Equine therapy, also known as Equine-Assisted Therapy (EAT), is a treatment that includes equine activities and/or an equine environment in order to promote physical, occupational, and emotional growth in persons suffering from ADD, Anxiety, Autism, Cerebral Palsy, Dementia, Depression, Developmental Delay, Genetic Syndromes (such as Down Syndrome), traumatic brain injuries, behavioral issues, abuse issues, and many other mental health problems.  Equine Therapy can help the individual build confidence, self- efficiency, communication, trust, perspective, social skills, impulse control, and learn boundaries.  Since the horses have similar behaviors with humans, such as social and responsive behaviors, it is easy for the patients to create a connection with the horse.  Riders with disabilities demonstrate their remarkable accomplishments in national and international sport riding competitions. Equine-Assisted Therapies have been recognized in the medical and mental health  field by most major countries.

Equine therapy dates back to the times when horses were used for therapeutic riding in ancient Greek literature. Orbasis of ancient Lydia documented the therapeutic value of riding in 600 B.C. In 1946, Equine Therapy was introduced in Scandinavia after an outbreak of poliomyelitis.

Therapeutic Riding was introduced to the United States and Canada in 1960 with the formation of the Community Association of Riding of the Disabled (CARD). In the United States riding for the disabled developed as a form of recreation and as a means of motivation for education, as well as its therapeutic benefits.

Animals such as elephants, dolphins, dogs, and cats have also been used for therapeutic purposes. Horses become the most popular animal to use in animal therapy because they give immediate feedback to the handler or rider’s actions. Horses also have the ability to mirror the feelings of the handler or rider. Horses’ large and intimidating appearance forces and individual to gain trust around them.

Equine Program:  Horses have played a key role in the history of Home On The Range.  This tradition continues today in a variety of treatment and leisure activities.  The Equine Program is a trauma informed, experiential based intervention, which includes the use of horses and mules.  This intensive, outcome based treatment program was designed for individuals presenting with externalizing issues such as poor anger management, impulsivity, low frustration tolerance and nonverbal communication difficulties.  The program is a combination of ground work with horses as well as riding and mule driving activities.  The overall intent of the equine program is improving emotional regulation, problem solving and team work skills.  The program consists of group, individual and family sessions as deemed appropriate and manageable.  Home On The Range, in collaboration with North Dakota State University, has been conducting outcome studies on the efficacy of equine therapy.  The research data has been nationally recognized and presented at various conferences.

Natural Lifemanship:  Natural Lifemanship is a Trauma Focused Equine Therapy model that is part of the Equine Program and includes a technique referred to as “Rhythmic Riding.”  This technique is relationship based experience between the group member and their chosen horse, and was designed to assist group members in learning how to self-regulate their emotional states.  Individuals with traumatic backgrounds often experience difficulty in regulating their “fight/flight” responses to stress and stimuli, and often take a longer time to “return to normal” after being triggered to a heightened state of arousal.  Trauma Focused Rhythmic Riding combines horse-back riding, mindfulness skill components, and relationships into a “dance” of learning opportunity.  Simply stated, residents are able to experience the present moment while listening to meaningful songs (they select) and riding to the rhythm of the music.  Between songs, mindfulness practice is utilized to assist group members in regaining emotional regulations which can so easily become dysregulated during the riding activity.

Horsepacking Program is a unique treatment intervention that joins two experiential, “bottom up” activities; equine and adventure therapy.  Participation in this program provides traumatized youth an opportunity to develop a bonded, mutually satisfying relationship with an equine partner, which relies upon interpersonal rhythm, visceral awareness and vocal and facial communication, all of which help traumatized youth reorganize their perceptions of danger and increase their capacity to manage relationships.  It is within the context of this relationally-driven intervention that recalibration of the autonomic nervous system occurs and gives rise to neurological re-wiring of secondary and primary process emotions.  Venturing into the backcountry with an equine teammate provides the catalyst for building connections to oneself, others and the great outdoors

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Equine-assisted psychotherapy, also called equestrian therapy or horse therapy, is a type of experiential mental health treatment that involves a person in therapy interacting with horses. Designed for people of all ages, equine therapy has been shown to treat a wide range of mental health issues, addressing both physical and psychological concerns associated with a diagnosis.

Individuals seeking help typically work with both a psychotherapist who specializes in equine therapy and a horse trainer who is familiar with their therapeutic application—though both roles may be filled by the same person.

The idea of combining equestrian activities and philosophies with the treatment of physical and mental health issues dates back centuries. Ancient Greeks wrote about the benefits of horse riding, calling this practice hippotherapy (from the Greek hippo, meaning horse). 

It wasn’t until the mid-1900s, however, that modern psychotherapists started using existing principles of therapeutic riding developed to treat polio and other health issues for treatment of mental health concerns. Equine-assisted psychotherapy as a modality grew out of therapeutic riding techniques and organizations designed to make horse riding accessible for people with disabilities.

Some organizations distinguish between equine-assisted therapy, hippotherapy, and therapeutic riding. Hippotherapy tends to focus more on occupational, speech, and physical therapy. Therapeutic riding is geared toward individuals with conditions such as cerebral palsy or Down syndrome which call for greater physical support while riding for the purpose of better back and structural health. All horse-assisted modalities can have significant associated mental health benefits. 

Studies have shown people of all ages can benefit from equine-assisted therapy, and horses have been incorporated into treatment for a wide variety of issues, including:

• Cerebral palsy
• Inattention and hyperactivity (ADHD)
• Addictions and substance abuse issues
• Mood-related issues
• Autism
• Asperger’s 
• Learning difficulties
• Eating and food issues
• Grief and loss
• Trauma and posttraumatic stress (PTSD)
• Bipolar
• Depression
• Anxiety 
• 
  

Equine therapy can target physical concerns such as behavioral tics, motor control issues, balance, posture, and coordination–especially in children and teens with cerebral palsy. In other cases, working with horses helped by increasing individuals’ cognitive skills, reducing stress, easing symptoms of PTSD, and addressing symptoms of depression. Equine therapy has even been shown to, for some individuals, have a positive effect on destructive relationship patterns that have developed or behaviors that compromise health or safety. 

In a study of over 30 people participating in an experiential equine-assisted therapy program, researchers found the individuals’ psychological distress reduced immediately following treatment and that psychological well-being improved. These positive effects held stable through a follow-up six months later. 

Equine therapy for the purpose of addressing mental health issues typically involves both a psychotherapist and horse trainer. Horses, which might be full-size or smaller ponies, are chosen as therapy animals based partially on their ability to withstand a great deal of distraction and tolerate unpredictable or erratic behavior from people riding or grooming them. Many have been trained to exhibit especially gentle and repetitive behaviors to put people at ease and make their interactions more predictable. 

Some residential treatment centers offer equine therapy programs; other courses are set up between an individual and their psychotherapist. Someone new to equine therapy will generally start with low levels of interaction with the horse: petting, grooming, and feeding. They might then work up to haltering the horse and leading it with a trainer or solo. Not all equine therapy incorporates riding horses, though it is frequently woven into the practice. 

Equine-assisted psychotherapy is said to work in part because of the natural ability horses have to pick up on human emotional expressions and needs. Particularly patient, perceptive, and attuned to displays of fear, anger, agitation, and despair, horses are able to mirror human moods in a nonjudgmental way, without motive or expectations. As the person in therapy bonds with the horse, self-awareness grows and emotional healing often takes place.

People interested in equine therapy should be aware of some dangers posed by the activity, not least of which is the size and weight of most horses. Though horses trained as therapy animals are less likely to pose any risk to riders out of fear or aggravation, their stature alone may be a concern for some people or parents. Additionally, some people experience allergic reactions to horses or their environments (barn dust or hay, for example) and should exercise caution when considering equine therapy. 

It is recommended that individuals with health issues such as spina bifida, scoliosis, or Down syndrome consult with a physician before their first experience with equine-assisted therapy. Riding horses can compromise spinal stability, so it may not be recommended for someone with back problems.

It is always a good idea talk with your personal therapist or counselor when considering a new treatment modality to ensure the method is a good fit for both of you.

References:

1. Benda, W., McGibbon, N. H., & Grant, K. L. (2003). Improvements in muscle symmetry in children with cerebral palsy after equine-assisted therapy (hippotherapy). The Journal of Alternative & Complementary Medicine, 9(6), 817-825. Retrieved from http://online.liebertpub.com/doi/abs/10.1089/107555303771952163 
2. Cumella, E. J., & Simpson, S. (2007). Efficacy of equine therapy: Mounting evidence. Remuda Ranch Center for Anorexia and Bulimia. Retrieved from http://www.psicoterapiaequina.cl/pdf/Efficacy_of_Equine_Therapy.pdf 
3. Klontz, B. T., Bivens, A., Leinart, D., & Klontz, T. (2007). The effectiveness of equine-assisted experiential therapy: Results of an open clinical trial. Society & Animals, 15(3), 257-267. Retrieved from http://booksandjournals.brillonline.com/content/journals/10.1163/156853007x217195/ 
4. Lucchesi, E. (2016, July 5). With hippotherapy, the horse provides the therapy. New York Times. Retrieved from https://well.blogs.nytimes.com/2016/07/05/with-hippotherapy-the-horse-provides-the-therapy/ 
5. Schultz, P. N., Remick‐Barlow, G., & Robbins, L. (2007). Equine‐assisted psychotherapy: A mental health promotion/intervention modality for children who have experienced intra‐family violence. Health & Social Care in the Community, 15(3), 265-271. Retrieved from http://psicoterapiaequina.cl/pdf/Equine%20Assited%20Psychotherapy.pdf 
6. Therapeutic riding vs. hippotherapy. (2013, January 30). Heartland Equine Therapeutic Riding Academy. Retrieved from http://hetra.org/therapeutic-riding-vs-hippotherapy
7. Tyler, J. L. (1994). Equine psychotherapy: Worth more than just a horse laugh. Women & Therapy, 15(3-4), 139-146. Retrieved from http://www.tandfonline.com/doi/abs/10.1300/J015v15n03_11 
8. Types of equine therapy. (n.d.) EquestrianTherapy.com. Retrieved from http://www.equestriantherapy.com/types-of-equine-therapy 
9. What is equine therapy? (n.d.) CRC Health. Retrieved from http://www.crchealth.com/types-of-therapy/what-is-equine-therapy
10. Yorke, J., Nugent, W., Strand, E., Bolen, R., New, J., & Davis, C. (2013). Equine-assisted therapy and its impact on cortisol levels of children and horses: A pilot study and meta-analysis. Early Child Development and Care, 183(7), 874-894. Retrieved from http://www.tandfonline.com/doi/full/10.1080/03004430.2012.693486?src=recsys