Equine Therapy: The Use of Horses for Healing


Last week we were kindly invited by Cathy Livingston to explore the use of horses in a therapeutic setting, as we learnt all about her work as an Equine Assisted Psychotherapist. This prompted me to explore an area of therapy that I (admittedly) do not have a great deal of knowledge in. However, I am always keen to learn about everything therapy-related, so I jumped at the chance to expand my knowledge and share with you some of my findings.

The use of animals in a therapeutic setting is not a new concept, in fact it was first documented as early as the late 1700’s (Trivedi & Perl, 1995). Animals can provide a sense of comfort, safety and calmness in people, as well as being effective at diverting attention away from stressful or anxiety provoking situations. Animals can help individuals stabilise emotions, develop a sense of confidence and trust, and improve communication and connection with others and the self.

Equine therapy has been shown to be effective at reducing psychological distress and enhancing psychological well-being (Klontz et al., 2007).

In one of the only clinical trials of Equine Therapy, positive results were found from individuals who completed short courses (4 ½ days) of Equine Therapy. These include individuals reporting that they felt more orientation to the present moment, they felt less burdened by regret, guilt and resentment and had less focus on fears related to the future. In addition, individuals reported they felt more independent and self-supportive. More recent research involving participants with Autism Spectrum Disorder has found Equine Therapy to improve social functioning and reduce aggressive behaviour (Trzmiel et al. 2018).

Although limited, the research literature does appear to be positive. This makes me question;

Why are horses so effective in a therapeutic setting?

Similarly to dogs, horses are highly intuitive and have a unique historical relationship with humans. Horses are herd animals, which means they are relational and accustomed to social experiences (Lentini and Knox, 2009). Horses are also prey animals, therefore it is essential that they are attuned to their surroundings in order to survive. As a result, they can sense the internal states of people and they can react and respond in a direct and honest way to these states (Lentini and Knox, 2009). Have you ever seen a horse act in a negative way to an anxious rider? This is because they can feel the anxiety from the rider and therefore react to that anxiety and become anxious themselves. Furthermore, horses live in present moment. In a therapeutic setting this allows their reactions to the client to be based on the present state of the client and not based on judgments or on a client’s history. This also means that transference reactions can be addressed without some of the confounding interpersonal factors present in more traditional therapies.

Equine therapy is focused on connection; to the self, the horse and to others. The therapist works with the client and the horse to build a strong relationship with the aim to get the horse to connect with the client. The client is then able to use the confidence gathered through this process and project it to their relationships with humans. The sheer size of the horse provides opportunities for clients to explore issues related to boundaries, vulnerability, control and power – all of which are essential when connecting with a 500kg animal!

Projection and transference can be experienced with horses (Klontz, Bivens, Leinart & Klontz, 2007), as patterns from human relationships can be seen in the relationship with the horse. In our taster session, a member of the group became frustrated that the horse was not doing as she wanted it to. Later, the individual acknowledged that she experiences this frustration in similar ways in relationships with people.

The relationship can be an avenue for modelling behaviours. A client can observe how their anxious behaviour affects the horse. This can then help them to understand how their behaviour can influence people around them.

Horses can provide feedback, feedback that is both accurate and unbiased, mirroring the physical and emotional states of the client. This provides clients the opportunity to raise their awareness and to practice congruence between their feelings and behaviours. The horse can sense incongruity and will appear confused until internal consistency is reached within the client.


Although the research is limited, there does appear to be a place for Equine Therapy. It has been successfully integrated into treatment programmes for adults, teens and children who are being treated for anxiety disorders, trauma, autism, substance abuse, depression and related conditions. I for one will have it in mind for any clients in the future who I believe could benefit from an integrated approach to therapy that includes Equine Therapy.

To find out more about Equine Therapy in Singapore check out Cathy’s website at: www.livingstoncounselling.com



Klontz, bivens, Leinart, klontz (2007). The effectiveness of equine-assisted experiential therapy: results of an open clinical trial.

Lentini, J., and Knox, M. (2009). A Qualitative and Quantitative Review of Equine Facilitated Psychotherapy (EFP) with Children and Adolescents. The Open Complementary Medicine Journal, 1, 51-57.

Trivedi, L., and Perl, J. (1995). Animal facilitated Counseling in the Elementary School: A Literature Review and Practical Considerations. Elementary School Guidance & Counseling, 29 (3), 223-233.

Trzmiel, T., Purandare, B., Michalak, M., Zasadzka, E. and Pawlaczyk, M. (2018). Equine assisted activities and therapies (EAAT) in children with ASD: a systematic review and a meta-analysis. Complementary Therapies in Medicine, 42, 104-113.