What is Equine Therapy?

 

Boy on a horseEquine Assisted Psychotherapy (EAP) is a method of psychotherapy which is experiential, involving the collaboration of a licensed trained mental health clinician, equine professional, horse and client.

As a result of the powerful authentic mirroring ability of the horse and the immediate feedback delivered to the client, EAP differs from traditional psychotherapy. Participating in EAP involves recognizing, developing, and internalizing healthy values and behavior. Examples of domains enhanced through EAP are:

trust, communication, boundaries, empathy, accountability, confidence, intimacy, deepened physical awareness, assertiveness, self-control

Patients with trauma, abuse, depression, anxiety, substance abuse, attention deficit disorder, eating disorders and autism spectrum disorders have been found to have significantly decreased psychological symptoms.

The client can often have a broader and increased understanding of symptoms and issues through the use of metaphors. The clinician uses the horse as a metaphor of what has been difficult for the client to deal with and how they may behave in social situations. The client’s interactions with individual horses or a herd of horses will reveal much about their interpersonal world outside of therapy.

Boy bonding with horseAs the horse's authentic nature begins to bond with and touch the client emotionally, many difficult feelings may begin to surface. Transference will increasingly occur as this bond develops and the client begins to connect with suppressed emotions and memories.

While riding a horse can be exhilarating and fun, EAP can be challenging and provocative. Groundwork is the initial contact between client and horse. This involves grooming, learning about horses’ attributes, longing, leading, and the concept of “joining up”. Joining up occurs as a sign that the client has achieved an authentic state, or congruent state of behavior and emotion while working with a horse. If this congruence is achieved, the individual is positively rewarded through the horse obeying simple requests: the horse will “join up” with the client. lf the client cannot achieve this congruency, the horse will be noncompliant with requests and move away from the client. This is immediate, authentic feedback. A horse simply is not capable of lying.

As a result of the nontraditional setting of EAP, adherence to treatment and reduction of resistance to treatment improve dramatically. Research has confirmed this for adolescents, men, war veterans and some minority populations. Providing therapy in a natural and experiential setting may be less stigmatizing and therefore translate to enhanced treatment goals being met and increased overall compliance with attendance.

EAP can be used as an adjunctive form of treatment with traditional psychotherapy, or it can be used as the sole method for meeting treatment objectives. In either case, processing of the sessions is important in order to extract the material revealed through the metaphors, to psychoeducate and to create a plan for the time outside the session.

Boy on a horseIn the late 1960s hippotherapy began to emerge and was predominantly utilized for those with physical injuries. In the past two decades the acceptance of EAP as an effective form of therapy is on the rise dramatically. This is in part due to the formation of organizations (PATH (formerly known as NAHRA), EAGALA, etc.) that are focused on teaching clinicians and horse trainers to be able to implement this form of therapy for both physical and psychological diagnoses.

Speech therapists have accepted EAP as being able to unlock those who are hypoverbal. Physical and occupational therapists have seen patients twisted with contractions from head injuries and cerebral palsy, whose contractions have relaxed to such an extent that their level of recovery cannot be predicted. They do not look like the same people coming off horse as they did going on. This process can take as many as four people or “walkers” to spot the patient on top of the horse as it slowly walks around the arena. The gait of the horse mimics our own and gradually relaxes the contractions. The psychological freedom these patients experience is immeasurable. One of the greatest values is related to increasing distress tolerance, whether it be for post-traumatic stress disorder, anxiety, hyperactivity, anger management, traumatic brain injuries, eating disorders, etc. The list is endless as to the physical and psychological benefits of desensitization to negative stress.

As a psychotherapist conducting EAP sessions for nearly eighteen years, my belief is that each session is worth approximately ten traditional “talk therapy” sessions. Individuals, groups, couples, families, men, women, children, adolescents, adults, young and elderly can be all served.

End of session

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Further reading

Here are two academic papers on Equine Assisted Therapy:

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