Equine Assisted Therapy's Past, Present and Future

The bond between humans and horses has been documented throughout history, but what can modern science tell us about the therapeutic benefits horses have on mental health? Consider this hypothetical case: it’s a beautiful late summer afternoon as a man takes a walk through a grassy paddock, he seems oblivious to the colours of the clouds, the breeze, birdsong and trees, and mostly looks down at the ground. A large bay horse looks up with mild curiosity as the man approaches, then continues grazing, watchfully. The man stands still – it appears as if he isn’t breathing, isn’t present. The horse slowly approaches the man and stops a few metres away as he reaches out his hand. The horse breathes out softly as the man steps closer and lays his hand on the horse’s neck.

Keeping with this hypothetical, the man in question is a first responder who is living with PTSD. His treatment team are compassionate, kind and experienced. They are very concerned about the man, who describes “living in an existential void, which fills with numbness, terror, anxiety and pain, leaving me no room for positivity or healthy thoughts”. After years of TF-CBT and exposure therapy, he still feels depersonalised and vacant. He often feels sick, exhausted and antisocial, even towards his partner and kids.

The practice of riding a horse to improve an individual’s physical disabilities dates to ancient Greece, with Hippocrates, recognising the therapeutic value of horses. Hippocrates wrote about the "healing rhythm" of riding, which was believed to raise the spirits and aid in physical rehabilitation (Asghari & Ghaffari, 2023). A more recent documentation of the impact of equine assisted therapy was produced by French physician, Chassaigne, who in 1870 published the first known scientific study examining the effects of riding on individuals with disabilities (Benda, 2018). In the 1920s, controversial psychoanalyst Wilhelm Reich stated that introducing horses into psychotherapy could help patients release repressed emotions, (Gilbert, 1999).

During World War One, cavalry soldiers referred to their horses as their trusted companions, friends and brothers in arms. The daily care soldiers gave to their horses provided routine and normality in an unpredictable environment. Multiple accounts state how horses and humans formed deep understandings between each other, despite both enduring gruelling conditions. Postwar hospital treatment continued to incorporate “horse-therapy” into treatment programs for wounded soldiers. (Bonfiglioli Stagni et al., 2015).

Horses continue to be valued beyond their physical prowess, usefulness, beauty and archetype, and more than a century after World War One, horses are once again providing a sense of comfort to defence personnel, first responders and other individuals living with mental health challenges. While equine therapy was historically based on riding horses – and hippotherapy and/or therapeutic riding (THR) continue to demonstrate benefits for physical conditions such as cerebral palsy, Down Syndrome, Parkinson’s Disease, and muscular dystrophy – the concept of ground-based, experiential activities with horses, is still a relatively new mental health intervention. The intersection with social movements around environmental and animal rights informs the field of EAT, which actively engages horses as sentient beings capable of consciously aiding in human health, wellness, and social development. This new paradigm and praxis have expanded to become an increasingly popular professional practice striving for formal recognition as a therapeutic industry in North America, South America, Europe, Australia and parts of Africa.

An exploratory study published in 2021 was one of the first to demonstrate that EAT can affect functional and structural changes in the brains of patients with PTSD (Zhu X, Suarez-Jimenez B, ZilchaMano S, et al., 2021). A related open trial (Fisher et al., 2021) indicated that EAT is an effective primary intervention or adjunctive therapy for veterans meeting DSM-5 PTSD criteria. These findings, among an accumulation of recent research, have encouraged professionals in the mental health field to continue to seek further validation and substantiation of the profound effect horses have on the human psyche.

Horses are curious animals, and for some people they provide a safe relationship space that meets them exactly where they are. Horses are highly intuitive animals who rely on their ability to quickly identify whether something feels safe and social or potentially threatening. They are incredibly sensitive to a person’s body language, physiology and emotional state, providing authentic feedback about an individual’s internal state without judgment. Essentially, horses are curious about and hyper-aware of the humans in their presence, and they respond to the most minute shifts in our nervous system.

Equine-assisted therapy is considered to not only be effective in supporting veteran and first responder populations experiencing PTSD, as noted earlier, but it is also a helpful treatment for a wide range of mental health and social-emotional challenges across the lifespan. This includes domestic violence survivors, neurodivergent individuals, people suffering from grief, individuals with alcohol and drug dependency issues and those living with anxiety and depression. (Cleary, et al., 2024; Kovács, et al., 2024; Coffin, et al., 2024; Chakales, et al., 2020).)

An equine assisted therapy session is led by a qualified and accredited mental health professional such as a counsellor, psychologist, occupational therapist or social worker, who incorporates the horses to a greater or lesser degree as part of a structured therapeutic support. In some cases, the mental health professional may be supported by an equine specialist. Sessions involve clients engaging in activities with horses, who express themselves and respond authentically to support the client’s mental health challenges and help them achieve their goals.

This approach is often referred to as equine-assisted psychotherapy (EAP). A range of interrelated models of equine assisted therapy has developed since the 1996 founding of the Equine Facilitated Mental Health Association (EFMHA) in the US.. Training and qualification for practitioners ranges from short professional development courses to university-level diplomas. Theoretical bases include somatic psychotherapy, Gestalt therapy, narrative therapy, neuroscience, and relational, trauma informed approaches integrated with safe, ethical horse management.

Despite there being access to several estimable equine-assisted training providers in Australia, the equine-assisted therapy field remains unregulated. This means it’s possible for unqualified practitioners to operate in a field that involves vulnerable humans and sensitive animals. Equine Assisted Therapy Australia (EATA), is a Queensland-based, Registered Training Organisation that has consistently aimed to professionalise the training standards to become an equine-assisted therapist, by developing a clinical specialty in equine assisted mental health. EATA has trained more than 300 practitioners, who earn an ACA recognised Diploma of Counselling qualification, as well as specialised skills in equine ethology, handling and welfare, neuroscience, and the trauma-informed practice of equine assisted mental health and counselling.

While EATA stands for Equine Assisted Therapy Australia, we often refer to this field as “equine-assisted mental health” or “equine-assisted services”, rather than therapy, psychotherapy, counselling, treatment or intervention. There are a few reasons for this: firstly, as an approach rather than a modality, equine assisted therapy can take many different forms – the key factor being that it is delivered by a registered, trained therapist. Secondly, it de-medicalises the language, which is important for many clients who find it difficult to engage in conventional forms of psychotherapy, while also referencing its strengths-based, person-centred quality. The term “equine-assisted” refers to the fact that horses assist consensually.

History has documented the enduring unspoken connection humans have had with equines over thousands of years. However, in increasingly digitised environments it is vital that we don’t lose our connection with horses, which can often be the last nexus we have with nature. The growing body of research supports EAT as an effective intervention for addressing psychological trauma and injury, particularly for clients who have not responded to conventional therapy methods. It provides opportunities for social-cognitive and personal growth in a supportive, evidence-based framework that is deeply connected to the natural world. It provides a space to practise attuned communication, and self-regulation in a way that can help a person feel accepted and supported.

A recent study by the University of South Australia (Stacy & Shabbar, 2026) revealed that equine-assisted therapy can help address the growing mental health crisis among children, but also highlighted the ongoing need for formal recognition and ethical guidelines. More scientific studies with larger, controlled trials, are needed to continue to prove the benefit of working with horses in the mental health field. Equine Assisted Therapy Australia will continue to work with leaders in the mental health field, contribute to research and ensure students obtain nationally recognised qualifications.

Equine Assisted Therapy’s Past, Present and Future

A brief history of horses and humans

About Horses

The equine-assisted therapy approach

How equine assisted therapy works in practice

Lifting standards

The language we use

The future of equine-assisted therapy

Further information

References