Equine Therapy

Equine therapy is a treatment involving horses. The therapy helps manage mental health and substance abuse issues by participating in activities that bring patients a sense of peace and focus. Equine therapy activities include grooming, feeding, and riding a horse.
Evidence Based
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What is Equine Therapy?

Equine therapy incorporates horses into the therapeutic process. People engage in horse-related activities, including grooming, feeding, and riding a horse. A mental health professional supervises these activities.

Equine-assisted therapy aims to help people develop specific skills and ways of thinking. These skills include:

  • Increased self-esteem
  • Emotional growth
  • Self-awareness
  • A focus on well-being
  • Problem-solving
  • Social skills

Mature horses can weigh between 900 and 2,000 pounds, sometimes more. Initially, it may sound daunting having such a large animal involved in your therapy sessions. However, horse therapy is popular because of its experiential approach. Many people find that working with horses makes them feel calm and mentally balanced.

There are other types of animal-assisted therapy sessions available as well. Elephants, dolphins, dogs, and cats can also be used in therapy. However, horse therapy is the most popular. 

Horses provide instant feedback to a person’s actions. They can also mirror the feelings of the handler or rider. Their magnificent appearance forces people to develop trust around them.

Equine-assisted therapy is used in different types of populations and various settings. Horse therapy is popular in counseling for people of all ages. Families and groups can also use it.

The History of Equine Therapy

Equine-assisted therapy dates back to when horses were involved in therapeutic riding in ancient Greek literature back in 600 B.C. In 1945, horse therapy was used in Scandinavia following an outbreak of poliomyelitis (polio), an infectious disease that can cause paralysis. 

This form of therapy was introduced in the United States and Canada in 1960. In the United States during these times, equine therapy was used specifically for disabled people. The treatment developed as a means of motivation for education, along with its therapeutic advantages.

Mental Health and Equine Therapy

Equine-assisted therapy helps manage several mental health issues. Here are a couple of mental health disorders that horse therapy can help with:


Anxiety affects more than 17 million Americans. While most people have some level of anxiety throughout their lives, some experience clinical anxiety that significantly affects their lives.

Many people who battle anxiety worry about their past and fear for their future. However, working with horses can help people stay present and focus on relevant activities at hand. 

Horses are sensitive to behaviors and feelings. They can sense dangers easily. This usually results in a change in their behavior and can lead them to try to escape. Many people who experience anxiety can relate to this way of sensing danger and respond similarly.

Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a mental health illness. The disorder involves increased reactivity to intrusive memories. 

People of all ages experience PTSD, including children and teenagers. There are a variety of traumatic events that can lead to PTSD. However, people who have experienced sexual assault, and veterans involved in combat are groups who have higher rates of PTSD.

Equine therapy has become popular as a mental health treatment for PTSD. Many people with PTSD believe they can never bond with someone again to develop a personal connection. But when spending time with horses, people with PTSD may develop emotional growth. They can then take that progress and apply it to the rest of their lives and their relationships.

Around seven to eight percent of the United States population will experience PTSD at some point in their lives.

U.S. Department of Veteran Affairs, 2019

Benefits of Equine Therapy for Drug Addiction

Equine-assisted psychotherapy provides a unique approach to treating drug addiction and co-occurring mental health conditions. A co-occurring condition refers to when someone experiences addiction with another mental health issue.

There are numerous benefits of equine therapy for drug addiction. Horse therapy can help people develop a sense of trust through their interactions with horses. They can gain an understanding of safety and create a relationship with the creatures. With help from a mental health professional, the experience can help clients to become vulnerable as they learn new social skills and interact with the horse.

Like with other types of animal-assisted therapy, horses can soothe and relax people. Horses can help to alleviate pain, boost mood, and reduce stress.

During drug treatment, equine therapy offers recovering substance abusers a new focus. This new perspective helps patients reduce their substance abuse and other unhealthy behaviors. 

During an equine therapy program, patients learn to take responsibility for their actions and maintain a consistent schedule. A successful treatment plan usually involves counseling and other talk therapy techniques too. This treatment combination encourages substance abuse patients to evaluate their lives, actions, and future. 

Types of Equine-Assisted Activities

Equine-assisted activities are any specific activities that involve the use of horses for therapeutic value. Equine-assisted activities can include grooming and stable management, shows, parades, demonstrations, and more.

Therapeutic Horseback Riding

Therapeutic riding contributes positively to the cognitive, physical, emotional, and social well-being of patients. A riding instructor monitors the treatment of the patient.


The term hippotherapy comes from the Greek word hippos. This translates to a horse.

Hippotherapy is a physical, occupational, or talk therapy treatment. It focuses on equine movement.

The following health professionals often use equine therapy treatment:

  • Occupational therapist
  • Physical therapist
  • Speech and language pathologist
  • Equine therapist

These groups use hippotherapy to address impairments, disabilities, functional limitations, and disabilities in people with neuromotor and sensory dysfunction. For example, hippotherapy is often used to treat people with cerebral palsy. This treatment is often used as part of a broader program.

Equine-Assisted Psychotherapy (EAP)

Equine-facilitated psychotherapy is an interactive treatment. A mental health worker or equine professional works with clients and suitable horses to address psychotherapy goals.

Equine-Assisted Learning (EAL)

Equine-assisted learning is an experimental treatment for growth and development. The process encourages the development of life skills for educational, professional, and personal goals through equine-related activities. 

Ready to Make a Change?


Young C, Horton J. Canine and Equine Therapy for Mental Health: A Review of Clinical Effectiveness, Ottawa (ON): Canadian Agency for Drugs and Technologies in Health, 2019 Aug 30, https://www.ncbi.nlm.nih.gov/books/NBK549209/ 

Assaf Shelef, Dorit Brafman, Thom Rosing, Abraham Weizman, Rafael Stryjer, Yoram Barak, Equine Assisted Therapy for Patients with Post Traumatic Stress Disorder: A Case Series Study, Military Medicine, Volume 184, Issue 9-10, September-October 2019, Pages 394–399, https://doi.org/10.1093/milmed/usz036 

How Common is PTSD in Adults?, U.S. Department of Veterans Affairs, 2019, https://www.ptsd.va.gov/understand/common/common_adults.asp

Hemingway, A.; Carter, S.; Callaway, A.; Kavanagh, E.; Ellis, S. An Exploration of the Mechanism of Action of an Equine-Assisted Intervention. Animals 2019, 9, 303, https://www.mdpi.com/2076-2615/9/6/303

Generalized anxiety disorder, MedlinePlus, 2020, https://medlineplus.gov/ency/article/000917.htm

Byongsu Jang, Jihye Song, Jiwon Kim, Seonwoo Kim, Jiyoung Lee, Hye-Yeon Shin, Jeong-Yi Kwon, Yun-Hee Kim, and Yoo-Sook Joung,The Journal of Alternative and Complementary Medicine.Sep 2015.546-553, http://doi.org/10.1089/acm.2015.0067 

Kay Sudekum Trotter, Cynthia K. Chandler, Deborah Goodwin-Bond & Janie Casey, 2008, A Comparative Study of the Efficacy of Group Equine Assisted Counseling With At-Risk Children and Adolescents, Journal of Creativity in Mental Health, 3:3, 254-284, https://www.tandfonline.com/doi/abs/10.1080/15401380802356880

Hilde Hauge, Ingela L. Kvalem, Bente Berget, Marie-José Enders-Slegers & Bjarne O. Braastad, 2014, Equine-assisted activities and the impact on perceived social support, self-esteem and self-efficacy among adolescents – an intervention study, International Journal of Adolescence and Youth, 19:1, 1-21, https://www.tandfonline.com/doi/full/10.1080/02673843.2013.779587

Naste, T.M., Price, M., Karol, J. et al. Equine Facilitated Therapy for Complex Trauma (EFT-CT). Journ Child Adol Trauma 11, 289–303, 2018. https://doi.org/10.1007/s40653-017-0187-3 

Kern-Godal, A., Brenna, I. H., Arnevik, E. A., & Ravndal, E., 2016, More than Just a Break from Treatment: How Substance Use Disorder Patients Experience the Stable Environment in Horse-Assisted Therapy. Substance Abuse: Research and Treatment. https://doi.org/10.4137/SART.S40475

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Updated on: August 25, 2020
Ellie Swain
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Medically Reviewed: August 21, 2020
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Annamarie Coy,
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