Equine Therapy

If you’ve ever had a beloved pet or seen a service animal in action, you know animals have the potential to make life better. The same is true of equine therapy, also known as equine-assisted therapy, which uses trained therapists and horses to help people deal with emotional, occupational or physical challenges. The discipline is relatively new, but it is now recognized around the world as a valid treatment for a wide variety of conditions. Therapeutic riding goes back to the time of Hippocrates, an ancient Greek physician known today as the Father of Medicine.

The Healing Power of Equine Therapy

The use of horses as metaphors for life lessons is both practical and profound. From teaching social skills and communication to boundaries and trust, equine therapy has been useful in the treatment of a wide range of conditions, including:

  • Anxiety
  • Depression
  • Attention Deficit Disorder
  • Autism
  • Dementia
  • Learning disabilities and developmental delays
  • Traumatic brain injuries
  • Cerebral palsy
  • Genetic disorders like Down syndrome
  • Behavioral challenges
  • Abuse
  • Post-traumatic stress disorder

Equine therapy helps participants become more confident and insightful, and some disabled riders even compete in national and international riding competitions. Horses also provide a natural form of biofeedback, sending immediate reactions to both the handler and the rider. In addition, their great stature demands respect, and they mirror human emotions. People sometimes project their difficult emotions onto the horse, and that makes it easier for a discussion to take place with a therapist.

Horses Teach Lessons About Life

“Unbridled” is the name of a movie that tells the story of a teenage girl who has given up after a lifetime of abuse. At a ranch for survivors, she gets to know Dreamer, a horse who also has a traumatic history, and she learns that it’s not too late for either of them to find trust and love. The movie is fiction, but it is based on a North Carolina horse ranch that works with young girls.

Many lessons can be learned from horses. For example, these animals don’t understand words, but they respond to the way people act and speak. They also react to human emotions and fears, teaching people how important it is to stay calm under pressure. Horses never hold a grudge, but riders must earn their trust. Horses are great examples of hard work, unconditional acceptance, and constant awareness. They are good role models, and they require patience. They also teach persistence and humility. It’s hard not to be humble when you’re crawling up off the ground onto a horse’s back. Without these skills, the rider will not go far in life or in the saddle.

The History of Equine Therapy

The earliest known use of equine therapy was the use of horseback riding to treat serious illnesses in ancient Greece, but there are examples of its use over the years. In the 17th century, equine therapy was touted for treating low morale, gout, and neurological disorders. In 1946, Scandinavian doctors used therapeutic riding to treat polio patients, and therapists in Switzerland, Austria, and Germany used it in the 1960s. In the late 1980s, Canadian and American therapists developed a standard hippotherapy curriculum after traveling to Germany to learn how horses were used there. In the 1990s, the United States formed the American Hippotherapy Association to promote good instruction and training of therapists. Hippotherapy is the discipline of using therapeutic riding to teach coordination, strength, and balance.

A young equestrienne named Lis Hartel played an important role in bringing equine therapy to the world’s attention. In 1944, while pregnant, she contracted polio. Although her legs were paralyzed, she recovered much of her strength and went on to compete in the 1952 Helsinki Olympic Games, winning a silver medal for Denmark in the equestrian event. She won another silver medal four years later in the Stockholm Olympics.

The Cycle of Anxiety and Depression

Every year, 40 million Americans aged 18 or over cope with anxiety disorders. Although many types of treatment options are available, only around 37 percent of people with anxiety disorders get help. They are six times more likely to be hospitalized for mental disorders and three to five times more likely to go to doctors than those without anxiety. Doctors attribute the cause of anxiety disorders to a combination of risks involving history, genes, brain chemistry, and personality traits.

Around 50 percent of people with anxiety or depression experience both disorders. Equine therapy is an effective treatment for the following kinds of anxiety and the depression that goes along with them:

  • Generalized anxiety disorder
  • Panic disorder
  • Social anxiety disorder
  • Obsessive-compulsive disorder
  • Post-traumatic stress disorder
  • Phobias
  • Major depressive disorder
  • Persistent depressive disorder, or dysthymia

Anxiety and Coexisting Conditions

People with anxiety often have another coexisting condition, such as depression. In this case, it is important to treat both conditions, not just one of them. It is common to see one or more of the following conditions with anxiety:

  • Depression
  • Eating disorders
  • Bipolar disorder
  • Headaches
  • Sleep disorders
  • Substance abuse
  • Chronic stress
  • Irritable bowel syndrome
  • Attention deficit/hyperactivity disorder
  • Chronic pain
  • Fibromyalgia

Children and Anxiety

Approximately 25 percent of children between the ages of 13 and 18 experience symptoms of anxiety disorder. If not treated, they are more likely to abuse alcohol or other substances, make bad grades in school or fall behind in social skills. Psychologists say equine therapy calms children’s anxiety, teaches leadership and instills compassion. A 2015 study shows that it also improves social skills and attention in autistic children. Horses detect tiny differences in human behavior, teaching riders and caretakers the consequences of even their smallest actions.

A 2017 article in U.S. News and World Report says that equine-assisted psychotherapy helps teens deal with depression and anxiety, boosts their self-esteem and enables them to recover from trauma. In other words, leading a horse through an obstacle course can teach individuals to make their way around the challenges in their own lives.

Equine Therapy as an Anxiety Treatment

Equine-assisted therapy sometimes involves riding, but it may also include tasks like grooming the horse, cleaning the barn or measuring out food. The time spent together while riding or caring for an animal gives individuals a chance to perform tasks or solve problems and then discuss the process with a therapist. This requires the ability to focus on the present moment instead of worrying about the past or the future.

Equine therapists use a variety of techniques, including cognitive, talk and play therapy. Individuals learn how to solve problems by practicing skills, planning activities and telling stories, and therapists have an opportunity to observe the thought process and question negative thinking patterns. Individuals may displace their own fears onto the horse, giving the therapist a better understanding of how to help them. Equine therapy also teaches participants to work with a team and cooperate with others.

Treatment centers and other organizations cater to specific groups, such as veterans and abused youth. It is important to note that horseback riding itself may be therapeutic, but it must include a trained therapist to be called “equine therapy.” Horseback riding, however, is not necessary. Some treatments involve caring for horses or walking beside them. The Equestrian Therapy website has a registry that lists certified therapists and centers across the country. In some cases, insurance companies may pay for the treatment, but it is typically recommended to complement other kinds of therapy.

Equine Therapy and PTSD

The Anxiety and Depression Association of America says that 7.7 million people 18 years or older have PTSD or post-traumatic stress disorder, but this can also affect children. The risk is higher among veterans and victims of sexual abuse.

Between 11 and 20 percent of veterans must cope with symptoms of PTSD each year. Every day, 22 veterans die of suicide, and another 20 percent become addicted to alcohol or other substances. Columbia University Irving Medical Center is trying to change those statistics with its Man O’ War Project, a program that researches the disorder and offers innovative treatments.

People who go through traumatic events often feel isolated and unable to connect with others. Horses give them a chance to build a connection, a necessary step for developing successful relationships in life.

Kinds of Equine-Assisted Therapy

Equine-assisted therapy is a broad term that includes several different levels and kinds of treatments, and therapists come from a variety of backgrounds. For conditions like depression and anxiety, therapists are usually licensed mental health counselors or psychologists while occupational therapists deal with illnesses like cerebral palsy.

Therapists may work with equine specialists, who are individuals trained to deal with horses in a wide range of settings. Specialists who want to work in therapeutic settings usually get certified by PATH International, an organization that develops curriculum and certification criteria. Horses are usually hand-picked to participate in the program. They must have a balanced gait and move freely.

Five of the most common categories of equine-assisted therapy fall into the following:

  • Therapeutic horseback riding
  • Hippotherapy
  • Equine-assisted psychotherapy
  • Equine-assisted learning
  • Specific disciplines, such as vaulting, managing stables or showing horses

Some schools offer bachelor or graduate degrees in equine-assisted therapy, but the field is so new that it is still being developed. To be certified by PATH, a candidate must teach for 120 hours or more at a PATH center, complete a workshop or training class and be a member of PATH. Most classes are taught in academic settings, but a few may be offered online. Anyone seeking help should ask for a certified therapist or specialist.

Equine Therapy in the News

From a story about horse therapy improving lives in Utah to the tale of a retired veteran who runs a nonprofit on his Georgia ranch, individuals and organizations are embracing the therapeutic use of horses. Providers include nonprofit organizations, pay-for-service treatment centers and individuals who want to make the world a better place.

Both anecdotal information and clinical research confirm the healing power of horses for a variety of physical and emotional conditions, but the field is growing and needs more research. Whether used as anxiety treatment for general anxiety or as a method of coping with anxiety that results from another condition, professionals say that it can make a difference as early as the second session of treatment.

A sense of personal identity is important to everyone, and so is being part of a community. Equine therapy restores self-esteem and provides a sense of connection. In the words of the great Winston Churchill, “There is nothing better for the inside of a man than the outside of a horse.”