Equine-Assisted therapy (EAT) is a highly specialized form of experiential therapy that involves working in collaboration with a horse, a therapist, and in some cases, a certified horse handler or equine expert. The term encompasses a range of therapeutic modalities that involve activities with horses and other equines which are designed to promote physical and mental health.

It’s widely known that working with animals provides people with a sense of companionship, comfort, and a strong sense of well-being. The origins of equine-assisted therapy date back to 600 BC in ancient Greece, when horses were involved in therapeutic riding. Throughout history, horses have been used to help treat a variety of disabilities and illnesses, including polio. Since the 1990s, equine-assisted therapy has assisted in the treatment of physical and mental health disorders, including ADHD, anxiety, eating disorders, post-traumatic stress disorder (PTSD), and substance abuse.

The overarching goal of equine-assisted therapy is to help individuals develop a sense of personal responsibility while learning new social skills and coping mechanisms; all of which can be highly beneficial to anyone recovering from a substance abuse disorder. Here you’ll find a breakdown of how equine therapy works, its many benefits, and what one can expect from treatment.

What is Equine Therapy?

Equine Therapy, also known as Equine-Assisted Therapy (EAT) or Equine-Assisted Activities and Therapy (EAAT), is a holistic and experiential form of animal-assisted therapy where participants learn how to work with horses to feed, groom, halter, and lead them. Horse-assisted therapy may or may not include horseback riding, depending on the specific kind of therapy and the condition being treated.

The purpose of equine therapy is to help patients identify, explore, and develop new skills, coping mechanisms, and ways of thinking that can benefit them long-term. While studies into the effectiveness of EAT are still limited, equine-assisted therapy has been shown to have a positive effect in as little as 2-3 sessions. It can help people develop the following:

Assertiveness
Ability to connect
Confidence
Emotional growth
Improved impulse control
Increased self-esteem
Increased sense of trust in oneself and others
Problem-solving
Self-awareness
Social skills
Overall wellbeing

For this reason, many addiction recovery centers offer equine therapy as a treatment option. By working with horses, those receiving treatment for alcohol and drug abuse can learn the necessary tools required to maintain sobriety and navigate the world free of addiction.

Different Types of Equine Therapy

There are different kinds of equine therapy programs, each with specific goals for the people involved. Some of the most common types of horse-assisted therapy that are used as part of addiction treatment programs include:

Equine-assisted Psychotherapy (EAP)

EAP involves mental health professionals that work alongside patients and clients to help them learn about their own behavior and patterns. During therapy sessions, patients will participate in activities with the horses and then work with the therapist to discuss and process feelings that come up during the experience. Since horses are non-judgemental creatures, EAP creates a safe environment for individuals to work through complex feelings associated with addiction, while building new positive skills.

No prior horse or riding experience is necessary to participate in equine-assisted psychotherapy. Since all therapeutic activities are done from the ground, it is completely safe and suitable for a wide range of different abilities.

Hippotherapy

The term hippotherapy comes from the Greek word hippos, which translates to horse. During hippotherapy, an occupational therapist, a physiotherapist, or a speech and language pathologist work alongside an equine specialist, the patient and a horse. The patient is encouraged to adjust their posture based on different movements of the horse. The goal of hippotherapy is to allow the horse to lead the patient, as opposed to having the patient control the horse.

Hippotherapy is often used as part of a broader program to treat conditions such as cerebral palsy, where a person experiences impairments, disabilities, functional limitations, and neuromotor and sensory dysfunction. However, it can also be used as part of addiction treatment programs. Relinquishing control and allowing the horse to lead can be a powerful lesson in humility and trust, which can be very beneficial to people recovering from addiction.

Therapeutic Horseback Riding

During therapeutic horseback riding, individuals work with a team of equine specialists, which usually includes a certified therapeutic riding instructor, two or more volunteers, and a horse. Patients will learn how to ride a horse and work with it on the ground. In addition to learning how to ride a horse, therapeutic horseback riding allows participants to develop physical and social skills that help support them on their journey of sobriety. This includes increased self-awareness, improved communication skills, increased physical fitness, greater trust in oneself and others, enhanced problem solving skills, more confidence and a sense of accomplishment and pride.

How Does Equine Therapy Work?

Equine-assisted therapy is performed by a licensed mental health professional working with a certified equine handler. Centers which are certified to administer horse-assisted therapy only use suitable horses for treatment programs. These are usually older mares and geldings.

Therapy sessions generally take place at a dedicated equine therapy facility that’s either standalone or associated with an inpatient rehab center. To ensure the therapeutic experience is tailored to an individual’s personal needs, the therapist will meet with patients beforehand to learn more about their background and treatment goals.

During individualized therapy sessions, the patient works with a licensed therapist, a certified equine specialist and a horse that they’ve selected, often as part of the therapeutic treatment plan. Depending on the kind of horse-assisted therapy, horseback riding isn’t necessarily involved. Instead, the patient will learn how to feed, groom and walk the horse. Patients are encouraged to practice mindfulness and pay attention to how the horse responds to their behavior.

While engaging in equine therapy, patients are able to see their own tendencies, including self-defeating or otherwise destructive thought patterns. Such insights provide both patient and therapist a unique base from which to discuss and process emotions both during and after the experience. As a result, EAT therapy sessions may also involve elements from traditional talk therapy, such as mirroring, role play and role reversal.

Benefits of Equine Therapy

Many of the benefits of equine therapy can be attributed to the characteristics of horses themselves. Horses are large, majestic creatures known for their gentle and calm nature. Learning to work with a horse can help people overcome fear and build confidence.

As pack animals, horses are highly sensitive to other creatures. This includes an ability to mirror and respond to human behavior. As a result, horses are very adept at interacting and working with humans in an even-tempered and non-judgmental way, which can be particularly supportive for people who are in the process of addiction recovery.

Equine therapy can also be very beneficial in helping people restore their trust in themselves and others. Individuals who struggle to express their emotions or form relationships, often find it easier to do so with a horse. Equine therapy allows people to form a close emotional bond with a horse based on shared affection, acceptance, and mutual respect.

Since horses frequently mirror the behavior, demeanor, and moods of the humans they interact with, a patient can actually see the effect they’re having on the animal, including how it shifts when they show up differently. Through equine-assisted therapy, horses help model and provide valuable lessons about affection, assertiveness, honest communication skills, healthy boundaries, leadership, responsibility, patience, play, self-awareness, and more.

Equine therapy also provides therapists with a direct channel through which to observe and assist the patient with a range of emotional and behavioral patterns associated with addiction, trauma, and mental health disorders.

Mental Health and Equine Therapy

While equine therapy is a relatively new facet of mental health and addiction treatment, data suggests it can be very beneficial. A 2008 study published in the journal of Clinical Practice and Epidemiology in Mental Health, found that individuals who engaged in equine therapy while receiving mental health treatment for conditions such as anxiety, schizophrenia, and personality disorders, reported higher levels of self-esteem and healthy coping mechanisms.

Equine therapy is commonly used to treat the following mental health conditions:

Anxiety: It’s estimated that 17 million Americans are affected by anxiety. Those who suffer from anxiety disorders often are worried about their past and their future. Through interacting with and caring for horses, equine-assisted therapy gives individuals the opportunity to be present and focus on the tasks at hand. In addition to the psychological benefits of horse-assisted therapy, working with horses can reduce people’s blood pressure and heart rate, which in turn can help calm the physical symptoms of anxiety.
Post-Traumatic Stress Disorder (PTSD): According to the U.S. Department of Veteran Affairs, approximately 12 million Americans live with PTSD. Post-traumatic stress disorder (PTSD) is also one of the most common root causes of drug and alcohol addiction. Equine therapy is used to treat people suffering from PTSD and co-occurring disorders. People who’ve been diagnosed with PTSD often struggle with trusting and forming emotional bonds with other people. Through equine therapy, individuals with PTSD can regain the ability to trust and form connections, which can translate to emotional growth in other areas of their lives.
Attention Deficit Hyperactivity Disorder (ADHD): Therapeutic horseback riding is often recommended for people with ADHD because caring for and riding a horse can help improve focus, organization, and executive functioning. The rhythmic stride of a horse can also be very calming.

In addition to the conditions mentioned above, equine-assisted therapy is also used to treat autism, behavioral problems, depression, eating disorders, grief, and more.

How Equine-Assisted Therapy Is Used in Addiction Treatment Programs

Mental health and substance abuse disorders are intrinsically linked. At least 20% of people with mental health conditions have a co-occurring substance use disorder. For people with schizophrenia, the number may be as high as 50%. Comparatively, people with substance use disorders are up to 3 times more likely to suffer from a mental health condition such as anxiety or depression.

Equine-assisted psychotherapy provides a uniquely beneficial approach to treating both drug addiction and co-occurring mental health conditions by helping people work through the underlying causes of addiction, develop a positive sense of self-worth and learn new coping mechanisms.

In addition to the benefits outlined above, a 2016 study found that the active outdoor environment can be more beneficial for some individuals as compared to traditional talk therapy focused addiction treatment. In that same study, participants reported that the stable environment allowed them to construct a positive self: one which is useful, responsible, accepted and different from the “patient/self” receiving treatment for alcohol and drug addiction.

Equine therapy programs provide addiction treatment patients with a new focus. Through working with horses, people learn how to take responsibility for their actions and maintain a consistent schedule.

Depending on the recovery center, equine therapy is offered as a treatment option in conjunction with other holistic, experiential and evidence-based therapies as part of a comprehensive alcohol and drug rehab program.

Effectiveness of Equine-Assisted Therapy

While more addiction treatment facilities are now offering equine-assisted therapy, research into it’s effectiveness is still scarce. The research that does exist is largely focused on the effectiveness of equine therapy in treating physical conditions and disabilities, as oppossed to addiction and mental health disorders. A 2019 review published in the Australian Journal of Psychology looked at the various studies on the effectiveness of equine therapy and found that while some studies reported improvements on a range of outcome measures, others found no change.

As a result, equine therapy is often paired with other evidence-based therapies as part of a comprehensive addiction treatment program.

Cost, Side Effects, and Other Considerations

While equine-assisted therapy can be beneficial to those undergoing treatment for drug addiction and co-occurring disorders, like any kind of therapy there are several key considerations to keep in mind.

Accreditation and certification: Since horse-assisted therapy is a highly specialized form of treatment, it’s vital that you seek treatment from an accredited facility. In the United States, there are two major organizations that certify equine centers: the Equine Assisted Growth and Learning Association and the Professional Association of Therapeutic Horsemanship International (PATH).
Availability: Since 1969, PATH has certified 873 centers around the world that offer a variety of horse-assisted therapeutic activities. In 2016, these PATH-certified facilities served over 66,000 people — a number that rose to more than 68,000 in 2017. However, as of 2017 only 244 PATH certified centers were associated with addiction treatment centers. Therefore, there’s a chance that those seeking equine-assisted therapy may not be able to find a certified facility in their local community.
Insurance coverage: Equine-assisted therapy is growing in popularity, but there are still limited scientific studies as to its effectiveness in treating substance abuse disorders and mental health conditions. Therefore, depending on coverage, insurance may not cover part or even any of the costs.
Cost: The cost of equine-assisted therapy varies depending on a variety of factors, including the location and the kind of therapy which is offered. Whereas therapeutic riding lessons may cost $80 to $115 per hour-long session, equine-assisted psychotherapy is generally more costly; averaging $115 to $300 for an hour-long session.
Side-effects: While negative side effects to horse-assisted therapy are rare, there have been reported incidents of lowered self-esteem and increased aggression in children and young adult participants. This can occur when a young person becomes attached to a horse and then has to say goodbye to their companion when therapy is over.
Supervision by a mental health professional: Difficult emotions may arise during a horse-assisted therapy program. Therefore, it’s crucial that equine therapy sessions are closely monitored by a mental health professional who is present at all times and can help patients work through any feelings that come up.

Get Help with Equine Therapy

Equine therapy is a great option for people looking for holistic therapies to complement their addiction recovery journey. When paired with an evidence-based addiction treatment plan that includes traditional therapy, equine therapy can be instrumental in helping people develop the necessary confidence and skills they need to live a fulfilling life free from alcohol and drug abuse.

If you or a loved one is struggling with drug or alcohol addiction, know that you’re not alone and that treatment is available. We are here to help.

Equine Therapy for Treating Drug and Alcohol Addiction