While the research behind equine therapy is limited, anecdotal evidence suggests it may help those with mental health or physical conditions.

Equine therapy, also called equine-assisted therapy, is an increasingly popular type of experiential treatment for various mental health and physical conditions.

The premise of equine therapy is that interacting with a horse under the supervision of a mental and physical health professional can complement traditional treatments to best support recovery. Such interactions may include riding or assisted riding, in addition to feeding, grooming, and providing other kinds of care.

While research on the efficacy of equine therapy is limited, anecdotal evidence suggests many people may benefit from equine therapy.

Animal researchers have observed that horses — like dogs, dolphins, and other intelligent nonhuman creatures — are keenly tuned in to people and their emotions.

Let’s review what we know about equine therapy, who it may benefit, and how it all works.

There are different types of equine therapy, with new forms being developed to provide people with personalized care. Some of the most common forms are:

  • Equine-assisted psychotherapy or learning: This may or may not involve horse riding. But together, the human-animal team works to create a healing environment for children and adults.
  • Hippotherapy: This is most commonly recommended for people with intellectual or physical disabilities or injuries. An occupational therapist and horse handler work together to help a person safely ride a horse or pony.
  • Therapeutic riding or driving: These sessions involve riding or driving a cart under the supervision of a therapist and horse handler.
  • Interactive vaulting: This is a more active and complex type of equine-assisted therapy that involves learning how to vault and do other kinds of gymnastics-like activities on horseback. An activities coach and horse handler provide safety and direction during the session.

How did equine therapy start?

Equine therapy originated more than 2,000 years ago in Ancient Greece. Greek physician Hippocrates — known as the “father of modern medicine” — wrote about horse-assisted therapy as a therapeutic form of exercise.

Modern equine therapy got a flood of attention when Danish equestrian athlete Lis Hartel won silver at the 1952 Helsinki Olympics. At the time, Hartel shared her story about recovering from polio by riding horses.

There’s not a large body of scientific evidence backing equine therapy, and the studies that do exist acknowledge the need for continued research to understand its full range of effects — particularly for hippotherapy.

However, the research that does exist shows some positive connections between equine therapy and recovery from physical and mental health conditions, disabilities, and injuries.

Examples of the benefits of equine therapy include:

  • For older adults: According to researchers who studied the perceived benefits of equine-assisted psychotherapy in older adults with cognitive or functional impairment, most who tried equine therapy reported gains extending beyond their interactions with horses. These included increased human social interactions and positive influences from peers.
  • For veterans: Researchers found that veterans experiencing trauma, stress, and anxiety showed fewer physical signs of stress when participating in an equine therapy program.
  • For at-risk youth: In a 2011 study, seven young people considered “at risk” of harming themselves or others were introduced to equine therapy. They reported positive effects on their resilience and reduced risks of crime, self-harm, and other issues. They reported benefits to their empathy, confidence, self-esteem, mastery, and self-efficacy.
  • For mental health: Equine therapy may also be useful for some autistic people. A 2018 research review reports beneficial effects on behavior and social communication skills.
  • For emotional health: For people who find it difficult to open up to others, working with horses may provide a more relaxed environment to facilitate trust and build a therapeutic relationship.
  • For physical health: There are numerous physical benefits to horseback riding, including increased cardiovascular and core strength, reduced blood pressure levels, and reduced stress.
  • For coordination: There’s a lot of anecdotal evidence to support horseback riding as a therapy for people with cerebral palsy or other neurological disorders. It may help people strengthen their balance and overall coordination, but the research isn’t conclusive.

Who benefits from equine therapy?

People of all ages seem to benefit from equine-assisted therapy, including:

A common thread among equine therapists is the desire for it not to feel like a normal therapy session in an office.

By using horses and shared activity, equine therapists hope to provide a more comfortable space where people can explore their mental or physical health at their own pace, under the guidance of a professional. The goal is for it to not feel like a typical in-office therapy session.

Session times may vary, though many will be around an hour. The specific activities in your equine therapy session will depend on your age and your specific needs. Possibilities include:

  • Non-riding activities:
    • learning gentle techniques of tactile engagement (petting or giving treats)
    • feeding, grooming, and caring for the horse
    • cleaning and maintaining your tack (saddle and equipment)
    • leading or walking with the horse
  • Assisted riding activities:
    • riding in a barn or larger indoor arena with the assistance of a therapist and equestrian
    • riding in or helping drive a small cart or carriage
    • trail riding or nature walks
    • learning to move with the different gaits of the horse
    • playing games and improving coordination while on horseback
  • Monitored riding activities:
    • learning to ride without the assistance of a therapist or horse handler
    • learning to drive a small cart or carriage on your own
    • riding in indoor arenas, large paddocks, or nature trails
    • participating in group rides with others in equine therapy
    • learning to jump or other equestrian games like barrel racing
    • learning vaulting or other elements of dressage on horseback
    • competing in 4-H or other low-stakes competitions on horseback

Still have questions? Here are answers to some of the most common questions about equine therapy:

Is equine therapy dangerous for kids?

No, horses in these facilities go through years of training to ensure safety. While there are always risks in working with animals, they can be minimized through the selection of accredited and properly insured therapy programs and wearing proper protective gear such as helmets.

How much does equine therapy cost?

Costs for equine therapy vary depending on the region and services offered. Rates generally run in the range of $50 to $300 per session, with group sessions being less expensive.

Is equine therapy covered by insurance?

Most equine therapies are not covered by insurance. However, hippotherapy may be covered by some insurance companies, as it is considered a medical treatment. Check with your insurer for more information.

How do I find an equine therapist near me?

If you’re in the United States, the American Hippotherapy Association has a therapist directory.

For other types of equine-assisted therapy, the search engine of your choice should be able to pull up a selection of local options for you, but make sure to ask important questions like:

  • What qualifications do your therapists hold?
  • Is your staff trained in first aid?
  • What professionals will be with me or my child during the session?
  • Can I visit the barn before my first session?

If you currently work with a therapist, they can also provide local recommendations. For hippotherapy, consult your doctor for recommendations or referrals.

There are several kinds of equine-assisted therapy, each designed to provide different benefits to people with physical or mental health conditions, disabilities, or injuries.

While there’s limited scientific evidence proving the benefits of equine therapies, some research suggests they can have positive effects. And there’s no shortage of anecdotes suggesting equine therapy is helpful for some people.