Horse therapy, more appropriately referred to as Equine Therapy or Equine Assisted Psychotherapy, is a growing field in mental and physical health care that involves working in partnership with horses to promote emotional well-being, personal growth, and healing. But how does equine-assisted therapy work? While some people picture horseback riding when they think of therapy with horses, the truth is that equine therapy includes several approaches—some that involve riding and others that are entirely ground-based.

Across the globe, people are discovering how this unique partnership with horses can support treatment for conditions like anxiety, PTSD, depression, trauma, developmental disorders, and more. Mental health professionals, occupational therapists, educators, and even parents are beginning to see how clients benefit from equine interaction in ways that go beyond what traditional therapy settings can offer.

In this blog, we’ll explore the different types of horse therapy and how each works. We’ll also take a closer look at the Eagala Model of equine-assisted psychotherapy, a leading ground-based approach that combines the insight of two professionals with the intuitive nature of horses to support powerful change.

Why Are Horses Good for Therapy?

A woman with a horse in a Colorado field with tall grasses.Horses are naturally suited for therapeutic work because of their sensitivity, honesty, and nonjudgmental presence. As prey animals, horses are always aware of their surroundings and quick to react to emotional shifts in the people around them. This makes them exceptional partners in therapy.

Unlike humans, horses don’t mask their responses or overthink their actions. They respond authentically in the moment, reflecting a person’s emotional state without criticism or interpretation. That honesty helps clients build self-awareness, improve emotional regulation, and explore personal patterns in a safe, grounded way.

Horses also offer something many traditional therapy settings don’t: connection without words. For people who struggle with verbal communication or emotional expression, simply being around horses—or engaging in activities with them—can be deeply therapeutic. Through observation, body language, and presence, clients can build communication skills and experience trust, boundaries, and emotional safety.

Whether it’s grooming a horse, leading it through an obstacle, or reflecting on a horse’s behavior, the simple act of working with horses invites people to slow down, tune in, and connect with their inner world.

Types of Equine-Assisted Therapy

There are several forms of equine-assisted horse therapy used today. Each has a different focus and is facilitated by specific types of professionals. Here are the most common:

1. Therapeutic Riding

Therapeutic riding is one of the most widely recognized forms of equine-assisted therapy. In this model, participants learn to ride horses with the guidance of a trained instructor. Unlike recreational riding, therapeutic riding focuses on improving communication skills, confidence, posture, and coordination, particularly for individuals with physical or developmental disabilities.

While not considered psychotherapy, therapeutic riding has measurable benefits for mental health and emotional well-being. The physical movement of the horse mimics the natural motion of walking, which can improve balance and motor function. Riders also build emotional connections with their horses, which can support personal growth and self-esteem.

Therapeutic riding sessions are often adapted to meet the needs of individuals with autism, cerebral palsy, ADHD, or learning disabilities. It’s a great option for children and adults alike who benefit from a hands-on, movement-based experience.

2. Hippotherapy

Hippotherapy is a clinical form of therapy that uses horseback riding as a tool within occupational therapy, physical therapy, or speech-language therapy. It is always directed by a licensed health professional, such as a physical therapist or occupational therapist trained in this approach.

In hippotherapy, the horse’s movement is used intentionally to engage the rider’s core, improve balance, increase sensory integration, and even stimulate language development. Sessions are highly structured and often part of a larger medical treatment plan.

While the focus of hippotherapy is physical and neurological development, the emotional connection with the horse can also enhance a client’s motivation and emotional engagement—especially important in pediatric care or rehabilitation settings.

3. Equine Assisted Psychotherapy (EAP) – The Eagala Model

A group of children interacting with a horse in a field.Among all forms of equine-assisted therapy, equine-assisted psychotherapy through the Eagala Model offers one of the most in-depth and clinically grounded experiences for improving mental health. This model is fully ground-based, meaning there is no horseback riding involved. Instead, clients interact with horses freely—often in a pasture or arena—along with the rest of the co-facilitating team: a licensed mental health professional and a certified equine specialist.

What sets the Eagala Model apart is its focus on emotional insight, metaphor, and self-directed learning. During therapy sessions, clients might be asked to complete tasks with the horses—such as guiding one through an obstacle course—or simply observe how horses respond to them in an open setting. These experiences become mirrors for internal challenges, helping individuals recognize behavioral patterns and emotional responses.

For example, someone who struggles with control may find it difficult to lead a horse without resistance. A person who feels invisible may notice a horse consistently turning away from them. These moments become powerful entry points for reflection, discussion, and healing.

Unlike traditional therapy modalities, the Eagala Model emphasizes experiential learning. Clients don’t need to explain their trauma in words; the therapy sessions unfold naturally, guided by what the client and the horse co-create in the moment.

This model is especially beneficial for those experiencing anxiety, trauma, depression, addiction, grief, and relationship challenges. It’s also gaining momentum in trauma-informed care for veterans, first responders, and survivors of abuse.

Who Can Benefit from Equine Therapy?

While equine therapy can support many populations, it’s particularly effective for:

The common thread? Equine therapy helps people who may struggle to articulate their feelings—or who have tried traditional methods without meaningful breakthroughs.

Whether someone is working on communication skills, emotional resilience, or developing trust, working with horses provides a new perspective that many find more approachable, especially for those wary of conventional talk therapy.

How a Session Typically Works

The structure of a session depends on the model, but here’s what clients might expect:

In Therapeutic Riding or Hippotherapy:

  • Mounted sessions, often in a covered arena.
  • Professional guidance from an instructor or medical therapist.
  • Activities focused on movement, coordination, and balance.
  • Goals set around physical or developmental milestones.

In the Eagala Model:

  • Ground-based therapy sessions—no saddles, reins, or riding.
  • Conducted in an enclosed space like an arena or pasture.
  • Free interaction with horses: observing, approaching, leading, or constructing exercises.
  • A mental health professional and an equine specialist support and guide the experience.
  • Reflections drawn from horse behavior, client choices, and metaphorical insight.

What’s consistent across all models is that therapy with horses is active, relational, and often deeply moving.

Is Equine-Assisted Therapy Supported by Research?

Two men in fatigues petting a horse in an open arena.Yes, equine-assisted therapy is getting more attention from researchers, and studies are starting to show how helpful it can be—especially for people dealing with mental health challenges like anxiety, depression, or trauma.

While more long-term studies are still in progress, early research and real-world experience both point to some powerful benefits. For example, people who take part in equine-assisted therapy often show:

  • Fewer PTSD symptoms, such as flashbacks, anger, or feeling on edge
  • Better emotional regulation, meaning they’re more able to stay calm and manage big feelings
  • Improved behavior, especially in children or teens who may struggle in traditional therapy settings
  • Increased trust, not just with horses but also in their relationships with other people
  • More confidence, also known as self-efficacy—the belief that they can handle life’s challenges
  • Less anxiety and depression, with people feeling more relaxed, supported, and hopeful
  • Stronger participation in therapy, because sessions with horses feel more engaging and less intimidating

These improvements aren’t just things people feel—they’ve been measured in studies, school programs, veteran support groups, and mental health centers.

As equine-assisted therapy continues to grow across the United States and around the world, more therapists, educators, and health professionals are including this work in their services. And with the help of organizations like Eagala, there are now standards and training programs in place to make sure the therapy is done safely and effectively.

Equine-assisted therapy isn’t a magic fix—but it’s a strong and growing option for people who haven’t found success with traditional approaches or who simply connect better in a natural, hands-on setting.

FAQs: How Does Equine-Assisted Therapy Work?

1. Is horseback riding required for equine therapy?
 Not always. In models like Eagala’s equine-assisted psychotherapy, all work is done on the ground. Other models, like therapeutic riding and hippotherapy, do involve riding under professional supervision.

2. How do horses help with emotional issues?
 Horses respond to human body language and emotion with honest, immediate feedback. This helps people gain awareness of how they show up emotionally and develop better emotional regulation.

3. What’s the difference between Eagala and other horse therapy models?
 The Eagala Model is focused solely on mental health and emotional development, grounded in structured, ground-based sessions. It uses a team of at least two professionals and a horse working together as a team, avoiding riding altogether, prioritizing reflection and metaphor in experiential work.

4. Who leads these therapy sessions?
 It depends on the model. Hippotherapy involves a licensed medical provider, therapeutic riding is led by certified instructors, and the Eagala Model requires both a mental health professional and an equine specialist to work alongside the horse.

5. Is equine therapy safe for beginners?
 Yes. All models involve trained professionals and safe environments. Clients do not need horse experience—just a willingness to engage.

6. Can children benefit from equine therapy?
 Absolutely. Many children and teens experience breakthroughs through working with horses, especially those who struggle with communication, sensory issues, or trauma.

Ready to Experience the Power of Equine Assisted Psychotherapy?

If you’re a health professional, educator, or therapist looking for innovative ways to support your clients—or someone seeking a new path for healing that has a deep knoweldge of horses—equine therapy offers something unique. Whether through riding, sensory work, or equine-assisted psychotherapy, the human-horse connection opens the door to profound personal growth.

Curious about the Eagala Model and how it might enhance your practice or your own healing? Explore upcoming training opportunities or connect with certified professionals around the world. With the right team, the right space, and the right four-legged partners, transformation is possible—one step, one session, one breath at a time.