What is equine therapy? How horses can help people cope with conditions ranging from autism to PTSD
therapyis provided by licensed professionals who incorporate horses into their treatment plans.
- People of all ages with diverse abilities can gain benefits from experiential equine-assisted therapy.
- A variety of equine-assisted therapies are used to treat conditions ranging from autism to PTSD.
Animal therapy typically brings to mind images of cats and dogs, but animal-assisted therapy goes beyond household pets. For years, there has been steady interest in the US on what horses can bring to the process of emotional and physical healing.
This emerging field is known as equine-assisted therapy (EAT), and the idea is straightforward: People of all ages, with diverse abilities, can gain benefits from working with horses therapeutically. Equine therapy services fall into three broad categories: therapy, equine-assisted learning, and horsemanship, which includes therapeutic and adaptive riding, or recreational riding for those with special needs.
Learn more about the process and benefits of equine-assisted therapy. If working with horses piques your curiosity - whether it's for yourself or someone you know - we've also included information on how to find established providers in your area.
What is equine therapy?
Equine-assisted therapy comes in many varieties and can range from occupational and physical therapy to psychological counseling. These services are provided by licensed professionals who incorporate horses into their treatment plans.
For example, therapists can use the natural movement and feedback of horses as physical therapy tools. In addition to the benefits of learning to ride a horse, unmounted horsemanship-related activities such as grooming, tacking, feeding and watering, and bedding or care of saddles may be offered as
Caitlin Peters, PhD, an occupational therapist and postdoctoral fellow at Colorado State University's Temple Grandin Equine Center administers occupational therapy in an equine environment. Peters also employs adaptive riding in her work, a form of equine-assisted therapy known as "hippotherapy" (hippos is Latin for horse), which is any physical, occupational, or language pathology therapy administered in the presence of horses.
"There's been a big push to put the therapy first, and then include that horses are a part of it," Peters says. The process varies significantly depending on the needs of the patient and what type of therapy it is.
In her occupational therapy research that focuses on youth with autism, Peters uses "sequencing" activities with multiple steps, such as learning how to put a saddle on a horse. "Or if I'm working on fine motor skills, then helping with the buckles on the saddle is a great activity," she says.
In speech and language therapy in an equine environment, riding horses can help patients practice breath control. In physical therapy, patients with cerebral palsy, for example, can ride the horses to improve their balance and posture.
Most of the places where equine-assisted therapy takes place are nonprofit facilities that have contracts with licensed therapists, Peters says, and there is someone in charge of taking care of the horses that are used during these sessions.
As for who equine-assisted therapy works best for, Peters says there isn't much research on that topic yet. "I will say, in my experience, there have been several of my clients who are initially very wary of horses," she says, but often "kids will really learn to love it."
Conditions that may benefit from equine therapy
Equine-assisted therapy is complementary to other more traditional forms of therapy. Numerous conditions have been studied by researchers and therapists using equine interventions.
- Cerebral palsy. In a 2020 meta-analysis, researchers found physical therapy with horses helped children with cerebral palsy recover gross motor function, which are whole-body movements such as sitting or standing.
- Multiple sclerosis (MS). A small 2020 study of 33 people with MS showed that this type of therapy intervention improved patients' ability to walk.
- Autism. "A lot of youth with autism have sensory processing differences," Peters says, so the equine environment is good for dealings with tactile, auditory, and olfactory (smell) sensations, as well as for the vestibular (balance) and proprioceptive (body position) systems. Her research has found occupational therapy for youth with autism that incorporates horses lead to improved communication and decreased hyperactivity.
- Post-traumatic stress disorder (PTSD). A small 2017 study of youth with PTSD found equine-facilitated psychotherapy was effective, but no more so than traditional office-based psychotherapy. A small 2020 clinical trial shows this type of therapy for veterans with PTSD may show promise for short-term symptom relief.
- ADHD. One small 2018 study of youth with ADHD found improvement of quality of life and attention with equine-assisted therapy, similar to the study group that used pharmacological intervention.
For all of these conditions, more research is needed in the equine environment. "The research on equine-assisted therapy has been mixed and largely depends on what outcomes you are looking at," says Megan Mueller, PhD, the co-director for Tufts Institute for Human-Animal Interaction. Mueller points out there are reviews that show a minimal effect from equine-assisted therapies, but more in-depth research appears promising.
What the research says: Though most of the studies on equine-assisted therapy are small, a comprehensive 2020 review found physical therapy with horses was helpful for children with cerebral palsy, who recovered significant gross motor functioning.
How to find equine therapy
If you are looking for a place to find equine-assisted services, some associations maintain databases. Peters recommends finding a facility with certification from The Professional Association of Therapeutic Horsemanship International or the American Hippotherapy Association to make sure they are following safety recommendations and other guidelines.
Important: Insurance may cover equine-assisted therapy in some states, but not in others. Sessions are typically hundreds of dollars out of pocket, although many facilities apply for grants to offset costs for patients.
Therapists can obtain credentials from the American Hippotherapy Association or Eagala to show they have experience in the equine environment. These associations all maintain searchable lists of providers that can help you located a therapist who practices equine-assisted therapy near you.
There are a variety of equine-assisted therapies people use to treat conditions ranging from autism to PTSD. There is promising evidence that equine-assisted therapy, which is performed by occupational therapists, physical therapists, speech and language pathologists, or psychotherapists, is beneficial for many conditions. More rigorous research is needed to discern the benefits of these therapies.
Anecdotally, therapy in an equine environment does work for patients according to providers.
"It's really beneficial for some people, whether it's because the horse is extremely motivating, so it gets clients who would otherwise not participate in therapy to really engage, or because it offers this really unique [physical activity], which provides both movements as well as sensory stimulation that's really difficult to mimic in a traditional clinic," says Peters.
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