I. The Basics of Equine Therapy

This guide covers basic information on how Equine Therapy works and how it’s used to treat ADHD, anxiety, PTSD, substance abuse, and various other conditions. An overview will also be provided on how Equine Therapy is administered, the cost of therapy, potential side effects, and other considerations of using this type of treatment.

Nearly any activity involving a person and a horse can be considered Equine Therapy, including riding, leading, feeding, and grooming. Equine-Assisted Psychotherapy is an experiential form of psychotherapy that also involves horses but generally doesn’t include riding. EAP is an interactive process, which requires a licensed mental health professional, an appropriately credentialed equine professional, and a suitable equine working together to address specific psychotherapy needs and overall goals, which you and your therapist develop together.

Generic Treatment NameEquine Therapy
Other NamesEquine-Assisted Therapy (EAT), Equine-Assisted Activities and Therapy (EAAT), Equine-Assisted Psychotherapy (EAP), Equine-Facilitated Psychotherapy (EFP), Horse-Assisted Therapy (HAT)
Conditions Commonly TreatedADHD, Anxiety, Behavioral Issues, Depression, Eating Disorders, PTSD, Substance Abuse
Conditions Commonly Treated with Hippotherapy (Therapeutic Horseback Riding)Autism, cerebral palsy, communication issues, dementia, developmental delay, Down syndrome and other genetic syndromes, multiple sclerosis, spinal cord injury, stroke, traumatic brain injuries
Availability/Who Administers TreatmentA licensed mental health professional working with an appropriately credentialed equine professional at an accredited equine therapy center
Common Equine ActivitiesVaries, depending on the condition being treated, and can include feeding, grooming, walking/leading, riding, vaulting, carriage driving
BenefitsIncreased accountability, communication skills, concentration, confidence, emotional awareness, empathy, focus, impulse control, interpersonal relationships, problem-solving skills, self-awareness, self-esteem, social skills, stress tolerance, and trust

Decreased aggression, anger, depression, dissociation, and impulsiveness.

DrawbacksCan be costly, not generally covered by insurance, certified facilities may be limited depending on the area
Length of SessionsUsually one hour
Potential Side EffectsAdverse effects are rare, but decreased self-esteem and increased aggression have been reported in younger patients

The therapeutic benefits of animals have been recognized for quite some time, but the specific benefits of horse-assisted activities and therapies are less well known. However, it is a rapidly growing field. Beginning in the mid-1990s, psychotherapists began using principles of Equine Therapy for the treatment of mental health concerns. There are now two major organizations in the U.S. that certify equine centers in equine-assisted activities and therapies: the Equine Assisted Growth and Learning Association and the Professional Association of Therapeutic Horsemanship International (PATH).

Since its founding in 1969, PATH has certified approximately 880 centers around the world in various types of equine-assisted activities. PATH-certified centers served over 66,000 people in 2016. This number rose to nearly 69,000 in 2017, and of the 750 PATH-certified centers that reported statistics that year, 250 centers served people suffering from substance abuse, 690 served people suffering from hyperactivity, and 490 served people suffering from PTSD.

II. How Equine Therapy Works

Equine Therapy, also known as Equine-Assisted Therapy (EAT), Equine-Assisted Activities and Therapy (EAAT), and Equine-Assisted Psychotherapy (EAP), includes a wide range of equine activities that may or may not include horseback riding, depending on the condition being treated. The goal is to help people develop specific attributes and skills they may be lacking, such as accountability, impulse control, problem-solving skills, responsibility, self-confidence, and self-control. It can also provide an innovative outlet for mental health professionals to help patients identify and address an array of behavioral and emotional challenges stemming from addiction, trauma, and mental health.

The more active outdoor environment combined with a less verbal therapeutic situation has also been found to be more beneficial for some individuals when compared to a standard therapy room atmosphere. Equine-Assisted Psychotherapy is generally not a stand-alone treatment but a complementary therapeutic service combined with more traditional treatments, such as cognitive behavioral therapy, so there is still a certain amount of talk therapy included.

While studies are limited, there have been indications that Equine Therapy has successfully helped patients with emotional awareness, empathy, interpersonal relationships, improving focus, learning boundaries, reducing aggression, relaxation, self-respect, social skills, stress tolerance, and trust issues. Some people begin seeing the benefits of Equine Therapy in as little as two to three sessions, but your mental health professional will work with you to create the ideal treatment schedule for your specific situation.

III. What Equine Therapy Is Used for

Equine Therapy has been used for several years to treat physical disabilities and genetic disorders, such as autism, cerebral palsy, developmental delays, Down syndrome and other genetic syndromes, multiple sclerosis, spinal cord injury, stroke, and traumatic brain injuries. More recently, it has been used for abuse issues, behavioral issues, and mental health issues, including ADHD, aggressive behavior, alcohol abuse, anxiety, depression, eating disorders, PTSD, and substance abuse.

Depending on your needs, Equine Therapy may be used in different ways. It can provide a sense of accomplishment for people suffering from ADHD while helping them develop trust and work towards meeting personal goals. People recovering from alcohol and/or substance addiction may use it for addressing trust issues, while learning responsibility and impulse control. It’s common for people facing substance abuse challenges to also have co-occurring conditions, such as anxiety, depression, or other mental health issues, so they may also use Equine Therapy to address stress tolerance, self-confidence, and mood enhancement. A person suffering from PTSD may use Equine-Assisted Psychotherapy to learn how to bond and feel a personal connection they can carry over into their human relationships.

IV. How Equine Therapy Is Administered

Equine Therapy must be administered by a licensed mental health professional working with an appropriately credentialed equine handler. Certified equine centers only use suitable horses for these programs, which are often older mares and geldings. When you first visit an equine center, your therapist will discuss your background, needs, and goals with you, so you can develop an appropriate treatment plan together.

During each equine therapy session, you will work with your therapist, an equine specialist, and a horse that you generally choose yourself as part of your therapy plan. Horseback riding isn’t necessarily included in Equine-Assisted Psychotherapy. Instead, your equine activities tend to be feeding, grooming, and walking the horse. Focus is placed on your attention and mindfulness to the horse and how you react to each other. Equine Therapy sessions may also include traditional psychotherapy techniques, such as mirroring, role-playing, and role reversal. Participating in equine activities and discussing your behaviors and feelings can help you learn more about yourself, which combined with the bonding experience, may help you achieve your therapy goals.

EAP may also be used in a variety of therapeutic settings, including addiction treatment facilities, trauma centers, and veterans’ groups. However, therapy is always overseen by a licensed mental health professional, usually a licensed psychotherapist, working with a trained equine specialist. These sessions also rarely involve horseback riding but focus on other equine activities that promote bonding, trust-building, and self-confidence.

V. Cost, Side Effects, and Other Considerations

Because Equine-Assisted Psychotherapy has only recently begun growing in popularity with limited studies as to its effectiveness for treating substance abuse and mental health issues, your insurance may not cover part or even any of the costs. Fees for EAP vary by location and treatment needs, so the cost can vary widely. While therapeutic riding lessons may cost $80 to $115 per hour-long session, EAP generally costs between $115 and $300 per hour-long  session, depending on the type of therapy involved.

Adverse side effects of Equine Therapy are rare, but there have been reports of lowered self-esteem and increased aggression in younger participants. These negative effects are thought to be caused by children and adolescents becoming attached to the horse, then losing their companion when therapy ends.

Because problematic feelings may arise during Equine-Assisted Psychotherapy, a licensed mental health professional must provide therapy. It’s vital that someone experienced in helping you process these feelings be present to ensure the safety and effectiveness of therapy.

As the popularity of EAP continues to rise, more facilities and providers may become available. However, since it isn’t widely available everywhere, it may be difficult to locate a facility offering this type of therapy in your area.

VI. How to Get Help and Additional Resources

To learn more about some of the disorders that Equine Therapy may help improve, visit these pages on Attention-Deficit/Hyperactivity Disorder, Generalized Anxiety Disorder, Alcohol Addiction, and Illicit Drug Addiction.

Note: The information contained in this guide is for informational purposes and only intended to educate the public on how this therapy is used. It is not recommending a specific treatment or giving medical advice. Always consult with your doctor or other qualified medical, mental health, and addiction professionals before beginning any type of treatment.