Equine-assisted psychotherapy can be an effective supplement to mental health treatment. Here’s how it works.

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The incorporation of animals in mental health treatment has a long history. Animal-assisted psychotherapy can be an evidence-based complementary treatment to traditional therapy.

Animals can aid in healing emotional and behavioral conditions. They can provide a source of comfort, consistency, and mutual nurturance, giving support to both the mind and the body.

Horses are one of those comforting social animals that can help people with their well-being. Nurturing interactions with horses allows humans to practice:

  • problem-solving skills
  • social skills
  • emotional regulation
  • empathy

Animals like horses also sense your emotions and mirror them back, offering people a way to talk about their own emotions without feeling as overwhelmed or judged.

Equine-assisted psychotherapy is a form of therapy that incorporates horses. It is an experiential treatment in which participants partner with horses in mental health treatment. A licensed mental health therapist and an equine specialist collaborate to supervise and lead these sessions.

Conditions it’s used for

Equine-based psychotherapy can be used for a variety of mental health conditions in both children and adults, including but not limited to:

Other medical conditions equine-based therapies may help with could include:

  • cerebral palsy
  • dementia
  • Down syndrome
  • stroke recovery
  • traumatic brain injury

Equine-assisted psychotherapy can consist of interacting and connecting with horses by:

  • grooming and petting the horse
  • bathing the horse
  • leading the horse to designated areas
  • feeding the horse
  • recreational and goal-oriented activities, either individually or in a group

According to researchers, the most standardized approach by the Equine Assisted Growth and Learning Association (EAGALA) focuses on unmounted, on-the-ground activities, which do not usually include horse riding.

Horses are usually unsaddled and free to move closer or farther away from the client — and vice versa.

This self-distancing approach allows for the modeling of boundaries and connections we would see in human-to-human interactions.

Equine therapists help provide safety training and observations about the behavior of horses. Licensed therapists also ensure that the experience is safe, both physically and emotionally, for the participant.

Therapists may also incorporate cognitive-behavioral techniques that allow clients to talk more freely about their emotions or anxiety without feeling constrained.

For example, suppose a horse appears to exhibit certain emotions. In that case, clients may be able to point to these emotions as a way to talk about their own and reframe existing cognitive distortions.

Sessions may also follow the SPUD framework by the EAGALA, which stands for shifts, patterns, unique aspects and discrepancies.

SPUD is a framework of reflective listening and observation that captures the behaviors, activities, and movements of both the client and the horse. In the technique, a therapist may:

  • ask you questions
  • make observational statements to you
  • invite you to tell your story, if you’re comfortable

This type of low-pressure environment allows participants to open up should they choose to do so.

While research on equine-assisted psychotherapy is limited as it’s an emerging treatment, what existing research suggests is that equine-assisted therapy and other animal-assisted psychotherapies may work because they:

Calm and soothe the nervous system

One reason animal-assisted therapies can be so effective is that animals can help regulate the nervous system, a 2016 study found. Contact with animals may promote feel-good hormones (endorphins) and help calm an overactivated nervous system that is overwhelmed by:

  • trauma
  • anxiety
  • depressive symptoms

Promote healthy attachment

Animals like horses can be a conduit through which humans learn and relearn healthy attachment patterns.

Trauma and other mental health conditions can disrupt how we attach to and bond with others. Clients may be able to “transfer” the productive life lessons and affirming bonds they experience with horses or other animals to their adult relationships.

Horses are social animals that can perceive emotions and their environment with heightened awareness. They can model for humans a sense of connectedness.

Participants may also feel a greater sense of purpose as they take on more responsibility for the horses.

Cultivate social learning and connection

Individuals who experience trauma or other mental health conditions can also experience social isolation and hypervigilance — a heightened sense of fear that danger is afoot.

Horses or other animals may be a calming force for folks challenged socially. With an animal, you can:

  • explore your self-perception
  • learn how you behave in relationships
  • communicate your emotions without fear of being shamed or judged

Folks can use their interactions with horses as a launching pad for identifying how they may be feeling.

For example

“The horse seems a bit shy today. I think she’s wary of strangers. I am too!”

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Since horses can exhibit a similar “flight” instinct as humans, people can relate to them easily.

A horse’s behavior can also be an avenue or metaphor to unpack your own story. For example, a participant who observes two horses fighting may ask questions about the fight and examine a recent conflict in their own lives.

Horses can also provide immediate feedback to folks, which helps participants become aware of their behavior and social skills.

For example

“The horse is distancing himself from me. I do feel a bit on edge today. Maybe he can sense that.”

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Enhance the client-therapist relationship

Such a secure base between animal and client also helps to promote the alliance between therapist and the participant — opening up lines of communication that may not occur in talk therapy.

As clients experience reductions in their anxiety, depression, and social isolation, they may experience greater emotional regulation.

Benefits of equine-assisted psychotherapy can include:

  • Greater confidence, self-awareness and social skills. Equine-based psychotherapy as well as other animal-assisted psychotherapy can build confidence and social skills by:
    • promoting communication of emotions
    • modeling boundaries
    • promoting social connection,
    • fostering empathy and nurturance
  • Reductions in anxiety, fear, depression and social isolation. This form of therapy can help with symptoms of trauma such as hypervigilance and social isolation. As participants learn to express themselves in a safe space they might break through roadblocks experienced in traditional therapy.
  • Ability to express emotions without fear. Equine-based psychotherapy opens up an avenue where clients don’t have to directly talk about their traumas or fears in order to communicate their emotions.
  • Mutually beneficial. Research indicates that not only do humans benefit physiologically from contact with animals, but contact with humans can also benefit the endocrine functioning in animals, managing their stress response and sympathetic nervous system as well. It’s a win-win situation for all.

Limitations can include:

  • Costs and accessibility. Accessibility to equine-based therapy may be limited by the high costs and geographic availability.
  • The welfare of both animals and humans must be carefully considered. There needs to be great care taken to ensure that animals who are traumatized, fearful, or avoidant aren’t further exploited in equine-assisted psychotherapy.
    • Some animals may have behavioral conditions or may be easily scared themselves.
    • Animals used in therapies should regularly receive a behavioral evaluation and a physical exam by a licensed veterinarian to ensure that animals are not adversely affected.
  • The effectiveness of this therapy as a stand-alone treatment is not assured. There isn’t enough research yet to use equine-based therapy as a stand-alone treatment, though there’s evidence for its efficacy as a complementary treatment. Your personal psychotherapy should be maintained.
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Equine-assisted psychotherapy is an evidence-based complementary treatment that incorporates interactions with horses. It’s a collaboration between the participant, therapist, and equine specialist.

This form of therapy can be used to treat a number of mental health and medical conditions.

Activities like grooming, petting, and other recreational group and individual activities are often combined with techniques from talk therapy to unpack your emotions and thinking patterns with less inhibition.

Horses can provide a safe space where participants can explore their anxiety, traumas, and fears without feeling overwhelmed or judged. Horses also provide the opportunity to practice problem-solving- and social skills. They can even help with harmful attachment styles.

If you’re interested in participating in equine-based psychotherapy, you can speak to a mental health professional to consider whether it would be helpful for you.

You may also want to visit the Equine Assisted Growth and Learning Association to find a program near you.

Trauma, anxiety, depression, and other mental health conditions can be overwhelming. You don’t have to face them alone. You can be supported by your fellow humans — and supportive animals, too.