Equine-assisted therapy

Equine-assisted psychotherapy involves the use of horses in the therapy process. In some centers, it is a team process with the patient working with the horses, a therapist, and an equine specialist.

Background

Humans have been connected with animals since before recorded history, as is evidenced by cave paintings from around the world. The ancient Greeks were the first to notice that horses helped seriously ill individuals as far back as 460 B.C. The first documented use of animals therapeutically was in ninth-century Belgium, when people with disabilities were asked to care for farm animals. Animals were used in the 1700s at the York Retreat, a progressive “lunatic asylum” for its times.

Dr. Boris Levinson is credited with starting the modern Animal Assisted Therapy movement. This approach advocated using pets to provide a safe environment for patients of all ages.

In 1969, the North American Riding for the Handicapped Association began and this has gradually developed into the Professional Association of Therapeutic Horsemanship (PATH), which is the leading organization for therapists involved with equine therapy. There are PATH centers around the globe providing services and training for clients and therapists alike.

Another association, the Equine Assisted Growth and Learning Association (Eagala), was founded in 1999. It was one of the first organizations to develop professional standards for incorporating horses into mental health treatment. It continues to try to increase awareness and set standards of practice for the field.

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Who can benefit from equine-assisted therapy?

Equine-assisted therapy has been found to benefit individuals with a variety of struggles in a myriad of ways. Horses are not just used as an adjunct to psychotherapy. Speech therapists, occupational therapists, and physical therapists promote this method.

As such, there have been reports of benefits for individuals with:

• Cerebral palsy
• Eating disorders
• Depression
• Anxiety and trauma-related disorders
• Attention disorders
• Autism spectrum disorders
• Stroke and other significant physical injuries

Equine-assisted psychotherapy techniques

Equine-assisted therapy, much like other animal-assisted therapy, isn't a technique that generally stands alone. Most of the time, EAT is used in conjunction with other modalities like psychodynamic therapy or cognitive therapy. The specific methods utilized will depend on the needs and goals of each client.

All forms of therapy emphasize the importance of active and reflective listening, collaboration with the horse as an active member of the team, and the belief that every individual can solve their problems with guidance in a way that creates a lasting effect.

Effectiveness

While studies based on equine-assisted therapy alone are limited, studies have been done into the effectiveness of EAT with various disorders. They have found that individuals show better balance and trust, improved self-esteem and self-efficacy, as well as an overall improvement in general well-being and quality of life.

Individuals who have participated in equine-assisted psychotherapy have reported significant improvement in confidence and social skills. Clients are working with the animals but also working side by side with a therapist guiding the path. This allows the client to work on skills in a way that is less threatening than sitting in a therapy room.

Working with animals in psychotherapy allows for the improvement of nurturing and empathy as well. As individuals work with animals, they can learn to be more aware of emotions and the stress response that all people and animals feel in a safe, nonjudgmental environment. This can help as they generalize this skill to interacting with other people in their lives.

Additionally, horses are highly sensitive to the emotions of others around them and allow individuals to work through problems without worrying about judgment.

Despite the lack of equine-specific studies, some demonstrate the positive effects of human-animal interactions that apply to equine therapy. One study from 2018 shows that seeing and touching animals can trigger positive physiological changes, including higher levels of serotonin, endorphins, and oxytocin. Additionally, lower baseline levels of the stress hormone cortisol was observed. Further research from 2016 has also linked animal-assisted therapy to improved blood flow in people experiencing heart failure. It may even reduce blood pressure for some people.

Downsides

As mentioned before, one of the downsides of this therapy is the lack of theoretically based clinical studies. While it has been recognized as beneficial anecdotally for many years, all animal-assisted therapies have only been widely clinically recognized as beneficial in the last 25-30 years, making it a relatively new clinical treatment. Due to the lack of research, it may not be allowed by some insurance companies for billing purposes and, as such, still has a cost-limiting factor on availability.

Another downside of equine-assisted therapy is the space required to hold therapy. While traditional therapy requires a small office, animal-assisted therapy requires a large enough space for humans and animals to be comfortable regularly. With horses, this means a much larger area is required, limiting the accessibility of this type of therapy and significantly increasing the cost both to the therapist or organization providing services and to the client receiving services.