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The Swedish Interest Association of Therapeutic Riding 19942014.

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Presentation on theme: "The Swedish Interest Association of Therapeutic Riding 19942014."— Presentation transcript:

1 The Swedish Interest Association of Therapeutic Riding

2 EAT influence on Function, Activity, Participation Easy to detect in practice Hard to confirm in research Hard to finance

3 In the very, very beginning Pia Tillberg (PT), Helena Sallnäs (PT), Charlotte von Arbin(PT), Rosmarie Åhlström (OT), Lena Svedberg(PT), Arja Lammi(PT), Ulrika Stengard Olsson (PT) and some others Decided to start an association…..and constituated it 14/ And they named it Intresseföreningen för Terapiridning ITR The Swedish Interest Association of Therapeutic Riding

4 Aims of ITR To support the development of equine assisted therapy

5 IRT Plans for year one 1994 Arrange a course in lounging or with a german physiotherapist Susanne von Dietze Start categorizing litterature, articles, thesis Collect information on international conferences and seminars Poster presentation of IRT at the congress for Swedish PT´s in 1995 Decide on statutes and membership Produce 3 newsletters a year for members

6 Looking in the mirror…. What happened between 1994 and 2014?

7 ….. bridging gaps and construckting bridges… Health care sectorEquine Sector Building skills and compensate for limited function Enhancing quality of life and a sustainable lifestyle ………………..for patients and for therapists

8 Building bridges ……bridging gaps ….where? Between health care sector/equine sector Between professions Between Nordic countries Under constant construction…….education In clinical everyday work and professional development

9 Persons and passions have built IRT and volontary work

10 Charlotte von Arbin GHRK Pia Tillberg, stift Hippocampus Helena Sallnäs Sven Forsling, Stall Frossarbo Ulrika Stengard Olson, Söderåsens Forsgård Helen Edwards Lutsch, Komhall/Little Owl Marie Gudmanson, Aktiv Rehab LisLott Andersson, Humlamaden Rehab Margareta Håkanson, Pegasus Arja Lammi, MIUN, Östersund psychiatry Persons in IRT created development

11 Some projects were lasting – some were not Evidence

12 A longlasting board……. Charlotte von Arbin years Ulrika Stengard-Olsson years Viktoria Wennström Kolm years Bodil Tillmann years Margareta Håkanson , years Ami Ireström years Pia Tillberg , years But here are just names….so let´s have a look at them

13 Chairmen – and founders of IRT Charlotte von Arbin – Lolo Chairman GHRK board FRDI board Classifyer Pia Tillberg initiated IRT Cashier Chairman Stift Hippocampus Project leader in several projects 2008,11,14 Teaching in the TR Education in Slovenia 18 years 8 years PT Neurology Habilitation

14 Victoria Kolm Wennström V chairman Ulrika Stengard Olsson secretary 1995 – 2010 Söderåsens Forsgård Education Ridfysioterapeut Skåne Bodil Tillmann cashier years12 years11 years PT´s Habilitation

15 Ami Ireström Social worker Certification EAT in social work Margareta Håkanson PT , v chairman Projectleader Research EAT in psychiatry 9 years12 years PT Psychiatry Social worker

16 Certification committée Ami Ireström, Arja Lammi PT Education MIUN responsible Pia Tillberg

17 Maria Johansson OT Marie Gudmunsson OT LisLott Andersson RN Pia Tillberg PT Renate Sundholm Social pedagogue Margareta Håkanson PT Present IRT board 2014 Ami Ireström Social worker

18 A short overview of IRT history Consolidation period Struggling on Development Striving with changes

19 Basic economic conditions Funding consist of membership fees Volontary work Expences have been paid for Telephone meetings, few physical board meetings Representation abroad funded externally Scarce sponsring of newsletters

20 Starting the growth……

21 Important facts Charlotte von Arbin was chairman in Gothenburg Riding club for disabled riders (GHRK) since it was founded in 1988 GHRK moved to Lunna 1994 and started a riding school alongside the therapeutic riding that was carried on GHRK and IRT have been closley intertwined Charlotte published her book Hippotherapy 1994

22 More important facts Projects for clinical development of rehabilitation were financed by the state 1992 – 96, PT´s were asked to apply for funding. ”Stiftelsen Hippocampus” with Pia Tillberg and Helena Sallnäs and ”Body Awareness on horseback” Margareta Håkanson, were financed as rehabilitation projects During the ”Dagmar money” financed clinical rehabilitation projects for PT´s and other professionals in primary care

23 what happened around us Sweden referendum on EU 94, joined EU 95 Rural policies in Europe influences Sweden from now on Finance crisis in the world Estonia sunk Personal assistance became a right in Sweden (LSS) and the care sector was turned towards focusing on patients rights Evidence based medicine was asked for and treatment without evidence was questioned from 1993/94 and onwards Projects were supposed to create new evidence

24 The Board Charlotte von Arbin PT Pia Tillberg PT Helena Sallnäs PT Rosie Åhlström OT, Lena Aztalos, PT Christina Ingvarsson PT Ulrika Stengard Olsson PT Agneta Olofsson Ehnertz OT Cecilia Karlsson OT Lena Svedberg PT PT 3 OT

25 ITR will be IRT 1995 New name – IRT Honorary membership to Kristina af Geijerstam Workshop on how to establish TR in society and in documentation

26 Consolidating IRT Education –stift Hippocampus and PT further education Uppsala Library – GHRK/Lunna International conferences – IRT Chairman board member of FRDI 1 st Nordic meeting – GHRK/Lunna Neurological Rehabilitation in focus in general in therapeutic riding Close cooperation with SEF Sports riding, para dressage riders and driving

27 What happned around us 1999? Region Västra Götaland, Region Skåne and Region Gotland were founded – the map for health care sector was rewritten, new organisations paralysed decisionmakers Funding for national rehabprojects ceased Therapeutic riding projects at psychiatric clinics in Östersund, Skellefteå and Vänersborg Heading for a new millennium

28 The Board Charlotte von Arbin PT Margareta Håkanson PT Kerstin Bergqvist, PT Lena Aztalos PT Lena Solders PT Bodil Tillmann PT Ulrika Stengard-Olsson PT Agneta Ehnertz OT, Viktoria Wennström,Kolm PT Beate SpangenPT PT 1 OT

29 Struggling on in IRT… Terminology Survey among members; education important ICF used by board members in discussions Courses for therapists were arranged by IRT/GHRK in Movement analysis, body awareness on horseback for Ann Marie Petterson, Balance in Movement for Susanne von Dietze Pollak Charlotte v A and Ulrika SO offers 100% EAT in their work IRT full member of FRDI Negotiations with different universities without results

30 Struggling on in IRT… Stretcing out towards others EU-Equus Pegasuseurope Nordic meetings 2000,02,04 Seminars on EAT in Psychosocial work and psychiatry 2000,2001 in Gothenburg and 2004 in Östersund

31 What happened around us 2004? Birdflu Olympic games and Paralympics in Athens The Tsunami in south east asia

32 The Board Charlotte von Arbin PT, Margareta Håkanson PT Marie Louise Nilsson, Spec Ped Bodil Tillmann PT, Viktoria Kolm PT, Eva Lindsjö Lindell PT Ami Ireström, Soc w, Ulrika Stengard-Olsson PT Helen Edwards Lutsch MD PT 1 MD 1 Soc work 1 Spec ped

33 Period of Development Terminology HUT/EAT is recommended University coarse MIUN 2005 First students from MIUN 2005 fulfilled education 2008 Membership qualifications changed, less PT dominance Certification 1 Susanne von Dietze courses 2005 Developing EAT in social sector IAHAIO Tokyo declaration 2007

34 Development Green care and SLU cooperation Department of Agriculture – projects National Horse Society – projects Scientific publications, articles and thesis, Scientific projects and other projects Certification of therapists 2005 BiM and 2008 IRT-certification Quality indicators for providers of facilities for EAT Ethical rules Starting to certificate members in the new system

35 2009 what happened around us Economic crisis in the world Barac Obama installed as new president – sitting on horseback as back pain prevention highlighted i CNN News in connection to this Hard new rules on sick leave in Sweden More private actors in health care sector

36 The Board Charlotte von Arbin PT, Margareta Håkanson PT Marie Louise Nilsson, Spec Ped Bodil Tillmann PT, Viktoria Kolm PT, Ami Ireström, Soc w, Lena Grip, Psol Pia Tillberg PT Maria Johansson OT Ulrika Stengard Olson PT Ida Runge, Soc w LisLott Andersson RN, Renate Sundholm, Soc w Marie Gudmundsson OT PT 3 Soc work 2 OT 1 RN 1 Psol 1 Spec ped

37 Striving on in a changing world Tuning in the certification process Multiprofessional board Professionalisation - participating in int conferens”Sittsymposium” Participating at professional conferences for psychotherapists Discussing PR strategi Discussing self employed members situation

38 What happened around us EAT courses at Malmö university and Linnéuniversity rise and fall Norwegian-Swedish education planning Projects on EAT in Dalecarlia (neurology), Stockholm (autism), Skåne (nature assisted therapy) Network building in Region Skåne IRT/Equine sector/health care sector Research projects on EAT going on in Stockholm, Gothenburg, Linnéuniversity, Linköping a o Research networks; humanistic network on human horse studies, network on sports technology, international networks, research network at ESH

39 Looking in the mirror…. From different perspectives………

40 Building bridges between professions…..

41 Equine assisted therapy Demand multiprofessional cooperation and/or multiprofessional competence On humans – with and without functional limitations On horses

42 Professonalisation Profession or occupation / exclude or preserv - working on diversity has been the Swedish choice Cerating legitimacy in two worlds – health care and equine sector, terminology, networking Research and education development

43 Work conditions influence on the process of professionalization Most therapists worked 10-20% with EAT wihtin ordinary health care employment In projects 100% working on professional issues in EAT became possible % EAT professional work at Habiliteringen in Gothenburg for IRT chairman Charlotte von Arbin % EAT professional work at Region Skåne with education and supervision as special task – 100% was offered

44 The map for work conditions changes 1994 all members are employed in the health care sector 2014 more than 16% of the members are self employed Today Health care sector is divided into public and private care Funding of care is not entirely public The patients may ask for interventions not available in the public system We do not know the effects for self employed IRT members

45 IRT – strategies for development of EAT Participate in the international development of EAT by strengthening professionalization, participate at int conf, arrange int educational courses Cooperate with the sisterorganisations in the nordic countries Develop a nordic educational programme in EAT Expanding the knowledge of EAT in the Swedish society Create standards for certification of therapists Create an ethical code Participate as official representatives and expertise in reports and investigations Internal development of IRT means and goals supporting practicians, researchers and members adjusting the access to membership in accordance with changes in society Develop IRT as an organisation Interact with society/health care/rural/equi ne sector International cooperation Nordic collaboration

46 Defining terms: Therapy and leisure riding in EAT Bad health Good health Wellness Disease Therapy FaR Adapted leisure riding Therapy Leisure riding Adapted leisure riding

47 Expanding therapeutic use A process from physical rehabilitation to preventing illness and promoting health

48 Learning and achieving skills on the horse

49 Learning and achieving skills with the horse

50 Learning and achieving skills from the horse

51 Professions represented 1994 and members PT 63 67% OT 17 18% RN 3 3 % Special ed 8 8 % Physician 1 Psychotherapist 1 Student members PT25 40% OT4 6% RN4 6% Spec ed6 9 % Social pedagogue2 Psychologist3 Physician2 Social worker5 8% Priest1 unknown prof5 8%

52 Members

53 Surveys members Survey members: what do you want from IRT? 2000 Work conditions Survey members Where do you work and how? 2004 Location Questionnaires by students How do you work? Questionnaires IRT Education in EAT and horse experience? 2006 Preparing certification process

54 Medical treatment Psycho social treatment homes Day care centres Special pedagogics P P PP H N H P Pv Pv,S H =5 H N Pv H P H VH =6 N P H =10 P Pv H N=9 P VH H VH N Pv =12 H H VH P = 17 P psykiatri H habilitering VH vuxen habilitering N neurologisk rehabilitering Pv primärvård/smärt- rehabilitering Medical treatment Survey on location of Equine assisted terapy in Sweden July 2008 Financed by Swedish Horse Society, Dept of Agriculture and Swedish university of Agricultural Sciences

55 MH09 Code of Ethics Inspired by PegasusEurope’s Code of Ethics EFMHA’s and EAGALA’s codes of ethics Completed by Swedish adjustments Multiprofessional

56 MH09 Code of Ethics An etical code aim to enhance sensitivity and understanding in therapy

57 MH09 Code of Ethics Different aspects Own profession Client Professional responsibility Horses Cooperating professionals

58 MH09 Code of Ethics Towards professional role Own professional ethical code has to be followed and respected Laws and regulations has to be considered and followed The therapist must not show false qualifications or otherwise be unserious

59 MH09 Code of Ethics Towards clients Security Goals Assessment Acceptance Physical contact Records Secrecy

60 MH09 Code of Ethics Professional responsibility Further education and training Self awareness of skills and limitations Personal intergity Security responsibility and risk assessment

61 MH09 Code of Ethics Horses Respect the horses need for wellbeing Select appropriate horses for therapy Take care of and train the horse according to age and educational level

62 MH09 Code of Ethics Cooperating professionals Give sufficient information of aim of therapy Give appropriate tasks possible to accomplish Stress etical rules and personal integrity Inform of secrecy rules

63 MH09 Development of structured education - non university education ”Balance and Movement”, international course A-D in movement analyses and treatment in EAT 29 participants fullfiled D course – IRT/GHRK structured further education in Region Skåne for PT’s in habilitation/child care 20 pt´s fulfilled

64 Development of structured education EAT – outside IRT at university level Negotiations Uppsala university Negotiations university of Gothenburg Negotiations SLU Finally things happened elsewhere Academic courses ground level , Miun,Malmö, Linné Academic courses advanced level 2014 ESH

65 Academic courses Ground level ”Therapeutic riding” Middle University College ”Use of horses in social work, 1 and 2” Malmö university college Use of horses in social work Linne university Advanced level ”Horses as therapeutic resource” 7,5 hp Ersta Sköndal university college 2014 ”Balance in movement A-D” – accepted as further education in PhD studies 2008 Gothenburg university

66 Scientific articles published Peer reviewed articles Key words: therapeutic riding OR hippotherapy OR equine assisted therapy

67 The library During the years the collection of articles went on for the library which was placed at GHRK During 2013 the library was digitalised New homepage give members only acess to the digitalised library Some books and articles will be preserved at ESH library some at GHRK

68 Building bridges between Nordic countries

69 Planning for Nordic cooperation-1995 Started already 1995 but it took long time to get contact and to find the time to get the five Nordic participants together

70 Nordic meetings 1999Sweden Terminology, education, documentation, organization 2000Denmark Guidelines for a nordic education of therapists and instructors 2002Norway Practice based research, twinriding, evidence based practice 2004Island PT therapy, education, project on patient with Parkinsons disease and the future development of nordic cooperation 2006Finland s ensory aspects on neurodevelopment, ethics, centred riding 2008no meetings…….. Ethics and a nordic ethical code was suggested 20121st Nordic research seminar at ESH, Stockholm 20142nd Nordic research seminar at ESH, Stockholm

71 Sweden invited for 2008, 2009, 2010 but did not fulfil the plans A new board 2013 decided to start the process from another angle and turned towards Norway …… and cooperation on education….

72 Building brigdes….. Health care sectorEquine sector Riders with functional disabilities Funding and maintaining educational levels for all involved Therapists Professional development Prevention and promotion Health politics Green care Horse knowledge Sports Rural politics Health politics Green care

73 IRT – Swedish Equestrian Federation Close personal relations between IRT board members and Swedish Equestrian Federation from the beginning 1994 and onwards Mutual support of parariders Development of classification systems nationally and internationally Cooperation in education of instructors for riders with disabilities Cooperation on education materials for disabled riders

74 Cooperation EU Equus IRT chairman at the ministry of sports preparing EUEquus meeting 1999 as representative for the equine sector IRT chairman involved with EUEquus seminar in Skara 2000 as representing part of the equine sector IRT chairman participate at Pet Night i Bruxelles 2005

75 Swedish Horse Society and Dep of Agriculture IRT participating in survey of therapeutic riding financed by NHS 2008 IRT part in project on certification, quality assurance and ethical code for EAT 2008 Negotiations on cooperation 2014

76 Exchange of knowledge Swedish university of Agricultural sciences (SLU) and IRT negotiation on education in Animal assisted therapy 2000 – no sucess IRT tries to lobby for special education for instructors in theraputic riding 2009 – no success IRT negotiate with Strömsholm on education for therapists 2014……

77 Under construction – education

78 2013 – a new start of Nordic cooperation…. Norway initiating a meeting with IRT in Oslo on future collaboration in education Aim – creating a higher education for therapists within the ordinary educational system available for nordic students and adjusted for working students

79 2014 Inital contact with Higher Vocational Education in Skara and at Strömsholm Meeting representatives from Norway and Sweden in June and November to plan the frames for education Planning start of education in 2016

80 ….. bridging gaps and construckt bridges… Health care sectorEquine Sector Lasting cooperation within professions and the Nordic countries for 20 years We still fight with legitimacy within the health care sector and patients acess to rehabilitation has ceased

81 Comparing IRT 1994 and plans Arrange a course in lounging or with a german physiotherapist Susanne von Dietze Start categorizing litterature, articles, thesis Collect information on international conferences and seminars Posterpresentation of IRT at the congress for Swedish PT´s in 1995 Decide on statutes and membership Produce 3 newsletters a year for members 2014 plans In cooperation withErsta Sköndahl högskola arrange Nordic Seminar in EAT Celebrate 20 years with IRT Continue the cooperation on nordic further education in EAT Support clinical work within EAT Support access to EAT Actively increase membership in IRT

82 Reflections on todays challenges Lifestyle – lack of time, sitting, digitalizing,social network on line, Few volontary workers available for NGO work Mental and Stressrelated ill health more evident than physical limitations Public finansed care is withdrawn for those with lasting functional limitations Short time economy rules public funding Diversity of new caring and coaching professions in selfemployment sector Urbanisation – and need for rural development

83 Visions for the 20 years to come EAT will be recommended as a cost effective and sustainable rehabilitation available to those who are in need Centres and multiprofessional teams will be available in most communities Nordic further education in EAT is prerequisite for therapists in the field EAT is public funded as ”best choice” in rehabilitation and prevention EAT will be primary choice in rehabilitation for persons with permanent functional limitations and for persons suffering from stress related ill health

84 The Swedish Interest Association of Therapeutic Riding Thank you for listening!


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