Spring Reins of Hope is an EAGALA model program in NY and NJ that offers both EAP (psychotherapy) and EAL (equine assisted learning). This presentation is of a class called Horses for Healers Workshop that was piloted with UMDNJ Medical students in Spring of 2012. Horses are masters of nonverbal communication and are great teachers of how subtle it is that we communicate safety or non-safety in our patient relations. This workshop is effective, experiential, memorable and fun!

1. The Horse Medicine Wheel
UMDNJ
Horses for Healers Workshop

2. 75% of patients complain that their medical
providers do not communicate well…
How is your bedside manner?
High GPA, but low Press-Ganey survey scores?
• The Horse Medicine Wheel / Horses for Healers Workshop is
specifically designed for healthcare professionals. At Spring Reins
of Hope (SROH) we are very happy to have the opportunity to
offer this workshop to UMDNJ Students!
• Because health science education stresses intellectual excellence,
much less attention is placed on proficient communication, both
verbal and non-verbal. Enhanced communication increases patient
satisfaction which improves therapeutic outcomes and reduces
malpractice claims [Stanford Medicine & Horsemanship, Kane,
2007]
• Learning to interact with horses helps us to become more aware of
our non verbal skills. With this enhanced self awareness we gain an
appreciation for all the messages we send and receive as it asks for
patience, gentleness, self-confidence, sensitivity, and focus.

3. SROH’s offers customized exercises enlisting
horses to help medical students with:
• Improved ability to establish immediate rapport and communication
with patients
• Enhanced bedside manner and an improved understanding of your
non-verbal messages (social skills based on a calming and safe body
language)
• Confidence building and greater awareness of your presence
• Manage time constraints with patients AND develop a
consistent/valued rapport
• Learning why congruency / consistency are desirable for patient
relations?
• Defining appropriate boundaries both physical and professional
• Identifying patterns of interaction based on the reactions elicited from
the horses and observing how that relates to both professional and
personal identity.

4. Spring Reins of Hope, Getting to the Horse of the Matter
UMDNJ Horses for Healers Workshop, Spring 2012
Photos by Dr. Shari Silverman, VMD (Simply Sound Horse)
Horses are prey animals and are experts are reading body language, in the wild their lives depend on an
accurate reading of intent and safety…we asked the students to approach their NEW patient and to
relay based on the horses reaction whether they were sending “safe / secure” messages with their
body language.

5. Spring Reins of Hope, Getting to the Horse of the Matter
UMDNJ Horses for Healers Workshop, Spring 2012
Human patients actually read body language too, and subconsciously or somatically feel the same warnings or safety that
the horses do, the difference is we humans have been conditioned to behave a certain way so if we don’t feel safe in our
doctors’ (or practitioners) care we aren’t going to rear and run out of the room…even though we might want to!

6. Spring Reins of Hope, Getting to the Horse of the Matter
UMDNJ Horses for Healers Workshop, Spring 2012
Photos by Dr. Shari Silverman, VMD (Simply Sound Horse)
Approach your patient and get as close as you BOTH feel safe to do so. As you approach what is happening? Where is
your focus? Are you breathing? Are you thinking about this patient, or the laundry list of life?

7. Spring Reins of Hope, Getting to the Horse of the Matter
UMDNJ Horses for Healers Workshop, Spring 2012
Photos by Dr. Shari Silverman, VMD (Simply Sound Horse)
Often times a doctor or nurse must ask a patient to follow them, or to follow a treatment plan and basically you are
strangers. Wouldn’t it seem to set up for a better outcome if your patient could understand (feel like) their best interests
were at heart? Seems that it would make the road to recovery an easier path to trust and walk by…

8. Spring Reins of Hope, Getting to the Horse of the Matter
UMDNJ Horses for Healers Workshop, Spring 2012
Photos by Dr. Shari Silverman, VMD (Simply Sound Horse)

9. Spring Reins of Hope, Getting to the Horse of the Matter
UMDNJ Horses for Healers Workshop, Spring 2012
Photos by Dr. Shari Silverman, VMD (Simply Sound Horse)
Sometimes it will take a little extra effort and patience to establish that “trust” with a new patient but think of how much ground is
covered once that is present. Malpractice claims certainly will be lessened because most cases come back to the patient not
feeling secure or that their situation was not most important to their health care provider. If you take the time in the beginning to
establish rapport and trust, there wont be as room for the doubt later.

10. Spring Reins of Hope, Getting to the Horse of the Matter
UMDNJ Horses for Healers Workshop, Spring 2012
Photos by Dr. Shari Silverman, VMD (Simply Sound Horse)

11. Spring Reins of Hope, Getting to the Horse of the Matter
UMDNJ Horses for Healers Workshop, Spring 2012
Photos by Dr. Shari Silverman, VMD (Simply Sound Horse)
Most of the time at the workshop is spent in the arena with the horses, but we do take time out to eat
(blood sugar) and lecture about the nature of body language and how and why horses are so
good at it!

12. Spring Reins of Hope, Getting to the Horse of the Matter
UMDNJ Horses for Healers Workshop, Spring 2012
Photos by Dr. Shari Silverman, VMD (Simply Sound Horse)
Part of the workshop is set up as a clinic atmosphere, where every patient you see is an unknown case. We asked medical
students to pick a horse from the “waiting room” and get the patient into the “exam room” where they had to keep it there
long enough to take vital signs, basic information, and observations. All of this is done without talking verbally – we rely far
too much on vocals anyway. Very interesting to see what we notice when not talking.

13. Spring Reins of Hope, Getting to the Horse of the Matter
UMDNJ Horses for Healers Workshop, Spring 2012
Photos by Dr. Shari Silverman, VMD (Simply Sound Horse)
We set up “Care Stations” where students worked in teams of 3 on a horse to determine what items could be
needed to care for their 4 legged patients and to assess based in the horses body language whether their choices
were working…or not. This exercise helps to teach the students how to notice nuances from their human patients
body language which does not always match the verbal, so it can be very important to notice.

14. Spring Reins of Hope, Getting to the Horse of the Matter
UMDNJ Horses for Healers Workshop, Spring 2012
Photos by Dr. Shari Silverman, VMD (Simply Sound Horse)
We asked students to “Send the patient away from them” without making a sound. NO verbal, NO noise. This illustrated very
flamboyantly that it really doesn’t take much to create an unsafe feeling with body language cues…SROH’s sensitive TB
mare flew around the arena AWAY from each student…

15. Spring Reins of Hope, Getting to the Horse of the Matter
UMDNJ Horses for Healers Workshop, Spring 2012
Photos by Dr. Shari Silverman, VMD (Simply Sound Horse)
Next we assigned a different task to each student to approach the same horse/patient with and get as close as they BOTH felt safe
to each other (again this was set to accomplish with NO verbal and NO noise, just physical communication). In this photo, the
student’s task was to “offer the patient a drink of water” – the horse didn’t drink, but was safe to come close enough to receive
the “offer”…

16. Spring Reins of Hope, Getting to the Horse of the Matter
UMDNJ Horses for Healers Workshop, Spring 2012
Photos by Dr. Shari Silverman, VMD (Simply Sound Horse)
Group processing / discussion time with SROH Facilitators – Christianna Capra “CC” (right) and Dr. Maria Katsamanis, PsyD
(left).

17. Spring Reins of Hope, Getting to the Horse of the Matter
UMDNJ Horses for Healers Workshop, Spring 2012
Photos by Dr. Shari Silverman, VMD (Simply Sound Horse)
Establishing a rapport with a new patient sometimes will require some creativity. Horses just like humans are sensitive beings and
have their own personalities, fears, and quirks…what works well with one may not work at all with another. Part of being skilled
socially with your patients will come back to being present/engaged and “seeing” what might work for a particular patient.

18. Spring Reins of Hope, Getting to the Horse of the Matter
UMDNJ Horses for Healers Workshop, Spring 2012
Photos by Dr. Shari Silverman, VMD (Simply Sound Horse)
Another part to thinking creatively for your patient outcome is to be able to adapt and utilize the resources available to you.
In this case we asked the students to get a horse/patient to follow them to a box pen, without any “equipment”.
Requiring a need for establishing trust (so the patient will follow) and creativity to travel from A to B…

19. Spring Reins of Hope, Getting to the Horse of the Matter
UMDNJ Horses for Healers Workshop, Spring 2012
Photos by Dr. Shari Silverman, VMD (Simply Sound Horse)
It becomes really beneficial when you can combine creativity, available resources and the assistance of another
professional! When a patient has a team of medical professionals who are all focused on creating a safe, conscience,
proactive and focused regimen – that has to feel empowering. Doctors and Nurses do this anyway by nature of the
business, however this concept would go a long way if it became centered upon a very open, communicative and
trusted rapport.

20. Spring Reins of Hope, Getting to the Horse of the Matter
UMDNJ Horses for Healers Workshop, Spring 2012
Photos by Dr. Shari Silverman, VMD (Simply Sound Horse)
Our group from UMDNJ became so skilled at conveying safe and inviting body language skills we had time to end the course with a
really great and fun team-building exercise called “Connected Obstacle Course” where all humans and all horses would need to
be connected in some way while traversing an obstacle course, IF at any point the connection gets broken, we have to start
over. We did allow verbal skills to be utilized on this one!

21. Spring Reins of Hope, Getting to the Horse of the Matter
UMDNJ Horses for Healers Workshop, Spring 2012
Photos by Dr. Shari Silverman, VMD (Simply Sound Horse)
Group photo – SROH Facilitators and Horses, ten students from University of Medicine and Dentistry of New Jersey’s 3rd and 4th
year medical school who attended the Horses for Healers pilot workshop in April 2012!
Thank you to UMDNJ – Dr. Tobia, Dr. Katsamanis, and the Students!
We look forward to a new class in Fall 2012!

22. Spring Reins of Hope, Getting to the Horse of the Matter
UMDNJ Horses for Healers Workshop, Spring 2012
Photos by Dr. Shari Silverman, VMD (Simply Sound Horse)
What some of the students had to say:
“I expected very little, but I got a lot more. I had fun and learned so many points that I will definitely
incorporate into my own patient encounters.” L. Lee (4th yr MS at UMDNJ)
“This workshop exceeded my expectations, I learned to be more aware of my presence and how it can
affect the horses/patients. A calm approach tended to have the horses more still and allow you to get
closer. I think more time should be spent with the horses!” J. Marmol (4th yr MS at UMDNJ)
“I found the difference between taking a moment to focus on the patient and remaining calm can be
huge in how I am received. Also paying closer attention to the non-verbal ques I am sending changes
how my patients will receive my messages. I would like more time with the horses and less on lecture!
We also learned a lot about team-work.” J. Wissocki (4th yr MS at UMDNJ)
SROH Welcomes Inquiries from Medical Schools,
Hospitals and Private Practice…the bedside
manner you will learn from a HORSE…
will not be easily forgotten!