Safety
Helmets
It is required that when a client of any age is around or on the horse that they wear a helmet as a safety precaution. It is important that the helmet be an equestrian helmet that is SEI certified. SEI (Safety Equipment Institute) is a set of standards and safety regulations for helmets and other safety equipment. If the rider falls and hits their head with the helmet, then the helmet is no longer considered safe. For very young clients or clients with postural instability causing the added weight of a SEI certified helmet to increase head instability, lightweight helmets may be substituted if in the judgment of the therapist a lightweight helmet is better and safer for the client.
​
Grab Belts
Gait belts are also important for clients to wear when they are around or on the horse. It is useful for helping the client transfer on and off the horse as well as staying centered while they are on the horse. They are also important to help with emergency dismounts if needed. There are different types and sizes of belts available depending on the needs of the client. Belts designed for equestrian use are not typical gait belts. Grab belts usually have one or two handle loops to provide therapists and sidewalkers a quick and easy place to grab in case of an emergency or to assist in movements, change of position or mounting/dismounting.
​
Sidewalkers
Sidewalkers are very important in hippotherapy for maintaining the safety of the client and assisting the therapist while clients are on the horse. Typically there is a sidewalker on each side of the client next to the horse who is in constant contact with both the client and the horse. Clients may require fewer sidewalkers or varying amounts of support depending on their needs and the treatment activity. Sidewalkers must go through training before they can participate in the treatment session. During the training, they learn about the hippotherapy and various methods to keep the client safe and support the therapy goals.
​
Safe Footwear
Sidewalkers and any other person, including parents or family members involved in the treatment or present in the arena, must wear shoes or boots that cover the feet completely, no sandals, open toes, or flip-flops are allowed in the arena.
​
Leaders/Horsehandlers
The horse handler is an essential part of the treatment team and makes it possible to use the horse in a therapeutic setting. The leader leads the horse throughout the session, following instructions from the therapist on speed, gait, cadence, and direction. They also play an important role in ensuring the client’s safety throughout the session. They must go through leader training to learn about hippotheraoy and related horse handling skills. It is important that the leader has demonstrated significant horse handling experience and has received specific training in leading for therapy before they participate in the hippotherapy treatment session. Depending on the training of the horse and the skill and experience of the horse handler, horses can be led from a halter and lead rope, a bridle, bit and reins, or can be long-lined/ground-driven (from behind) during a treatment session. Long-lining/ground driving is often a better method of handling a horse in a therapy session as the horse receives clearer signals, is often happier, straighter, and moves in varies/grades movement better than when led from a halter or bit from beside its head. Long-lining/ground driving a horse is an advanced skill that is not safe to attempt in a therapy session without specialized training of both horse and horse handler. A light whip of length appropriate to the horse handling methods listed above can be used to touch, cue, and communicate with the horse and is never a tool for punishment. Sometimes it is important to explain the use of a whip to non-horse people who observe hippotherapy and do not understand its appropriate use.
​
​
Transfers
Transferring the client on and off of the horse during a hippotherapy session can be challenging, depending on the client's abilities. Often, it is best to use a mounting block in the ring where the session will take place. Before transferring the client onto the horse, the therapist must ensure that they are wearing both an appropriate helmet and grab belt. There should be sidewalkers on both sides of the horse to help with the transfer and to ensure that the client is safe. If the client uses a wheelchair or has other physical impairments, a ramp may be necessary for the transfer. The horse must be properly trained and comfortable with being confined between the two sides of a ramp and the ramp transfer prior to the session. Also, everyone on the treatment team must understand how to use the ramp for the transfer. Lifts may also be used with the ramp for transfers. Again, the therapist (with possible assistance from a riding instructor as a partner to the therapist) has the primary responsibility to ensure that the treatment team and horse are comfortable with the transfer prior to the hippotherapy session.
Horses
Hippotherapy horses are specially trained horses that are used in the treatment process. They must go through an extensive amount of training and desensitization to common treatment activities that are different from normal horse experience before they are used during the hippotherapy session. Even though the horses are trained and selected for hippotherapy, everyone working with or around the horse must take safety precautions at all times. The therapist does not need prior experience with horses to provide this type of treatment to clients however, there needs to be at least one person on or supporting the treatment team who is knowledgeable about horses and certified as a riding instructor (if the treatment occurs in a PATH accredited site). The client and the horse must be under the supervision of the therapist at all times. If the client demonstrates negative behaviors around the horse that compromises the safety of the horse, client, or team member, then the therapist and client can work on their behaviors in a separate area away from the horses until the client is better able to manage behaviors. If the horse demonstrates negative or unsafe behaviors, the client should be removed from the horse immediately. Safety for all involved is the most important consideration during the hippotherapy session.