can take the clinic/certification. I will say it is EXTREMELY helpful if you already have riding instruction experience and are a good teacher. Also if you’re a good rider. Their failure rate is over 60%. Out of the 13 people that tested at the clinic I took, only 5 passed. There is a riding test that you have to do that’s fairly involved. You also have to pass a riding instruction test.

It’s very involved, but incredibly rewarding when you pass and get your certification.

Once you have your cert, you have to have 25 hours of continuing ed classes or qualifying sources each year to maintain your certification. There’s lots of options for that too.

Very involved, but again, rewarding.

[VaqueroToro]

I volunteer for a program with one PATH certified instructor – that program also runs entirely on a volunteer basis. Depending on the student, it can take up to three volunteers plus the instructor. Getting instructor status is the first step. A lot of companies won’t even offer you insurance to cover working a therapeutic program at a barn unless you have a PATH certified instructor running it.

Your $600 - 700 price tag to do the instructor certification is in the right ball park, depending on certain factors. You need to become a PATH member ($60) before even starting the process. If you fail one of the online tests (there’s two total), you need to pay to take that again. You have to carry current Red Cross certification in First Aid and CPR, so that might cost you for a class. That’s all part one.

The $600 - $700 is for the workshop/certification class itself – that’s part two. That doesn’t cover the cost of travel/hotel stay if you must travel to a PATH site for that – it’s a three day workshop with one day for the certification itself. If you fail the certification, you have up to a year to redo it (but I think they absorb the class costs the second time, just not the travel expenses).

I attempted but failed the certification – it was easily the most stressful situation I have ever faced. They are very stringent in the evaluations, but that is a very good thing for all involved.

[equinekingdom]

oh yea, i forgot the CPR/First aid qualifications…

[betsyk]

I’ll add a couple other thoughts related to the program side of things. A high quality program needs regular, consistent input from a therapist, ideally a team of therapists, who KNOW hippotherapy. That means you need to look at costs for training your therapists and getting them certified as well. You may only have a small hippotherapy program, or no hippotherapy program, but your therapists will provide input to your instructors in working with your more complicated and challenging participants. Especially if you have a horse background and not another professional credential in PT/OT/Speech/special ed/MFT/social work/whatever, you will need input from other professionals in order to do this job really well. And those professionals really need to be INVOVLED with your program. It really doesn’t work to have them as occasional consultants or casual volunteers.

Insurance, in our state, pays nothing. Other state funded sources of support have also dried up. You will most likely need to plan for direct pay by families, and/or scholarship support funds raised by your program.

Startup costs for the facility - read the Standards manual. Much of it is worded rather vaguely but some things are quite specific. You don’t need state of the art hydraulic lifts at your mounting ramp, but your mounting ramp needs to be up to standard, and there are some other requirements for mounting areas, arena fencing, etc. Look at your facility with an eye toward accessibility. Even if you plan to focus on the EFMH side of things (I probably have the wrong term, they keep changing their acronym) you want your facility to meet ADA standards because of the message it sends. That person with PTSD may also use a wheelchair.

If you are currently a 501©3 organization, you probably do some fundraising. PATH has all kinds of information about selecting boards of directors. United Way may be a good resource, too. An informational interview with your local United Way may give you an idea of the fundraising climate in your area. Basically, can you raise the money to fund your program in your area, and how do you find the board members who can make it happen for you? No program should ever, ever, EVER be a one-person show. The better the team, the better the long term health of the program.

Look at PATH accredited center websites. Some may have their annual reports posted. Look at lots of different centers of different sizes, in communities like yours and different from yours. The days of a 4H leader and a special ed teacher getting together to offer a few lessons to the neighbor kid with Down syndrome are over… our program started that way 30 years ago but you couldn’t do it now!

[hca86]

[QUOTE=Tbrown28;6844178]
The little bit of reading I’ve done this morning is already daunting. While I understand the differences between TR and HT, I am pitching this proposition to a board of business men. Ergo, I have to ask, which is more lucrative? Which is a more feasible avenue to pursue starting from the ground up?

To my understanding in TR, the bare minimum of handlers in the ring must be two: a certified instructor, and a licensed OT, COTA, or PT, correct? And possibly handlers depending on the rider’s needs. Do handlers need to be certified as well? Or can they be adult volunteers? I understand at least one handler must be present for HT, but those are strictly one on one sessions. [/QUOTE]

I quoted the above as from reading this I still think there is some confusion. Therapeutic riding (TR) is adaptive riding. What is required are instructors, PATH registered if you become a PATH premier center and volunteers/horse leaders. I find it really important for these instructors to really know how to teach riding and how to work with a variety of disabilities. This can be groups, privates (one-on-ones) etc. in all disciplines of riding. Remember this is riding, not therapy.

Hippotherapy (HPOT) is therapy on the horse provided by an occupational, physical, or speech therapist. This is just one specific intervention tool that can be used as part of their scope of practice. You will need volunteers or paid horse staff depending on how you want to run it. In my opinion, if you go this route you need to hire a therapist with experience using HPOT as a treatment strategy to build this program. A therapist needs to build a therapy clinic (including using hippotherapy) as they went to school for this. I see no problem you overseeing the center in terms of horses, volunteers, etc. You will be in the health care field this way, so no need to go non-profit, however, again a therapist with experience billing insurance companies needs to be doing this.

Where in NW Georgia are you? A well know American Hippotherapy Association Faculty member lives in that area and I have worked with her for a while. She could help you more if you have questions from a local perspective.

[findthedistance]

hca86 has given you good information on the difference between TR and HPOT. Our program does mostly TR and has recently begun offering HPOT. For a variety of reasons, the therapist has her own LLC and contracts with our nonprofit for use of the facility/horses/volunteers/access to an instructor. She has a background with horses and is very good at her job, so we decided to take a chance and let her pilot a program while she works on her AHA certification. She bills for HPOT at her standard therapy rate, and a session generally includes both mounted and unmounted work. Our rate for TR is $50/private 30 min lesson, which is on the low side of the going rate in my area.

If you are more interested in the mental health side of things, the EFMHA and Epona models are pretty mainstream. That’s a different skill set from TR or HPOT, and outside the realm of my knowledge.

Another potential revenue stream would be vaulting… either able-bodied or therapeutic. Finding the right horse could be tricky (or maybe it’s already in your barn), but one horse can serve a lot of participants in a single session, so the fixed costs are in your favor.

[hca86]

Findingthedistance’s suggestions for how her program has a therapist come in and offer therapy is a great way to start. I currently do the same thing, work through an agency (not my own LLC so I don’t do the billing, my agency does) as an independent contractor and come use the facility/horses/volunteers. The agency I work for pays a flat fee for each hour I am at the therapeutic riding facility (includes horse and facility use). This is a nice addition and a safer approach I feel, plus you can do primarily therapeutic/adaptive riding and have this as an additional.

Remember, you need a really good therapist, one with horse skills (really understands the horse’s movement). Starting off as a new facility, a therapist you want to hire should plan or already taken some of the American Hippotherapy Association courses, did graduate level work using hippotherapy as a treatment strategy, and/or worked previously with faculty members of the American Hippotherapy Associations. Feel free to ask me about my perspectives of being a therapist coming into a center and I bet findthedistance will also have a great perspective from the other side as well.