Equine assisted therapy (EAT) is a structured therapeutic practice in which interactions with horses are used to support emotional, psychological, and physical rehabilitation. It is delivered by qualified professionals — typically a therapist and an equine specialist working together — and it draws on the horse’s unique behavioural qualities to facilitate outcomes that can be difficult to achieve through conventional talking therapies alone.
How Equine Assisted Therapy Works
Horses are highly attuned to human body language and emotional state. They are prey animals hardwired to read their environment for signs of tension or calm, and they respond to humans in kind — a nervous, tense person approaching a horse will often cause the horse to become alert or move away, while a calm, grounded person tends to find the horse relaxed and willing to interact. This responsiveness makes horses unusually effective therapeutic partners.
In a session, participants may groom, lead, or simply be present with a horse in an unmounted setting. Activities are chosen to provoke reflection, build trust, or develop emotional regulation skills. The therapist facilitates discussion around what is observed — both in the horse’s behaviour and in the participant’s own responses. There is no need for riding ability, and many EAT programmes are entirely unmounted.
Conditions Equine Assisted Therapy Is Used For
EAT is used across a wide range of clinical and developmental contexts, including:
- Post-traumatic stress disorder (PTSD), particularly in veterans and trauma survivors
- Autism spectrum disorder — horses provide sensory input and non-verbal communication opportunities
- Anxiety, depression, and mood disorders
- Substance misuse recovery programmes
- Learning disabilities and developmental delays
- Physical rehabilitation — particularly hippotherapy, where the horse’s movement is used to improve balance, posture, and muscle strength
Hippotherapy is a specific subset of equine assisted therapy in which a physiotherapist, occupational therapist, or speech-language therapist uses the rhythmic, multidimensional movement of the horse as a treatment tool. It is distinct from general riding and requires specialist training.
Equine Assisted Therapy in the UK
In the UK, several organisations provide or accredit equine assisted therapy programmes. Riding for the Disabled Association (RDA) is one of the largest, offering therapeutic riding, carriage driving, and vaulting to people with disabilities and special needs across hundreds of centres nationwide. More information is available at bhs.org.uk.
Practitioners delivering clinical EAT — particularly where a therapist is working with participants on psychological goals — should hold appropriate clinical qualifications alongside their equine training. The sector is still developing its regulatory frameworks, so checking the credentials of any provider is important.
The Horse’s Welfare in Therapy Settings
Welfare of the horses used in therapy programmes is a central concern. Horses used in therapeutic settings are exposed to unpredictable behaviour, high-stress environments, and sometimes many sessions per day. Responsible programmes manage working hours carefully, monitor horses for signs of stress, and rotate animals to prevent burnout. A horse that becomes dull, reluctant, or avoidant is showing clear welfare signals that should be heeded. See our entry on the companion horse for more on equine social and emotional needs.
The British Horse Society provides welfare guidance relevant to all working horses, including those in therapeutic roles.
Frequently Asked Questions
Do I need riding experience to participate in equine assisted therapy?
No. Many equine assisted therapy programmes are entirely unmounted — the therapeutic work happens on the ground, through grooming, leading, or simply being present with horses. Hippotherapy, which uses the horse’s movement therapeutically, does involve being on the horse’s back, but it is guided by a therapist and does not require any prior riding skill.
Is equine assisted therapy evidence-based?
The evidence base is growing. A number of peer-reviewed studies have demonstrated positive outcomes for EAT in PTSD, autism spectrum disorder, and anxiety. The research quality varies, and the field acknowledges that more rigorous large-scale trials are needed. Most practitioners consider it a complementary intervention used alongside, not instead of, other treatments.
How is equine assisted therapy different from therapeutic riding?
Therapeutic riding uses riding as the activity and focuses on physical, emotional, and social benefits through riding itself. Equine assisted therapy is broader — it may be unmounted and is typically facilitated by a mental health professional with specific therapeutic goals. Hippotherapy is a clinical form of therapeutic riding delivered by healthcare professionals as a treatment modality.