Services of Equine Assisted Therapy (EAT)
Butler University Undergraduate Research Conference, 2023
Abstract
Equine assisted therapy (EAT) utilizes equine activities and
an equine environment as a treatment method for those
individuals with physical or mental disabilities. Activities such
as grooming, ground level work, horseback riding, and
horsemanship have provided numerous opportunities for
individuals to develop and progress. EAT services were
inclusive to all age groups and abilities as the programs have
been uniquely designed to appropriately address their
individualized needs. Individuals were able to strengthen their
physical abilities and construct a positive self-image which
boosted self-confidence. The benefits of these programs
were supported by five case studies and other supplemental
resources. Based on the data collected, it has been
determined that EAT is an inclusive, unique, and practical
course of treatment for many.
Introduction
Equine Assisted Therapy (EAT) originally began in 600 B.C.
when the ancient Greeks were using horses as a form of
therapy. It was not until 1960 when the formation of the
Community Association of Riding of the Disabled (CARD)
introduced therapeutic riding in the United States and Canada.
Equine-assisted therapy is a form of treatment that utilizes
equine activities and/or an equine environment to aid individuals
who are disabled (Good Therapy, 2017). Through these
experiences, individuals have been able to develop soft skills,
build confidence, and foster meaningful relationships with their
fellow equine partners. Therapy sessions were tailored for each
individual depending on their appropriate needs. This has made
EAT one of the most inclusive therapy treatments. The services
provided by EAT promoted physical, occupational, and
emotional growth in persons that have suffered from physical,
mental, and emotional disabilities.
EAT is also known as “Hippotherapy” because “hippos” means
“horse” in Greek (Koca and Ataseven, 2016). Unlike other
equine activities, hippotherapy does not teach an individual how
to ride a horse. Instead, therapists have used the movement of
the horse to engage specific muscles in therapy patients. The
dynamic movement and consistent rhythm of the horse allowed
individuals to progress and achieve their goals in a way that no
other treatment has provided. The horse’s gait mimics the
motion of the pelvis that humans rely on to walk (Heussen and
Häusler, 2022). Hippotherapy has also been known to help
individuals strengthen their balance and improve their
coordination and stability.
Services
Studies have shown that individuals of all ages and abilities
can benefit from equine-assisted therapy. Horses have
provided numerous services to people including but not
limited to those with:
• Cerebral Palsy
• Autism
• Asperger
• Addictions and Substance Abuse Issues
• Eating Disorders
• Grief and Loss
• Trauma and Posttraumatic Stress (PTSD)
• Depression
• Anxiety
• Bipolar
• Inattention and Hyperactivity (ADHD)
Erin Cummins - College of Education
BPS Model
Figure 1 (Biopsychosocial Model)
Unique Role of Horses
Horses have several unique abilities that make them suitable
for individuals with varying needs. Equine Assisted Therapy,
2016 had an in-depth explanation on the usefulness of a
horse:
Non-judgmental and Unbiased
Horses do not have predetermined biases, nor do they judge
individuals on their past experiences. Instead, the horse only
reacted to the individual’s behaviors and emotions they
displayed. This allowed patients to develop self-esteem and
self-confidence because individuals were not judged on their
past. It also challenged individuals to be present and, in the
moment, rather than dwelling on the “what ifs”
Feedback and Mirroring
Horses are keen observers, hyper vigilant, and sensitive.
Their nature of being a prey and herd animal was beneficial
because they reacted quicker and gave prompt and
consistent feedback as compared to a human therapist.
Horses also have an innate tendency to mirror the
individual’s behavior, physical movement, and emotions. This
allowed individuals to have their feelings validated, especially
those who could not communicate verbally. The horse was
able to replicate and display those feelings for their human
partner.
Metaphor for Real Life
Horses acted as the medium that helped individuals cope
with their own challenges. Individuals were able to problem
solve and apply what they learned on horseback to real life
situations. This brought them a sense of comfort and new
inspiration as they overcame their challenges.
Local Facilities
The Children’s TherAplay Foundation, Inc. 
Address: 9919 Towne Rd, Carmel, IN 46032
Phone Number: (317) 872-4166
Morning Dove Therapeutic Riding Center
Address: 7444 W 96th St, Zionsville, IN 46077
Phone Number: (317) 733-9393
Agape Therapeutic Riding Resources
Address: 24970 Mt Pleasant Rd, Cicero, IN 46034
Phone Number: (317) 773-7433
Benefits
Equine-assisted therapy reflects the Biopsychosocial Model
seen in Figure 1. It aids individuals in achieving mental health
through all three components; biological, psychological, and
social. Equine partners provided patients with the opportunity to
be included regardless of their disability. They help their muscles
move in patterns consistent with how they would normally walk
which aided them in developing gross motor function and motor
capabilities. Patients were able to build self-esteem, gain
perspective, exercise autonomy, and learn coping skills as they
worked alongside their equine partners (White-Lewis, 2019). A
horse's natural ability to pick up on human emotional
expressions and needs allowed individuals to feel validated.
Lastly, EAT provided patients an opportunity to create
relationships, strengthen communication skills, and to build a
bond with their equine partners. As patients were able to
become more self aware through EAT, it led to physical and
emotional healing.
Figure 2 - (Children’s TherAplay Foundation, Inc)
Research has shown that people with both physical and emotional
needs have benefited from working with horses. EAT programs
have proven to be extremely inclusive as their services are offered
to individuals of any varying need, age, ethnicity, or sexual
orientation. One benefit of hippotherapy is shown in Figure 2. This
image demonstrates an individual with a physical disability learning
how to find their balance by engaging their core strength. A
research study by Koca and Ataseven (2016) proved that
hippotherapy as a treatment modality is effective in patients with
both physical and mental disabilities. More specifically, it was used
as a therapeutic tool for patients learning to walk (Heussen and
Häusler, 2022).
Limitations
As stated by GoodTherapy (2017), the first cause for concern is
the size and weight of the horse. EAT facilities have done their very
best to keep all their clients safe as that is a top priority. However,
the addition of an unpredictable animal can lead to unforeseeable
accidents. The massive size of horses was also worrisome. To
combat this issue, EAT facilities assured that all of their therapy
horses were vetted and well-trained before becoming a certified
therapy horse (Hippotherapy, 2023). All instructors and volunteers
also go through extensive training to ensure the safety of all parties
involved.  Koca, T. T., and Ataseven, H. “What Is Hippotherapy? the Indications and Effectiveness of
“Another limitation is that some people might experience allergic
reactions to the horses, their environment, or both. Those
individuals with dust, hay, or animal allergies have been required to
exercise caution before considering equine therapy”
(GoodTherapy, 2017). EAT facilities have taken this issue into
consideration and implemented cleaning and sanitation procedures
to keep all patients comfortable and safe.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6917924/.
A third concern was the cost of these programs. The expense of
lessons has detoured some families from utilizing this treatment
method. However, EAT facilities have done their best to
accommodate this limitation by relying on grants and donations to
help lessen the financial strain.
Conclusion
Figure 3 - (Menor-Rodriguez et al., 2021)
Equine assisted therapy has proven to be an effective
treatment method to individuals with varying disabilities. The
utilization of the horse is key to this method as they had a
strong influence on humans that interact with them. The
sensitivity of the animal allowed the individuals to gain
immediate feedback while not being challenged against their
past mistakes or limitations. For individuals with physical
disabilities, the rhythmic movement of the horse’s gait
appeared to be very beneficial. While on horseback,
movements such as rotational, forward, and side-to-side
strengthened the client’s balance and coordination (Koca and
Ataseven, 2016). For individuals with mental or learning
disabilities, the horse provided them with a safe space to gain
self-confidence, focus on the present, problem solve, and
develop their self identities  (Kern-Godal et al, 2016).
Figure 3 reflects the results of an individual utilizing EAT
services. This table concluded that the individual’s balance,
posture, and stability improved greatly. While there were
limitations to this treatment, EAT facilities have done their best
to eliminate as obstacles as possible. Overall, this treatment
method should be acknowledged more deeply by physicians
as it would benefit a great number of patients and their
families.
References
Biopsychosocial Model. Physiopedia, https://www.physio-pedia.com/Biopsychosocial_Model.
Equine Assisted Therapy. The Anxiety Treatment Center, 13 June 2016,
https://anxietytreatmentexperts.com/equine-assisted-therapy/.
GoodTherapy. “Equine-Assisted Therapy.” Equine–Assisted Therapy, GoodTherapy, 12 Nov.
2017, https://www.goodtherapy.org/learn-about-therapy/types/equine-assisted-therapy.
Heussen, N., and Häusler, M. “Equine-Assisted Therapies for Children with CerebralPalsy: A
Meta-Analysis.” American Academy of Pediatrics, American Academy of Pediatrics, 3 June
2022, https://publications.aap.org/pediatrics/article/150/1/e2021055229/188239/Equine-
Assisted-Therapies-for-Children-With?autologincheck=redirected%3FnfToken.
Hippotherapy, https://www.childrenstheraplay.org/hippotherapy (date accessed, March 2023).
Kern-Godal, A., et al. “More than Just a Break from Treatment: How Substance Use Disorder
Patients Experience the Stable Environment in Horse-Assisted Therapy.” Substance Abuse :
Research and Treatment, U.S. National Library of Medicine, 6 Oct. 2016,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5054942/.
Hippotherapy.” Northern Clinics of Istanbul, U.S. National Library of Medicine, 15 Jan. 2016,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5175116/.
Menor-Rodríguez, María José, et al. “Role and Effects of Hippotherapy in the Treatment of
Children with Cerebral Palsy: A Systematic Review of the Literature.” Journal of Clinical
Medicine, U.S. National Library of Medicine, 11 June 2021,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8230898/.
White-Lewis, Sharon. “Equine-Assisted Therapies Using Horses as Healers: A Concept
Analysis.” Nursing Open, U.S. National Library of Medicine, 27 Sept. 2019,