Equine assisted psychotherapy (EAP) is a relatively new term gaining popularity in the equestrian world. EAP is a field of science in which horses are used specifically as a tool for emotional growth and learning (1). The process is not limited to riding horses, such as traditional therapeutic riding for the disabled. EAP goes beyond the activity of riding, and utilizes the tasks of caring for the horse and the bonds that form through that caring as a means of establishing trust, respect, and responsibility (3). This allows the psychologist and equine specialist to proceed at a manner safe for all involved, and forms the basis for many of the benefits of EAP that traditional therapy falls short of providing.

Although it is a relatively new term, equine assisted psychotherapy has its roots over two centuries ago. Two German physicians, Gerard van Swieten (1700-1772) and Anton de Haen (1704-1776) recommended horseback riding in cases of mental illness. They felt it had a soothing effect on the muscle fibers, which reduced attacks of hypochondria and hysteria (5). Tissot in 1782 described the psychotherapeutic effects in this manner:

In fact, the Germans were the forerunners in promoting and standardizing therapeutic riding, including EAP. In 1977 Germany had developed a basic model of therapeutic riding that defined three areas of concentration: medicine, psychology-education, and horsemanship. Dr. Wolfgang Heipertz outlines these in his text " Therapeutic Riding, Medicine, Education, and Sports" (1977). The concentration of medicine was cultivated for reducing physical ailments, psychology-education for treating mental disorders, and horsemanship for rehabilitating disabled riders to obtain increased motor control (6).

Heipertz states in his book the following indications for psychiatric treatment using horses as: " Psychotic and other behavioral and traumatic disruptions, schizophrenia, mental defects, mongolism, abnormal personality, psychosomatic disorders, depression, neurosis, addictions (2)." Riding and vaulting were the tools used for this class of equine assisted psychotherapy. Antonius Kroger, principal of the special municipal school for children with behavioral problems in Munster/Westf, has been overseeing a vaulting program there for children with socialization problems since 1963 (2). The vaulting was used for children with high functioning motor skills, who were placed on a lunge line and performed gymnastic exercises atop the horse at a trot, under the supervision of an educational psychologist. The activity was to "motivate, diminish anxieties, develop trust, learn self-evaluation, self-esteem as well as socialization skills" (6).

Unlike Germany, the United States has been slow in developing a systematic approach to this kind of therapy. In fact, the United States’ focus was merely on riding for the handicapped from about 1960 to 1982 (6). According to several sources (3,5,6), the field of equine therapy did not evolve in the U.S. until about 1970 and due to the complex nature of psychotherapy the field has only recently started to develop a formal organization. The Equine Facilitated Mental Health Association (EPMHA) was formed as a division of the North American Riding for the Handicapped Association (NARHA). The goals of the EPMHA are to develop knowledge, research, certifications, credentialing, and standards in order to professionalize this field of psychotherapy (4). Because of the lack of such standardization few insurance carriers are willing to cover treatment as of the date of the listed reference. Research and promotion of EAP as a professional treatment will be the key to its further implementation and ultimate success (6).

One of the initial programs of EAP in the United States is the Three Eagles Equine Experience in Calistoga, California. Three Eagles Equine Experience was founded by Adele von Rust McCormick, Ph.D., and Marlena Deborah McCormick, Ph.D., psychotherapists for over 30 years who also had a love for horses and kept them for companionship.

In their many years of practice it became apparent that the answers to helping their patients on the road to well being did not come from a textbook, but more often than not from basic human instinct. Upon observing this instinctive communication in their interaction with their horses, they decided to incorporate the horses into their practice. In 1981 they moved their practice to the country and ventured into the realm of equine assisted psychotherapy. They discovered that the environment alone helped ease the complications of traditional therapy. Upon asking some of their patients what the ideal healing place was, unanimously the setting was in the country with animals present. In contrast a typical office environment in the city emits a chaotic, unnatural, and uncomfortable setting (3). The McCormick's realized the potential for using the horse in therapy due to its similarity to humans, in that it is a social animal. However, it is the horse's differences to the socialized man that brings about the successes that the traditional therapist can not achieve. Horses allow us to unite unconditionally with another living being. We can take our masks off without fear of rejection. The horse has no expectations, prejudices, or motives. All of these traits allow the patient to open up and reveal their selves and receive feedback from the horse’s responses. This is the key to healing: expressing true feelings and interaction with another being to develop a true self-concept. Many times we know what people want to hear and respond in fashion, revealing a false self. This inhibits the healing process. A horse's natural instincts can not be deceived. The horse, through their senses, knows the true self even when well disguised, for we all in some small inconspicuous manner display our true feelings (3).

The horse also provides an excellent tool for self-awareness, as the horse will respond to you in reaction to your actions. This self-awareness is used in particular for anger management. For instance, a rider must learn to control their anger to properly control the actions of the horse. The horse will make the patient responsible for their emotional state, because if the rider displays their anger in instructing the horse, the horse will respond in a disobedient fashion (3). Likewise, antisocial teenagers are shown through the horse's actions that they must control their aggressive behavior in order to obtain the horse's cooperation. (6)

The size of the horse alone demands respect, a necessary ingredient if the therapist is to have any influence on the patient. Traditional therapy for a child unwilling to participate often creates a great barrier, but a therapist utilizing the horse will likely receive respect, for they have power over the massive equine. Once the respect is established the child will more likely than not listen to the guidance of their therapist. Many times the children eagerly anticipate the sessions perceiving them as enjoyment and not therapy. All sources (1,2,3,4,5,6) site this as a relief from the normal struggle of contradicting the negative attitude people have towards therapy.

These sources seem to indicate a growing consensus that EAP has a definite place in the world of psychiatry. Although not as highly focused on as equine facilitated physical therapy, the sources reveal a moving trend to this form of therapy. With the introduction, growth, and recognition of the EFMHA, the public will be educated of the benefits of this unique form of therapy. While the treatment is not yet widely covered by insurance carriers (3,4,6), the goal is that with the standardization provided by this professional organization it will soon be accepted, allowing many to benefit from our equine friends (6).

1. Kersten, G. (1998). Equine Assisted Psychotherapy. Aspen Ranch web page: http://www.aspenranch.com

2. Heipertz, W. (1977). Therapeutic Riding. Ottawa, Canada: National Printers (Ottawa) Inc.

3. McCormick, A., McCormick, M. (1997). Horse Sense and the Human Heart. Deerfield Beach, Florida: Health Communications, Inc.

4. McDaniel, I. (Winter 1998). What Exactly is "Equine Facilitated Mental Health & Equine Facilitated Learning?" NARHA Strides Magazine reprint from NARHA web page: http://www.narha.org

5. Riede, MR Doz. Dr.sc.med. (1988). Physiotherapy on the Horse. Renton, Washington: The Delta Society.

6. Spink, J. (1993). Developmental Riding Therapy: A Team Approach to Assessment and Treatment. Tucson, Arizona: Therapy Skill Builders.