Equine therapy is a technique that uses interactions between patients and horses as metaphors for life lessons. Often used with young people who have resisted other kinds of treatment, it can have many potential benefits when administered by a trained equine therapist. The formal practice of using horses therapeutically began in the 1990s, but the knowledge that riding had health benefits goes back to ancient Greece. Because there are so many names for similar therapies, it has been difficult for researchers to measure data, but they have been studying its benefits since 2007.

What is equine therapy?

The therapy is known by various labels, but all involve some form of treating physical, emotional or thought disorders. Some of the variations include the following.

  • Therapeutic horseback riding usually involves a team that includes a certified riding instructor, a horse, and at least two volunteers. The team teaches individuals how to work with horses and how to ride them.
  • Hippotherapy uses horseback riding to teach balance, strength, and coordination. It sometimes involves a physiotherapist, a speech therapist and an occupational therapist. However, the term may also apply to other forms of therapy with horses.
  • Assisted learning (EAL) teaches life lessons through equine-related experiences.
  • Assisted psychotherapy (EAP) involves activities like grooming, feeding and caring for horses on the ground but does not include riding. While completing the work, licensed mental health professionals help clients deal with emotions, actions, and behavioral patterns.
  • Facilitated psychotherapy (EFP) uses the interaction with the horse as biofeedback to reach goals set by the client and mental health therapist.
  • Equine-assisted therapy (EAT) is a broad term that includes the use of an equine environment to treat mental, physical or cognitive conditions.
  • Therapeutic carriage therapy involves the management of a horse from a wheelchair or carriage.

Other terms that also apply to general types of equine-assisted therapy include equine-assisted therapy (EAT), facilitated wellness (EFW), facilitated counseling (EFC), facilitated mental health and assisted activities (EEA).

What conditions does the therapy treat?

The ancient Greek physician Hippocrates is credited with saying that horseback riding in the clean air strengthened muscles and kept them in good form. Therapists use horses to help clients deal with a wide range of conditions ranging from handling emotions and addictions to dealing with chronic illness and trauma. The therapy may also teach life skills that come from routine chores, a practice that helps children with learning disabilities or adults with developmental or emotional problems. It is not unusual for someone with a substance abuse disorder, for example, to miss some important lessons before recovering from addiction.

The British publication EFT Resource lists the following practical applications of the therapy for students.

  • Students learn about weights and measures, including fractions and measurements, through the process of preparing food for the horses.
  • Students learn to handle their personal space, a skill that carries over into the community by helping them perceive danger, respect others and understand boundaries.
  • Students learn about personal hygiene while shampooing and grooming the horses, and they learn the value of a good diet and exercise.
  • Students learn how to ride safely in the pasture and on the road. This teaches them to be aware of the terrain, to watch for vehicles, read road signs and pay attention to their own safety and the safety of others.
  • Students learn to overcome the dread of medical visits when they observe or assist with horses being cared for by veterinarians. Seeing the fear in an animal as big as a horse can sometimes help individuals accept their own fears more readily.

Working with horses can also be good for people with learning disabilities. Benefits include the following.

  • It helps autistic children and adults feel sensations, develop communication skills and create emotional bonds. It also helps with coordination and motor skills.
  • It helps people with attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD) observe their own thoughts and intentions before acting. It also helps them build confidence and calm themselves.
  • It helps people with dyslexia and other visual processing disorders by teaching them to align their thoughts and actions. It also increases confidence and gives students a break from feeling judged or labeled.

Equine-assisted therapy is useful in the treatment of mental and emotional conditions because it requires individuals to trust and understand the feelings of both the horse and the rider. It also teaches the value of dependability, consistency and emotional bonding, making it a powerful treatment for conditions like depression, anxiety, and substance use disorder. Equine-assisted psychotherapy follows two basic structures: the diamond and the triangle.

  • In the diamond, the therapist, the individual, the animal handler and the horse work together. The therapist watches the way the individual responds to the horse. The handler observes the horse’s body language and makes sure everyone is safe.
  • In the triangle, the therapist, the individual, and the horse work together. The therapist interprets the behavior of the horse and its interaction with the individual. The individual learns the effect of his behavior on the horse.

Equine-assisted psychotherapy has also been used to help with speech impairments, substance use disorder, post-traumatic stress disorder (PTSD), eating disorders and sexual abuse. Among the many lessons that psychotherapists teach with horses are mirroring, role-playing and keeping pace with the horse. Benefits include better communication skills and relationships, increased trust and self-awareness, better focus, greater confidence, and more self-control.

Equine therapists also work with occupational therapists to treat individuals with physical illnesses and disabilities, such as brain injuries, spinal paralysis or neurological problems. Programs like Easter Seals incorporate the techniques into traditional therapies because they are good for improving muscle strength, coordination, and flexibility. They also say working with horses makes people happier and healthier.

This video tells the story of three individuals who experienced “miracles” from equine therapy. Unexpected Miracles explores the treatment of a young equestrienne who suffers a stroke, an Afghanistan and Iraq veteran diagnosed with PTSD and a teenager with autism. Their tragic but heartwarming stories show how their healing relationships with their therapists and horses brought hope and joy to their lives.

What kind of training do equine therapists have?

Some schools offer degrees in equine assisted learning and psychotherapy, but students may also choose to major in a particular field of psychology and then focus on equine therapy. The area may expand in the next few years to meet rising needs. There are even some two or four-year training programs.

Candidates for degrees study the anatomy of horses, riding methods and human psychology. Other courses include subjects like business concepts, child development, and methods of equine-facilitated learning. Some colleges provide therapeutic centers that allow the public to get therapy while students gain experience. Much of the training will be hands-on, but students may be able to take some classes online.

After graduating, students must pass the Professional Association of Therapeutic Horsemanship exam, which is offered online. The Professional Association of Therapeutic Horsemanship (PATH) provides certification for all levels in the field. A college degree is not necessary to be certified for some equine therapy-related jobs. PATH offers the option of enrolling in a school program or taking workshops necessary for certification. After passing the exam, candidates for certification must submit both a resume showing experience in the field and a letter of recommendation from a professional in the field. Candidates must also be certified in CPR or First Aid.

What is the history of equine therapy?

Not only did Hippocrates write about the virtues of horseback riding, but French and Italian writers also talked about its benefits in 1569 and 1780. Then, in 1875, a French neurologist named Charles Chassaignac did studies that showed riding improved balance, motion, joint function and muscle tone. He also noticed an improvement in the mood of his patients.

Around 1900, the idea reached the United Kingdom when Oliver Sands used equestrian therapy to help soldiers who had been wounded during World War I. After his initial work at Oxford Hospital, British physiotherapists considered the practice to treat other kinds of injuries and handicaps. Then, in 1952, a Danish equestrienne named Liz Hartel won a silver medal at the Helsinki Olympics. Hartel gained the attention of the medical profession because she had used horseback riding to strengthen her legs after she was partially paralyzed by polio.

In 1969, two organizations were founded: the British Riding for the Disabled Association (RDA) and the North American Riding for the Handicapped Association (NARHA), which later became the Professional Association of Therapeutic Horsemanship (PATH). PATH became the advisory board that set standards for instructors, training and safety. In 1999, the Equine Assisted Growth and Learning Association (EAGALA) was founded in the United States to offer certifications in Equine Assisted Learning (EAL) or Equine Assisted Psychotherapy. These organizations brought credibility and acceptance to the practice.

Does equine assisted therapy help with substance use disorder?

In 2008, researchers looked at the effects of a 12-week protocol of animal-assisted therapy on participants. Individuals with personality disorders, affective disorders, schizophrenia, and anxiety had better coping skills and higher levels of confidence after their experiences. Animals included horses and farm animals.

Substance use disorder falls under the classification of mental illness, and many people who struggle with addiction also have a diagnosable mental illness. Likewise, many people who have mental illnesses also turn to substances to self-medicate their emotional issues. This suggests that equine-assisted therapy can be helpful to individuals undergoing treatment for addiction and dependency.

A 2018 article in PscychCentral explains that horses are pack animals and can sense when people are sad, anxious, happy or scared. Equine assisted therapy can help them in these ways:

  • Horses give instant feedback because they sense and respond to an individual’s emotions, thus providing a mirror to help a person recognize and understand his feelings.
  • Interactions with horses provide lessons on dealing with people and often lead to discussions of issues like addiction.
  • Horses are nonjudgmental and can build confidence in individuals who are struggling with negative situations.
  • Equine therapy provides a safe place for building trust without having uncomfortable conversations.

What is the difference between hippotherapy and equine-assisted therapy?

Hippotherapy is about the rhythmical, repetitive movement of the horse. This kind of therapy, when used with other traditional practices, is good for treating conditions like traumatic brain injuries, multiple sclerosis and language disabilities. Therapeutic riding, on the other hand, is more comprehensive. It includes riding, grooming and feeding the horse, learning about the health benefits and many other activities linked to the horse and therapy.

If you or someone you love wants to try equine-assisted therapy, help is available at PATH providers around the country.

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