Located in Montgomery County, MD, Cultivate Rehabilitation Services is a therapist-owned private practice that offers occupational therapy services in various settings, including nature-based therapy, hippotherapy, and home- and clinic-based therapy. Alongside OT services, Cultivate offers therapeutic/adaptive riding lessons. Therapeutic riding lessons are adaptive, recreational riding lessons for children and adults with disabilities. Cultivate primarily serves children, teens and young adults. Occupational therapy services start at age 2 and therapeutic riding lessons start at age 4.
Occupational therapy (OT) is a healthcare profession that focuses on rehabilitation. OT can help people of all ages to increase their independence in meaningful daily activities, otherwise known as “occupations”. For a child, occupations can include: play, social interaction, self-care skills and academic skills. OTs evaluate motor skills, cognitive skills, psychological skills, social skills and sensory skills to determine deficit areas that are impacting a child’s independence. OTs utilize research based techniques to treat these deficits in order to help improve the child and caregivers quality of life.
Therapeutic/Adaptive Horseback Riding is an adaptive, recreational way to participate in the sport of horseback riding. The focus of therapeutic/adaptive riding is for the participant to learn the skills of horseback riding in a lesson format and in a way that adapts to your child’s unique needs. Therapeutic riding instructors are educated on various disabilities and ways to modify/adapt the recreational activity of horseback riding to promote learning and carry-over of skills.
Our Treatment Space
Our nature based therapy sessions, hippotherapy and clinic based outpatient occupational therapy sessions take place at Moon Rising Farm in Boyds, MD. Moon Rising Farm is a beautiful farm setting that allows for a unique multi-sensory experience for patients.
Common Diagnoses we treat:
- Autism
- Sensory Processing Disorder
- Cerebral Palsy
- Down Syndrome
- Developmental Delay
- ADHD
- Learning Disabilities
- Neurological Disease and Trauma
- Genetic Disorders
- Anxiety/Mental Health Disorders
- Motor Delay
Meet Our Staff
Nathalie Miller, MS, OTR/L, Owner/Occupational Therapist
Nathalie has been riding and working with horses for 20 years. She has been utilizing the outdoor environment and animal assisted activities to help others for the past 10 years. Her career began as a Certified Therapeutic Riding Instructor through the Professional Association of Therapeutic Horsemanship (PATH). Next, she certified as an Equine Specialist through the Equine Assisted Growth and Learning Association. Then, she decided to further her education and went to Salus University to get her Masters degree in occupational therapy. As an occupational therapist, Nathalie has continued her education in the use of equine movement and the use of the farm environment by completing level 1 and level 2 courses through the American Hippotherapy Association. She is passionate about utilizing equines and the outdoor environment as a treatment tool and educating other professionals on the use of this amazing tool.
Alison Duval, CTRI
Alison is a PATH CTRI and started in the therapeutic riding community as a volunteer in 2000 at the National Center for Therapeutic Riding. In 2004, she started volunteering for the therapeutic riding program at Rock Creek Park Horse Center in Washington, DC while she was an art teacher at a variety of schools and programs in the DC area. She became an instructor at Rock Creek Park Horse Center in 2012 and became a PATH Intl Registered Instructor in 2016. When her mentor and fellow instructor retired in 2018, Alison took over the therapeutic riding program at RCPHC. Alison joined Loudoun Therapeutic Riding in Lovettsville, VA in the summer of 2021 teaching at both centers until the spring of 2025. She started teaching at Great and Small in the summer of 2025 when the TR program ended at RCPHC. Alison enjoys being able to still teach art and photography while also teaching people how to ride.