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Equine-Assisted Therapy

Reviewed by Psychology Today Staff

Equine-assisted psychotherapy, sometimes referred to as EAP, EAT, or “equine therapy,” refers to activities with horses that are conducted while being supervised by a mental health professional and a horse trainer or other equine specialist. Equine therapy has been used to treat anxiety, ADHD, eating disorders, addiction, depression, and many other mental health conditions, and, in addition to targeting symptoms of those disorders, is theorized to help patients build confidence, self-awareness, and empathy. However, some researchers caution that the evidence in favor of equine therapy is lacking or inconclusive, and that it should not be used in place of traditional therapy. It is most often used as a complement to other kinds of mental health treatment.

When It's Used

Equine-assisted psychotherapy is available to both adults and children, generally those over the age of 6. It has been theorized to treat a number of conditions, including ADHD, addiction, autism, PTSD, anxiety, and depression. It may also be recommended to help address common life challenges such as grief or low self-esteem. For most of the targeted conditions, few high-quality studies in favor of equine therapy exist, and many researchers caution that more research is needed to determine equine therapy’s efficacy against specific mental health conditions; however, anecdotal evidence suggests that many patients find the practice beneficial.

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What to Expect

During an equine-assisted therapy session, the client will typically engage in basic caretaking activities with the horse with the help and direction of an equine specialist; common examples include grooming the animal, feeding it, and leading it around an enclosure. They may also take on more complex activities, such as creating a basic obstacle course for the horse and guiding them through it. (Riding the horse is not often a component of mental health treatment, but may occur during equine-assisted physical therapy or occupational therapy.) Afterward, the mental health professional and the client will usually discuss what occurred, what was learned, and what behaviors or emotions they might target in their next session with the horse.

How It Works

Because horses have long been domesticated and live alongside humans, it’s thought that they are especially attuned to humans’ emotions and nonverbal signals and that they respond accordingly. While engaging in activities with the horse, the client will attempt to recognize how the horse’s behaviors might be due to their own emotional signals—a client who is angry or anxious, for example, may see the horse pull away or otherwise respond negatively. This “mirroring” process is thought to help the client identify what they’re feeling and potentially modify their emotions for the better, all in a nonjudgmental environment. Equine specialists may also promote the practice of mindfulness, or focusing on the present moment, when the client is interacting with the horse.

Because horses are large, powerful, and may be intimidating to many people, engaging with them in a supervised environment is thought to help anxious individuals face their fears and practice vulnerability in a safe space. Indeed, some clients report that simply interacting with the horses and successfully guiding them through challenges is beneficial for their anxiety and self-esteem. Over time, many clients form a bond with the horse(s) they work with, which is theorized to foster empathy and build trust, especially among clients who have been traumatized in some way. What’s more, learning to interact with a horse calmly and safely is thought to help individuals, particularly children, who struggle with impulse control or hyperactivity.

What to Look for in an Equine Therapist

Interested clients are advised to look for an equine therapy program that has experience treating their particular challenges. It's critical to talk to a mental health professional beforehand to determine whether equine therapy is right for them; someone with a serious fear of horses, for example, or who has certain physical limitations that may interfere with their interactions with the horse, may determine that equine therapy is not the best treatment option. Certain organizations, such as the Equine Assisted Growth and Learning Association (EAGALA) and the Professional Association of Therapeutic Horsemanship International (PATH Intl.), offer certifications to mental health professionals and equine specialists who practice equine therapy; clients may wish to seek out programs that have obtained certifications from these or other groups. However, there is not yet a single organization that sets standards for equine therapy in the U.S.

Anestis, Michael D., et al. “Equine-Related Treatments for Mental Disorders Lack Empirical Support: A Systematic Review of Empirical Investigations.” Journal of Clinical Psychology, vol. 70, no. 12, 2014, pp. 1115–1132.,
Pérez‐Gómez, Jorge, et al. “Equine‐Assisted Activities and Therapies in Children with Attention‐Deficit/Hyperactivity Disorder: A Systematic Review.” Journal of Psychiatric and Mental Health Nursing, 2021,
White, Eleanor, et al. “The Effect of Equine-Assisted Therapies on Behavioural, Psychological and Physical Symptoms for Children with Attention Deficit/Hyperactivity Disorder: A Systematic Review.” Complementary Therapies in Clinical Practice, vol. 39, 2020, p. 101101.,
Last updated: 05/25/2022