Equine therapy

Written by Becky Banham
Becky Banham
Counselling Directory Content Team

Last updated 9th May 2024 | Next update due 9th May 2027

The use of animals in therapy can be traced back thousands of years. Their ability to read human emotion and their inherent honesty is perhaps why we often look to them in times of distress. While many animals are well known for being therapeutic, horses are becoming particularly well known for their ability to foster change. Here we'll explore equine therapy and what it can help with.

What is equine therapy?

Horses have been used in physical therapy since the early 1950s, helping people to refine their motor skills in a gentle way. Since then, the unique bond between humans and horses has been incorporated into psychological therapy.

Equine therapy, or hippotherapy (from the Greek word 'hippos', which means horse), puts people and horses together with a therapist in an environment designed to promote emotional growth and learning. The role of the equine therapy team is to guide the individual or group, encouraging them to reflect on their experiences and what it means to them. 

After an initial consultation, a set of exercises will be carried out according to the needs of the person taking part. Equine-assisted therapy can help with many issues and is considered to be especially helpful for those who want to change elements of their behaviour. 

What happens in an equine therapy session?

There is normally no horse riding involved, and if you don't want to - you don't even have to touch the horse. Exercises are set up to help you think and act in ways you may not have thought of before. Normally the exercises will require you to interact with the horse; you may be asked to lead the horse over a series of obstacles or to lead it in a certain direction - often without the aid of a lead rope.

This kind of exercise requires a creative way of thinking and may force you to reconsider the way you act. The horse expert will be on hand to ensure everything is safe, however, you will not be told how to complete your task - it is up to you to explore different methods.

After you complete the exercises, your therapist will talk to you about your experience. Discussing how the exercise made you feel and why you think you were successful or unsuccessful can lead you to learn more about yourself and your behaviour. Over time you may find that you develop a bond with the horse, and this in itself can be incredibly powerful.

Counsellor Dr Danielle Mills, PhD, PGCert, BSc (Hons), MBACP (Accred) explains how equine therapy benefits her clients.

History of equine therapy

The concept of using horses within therapy can be traced back to ancient Greek times, where writings by Hippocrates described 'hippotherapy' (horse therapy). The technique became popular in Germany, Austria and Switzerland in the 1950s when the therapy was used alongside physiotherapy for those with physical disabilities. In this type of therapy, the movements of the horse were used to influence neuromuscular changes in the patient. In recent years, equine therapy has evolved to include psychological therapy.

Why are horses useful in therapy?

When people first hear about equine therapy, the first question is usually - why horses? Other animals (such as dogs) are commonly used in animal-assisted therapy, however, horses are considered to provide more scope for behavioural change. There are several reasons for this, including the following:

Because of their size

As horses are large and powerful animals, they can be intimidating. For some people, this presents them with a challenge as soon as they start therapy - to overcome this fear. Combating this initial issue can be incredibly liberating and helps to boost feelings of confidence and self-esteem. Accomplishing tasks and gaining the trust of such animals only continues to reinforce these feelings of empowerment.

Because they are herd animals

Horses are herd animals, which means they naturally desire company and often want to be led. This makes them very social animals that want to create bonds - and this can be especially poignant when it comes to humans. Horses are therefore ideal for this type of therapy, as they will be inclined to develop a relationship with you when you are ready.

Because they mirror behaviour

Another reason horses are used is because they have an innate ability to mirror the thoughts and behaviours of others. Because they are prey animals, they can read body language and respond instantly. This means that if you enter the horse’s space with a negative attitude and defensive body language, chances are the horse won't want to interact with you. Alternatively, if you enter with a sense of calm, confidence and openness - you should find the horse responds more positively.

It is this trait that helps you to reflect on your behaviour and challenge the way you approach situations both inside and outside of your equine therapy session.

Because they have their own personality

Horses can be incredibly human in their personalities - they can be stubborn and seemingly defiant at times. They also like to have fun and often turn exercises into games. Horses can be incredibly caring too, and if you are upset they often respond in a nurturing manner. These personality traits once again make horses a natural companion during the therapeutic process, providing vast opportunities for growth.

They respond in the moment, giving immediate feedback and they are masters of body language and know how you feel even before you do. They challenge you to reflect upon your own behaviour providing excellent opportunities for problem solving and personal growth.

-  Counsellor Julie Reeves MSc.Counselling, BSc.Psych. EMDR Therapist, MBACP (Accred).

What conditions does equine therapy treat?

While research into the effectiveness of equine-assisted therapy is still in its early stages, it is thought to be beneficial for a range of issues, including the following:


Working with horses can help addicts overcome some of the common psychological blocks when it comes to recovery. For some, this involves learning to trust, for others, it is about getting in touch with their own emotions. A lot of people struggling with addiction enjoy equine therapy as it gets them out of their own heads and doesn't allow them to over-analyse or intellectualise everything.


Those dealing with anger can also benefit from animal-assisted therapies. Horses don't respond well to anger and this encourages people to act in a different way to get the desired response. Working with horses can also encourage the person taking part to examine what they think is causing their anger and what techniques help to overcome it.


Anxiety and anxiety-related disorders could also be addressed during equine-assisted therapy. Being in the same space as a large animal can instil feelings of anxiety, but when you overcome these feelings and accomplish tasks with the animal - these feelings can diminish. Equine-assisted therapy is also a very physical therapy, taking people away from their internal worries in a helpful way. Because of this physicality, the therapy is also a great way of bringing people into the present moment - and as anxiety is usually rooted in future worries, this can be valuable.


For people on the autistic spectrum, animal-assisted therapy can be both fun and beneficial. In contrast to regular therapy, equine therapy involves little verbal communication and focuses more on behaviour and non-verbal cues. This can help autistic people to understand behaviour better outside of their therapy sessions. Those who require occupational or physical therapy may also benefit from therapeutic horseback riding to further develop their motor skills.

Behavioural problems

As we have previously mentioned, equine-assisted therapy is especially effective when it comes to altering behaviour. For those who have broken the law or lack social skills, group equine therapy sessions can be useful. During these sessions you will be asked to work with other people to accomplish the set tasks, helping to develop communication skills and team-building skills.

Low self-confidence

Having low self-confidence can affect all areas of your life. Equine-assisted therapy encourages you to confront any fears you may have and boosts confidence with each completed task. Creating a bond with the horse and learning how to interact with it in a positive and confident way can also help you to come out of your shell outside of the therapy space.


Experiencing any kind of trauma can be difficult to overcome. Equine-assisted therapy uses the gentle nature of the horse to help trauma victims rebuild trust and confidence. Horses are non-judgemental and honest, and for some people who have been through a traumatic experience, these are invaluable qualities.

Equine-assisted learning

Equine-assisted learning is similar to equine-assisted therapy and still involves a therapist and a horse expert. In equine-assisted learning sessions, however, the focus is on learning specific skills.

The kinds of skills you can learn in these sessions include:

  • leadership
  • problem-solving
  • teamwork
  • assertiveness
  • creative thinking
  • confidence

Some businesses use equine-assisted learning to help train and develop their staff. Many of the skills you learn in these sessions translate well into the business world and, because the environment is so different from what you're used to, it will help you to think more creatively.

Will it work for me?

Equine therapy remains an experiential therapy and, as of yet, there is no hard evidence to prove its effectiveness. That being said, the therapy has proven incredibly popular in the US and is gaining steam here in the UK with many finding it a useful tool. As with all types of therapy, there is no guarantee that it will 'cure' you of your problems, it simply offers a new way of exploring your feelings.

You don't need any previous experience with horses and you do not have to be a die-hard animal lover to benefit from equine-assisted therapy. The best way to get the help you need is to try different therapy methods until you find one that works best for you.

If you think equine-assisted therapy could help you, your best course of action is to seek out a therapist and speak to them further about their practice. You may then be offered a taster session where you can figure out if horse therapy is the right way for you to go.

Animal-assisted therapy 

Alongside equine therapy, there are more therapeutic approaches that incorporate other animals, such as dogs and pigs. These fall under the category of ‘animal-assisted therapy in counselling’ (AAT-C).

Depending on your reason for seeking counselling, the nature of your therapy sessions, and the type of animal involved, the way you interact with the animal will vary. You may have an animal at your side throughout the day for emotional support, a trained therapy animal (such as a therapy dog) and its handler may visit you, or you might learn to care for a therapy animal, for example, a horse that is housed at an equestrian school.

You and your therapist may discuss the animal or it may simply be there as an aide - to help you feel more comfortable and relaxed - rather than being the focus of your conversation.

Canine-assisted therapy

Dogs are a popular choice for animal-assisted therapy, due to their friendly and welcoming nature. They can provide comfort via body contact, which helps to reduce feelings of stress and anxiety. This, in turn, can help you to explore difficult emotions with your counsellor, that you may otherwise find hard to talk about.

Therapy dogs can be any breed and any size - from a Chihuahua to a Great Dane - but, not all dogs are suitable for therapeutic use. It’s important that they are suitable for the nature of therapy, for instance, that they are calm in temperament and are accommodating when meeting new people. 

Canine-assisted therapy can be used as a complement to other therapies and can be particularly successful in helping with issues such as post-traumatic stress disorder (PTSD), attention deficit hyperactivity disorder (ADHD), autism, and dementia.

Therapy dogs are also becoming popular in schools in the UK, helping children to develop their social and communication skills.

Animal-assisted interventions aim to encourage physical and mental well-being. This type of intervention is currently being used in a variety of organisations and environments, including care homes, schools, hospitals, prisons, and the counselling sector, all with positive results.

- Counsellor Anna Dance, Fda Integrative Counsellor

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