What Is Equine-Assisted Psychotherapy? The Evidence Behind Healing with Horses

When people first hear about therapy involving horses, they often picture riding lessons. In reality, equine-assisted psychotherapy rarely involves riding at all. It is a structured, clinically grounded form of psychotherapy in which a licensed mental health professional incorporates interactions with horses, such as grooming, leading, observing, and groundwork, into the therapeutic process.

At Hope Valley Psychotherapy, equine-assisted work is always facilitated by a Registered Psychotherapist, with support from experienced equestrian professionals who safeguard the welfare of both the participants and the horses. The horse is not a tool. The horse is a sentient partner in the work, and that partnership is precisely what makes this approach so powerful.

Why Horses?

Horses are prey animals, which means their survival has always depended on reading the emotional states of the beings around them. They notice changes in body language, breathing, and muscle tension that humans often miss, and they respond to those cues honestly and immediately. For a client, this creates a rare kind of feedback loop: the horse reflects back what we bring into the paddock, without judgment, agenda, or social politeness.

Researchers studying human-animal interaction have proposed several mechanisms for why this contact is therapeutic. In a widely cited review, Beetz and colleagues (2012) synthesized evidence that positive human-animal interaction is associated with reduced cortisol (a primary stress hormone), reduced heart rate and blood pressure, decreased self-reported anxiety, and increased social engagement, with the hormone oxytocin proposed as one biological pathway underlying these effects.

In other words, time spent in calm, structured contact with animals appears to help regulate the human stress response, and a regulated nervous system is the foundation on which all other therapeutic work is built.

What Does the Research Say?

The research base for equine-assisted interventions has grown considerably over the past two decades.

A systematic review by Kendall and colleagues (2015) examined the efficacy of equine-assisted interventions on psychological outcomes across multiple studies, finding promising results for a range of populations while also noting that the field needs larger and more rigorous trials. Similarly, Lentini and Knox (2015) reviewed the literature on equine-facilitated psychotherapy with children and adolescents specifically, documenting reported improvements in areas such as self-esteem, emotional awareness, and behaviour.

Some studies have focused on young people facing significant adversity. Bachi, Terkel, and Teichman (2012) studied equine-facilitated psychotherapy with at-risk adolescents in a residential treatment setting and reported positive trends in self-image, self-control, and trust. A meta-analysis by Wilkie, Germain, and Theule (2016) examined equine therapy among at-risk youth and found overall positive effects, while again calling for stronger study designs.

It is worth being honest about the state of the science, because integrity matters in mental health care. Critical reviews, such as Anestis and colleagues (2014), have rightly pointed out that many early studies in this field had methodological limitations, including small samples and lack of control groups. This is exactly why, at Hope Valley, equine-assisted work is never offered as a replacement for evidence-based psychotherapy. It is offered as a setting and a relational medium through which evidence-based psychotherapy is delivered by a regulated clinician.

What a Session Actually Looks Like

A typical equine-assisted session may include grounding and arrival practices, guided observation of the herd, grooming or leading exercises designed around a therapeutic goal, and reflective conversation that connects what happened with the horse to what happens in the client's everyday life. The clinical thread always comes first: the horse work serves the therapy, not the other way around.

Because the work happens outdoors, on a working farm, it also carries the well-documented benefits of nature-based practice: movement, fresh air, sensory grounding, and a setting that feels very different from a clinical office, which can be especially helpful for clients who find traditional talk therapy intimidating.

Is Equine-Assisted Psychotherapy Right for You or Your Child?

Equine-assisted psychotherapy can be a meaningful fit for children, youth, and adults working through anxiety, low self-esteem, social difficulties, grief, trauma, and life transitions. Because every situation is unique, we begin with a conversation to make sure the approach, the group, and the timing are right.

To learn more about upcoming equine-assisted programs at Hope Valley Psychotherapy, visit hopevalleypsychotherapy.ca or email jenny@hopevalleypsychotherapy.ca.

References

Anestis, M. D., Anestis, J. C., Zawilinski, L. L., Hopkins, T. A., & Lilienfeld, S. O. (2014). Equine-related treatments for mental disorders lack empirical support: A systematic review of empirical investigations. Journal of Clinical Psychology, 70(12), 1115–1132.

Bachi, K., Terkel, J., & Teichman, M. (2012). Equine-facilitated psychotherapy for at-risk adolescents: The influence on self-image, self-control and trust. Clinical Child Psychology and Psychiatry, 17(2), 298–312.

Beetz, A., Uvnäs-Moberg, K., Julius, H., & Kotrschal, K. (2012). Psychosocial and psychophysiological effects of human-animal interactions: The possible role of oxytocin. Frontiers in Psychology, 3, 234.

Kendall, E., Maujean, A., Pepping, C. A., Downes, M., Lakhani, A., Byrne, J., & Macfarlane, K. (2015). A systematic review of the efficacy of equine-assisted interventions on psychological outcomes. European Journal of Psychotherapy and Counselling, 17(1), 57–79.

Lentini, J. A., & Knox, M. S. (2015). Equine-facilitated psychotherapy with children and adolescents: An update and literature review. Journal of Creativity in Mental Health, 10(3), 278–305.

Wilkie, K. D., Germain, S., & Theule, J. (2016). Evaluating the efficacy of equine therapy among at-risk youth: A meta-analysis. Anthrozoös, 29(3), 377–393.