Instead of meeting for the usual office visits, some mental health professionals and their patients are holding their sessions in barns, pastures, or paddocks. The unconventional settings are the backdrop for a growing clinical approach called equine-assisted therapy, which uses interactions with horses to help patients work through difficulties and feelings they experience in their daily lives.
For example, a horse that a patient tries to bridle could resist, continually throwing its head back. Frustrated after a couple of attempts, the patient’s immediate impulse might be to give up, or blame the horse for being stubborn. But with guidance, patients might also find that successfully dealing with some animals, like some people, just requires the flexibility to take a different tack.
“Often the interaction mirrors how you approach other problems,” says Lisa Baugh, a marriage and family therapist based in Palm Beach County, Florida, who also has trained to do equine-assisted psychotherapy.
Equine-assisted therapy can be used to augment traditional psychotherapy and counseling, or it can serve as a primary intervention, says Denny Cecil-Van Den Huevel, the program director of Professional Counseling at South University — West Palm Beach. Cecil-Van Den Huevel has tapped Baugh’s expertise both in clinical practice and in her classes.
It becomes metaphorical. The horses aren’t horses, they’re what they represent to the client.
“I originally became interested in it from a supplemental point of view, with a few patients who needed an experiential kind of therapy,” she says. In her classes, she works with Baugh to introduce equine-assisted therapy because “I like to expose students to different modes of therapy so they see ways of thinking outside the box and possibilities other than sitting in an office doing talk therapy.”
Baugh says equine-assisted therapy has roots in the experiential therapies that evolved from Gestalt, a school of thinking that held real-world situations were essential to psychological research and treatment. One mode of experiential therapy that has grown over the past half century is animal-assisted therapy. Some sources credit the seminal work in that area to child psychologist Boris Levinson, who wrote in the 1960s about his success using his own dog, Jingles, to reach young patients. The field has since expanded to encompass work with horses, dolphins, and other creatures.
Using horseback riding as a therapeutic activity and “the idea of incorporating horses in activities to help people has been around for hundreds of years, but it didn’t become more formalized probably until the early 1990s,” says Lynn Thomas, executive director of the Equine Assisted Growth and Learning Association (EAGALA), based in Santaquin, Utah.
Because horses are large, powerful animals, they can be particularly useful in representing big, life challenges and for helping people build confidence or overcome fears, Thomas says. Although they are social animals, they also have distinct personalities, moods, and a preference for their herds. These attributes can call forth some of the same reactions and behaviors from patients as they exhibit in human interactions or in coping with challenges in their own lives.
“It becomes metaphorical,” Thomas says. “The horses aren’t horses, they’re what they represent to the client.”
There’s no specific kind of patient to whom equine-assisted therapy is most suited, Thomas says. But she noted that people uncomfortable with the idea of traditional talk therapy might find equine-assisted sessions “less intimidating,” because the interactions serve as a natural focus for discussion. Animal therapy, in general, also can be particularly useful for people with attachment disorders, Cecil-Van Den Huevel notes.
Nor is there a single style of practice among professionals who offer equine-assisted therapy.
“There are different models,” says Thomas, a licensed clinical social worker who co-founded EAGALA after gaining exposure to equine-therapy through work at a residential treatment ranch for youth with social and emotional difficulties. The models range from using horseback riding to help patients overcome physical or emotional handicaps to setting up situations that facilitate psychotherapy, she added. Equine-assisted activities also attract individuals who are seeking personal growth or groups of people seeking to understand or improve their interactions.
There is no licensure or formal training requirement for equine-assisted therapists, though as the largest professional organization for practitioners, with more than 3,500 members, EAGALA is trying to bring standards to the field with its own certification program, Thomas says. EAGALA offers training and promotes a practice standard under which teams of two — an equine specialist and a licensed mental health professional — work together with patients.
Costs for equine-assisted therapy vary, depending on the region in which it’s given, the credentials of the professional involved, and limits under insurance plans that cover it, Thomas says. She estimated that in the U.S., individual sessions, usually lasting an hour or so, average between $75 and $175. It’s also impossible to estimate how many people are undergoing equine-assisted therapy, though EAGALA is surveying members about their volumes. Thomas believes the field “is definitely growing” based on media attention and her organization’s growth.
Research documenting the benefits of equine-assisted therapy is not yet robust, though EAGALA gathers and posts published studies and academic papers on a portion of its website.
“The small amount that’s been done has been very positive about the results people get with this modality,” Thomas says.