Equine Therapy as a Mental Health Treatment: How It's Used (2023)

Animals can offer an extraordinary amount of emotional support. Aside from the relationship between pet and owner, which many of us have experienced lovingly, animals are sometimes used in therapeutic settings to help clients navigate challenging emotional experiences.

Equine Therapy as a Mental Health Treatment: How It's Used (1)

What is equine therapy?

Equine-assisted psychotherapy involves horses in the therapeutic process. People engage in activities such as grooming, feeding, and walking a horse while under the supervision of a psychiatrist.

Goals of this form of therapy include helping people develop skills such asemotional regulation, self-confidence and responsibility. With adult horses weighing between 900 and 2,000 pounds or more, it can be a little intimidating to have such a large, majestic creature attend your therapy sessions.

However, equine-assisted therapy is enjoying increasing popularity due to its increasing popularityexperiential approachand some burgeoning evidence of its effectiveness. There are a variety of terms used to describe or refer to equine-assisted psychotherapy, including:

  • Equine Assisted Mental Health
  • Equine Assisted Counseling
  • Equine Assisted Psychotherapy
  • Equine Assisted Therapy

The last term, equine-assisted therapy, can often refer to other forms of therapy that use horses, such as occupational therapy.

History of Equine Therapy

Horses have been used for therapeutic purposes since ancient Greek times. The Greek physician Hippocrates, known as the "Father of Medicine," wrote about the therapeutic potential of horseback riding.

Horseback riding became increasingly popular as a therapeutic tool in the 1950s and 1960s. In 1969 the North American Riding for Handicapped Association was formed, which later became the Professional Association of Therapeutic Horsemanship (PATH) International.

who it is for

Equine-assisted psychotherapy (EAP) can be used with a wide range of populations and in a wide variety of therapeutic settings. In fact, horses can be used in counseling for individuals of all ages, even families and familiesThe group.

Equine-assisted psychotherapy is often not the only form of treatment, but rather a complementary therapeutic service that can be used in partnership with more traditional treatment.

Offers a very different experience thanclassic talk therapy, EAP brings people outside and offers the opportunity to use all the senses in learning and processingemotional challenges.

children and young people

Equine-assisted psychotherapy can be just as effective with children and adolescents as it is with adult clients. As with adults, children may experience challenges such asTrauma,Angst,Depression,PTSD, and more.

Equine therapy provides them with a therapeutic environment that can feel less threatening and more welcoming than a traditional talk therapy practice. The majority of children participating in the EAP are between 6 and 18 years old.

Children often find it difficult to open up and process painful emotions and experiences. Equine-assisted psychotherapy enables youth and people of all ages to work on issues such as:

  • assertiveness
  • Trust
  • build and maintain relationships
  • Emotional Awareness
  • Empathy
  • impulse control
  • Problem Solving Skills
  • Social skills
  • Trust in others
  • Trust in yourself


Although a variety of animals can be used in the psychotherapeutic process, horses offer unique characteristics that have made them the prime choice for animal-assisted therapy. According to anxiety expert Dr. Robin Zasio horses bring the following unique elements to the therapy process.

Valuable and unbiased

As much as people, especially therapists, do our best to provide clients with a safe space in which to explore deep emotional hurt and painful experiences, clients can feel uncomfortable sharing their thoughts openly.

Building a therapeutic relationship can take time as participants work towards building trust and practicing vulnerability in the session.

The horse's presence can instill a sense of peace as it responds only to the client's behavior and emotions, with no risk of bias or judgment of their emotional experience.

feedback and mirroring

Horses are keen observers and are alert and sensitive to movement and emotion. They often reflect a client's behavior or emotions and convey understanding and connection that allow the client to feel safe.

This also allows clients to maintain a sense of self-awareness, using the horse's behavior and interactions for feedback and opportunities to review and process what is happening.

Manage vulnerabilities

Because clients might feel vulnerable when trying to open up about emotional challenges, past experiences, or life transitions, the horse can provide a reference point for processing.

When something feels too painful to talk about, clients may feel a little easier to process through the horse's example or to align their experience with the horse's experiences in the moment. Externalizing the content in this way can make it easier to approach and process.

Other benefits

Some other potential benefits of equine therapy include increased:

  • adaptability
  • stress tolerance
  • Emotional Awareness
  • independence
  • impulse control
  • Self-esteem
  • social awareness
  • Social relationships

Horses need work too. They need to be fed, watered, exercised and cared for. Providing this type of care can often be therapeutic. It helps establish routines and structure, and caring and caring for something else can help build empathy.


Equine therapy has some evidence of its effectiveness in treating various conditions.


Anxiety disorders affect more than 17 million Americans. Although most people experience some level of anxiety at certain times in their lives, particularly during experiences of change and uncertainty, there are times when people experience anxiety that meets clinical diagnostic criteria. Anxiety-related conditions include, but are not limited to:

  • Agoraphobia
  • Generalized Anxiety Disorder
  • panic disorder
  • separation anxiety
  • selective muteness
  • Social Anxiety Disorder
  • Specific phobia

Many people who struggle with anxiety find themselves stuck in worries about their pastfear for their future.like dr Zasio emphasizes that working with a horse during the therapeutic process can create an opportunity for clients to "stay present and focused on the task at hand."

Because horses are alert and sensitive to behavior and emotions, they can sense danger and respond with heightened awareness, usually leading to behavioral change and possible escape attempts. Clients struggling with anxiety can relate to this ability to recognize and respond to danger cues.

Processing challenges posed by a horse's behavior may be easier for certain clients than talking directly about their own personal experiences with anxiety.

Another benefit of horse-assisted psychotherapy in treating anxiety is helping clients practice vulnerability in a safe environment. As clients learn to interact with the horse and try new things, they are encouraged to step out of their comfort zone with the help and support of the therapist and horse.

Clients can then process their experiences, such as fears and challenges, as well as insights, discoveries or victories in those moments during therapy.


Post-Traumatic Stress Disorder (PTSD), a disorder characterized by increased arousal and responsiveness, intrusive memories and nightmares, and avoidance symptoms following a traumatic event, can feel debilitating. According to the Anxiety and Depression Association of America (AADA), an estimated 7.7 million people ages 18 and older have PTSD.

Children, teens, and adults can struggle with PTSD. Although people can experience a variety of traumatic events that could affect the development of PTSD, those who have experienced sexual assault and veterans who have experienced combat are populations that tend to have higher rates of developing PTSD.

The use of equine-assisted psychotherapy in the treatment of PTSD in veterans is increasing.

Tess Hassett, a riding instructor with the Northern Virginia Therapeutic Riding Program, has a background in clinical psychology and works with veterans using EAP.

Describing her work with veterans, Hassett noted, "Many of them have said that after what they've been through with their PTSD and depression, they never thought they could connect with someone again and feel that personal connection. But with your horse you feel this connection. You can take that into the rest of your life and into your relationships.”

addiction treatment

Drug and alcohol addiction is known to continue to increase and be problematic in the United States. The Centers for Disease Control and Prevention (CDC) estimates that more than 70,000 people died from drug overdoses in 2017.

Many of these were a result ofOpioidepidemie, with nearly 50,000 deaths as a result of opioid use. The need for effective therapies to treat addiction is greater than ever.

Equine-assisted psychotherapy offers a unique approach to treating addiction andconcurrent conditions. A co-occurring condition, formerly known as dual diagnosis, describes someone struggling with addiction in addition to another mental illness — a common occurrence.

The ultimate goal of addiction treatment is to help clients lead sober, healthy, and productive lives. Oftentimes, addiction treatment clients also work hard to heal injuries within the relationship dynamic, e.g. B. within a family or with her partner. Learning to trust, practice vulnerability, and communicate effectively can be challenging during this treatment process.

EAP can help clients learn how to develop a sense of trust through their interactions with the horse while gaining a sense of security and building a relationship. The experience can encourage clients to be vulnerable as they learn new things and interact with the horse.


Attention Deficit Hyperactivity Disorder (ADHD), is another area where equine-assisted psychotherapy can be helpful.Some report that EAP is attractive to adults and adolescents with ADHD because it offers them an active, fun, and hands-on experience.

During equine-assisted therapy, the client is usually with a trained therapist, an equine specialist, and the horse. Horseback riding is not necessarily related to equine-assisted psychotherapy. Rather, the focus is on presence, attention, mindfulness, boundaries, social cues, and more.

Kay Trotter, PhD, Licensed Professional Counselor, Author and Founder of Equine Partners in Counseling (EPIC) Enterprises, was one of the first to devote research to the effectiveness of equine-assisted psychotherapy.

Trotter found that introducing horses into the therapeutic process produced significantly positive behaviors while reducing negative behaviors.

Their study was one of the first to be published on the effectiveness of EAPJournal of Creativity in Mental Health. It has been shown that patients can experience a variety of benefits from equine-assisted psychotherapy, such as:

  • Increased self-esteem
  • Increased self esteem
  • Improved adaptation to routines and policies
  • Improved focus
  • Less stressful friendships
  • Reduced aggression

For clients struggling with ADHD, the sense of achievement of an equine-assisted psychotherapy session can be of great benefit. As a licensed clinical social worker, Kit Muellner says that “clients feel like they've accomplished something on their own, rather than being told to do something by a parent or teacher.

A 1,500-pound animal responds the way you want it to because you've been able to focus. So you've achieved something you wanted to do as opposed to something someone else wanted you to do."

That sense of accomplishment can feel meaningful for anyone, especially someone struggling with ADHD. In those moments, they receive instant feedback from their horse and learn how to build trust, communicate effectively, and work towards achieving a personal goal or milestone.

Equine Assisted Therapists

TheEquine Assisted Growth and Learning Association(EAGALA) is a non-profit organization dedicated to setting the standard for professionals working with horses in a therapeutic setting. They offer training and have established a specialized certification process for those wishing to become an accredited, trained equine assisted therapy professional.

In addition to EAGALA, there are other programs dedicated to proper training and maintaining standards for those working with clients in the EAP space.

In order to conduct therapy, whether or not you offer equine-assisted therapy, you must contact your state regulatory agency for information on the educational and clinical requirements necessary to become a licensed professional counselor or therapist in your to become a state.

Equine-assisted therapy is a distinct style and specialization in the field of psychotherapy, with clinicians seeking and earning specific training and certification related to the practice of EAP.

things to consider

There are a few factors to consider when deciding to explore equine assisted therapy for yourself or a loved one. Always consider physical ability and general health. If you have scoliosis, spina bifida, or any other back-related health condition, talk to your doctor before attempting equine therapy.

Timed coordination

Depending on the challenges the customer is facing, the timing for EAP may or may not be appropriate. For example, when someone is dealing with addiction, they need adequate time to detoxify and establish adherence to an appropriate treatment program before potentially incorporating equine assisted therapy services.


Although equine-assisted therapy has been shown to be helpful in treating anxiety, a client may be afraid of being around a large horse and not feel motivated to participate in this type of treatment. There may also be a traumatic memory of animals that would prevent someone from participating.

It is important to speak with a licensed psychotherapist to determine if you or your loved one are a good fit for equine-assisted therapy. Most programs have an evaluation process to determine if EAP is right for you before beginning any treatment.


With equine-assisted psychotherapy only recently gaining popularity and gaining traction as an effective treatment for mental health and substance abuse, keep in mind that this service may not be covered by insurance.

EAP service fees vary by location and may vary in price. It is recommended that you contact your insurance company and your local equine therapy facility to discuss these details in advance.

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