Whether it’s a nuzzle of their wet nose, a game of fetch or a walk around the block, spending time with our pets can make us feel better, calmer and even happier. Indeed, studies suggest that people with pets experience both emotional and physical benefits (Barker, 1999).

But can time spent with an animal truly translate into a meaningful, healing experience? That’s the goal of equine-assisted psychotherapy (EAP), an increasingly popular experiential treatment where individuals interact with horses in a variety of activities, including grooming, feeding, walking and equine games, for improving their psychological health. Both a licensed therapist and horse professional conduct EAP.

According to the Equine Assisted Growth and Learning Association, EAP is used to treat “behavioral issues, attention deficit disorder, substance abuse, eating disorders, abuse issues, depression, anxiety, relationship problems and communication needs.”

The Equine Facilitated Mental Health Association (EFMHA) also includes riding and vaulting as part of treatment.

How Can EAP Help?

  • Providing insight for observation and growth. According to Brad Klontz, Psy.D., therapists can use clients’ reactions to horses’ behaviors to understand how clients interact with people and help them gain self-awareness. “A cognitive-behavioral therapist might use a client’s interpretation of a horse’s movements, behaviors or reactions as a metaphor to identify and change negative patterns of thinking that lead to depression or relationship problems,” Klontz said.
  • Offering instant insight. Because horses offer “instant and accurate feedback,” Klontz said, they shed light on the client’s thoughts and feelings before both the client and therapist are conscious of them.
  • Fostering a healthy relationship. According to Amy Gerberry, M.A., L.P.C., director of administrative services at Remuda Ranch — a residential, faith-based eating disorders treatment program that requires equine therapy — “the horses offer a pure, nonjudgmental relationship” for patients. The animals “aren’t concerned with their appearance or how much they weigh.”

    Because of this, horses “allow patients to connect to a living being without the risk of rejection or criticism,” said Sari Shepphird, Ph.D., clinical psychologist and eating disorder specialist in Los Angeles. Shepphird refers her patients to equine programs. EAP “makes the transition into healthy relationships less threatening,” Shepphird said.

  • Building trust. Many patients with eating or other mental health disorders have experienced trauma, which makes it difficult for them to trust others and feel safe. Patients might be resistant to opening up to a therapist and expressing their feelings or might not be skilled in verbal communication. EAP can serve as a first step in helping individuals break through these barriers and become more comfortable.

Existing Research

Today, psychologists stress treatments whose effectiveness has been extensively researched and substantiated. The American Psychological Association calls these treatments evidence-based practice in psychology (EBPP). “The purpose of EBPP is to promote effective psychological practice and enhance public health by applying empirically supported principles of psychological assessment, case formulation, therapeutic relationship and intervention,” according to Rob Heffer, Ph.D., clinical child psychologist and clinical associate professor at Texas A&M University.

With EAP, however, scientific results regarding its usefulness is lacking. Anecdotal evidence, such as case studies, has shown benefits, however. In their comprehensive book about equine therapy, Horse Sense and the Human Heart: What Horses Can Teach Us About Trust, Bonding, Creativity, and Spirituality, McCormick and McCormick (1997) describe various case studies where young people with severe behavioral problems were helped by working with horses.

To date, just a handful of quantitative studies have been published. Klontz and colleagues (2007) looked at psychological distress and well-being among 31 participants, ages 23 to 70. Findings from self-report questionnaires revealed reductions in psychological distress and less psychological symptoms. Participants reported being more independent and self-supported, better able to live fully in the present and less troubled with regrets, resentment and guilt. However, the researchers noted limitations like the absence of a control group and a randomly selected sample.

In a recent pilot study, researchers explored EAP’s effectiveness in 63 children who witnessed violence between their parents and experienced child abuse (Schultz, Remick-Barlow & Robbins, 2007). After an average of 19 sessions, all children showed improved scores on the Children’s Global Assessment of Functioning (GAF), which measures psychological, social and school functioning for six- to 17-year-olds. Limitations included a self-selected sample, no control group and the use of one measure.

Other research with at-risk adolescents has produced mixed results. While earlier studies (Bowers & MacDonald, 2001; MacDonald & Cappo, 2003 as cited in Ewing, MacDonald, Taylor & Bowers, 2007) found a decrease in depression and increase in self-esteem, recent research didn’t show any significant changes in 10- to 13-year-olds in a nine-week equine program (Ewing et al., 2007). However, the authors presented several case studies that suggested the program was helpful. Speculating on the nonsignificant findings, the authors pointed to the program’s short duration; the devastating changes many of the kids experienced in their family life during the study; and the children’s severe disorders.

Why The Lack of Research?

It’s natural to wonder why there is a shortage of published studies on EAP. Experts suggest it may be because experience-based therapy, such as storytelling or art therapy, is difficult to quantify. In other words, the questionnaires that psychologists typically use to measure a treatment’s effectiveness might not capture the changes or positive benefits of EAP. EAP also is a relatively new form of therapy.

Should You Try It?

Though the empirical data is currently lacking, some research and anecdotal evidence do illustrate positive results. Remuda Ranch has the highest success rate in the nation, Gerberry, the director, said. Most believe EAP to be a beneficial adjunct treatment for eating disorders but should not replace medication and therapy.

When looking for a reputable program, consider the following:

  • A well-qualified treatment team including mental health and equine experts.
  • A trained mental health provider with licensure to practice in his or her state. The therapist should have advanced training in EAP.
  • A particular therapist’s treatment approach. Each may have different ideas about the best way to proceed.
  • A program with EAGALA or NARHA certification (see the websites listed below).


Barker, S.B. (1999). Therapeutic Aspects of the Human-Companion Animal Interaction. Psychiatric Times, 16.

Equine Assisted Growth and Learning Association.

Equine Facilitated Mental Health Association.

Ewing, C.A., MacDonald, P.M., Taylor, M., Bowers M.J. (2007). Equine-facilitated learning for youths with several emotional disorders: A quantitative and qualitative study. Child Youth Care Forum, 36, 59-72.

Klontz, B.T., Bivens, A., Leinart, D., Klontz, T. (2007). The effectiveness of equine-assisted experiential therapy: Results of an open clinical trial. Society and Animals, 15, 257-267.

McCormick A., & McCormick M. (1997). Horse Sense and the Human Heart: What Horses Can Teach Us About Trust, Bonding, Creativity and Spirituality. Deerfield Beach, Florida: Health Communications, Inc.

Schultz, P.N., Remick-Barlow, A.G., Robbins, L. (2007). Equine-assisted psychotherapy: A mental health promotion/intervention modality for children who have experienced intra-family violence.Health and Social Care in the Community, 15, 265-271.