Equine-assisted psychotherapy: What it is and how it works

Reviewed by Brooks Baer, LCPC, CMHP

Written by

therapist.com team

07/29/2025

Share this article

Share article

Share this article on Facebook Share this article on Twitter Share this article on LinkedIn Share this article on Messenger Share this article in email Copy the link to this article Print this article

Equine-assisted psychotherapy (EAP), or equine-facilitated psychotherapy (EFP), is a type of animal-assisted therapy (AAT) that involves working with a therapist while interacting and bonding with horses. EAP’s goal is to help people explore and address emotional and psychological challenges.

EAP is a complementary form of therapy, meaning it isn’t a standalone treatment for any mental health condition. There isn’t much research yet to prove whether it’s effective on its own. It can be expensive, and it’s generally not covered by insurance.

With all that said, EAP can still be a rewarding, enjoyable, confidence-building complementary approach. It can be paired with evidence-based mental health treatments such as cognitive behavioral therapy (CBT) or medication. It can also offer people an appealing alternative to traditional therapy settings.

Other equine-assisted services

While EAP focuses on mental health, there are many other equine-assisted services (EAS) with different goals. EAS may center on physical therapy, occupational therapy, recreation, or experiential learning. These activities are widely available and very popular, but like EAP they don’t yet have great evidence supporting their effectiveness.¹

Equine-assisted services include:

• Therapeutic riding: Learning recreational horseback riding skills to help improve things like balance, coordination, and self-esteem
• Equine-assisted learning (EAL): Activities with horses geared toward helping people develop skills like communication, leadership, problem-solving, and teamwork
• Hippotherapy: Equine-assisted treatment that may be used in occupational or physical therapy to support functional outcomes

What to expect from EAP

EAP involves both a licensed therapist and at least one horse handler or equine specialist who’s responsible for the care and handling of the horses during therapy sessions. The therapist, along with the specialist or handler, structures the sessions based on the client’s goals and needs.

During EAP sessions, the client interacts with horses in various ways, such as grooming, leading, or observing them. EAP doesn’t necessarily involve riding; one of the main goals is building a bond with the horses. The therapist asks the client to draw parallels and make connections between these interactions and the client’s own life experiences and challenges.

EAP sessions can take place in a variety of settings, such as a stable, an arena, or outdoors in nature. The sessions’ duration and frequency can vary. Since EAP can be costly, experiencing it in a group setting may help make it more affordable.

EAP and other equine-assisted services incorporate different therapeutic elements into their programming. For instance, one youth riding program that borrowed principles from CBT seemed to help participants reduce symptoms of anxiety.² Other types of therapy that have been combined with equine-assisted services include eye movement desensitization and reprocessing (EMDR) and Internal Family Systems (IFS) therapy.³

Who is EAP for?

While EAP isn’t a standalone mental health treatment, it can be used as a complementary therapy alongside other treatment approaches.

More research is needed into EAP’s effectiveness, but it may at least offer positive, hopeful experiences to people with conditions including anxiety, depression, attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD).^4,5,6,7

Children and adolescents

While research is limited, EAP may be beneficial for young people who have experienced complex trauma, as well as children and adolescents with anxiety, depression, and other mental health challenges.^8,9

PTSD

Some early research suggests equine-assisted programs may be valuable for people with PTSD. A small study of an equine-assisted group therapy program designed for military veterans with PTSD showed reductions in PTSD and depressive symptoms.¹⁰

In another study, EAP helped couples with deployment-related trauma and PTSD improve their communication, symptoms of depression, and relationship quality.¹¹

Substance abuse

In one small study, equine-assisted psychotherapy improved mood scores of hospitalized people with substance abuse disorder (SUD).¹² While people with SUD may enjoy equine-assisted activities and benefit from opportunities to bond with horses, researchers don’t yet know if it’s an effective complement to substance abuse treatment.¹³

How to find EAP near you

If you’re interested in equine-assisted services in general, the Professional Association of Therapeutic Horsemanship (PATH International) can help you find accredited equestrian therapy centers in your area. You can also connect with a licensed mental health professional and ask them for recommendations.

You can also reach out to local equestrian centers or riding stables and ask if they work with EAP providers.