Child of about six years old with long hair reaches out to pet horseEquine-assisted psychotherapy, also called equestrian therapy or horse therapy, is a type of experiential mental health treatment that involves a person in therapy interacting with horses. Designed for people of all ages, equine therapy has been shown to treat a wide range of mental health issues, addressing both physical and psychological concerns associated with a diagnosis.

Individuals seeking help typically work with both a psychotherapist who specializes in equine therapy and a horse trainer who is familiar with their therapeutic application—though both roles may be filled by the same person.

History and Development of Equestrian Therapy

The idea of combining equestrian activities and philosophies with the treatment of physical and mental health issues dates back centuries. Ancient Greeks wrote about the benefits of horse riding, calling this practice hippotherapy (from the Greek hippo, meaning horse). 

It wasn’t until the mid-1900s, however, that modern psychotherapists started using existing principles of therapeutic riding developed to treat polio and other health issues for treatment of mental health concerns. Equine-assisted psychotherapy as a modality grew out of therapeutic riding techniques and organizations designed to make horse riding accessible for people with disabilities.

Some organizations distinguish between equine-assisted therapy, hippotherapy, and therapeutic riding. Hippotherapy tends to focus more on occupational, speech, and physical therapy. Therapeutic riding is geared toward individuals with conditions such as cerebral palsy or Down syndrome which call for greater physical support while riding for the purpose of better back and structural health. All horse-assisted modalities can have significant associated mental health benefits. 

How Can Equestrian Therapy Help?

Studies have shown people of all ages can benefit from equine-assisted therapy, and horses have been incorporated into treatment for a wide variety of issues, including:

Equine therapy can target physical concerns such as behavioral tics, motor control issues, balance, posture, and coordination–especially in children and teens with cerebral palsy. In other cases, working with horses helped by increasing individuals’ cognitive skills, reducing stress, easing symptoms of PTSD, and addressing symptoms of depression. Equine therapy has even been shown to, for some individuals, have a positive effect on destructive relationship patterns that have developed or behaviors that compromise health or safety. 

In a study of over 30 people participating in an experiential equine-assisted therapy program, researchers found the individuals’ psychological distress reduced immediately following treatment and that psychological well-being improved. These positive effects held stable through a follow-up six months later. 

How Does Equine-Assisted Therapy Work?

Equine therapy for the purpose of addressing mental health issues typically involves both a psychotherapist and horse trainer. Horses, which might be full-size or smaller ponies, are chosen as therapy animals based partially on their ability to withstand a great deal of distraction and tolerate unpredictable or erratic behavior from people riding or grooming them. Many have been trained to exhibit especially gentle and repetitive behaviors to put people at ease and make their interactions more predictable. 

Some residential treatment centers offer equine therapy programs; other courses are set up between an individual and their psychotherapist. Someone new to equine therapy will generally start with low levels of interaction with the horse: petting, grooming, and feeding. They might then work up to haltering the horse and leading it with a trainer or solo. Not all equine therapy incorporates riding horses, though it is frequently woven into the practice. 

Equine-assisted psychotherapy is said to work in part because of the natural ability horses have to pick up on human emotional expressions and needs. Particularly patient, perceptive, and attuned to displays of fear, anger, agitation, and despair, horses are able to mirror human moods in a nonjudgmental way, without motive or expectations. As the person in therapy bonds with the horse, self-awareness grows and emotional healing often takes place.

Equine Therapy Limitations and Concerns

People interested in equine therapy should be aware of some dangers posed by the activity, not least of which is the size and weight of most horses. Though horses trained as therapy animals are less likely to pose any risk to riders out of fear or aggravation, their stature alone may be a concern for some people or parents. Additionally, some people experience allergic reactions to horses or their environments (barn dust or hay, for example) and should exercise caution when considering equine therapy. 

It is recommended that individuals with health issues such as spina bifida, scoliosis, or Down syndrome consult with a physician before their first experience with equine-assisted therapy. Riding horses can compromise spinal stability, so it may not be recommended for someone with back problems.

It is always a good idea talk with your personal therapist or counselor when considering a new treatment modality to ensure the method is a good fit for both of you.


  1. Benda, W., McGibbon, N. H., & Grant, K. L. (2003). Improvements in muscle symmetry in children with cerebral palsy after equine-assisted therapy (hippotherapy). The Journal of Alternative & Complementary Medicine, 9(6), 817-825. Retrieved from 
  2. Cumella, E. J., & Simpson, S. (2007). Efficacy of equine therapy: Mounting evidence. Remuda Ranch Center for Anorexia and Bulimia. Retrieved from 
  3. Klontz, B. T., Bivens, A., Leinart, D., & Klontz, T. (2007). The effectiveness of equine-assisted experiential therapy: Results of an open clinical trial. Society & Animals, 15(3), 257-267. Retrieved from 
  4. Lucchesi, E. (2016, July 5). With hippotherapy, the horse provides the therapy. New York Times. Retrieved from 
  5. Schultz, P. N., Remick‐Barlow, G., & Robbins, L. (2007). Equine‐assisted psychotherapy: A mental health promotion/intervention modality for children who have experienced intra‐family violence. Health & Social Care in the Community, 15(3), 265-271. Retrieved from 
  6. Therapeutic riding vs. hippotherapy. (2013, January 30). Heartland Equine Therapeutic Riding Academy. Retrieved from
  7. Tyler, J. L. (1994). Equine psychotherapy: Worth more than just a horse laugh. Women & Therapy, 15(3-4), 139-146. Retrieved from 
  8. Types of equine therapy. (n.d.) Retrieved from 
  9. What is equine therapy? (n.d.) CRC Health. Retrieved from
  10. Yorke, J., Nugent, W., Strand, E., Bolen, R., New, J., & Davis, C. (2013). Equine-assisted therapy and its impact on cortisol levels of children and horses: A pilot study and meta-analysis. Early Child Development and Care, 183(7), 874-894. Retrieved from