Equine Therapy: Harnessing Horses for Mental Health Treatment

Animals provide significant emotional support in the familiar pet-owner relationship and in therapeutic settings where they assist clients with tough emotional challenges.

What Is Equine Therapy?

Equine-assisted psychotherapy involves using horses in therapy sessions, where a mental health professional supervises activities like grooming, feeding, and leading them.

The goals include helping people develop emotional regulation, self-confidence, and responsibility skills. Despite the intimidating size of mature horses, which can range from 900 to over 2,000 pounds, this therapy is gaining popularity due to its hands-on approach and growing evidence of its effectiveness.

Other terms for equine-assisted psychotherapy include:

• Equine-assisted mental health
• Equine-assisted counseling
• Equine-facilitated psychotherapy
• Equine-assisted therapy 

Equine-assisted therapy can also encompass other therapeutic approaches involving horses, such as occupational therapy.

History of Equine Therapy

Horses have been utilized for therapeutic purposes since ancient Greek times. Hippocrates, the "Father of Medicine," wrote about the therapeutic benefits of horseback riding.

Riding as a therapy tool gained popularity in the 1950s and 1960s. In 1969, the North American Riding for Handicapped Association was established, which later evolved into PATH International (Professional Association of Therapeutic Horsemanship).

Who Is It For?

Equine-assisted psychotherapy (EAP) is versatile and applicable across different populations and therapeutic environments. It can be used in counseling for individuals of all ages, as well as with families and groups.

EAP typically complements traditional treatments rather than replacing them entirely. It provides a unique experience compared to conventional talk therapy by taking people outdoors and engaging all senses while addressing emotional challenges.

Children and Teens

Equine-facilitated psychotherapy can be equally effective for children and teens as it is for adults. Like adults, young individuals face challenges such as trauma, anxiety, depression, and PTSD.

Equine therapy provides a therapeutic environment that feels less intimidating and more welcoming than a traditional talk therapy setting. Most children involved in EAP are between 6 and 18 years old.

Children often struggle to express and process difficult emotions and experiences. Equine-assisted psychotherapy allows youth and individuals of all ages to address issues, including:

• Assertiveness
• Confidence
• Developing and maintaining relationships
• Emotional awareness
• Empathy
• Impulse control
• Problem-solving skills
• Social skills
• Trust in others
• Trust in self

Benefits

While various animals can assist in psychotherapy, horses stand out for their distinctive qualities, identified by anxiety expert Dr. Robin Zasio as beneficial in animal-assisted therapies.

Non-Judgmental and Unbiased

Even though therapists strive to create a safe environment for clients to delve into deep emotional wounds, it can still be challenging for clients to express themselves openly. Establishing therapeutic rapport requires time as participants work on trust and practicing vulnerability during sessions.

The presence of a horse can bring a sense of calm, as they respond only to the client's behavior and emotions without any bias or judgement toward their emotional experiences.

Feedback and Mirroring

Horses are perceptive and attuned to movement and emotion. They frequently mirror a client's behavior or feelings, fostering understanding and a sense of safety. This enables clients to stay self-aware, using the horse's responses as feedback to reflect on and process their current experiences.

Managing Vulnerability

When clients feel vulnerable discussing emotional challenges, past experiences, or life changes, horses provide a reference point for processing.

If something is too painful to talk about directly, clients may find it easier to process by comparing their experiences to those of the horse. This externalization can help make the content more approachable and manageable.

Other Benefits

Equine therapy may also lead to:

• Improved adaptability
• Enhanced distress tolerance
• Greater emotional awareness
• Increased independence
• Improved impulse control
• Boosted self-esteem
• Heightened social awareness
• Enhanced social relationships

Caring for horses, including feeding, watering, exercising, and grooming them, is also therapeutic. It establishes routines and structure and fosters empathy through nurturing and caregiving.

Conditions

There is evidence supporting the effectiveness of equine therapy in managing various conditions.

Anxiety

Equine therapy shows evidence of effectiveness in managing various conditions, including anxiety disorders such as:

• Agoraphobia
• Generalized anxiety disorder
• Panic disorder
• Separation anxiety
• Selective mutism
• Social anxiety disorder
• Specific phobia

According to Dr. Zasio, working with horses in therapy helps clients stay present and focused. Horses' sensitivity to behavior and emotions allows clients to relate to their heightened awareness and responsive nature.

Processing challenges through horse behavior can be more comfortable than discussing personal anxiety experiences directly.

Equine-assisted psychotherapy also supports clients in practicing vulnerability within a safe environment. It encourages stepping out of comfort zones with therapist and horse support, leading to reflection on fears, challenges, insights, and successes during sessions.

PTSD

Equine-assisted psychotherapy is increasingly used to treat PTSD in veterans. Tess Hassett, a riding instructor at the Northern Virginia Therapeutic Riding Program with a background in clinical psychology, works with veterans using EAP.

Describing her work, Hassett said, "Many veterans have shared that despite their PTSD and depression, they never expected to bond with anyone again or feel that personal connection. Yet, with their horse, they experience that connection. This ability carries over into their lives and relationships."

Addiction Treatment

Drug and alcohol addiction remains a growing issue in the United States, with over 70,000 drug overdose deaths reported by the CDC in 2017, many of which were linked to opioids.

Equine-assisted psychotherapy offers a unique approach to treating addiction and co-occurring conditions where individuals struggle with addiction alongside other mental health issues.

The primary goal of addiction treatment is to help clients achieve sobriety and lead healthy, productive lives. In therapy, clients often work on healing relationship dynamics, such as within their family or with their partner. Developing trust, practicing vulnerability, and improving communication skills are critical challenges.

EAP helps clients build trust through horse interactions, fostering a sense of safety and relationship-building. This experience encourages clients to be open and vulnerable as they learn and engage with the horses.

ADHD

Equine-assisted psychotherapy can benefit individuals with Attention-Deficit/Hyperactivity Disorder (ADHD). Many find it appealing because it provides an active, enjoyable, hands-on experience for adults and youth.

The client typically works with a trained therapist, an equine specialist, and a horse during equine-assisted therapy. Riding isn't always part of the therapy; instead, the focus is on presence, mindfulness, boundaries, social cues, and more.

Kay Trotter, PhD, a licensed professional counselor and founder of Equine Partners in Counseling (EPIC) Enterprises, researched the effectiveness of equine-assisted psychotherapy. Her study, published in the Journal for Creativity in Mental Health, showed significant increases in positive behaviors and reductions in negative behaviors among participants.

Equine-assisted psychotherapy can offer clients various benefits, including increased self-esteem and self-respect, improved adjustment to routines, better focus, less stressful relationships, and reduced aggression.

For clients with ADHD, the sense of achievement during equine-assisted psychotherapy sessions can be particularly valuable. As licensed clinical social worker Kit Muellner explains, clients feel empowered by accomplishing tasks independently, such as gaining a horse's cooperation through focused attention.

This achievement is especially meaningful for individuals with ADHD, as it provides them with immediate feedback and opportunities to build trust, enhance communication skills, and work towards personal goals.

Equine Assisted Therapists

The Equine Assisted Growth and Learning Association (EAGALA) is a nonprofit organization that sets standards for professionals using horses in therapy. It provides training and offers a specialized certification process for those aspiring to be recognized equine-assisted therapy professionals.

Other programs, in addition to EAGALA, focus on training and maintaining standards for practitioners in equine-assisted psychotherapy (EAP).

To practice therapy, whether equine-assisted methods or not, professionals must comply with educational and clinical requirements set by their state regulatory board. EAP is a specialized area within psychotherapy, requiring clinicians to undergo specific training and certification related to this practice.

Things to Consider

When considering equine-assisted therapy for yourself or a loved one, several factors should be taken into account:

1. Physical Health: Always consider physical abilities and overall health. Before trying equine therapy, a doctor should discuss conditions like scoliosis or spina bifida.
2. Timing: The appropriateness of timing for EAP depends on the client's current challenges. For instance, individuals dealing with addiction may need time to detox and comply with a treatment program before considering equine-assisted therapy.
3. Fear: While EAP can help with anxiety, some clients may fear being around large horses or have traumatic memories involving animals that could hinder their participation.
4. Consultation: It's crucial to consult a trained mental health provider to assess whether equine-assisted therapy is suitable. Most programs conduct assessments to determine the suitability of EAP before starting treatment.
5. Cost: Due to its relatively recent popularity, equine-assisted psychotherapy may not be covered by insurance. Costs vary by location and facility, so you should check with your insurance provider and local equine therapy center in advance regarding fees and coverage options.

Equine therapy offers a unique and promising approach to mental health treatment by harnessing the therapeutic power of horses. From enhancing emotional awareness to fostering trust and communication skills, the interactions between clients and horses in equine-assisted psychotherapy can lead to profound personal growth. However, it's essential to consider individual health factors, timing, potential fears, and financial considerations before embarking on this therapeutic journey. As research and understanding of equine therapy continue to evolve, it promises to remain a valuable option for those seeking innovative and effective mental health interventions.