Equine Therapy for Addiction Treatment

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A Guide to Equine Therapy

Anyone who has owned a pet can attest to the immense amount of emotional support they can provide. This makes them ideal for some types of therapy. Often, they do a better job of helping someone deal with emotional pain than a human friend. One type of animal that is often used for therapeutic applications is a horse.

Equine Therapy

What Is Equine-Assisted Therapy?

Equine-assisted psychotherapy is a type of healing modality that incorporates horses in therapeutic processes. Clients who receive this therapy will interact with the horse in a variety of ways.

They will learn to care for the horse and interact with it by grooming, feeding, and leading it on a rein. They may also be taught how to saddle the horse and then ride it. They will typically be supervised while taking part in these activities by someone who is trained to help in these situations.

Because a mature horse is so much larger than a person, it is important that clients exercise self-awareness when interacting with it. This helps clients build self-confidence as they interact with a majestic animal so much larger than themselves. They also have to accept responsibility for the care of the horse. Finally, this leads to self-regulation of their own emotions, since the animal will pick up on the person’s feelings and react appropriately.

This form of therapy has been increasing in popularity since there is a growing body of evidence that therapy with horses is effective.

Historical Origins

Horses were used therapeutically in ancient Greece, when Hippocrates wrote about horseback riding having therapeutic value. Riding was a popular form of therapy in the United States in the middle of the last century. Several groups were formed to encourage the use of horses to help those in need. For example, horses could be used to help physically rehabilitate injured people.

Equine-Assisted Psychotherapy or EAP

This type of therapy has many types of uses. Horses can be used to help individuals, groups, or families. They can aid people of all ages, including children and elders. One advantage that working with horses has over other types of therapy is that it takes place in an outdoor setting and relies on nonverbal communication. This allows it to be complementary to traditional forms of therapy.

Helping Youth

Equine-facilitated psychotherapy can work for children and teens, particularly those who have a hard time talking about their emotions.

While youngsters can often feel intimidated by therapy in a traditional office setting, they might feel more able to process their feelings while interacting with a beautiful and fascinating horse. This type of therapy can help them cope with trauma and PTSD as well as anxiety and depression.

Equine-assisted therapy offers something that is unique. It allows clients to participate in an interaction that feels safer than the type of therapy that normally occurs in an office. Most children who participate are 6 to 18 years old.

Children may not open up to adults when they experience emotional pain, but they will often open up to animals such as horses that seem to offer nonverbal sympathy. Interacting with them can help troubled youth develop:

• Assertiveness
• Confidence
• Strong relationships
• Emotional awareness
• Empathy
• Impulse control
• Problem-solving skills
• Social skills
• Trust in others
• Trust in self

Unique Benefits of Horses

Why are horses so beneficial? They have a number of unique traits that make them ideal for animal-assisted therapy, according to Dr. Robin Zasio.

Horses Are Nonjudgmental

While therapists are trained to offer a “safe space” for clients, the reality is that it’s often hard — even for adults — to overcome the barriers to sharing their deep emotional pain and traumatic experiences with another human being. There is always the fear that they will be judged, and it can take time to overcome this and build trust.

A horse, on the other hand, can make a client feel relaxed. This is particularly important for young people, who often feel judgment more acutely.

Clients experience peace, knowing that the horse does not judge their past. The horse only reacts to their current behavior and emotions. There is no hidden bias to contend with.

Mirror Neurons

Another reason that horses may be so useful when it comes to therapy is that they likely have the most mirror neurons in the animal kingdom. Mirror neurons are brain cells that allow the possessor to recognize and empathize with the emotions of other living creatures.

Horses, being both prey and herd animals as well as having a long relationship historically with people, are often very good at mirroring clients’ emotions and their behavior. They are keen observers and are both vigilant and sensitive. This forces clients to remain self-aware.

Understanding and Coping With Vulnerability

If clients open up to a horse, its reaction will help them decipher and process emotions. The horse provides a reference point. This helps them not only in that moment but also helps them in other social interactions and relationships.

Work Required

Looking after a horse is not easy. It needs to be fed and watered, and it must be exercised and groomed. Its hooves need to be checked. Horses feel more secure with an established routine and structure.

Working on caring for a horse builds responsibility. It forces clients to think of the needs of a creature besides themselves. When they care for and nurture the horse, it helps them to build empathy.

Conditions That Equine Therapy Can Help With

There are several specific conditions with which equine-assisted therapy can help.


Most people experience anxiety at some moment in their lives. However, for millions of Americans, the condition is severe enough to meet clinical diagnostic criteria.

Horses can help people dealing with anxiety. A horse has a heightened awareness of danger and responds to it in the moment. Clients will notice the behavioral changes. For example, the horse might seek to get away from a situation. Clients struggling with anxiety relate to this. Because they often feel more secure and safe with the horse than they do with people, they can be more vulnerable and open.

As clients spend time interacting with the horse, during which they will try new things, they will often no longer be in their comfort zone. The horse helps them push boundaries. Follow-up therapy can help clients further process these experiences.


Post-traumatic stress disorder, or PTSD, afflicts many groups, notably veterans. Working with horses can help these individuals. Two groups that are particularly afflicted include those who have experienced combat and those who were sexually assaulted. Equine-assisted psychotherapy to help veterans is growing in popularity.

Many individuals suffering from these types of trauma can’t bond with or open up to a fellow human being. However, they can connect with a horse. This can lead them to once again relate to other people.

Substance Use Disorders

The United States continues to face challenges when it comes to the prevalence of drug and alcohol addiction. In 2019, over 70,000 people died from drug overdoses. Almost 50,000 of these were due to the use of opioids, which has reached epidemic proportions. It is imperative to have therapies that can effectively help those who are struggling with addiction.

Equine-assisted therapy can assist clients who are dealing with addiction. It is particularly helpful for those who suffer from co-occurring conditions. Also called a dual diagnosis, it is used to describe the condition of someone who is coping with both addiction and mental disorders.

Since working with horses can help clients improve their ability to trust, to be vulnerable, and to communicate, it can also help them improve their relationship dynamics with family and friends who they may have hurt. Clients also learn to trust themselves more as they work with horses. They learn to be more responsible and engaged. This helps alleviate the sense of shame they may feel due to their addiction.


Attention-deficit/hyperactivity disorder (ADHD) can be helped with equine-assisted therapy. Working with horses can appeal to both adults and youths who suffer from ADHD as it is hands-on and interactive. Active people, therefore, find it both engaging and fun. They may improve their self-control and find the process of working with horses both exhilarating and calming.

It has been found that for these clients, working with a horse adds to their feeling of accomplishment. This is very beneficial as it empowers them in a unique way.


Often those on the autism spectrum have a hard time reading the emotions of those around them and responding in appropriate ways. Working with a horse often helps them immensely. The horse does not rely on verbal cues but rather reads the intent and emotions of the person. This can be very reassuring to an autistic child or adult.

While people may try to control how they express themselves, a horse is honest. This makes it simpler for the client to interpret the emotional response.

Incorporation of Horses in Therapy

Equine-assisted therapy is one variant in the field of psychotherapy. In order to qualify to work with clients in this field, a therapist needs to obtain specialized training.

Kay Trotter, Ph.D., started an organization dedicated to equine counseling. She was one of the first to research equine-assisted therapy.

The process that evolved includes a client working with both a horse and a trained therapist. While the client works with and cares for the horse, riding may or may not be included. The focus of the therapy is on factors like a feeling of presence, being attentive and mindful, and respecting boundaries and social cues.

Trotter discovered that introducing horses in a therapeutic setting significantly increased positive behaviors and reduced negative ones.

There was a great increase in self-confidence among those taking part in equine-assisted therapy. Having a 1,000- or 2,000-pound animal respond to you is empowering. Being able to emotionally connect with another living creature broke barriers for those suffering from trauma.

People involved in working with horses learned to control their own irritability, anger, aggression, and other issues as horses will not tolerate these things. In the process of caring for the horse and working with it, clients had to exercise greater self-control. This actually empowered them.


There are several factors to consider before you can decide if equine-assisted therapy is the right modality for you or someone you love. These include:

• Health Conditions: Discuss your health status with your physician before starting. Some people with certain medical conditions should not try equine-assisted therapy.
• Timing: If a client is dealing with addiction, detoxification and other therapies should be encouraged before embarking on a program that incorporates equine-assisted therapy.
• Fear: Not everyone is comfortable with animals. Some might be fine with small animals but may be afraid of a large horse. In these cases, working with equines is not the best idea.
• Cost: Often insurance will not cover the costs of this type of treatment, and it can be expensive. There are groups that do provide either free or low-cost equine therapies to certain groups, such as abused children or veterans, but these are only available in certain locations.

While equine-assisted therapies are becoming more popular and are proving their effectiveness for many people, they are not for everyone.

They have proven particularly helpful for certain groups that may have difficulty with verbal communication, such as those suffering from autism, veterans, and children dealing with great emotional trauma.

The treatment can also benefit many other groups as they help clients experience greater confidence in themselves, greater emotional openness, and also greater empathy, communication, and trust. Many people find they are better able to control their own emotions and they also become more responsible and capable.

While the benefits of equine-assisted therapy can be great, there are also some drawbacks. It’s best to consult with a mental health professional to determine if this type of therapy is right for you or your loved one.

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Reviewed By:

Dr. John Elgin Wilkaitis

Dr. John Elgin Wilkaitis completed medical school at The University of Mississippi Medical Center and residency in general psychiatry in 2003. He completed a fellowship in Child and Adolescent Psychiatry at Cincinnati Children’s Hospital in 2005. Following this, he served as Chief Medical Officer for 10 years of Brentwood Behavioral Healthcare a private health system including a 105-bed hospital, residential treatment, and intensive outpatient services.

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