Therapeutic Riding as a tool for the renewal of the Rehabilitative Project

When speaking of Rehabilitation, a distinction must be made between the two methods: Technical Rehabilitation (R1) and Social Rehabilitation (R2) (Papini, 1996). The aim of R1 is to reduce to a minimum level the degree of functional incompetence which is typical of disability. This is achieved by employing specific rehabilitative approaches. R2 focuses on reducing the problems deriving from the handicap. Therefore, it essentially deals with the problems of symbiosis, viewed as the basic nucleus of thought and of behaviour on the part of the disabled and of the family. The rehabilitative approach that best grasps and supports the healthy characteristics of the subject belong to a particular type of Rehabilitation: Integrated Rehabilitation (Papini, 1996). It exploits the elements of spontaneous healing which are present in the environment and is achieved when rehabilitative measures employed for the disability (R1) are included in activities also undertaken by normal subjects (R2), thus making it possible to integrate these measures. From this point of view, Therapeutic Riding (TR) proves to be especially effective because it takes place in a non-medical setting, albeit highly professional. This provides for a totally correct form of rehabilitation (R1) and at the same time makes it possible for the disabled to guide the horse, to move in space by means of the animal and to actively engage in a relationship with others (R2). The subject, especially if an adolescent or young-adult, can thus embark upon a process of self discovery, at times achieving unexpected results in terms of adaptation and independence which can even lead to possible work opportunities. All this entails careful and complex work on the part of the TR professionals (TR Team which includes a Specialized Physician) (Pasquinelli, 1996) in order to avoid triggering a variety of hidden dynamics of expulsion (problems of scheduling, fatiguing the subject, excessive economic burden etc) aimed at interrupting TR so that the family may reaffirm its control over the subject. Another feature that should be taken into account is the degree of anger in the disabled adolescents who often contrast and reject all educational and social proposals in a vain attempt to reaffirm their identity: TR offers an informal approach, reassuring professionals, with a sports connotation. All this may encourage the subject to accept being helped (“to make use of it”). Disabled adults must not be forgotten. They are often crystallized within a dimension where there are no objectives or significant relationships: besides being an effective form of rehabilitation, TR can offer these subjects an opportunity to create authentic relationships and to prove to the family that they are capable to deal with new experiences. A different context, but no less difficult, involves seriously-affected subjects where the rehabilitative project clashes dramatically with the seriousness of the pathology. Quite often this condition is followed by “giving up” attitude on the part of everyone involved. In such cases, TR is one of the few effective alternatives: the results, at times quite marked (Pasquinelli et al, 2003), lead to new prospects for the family. Consequently, family members as well as the professionals are willing to reinvest in the child (Allori and Pasquinelli, 2001). The complexity of the situations, the consideration of the evolutive passages (disjointed from actual age of the subject), the possibility of regression and recovery, suggest a period of time not inferior to 1-2 years to renew TR rehabilitation, while another 2-3 years are required for consolidation (Allori et al, 2006). Examples of clinical cases involving a renewal of rehabilitation at different ages and in different conditions will be presented.