By Melissa Jackson
BBC News Online health staff
The old adage "never work with children and animals" has been swept aside by medical experts who have used horses to help child cancer patients.
Children and horses became best of friends
The children, who had leukaemia and other life-threatening cancers, worked through various challenges, but no riding was involved.
At the end of the course, parents said their children were more confident and had a more positive outlook on life.
They were also better able to cope with their illness, say organisers.
The young cancer patients spent four days with horses at the Equine Assisted Therapy Retreat in Tucson, Arizona.
All seven children had been referred to the retreat from the nearby Sunstone Healing Center for people with cancer.
Each child took a parent along and they worked as a team, tackling exercises with the horses designed to improve communication and coping skills.
Course organiser, Allan Hamilton, a Harvard-trained neurosurgeon at the Arizona Cancer Center, said the results were amazing.
He said: "It was one of the most powerful and emotional experiences I have had.
"A lot of the children started off the weekend not knowing anything about horses but by the end of the it they felt they had mastered something and forged a real bond with the animals.
"One girl was extremely shy and hesitant at the beginning of the course, but by the end of it I noticed she was standing right beneath her horse and handing it mouthfuls of hay.
"She was so much more confident about her horse and herself and that's what they have to learn, that cancer is a big, powerful thing, but they can learn skills to help them be in control rather than out of control.
"They can be a participant, rather than a victim."
Anxiety and frustration
The so-called equine assisted therapy also helped improve the relationship between parents and children, where it had broken down.
Most of these children had undergone intensive treatments, including chemotherapy and bone marrow transplants.
In some cases, their parents had become "a metaphor for treatments", said Dr Hamilton.
This resulted in parents being an easy target for the children's anxieties and frustrations.
Dr Hamilton explained: "One parent told us her child had been going through chemotherapy for six months and they had been feeling very distant from each other.
Children get hands on experience with their horse
"But after their experiences with the horses, they had a cuddle for the first time in six months.
"Another parent said it was the most fun they had had with their child since they had been diagnosed with cancer."
The children and parents were given a series of exercises - one of which was to go into the pasture and catch their horse without anything other than a halter and a rope.
Some of these children were in wheelchairs, but they rose to and completed the challenge.
Another exercise involved taking their horse through an obstacle course. They were also taught grooming skills.
"Some of the best ideas came from the children themselves. They were often better than the adults," said Dr Hamilton
Some exercises involved the children telling their parents what to do - a complete role reversal, which empowered them, said Dr Hamilton.
"The children were much more confident by the end of it," he concluded.
Dr Hamilton has been running equine assisted programmes for adults for eight years, but this was the first one designed specifically for children.
His association with horses began as a hobby and he has been training them for the last 10 years, but he soon recognised their therapeutic potential.
He said: "Therapy needs to be integrated.
"You mustn't forget about a patient's emotional wellbeing. It is vital to the outcome of their treatment."
Horses work very well with patients who have serious illness, said Dr Hamilton, but he stresses that they cannot provide a cure.
"They are completely tuned in to the emotional state of the person working with them," he said.
"They read body language very astutely and that's how they communicate.
"They realise these children may be vulnerable and not a threat to them.
"I call horses 'divine mirrors' - they reflect back the emotions you put in.
The parent-child relationship improved on the course
"If you put in love and respect and kindness and curiosity, the horse will return that."
Dr Deji Ayonrinde, a consultant psychiatrist at, Maudsley Hospital in south London, has seen how animals can help patients with mental illness.
He said: "Some people have found the benefits they get with pets are greater than using medication.
"Pets are socialising, so if you are isolated at home and take your dog for a walk, other people will stop and talk to you as a pet owner, but if you went for a walk alone in the park alone, people wouldn't necessarily talk to you.
"Animals are good companions and for people with depression they can help lift moods.
"Caring for a pet gives people a role and a purpose."
Animal assisted therapy is one of the treatments used at
Barretstown Gang Camp in the Republic of Ireland - a centre which runs residential activity programmes for children with cancer (and other serious illnesses) and their families.
They have a pet farm with rabbits, lambs, kittens, horses, pigs and other animals.
The children feed, groom and clean the animals, as well as play with them.
Barretstown programme director Terry Dignan said the animals had a powerful effect on children.
He said: "Children with cancer have had a huge amount of control taken away from them because parents and siblings do everything for them because of their illness.
"Animal assisted therapy really does bridge the gap left in their lives. It re-empowers them and builds up their self esteem."
Barretstown sees its programme as an extension of a child's clinical treatment.
"Doctors say that if a child has a positive attitude and takes control of their illness, it can help bring about physiological improvements," said Mr Dignan.
More importantly for the children perhaps, animal contact gives them a well-earned break from what can be a very stressful and traumatic time.