Could spending directed time with horses be the therapeutic experience you’re looking for? And what is it about these particular creatures that makes them a perfect match to improve our mental health?

There’s something about horses. From the workhorses that supported agriculture in years gone by to the showhorses capable of magnificent feats and, now, therapy horses supporting us to navigate various mental health challenges in facilitating, creative ways.

Equine-facilitated psychotherapy (EFP) – sometimes also known as ‘equine-assisted psychotherapy’, ‘hippotherapy’, or just ‘equine therapy’ – describes a range of different wellbeing treatments that incorporate horses (as well as other equines such as donkeys and ponies) into a therapeutic session.

Incredibly, equine therapy can be traced all the way back to Ancient Greece, and the philosopher Hippocrates wrote about ‘hippotherapy’ and ‘riding’s healing rhythm’, going on to explain that the gate of a horse mimics the natural movement of a healthy human. The first study into equine therapy was in 1875 by French neurologist Charles Chassaignac. What he concluded was that riding could be an effective form of physiotherapy, but he also found that it improved mood and cognitive function. More recently, in 2023, a study published in BMC Complementary Medicine and Therapies found that equine-assisted therapy was effective in improving emotional regulation, self-efficacy, and self-esteem in patients with substance use disorders.

“Research suggests that therapeutic outcomes may be improved by incorporating a focus on sensory experiences – this is where our four-legged companions come in,” says Dr Danielle Mills, a counsellor and founder of Pony Partnerships. “Embodied awareness through EFP supports an increase in the way clients experience and interpret their understanding of what they are doing, and how they are doing it. Horses help us connect to our somatic (bodily) selves, offering insights into how we relate to the world as well as to others.”

Through this connection, Dr Mills believes that clients can better understand sensory experiences such as:

  • Proprioception (awareness of the body’s position and movement)
  • Neuroception (the ability to sense safety or danger in people and situations)
  • Interoception (noticing and regulating internal bodily signals).

“Equine-facilitated psychotherapy is for everyone, no horse experience necessary!” Dr Mills continues. “We work with clients of all ages and neurotypes, from horse enthusiasts to those who might feel a little nervous around them. Whether you’re drawn to horses or hesitant about them, this approach can provide a safe and enriching way to explore personal growth.”

Why horses?

For those who haven’t spent a lot of time around horses, the idea of using them for therapy in this way may seem a little unusual. But there are several reasons why these particular creatures can be so effective in supporting us.

First and foremost, consider their size. Likely one of the first things you will notice about a horse is how big it is, and that physical presence can have an equally big impact on the way we interact with them. Horses are powerful animals, and that can be intimidating for some people. But overcoming that fear can feel liberating and affirming.

Additionally, horses are herd animals, desiring company and wanting to be led. As part of this, they also mirror behaviours, sometimes reflecting back our own emotions – demonstrating the things we might not have been aware we were feeling.

“I grew up around horses, so they were always part of my life, and have been integral in my own therapeutic journey,” Dr Mills says. “I first discovered that equine-facilitated psychotherapy [EFP] was a ‘thing’ when I was 15 and, from that moment, I knew it was something I wanted to do one day! It’s been quite a journey, but, in 2015, I completed my initial training and founded Pony Partnerships CIC, operating out of Moo Haven – a wonderful pony rescue.”

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What happens during an equine therapy session?

There’s no exact answer to this question, as there are several different approaches and belief systems around this type of therapy. The majority of the time, though, there will be no actual horse riding involved – although, this is also a specific option for the right people.

Usually, there will be exercises that require the individual to interact with the horse. There may be practical, creative problem-solving exercises, or mindful movement.

“For me, EFP sessions are all about collaboration, with the horses being active participants in the therapeutic process,” Dr Mills explains. “Clients work alongside a therapist and a horse or horses, creating opportunities to explore different ways of thinking, being, and relating.”

Dr Mills follows the three key principles of the HERD approach, developed by Dr Veronica Lac, which are:

  • Here and now. “This is our ability to remain in the moment in a fully embodied way, and includes both our internal and external awareness,” says Dr Mills. “As practitioners, it is our job to support and explore the client’s awareness of self, other, and their environment. By supporting the client to stay in the here and now, we can support them to connect their cognitive and embodied awareness.”

  • What and how. “This is based on the philosophical concept of phenomenology – as a practitioner we seek to understand the client’s experience without interpreting it. This allows the client to explore and make their own meaning from each experience.”

  • I and thou. “This relates to Buber’s (1965) concept of the moment of connection between self and other and the more objectified ‘I-It’ relationship. The HERD approach focuses on the movement between these moments, and attending to the embodied nature of these encounters for all involved.”

With this in mind, Dr Mills notes that sessions are unstructured and guided by the client’s needs, with the horses given the freedom to choose their level of involvement. She says: “This natural, respectful approach creates a calm, collaborative environment for growth and reflection.”

A way over the hurdles

Whatever the challenges we face, one thing’s for certain: there’s no one-size-fits-all solution.

“For some, the traditional therapy setup – sitting face-to-face in a room, with the focus on talking – can feel intimidating or overwhelming,” Dr Mills says. “Equine therapy offers an alternative: working outdoors with horses, and in nature, can provide a unique flexibility to explore the client’s experience of the world. It’s a space for exploration, connection, and healing, where nature and animals come together to foster change.”