Equine Facilitated Psychotherapy: The Healing Power of Horses within Clinical Practice By Kelsey Craig, MSW, LCSW on 9/27/19 - 11:56 AM

Horses are amazing, beautiful animals—everyone knows that. I’ve had a mild obsession since my first riding lesson at age six (Thanks, Mom and Dad!). After twenty-two years of competitive riding, and a few degrees later, I was eager to incorporate horses into my clinical practice. During graduate school, I took a course entitled Animal Assisted Interventions, and while it certainly sparked my interest, at the time I didn’t put a lot of thought into it. My primary focus at that moment, like most recent graduates, was finding gainful employment. Three years later, I found myself wanting to combine my two passions: therapy and horses. At the beginning of 2019, I was able to do just that—I started offering Equine Facilitated Psychotherapy at the North Carolina Therapeutic Riding Center in Mebane, NC.

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Equine Facilitated Psychotherapy (EFP) is a relatively new framework within the mental health field. Experts have long agreed on the healing power of animals, which is evidenced by the recent surge in emotional support animals. Although, I find comfort in simply being around animals, there has always been something unique about horses. After doing quite a bit of research, what I always suspected to be true was confirmed: horses mirror human emotions. Even non-horse people have heard, “if you’re afraid while you’re riding a horse, the horse can sense it.” The reason behind that is the horse’s ability to respond to and interpret non-verbal communication offered by humans.

EFP is deeply rooted in observing the horse’s feedback to a client—and then connecting that information to the individual’s life. For instance, if a client has mild anxiety but can present more confidently, the horse will likely still pick up on that anxiety and may take a few steps back when approached by the client. This interaction then holds space for a conversation around the client’s anxiety which may have gone unnoticed in a traditional office setting. Angela Dunning, author of The Horse Leads the Way, notes, “subtle changes in breathing, heart rate, muscle tension, nervous system, and energy levels offer invaluable information about our true emotional state. Therefore, because horses fully inhabit their bodies, their inherent ability to pick up on these subtle changes is one of the main reasons why equine facilitated practice is such a powerful method.” If a client is not making marked progress within the confines of office, EFP is a great option to have.

Trust building is another large component of EFP, highlighted by granting the horse an option to participate willingly. That is, we emphasize the horses’ consent in activities by not tying them and forcing their involvement. To a client that may not have a lot of autonomy in their personal life, the treatment of the horse speaks volumes. Further, when the horse chooses to participate in the session, the client feels a sense of accomplishment in building trust in that relationship. When a horse makes a choice about whether to participate in an activity, it encourages dialogue around emotional regulation and past trauma, and paints a picture of patterns within interpersonal relationships.

The benefits of EFP are endless, as it can address a broad spectrum of mental health concerns. Aside from the therapeutic results, Equine Facilitated Psychotherapy can also encourage professional growth in mental health practice. Although I personally have an equine background, it is not necessary for the mental health professional practicing EFP to be a seasoned equestrian. PATH Intl guidelines require both a mental health professional and an Equine Specialist to be present in each session. The Mental Health Professional’s primary focus is the client and interpreting feedback as it comes up. The role of the Equine Specialist is equally important, as they operate to keep the horse, and all human participants, safe. The Equine Specialist and Mental Health Professional collaborate to plan activities for each session, which encourages a partnership between the two roles.

Recently, I have been working with a teenage client who was placed in foster care. This client entered treatment with the implicit disclaimer: I will likely not talk to you, and when she first arrived, understandably she was eager to keep me at an emotional distance. With all clients, the first activity I utilize in a session is “Observe the Herd.” This activity is exactly what it sounds like: you ask the client to observe a herd of horses, and describe what they believe the horses are doing and feeling, and why they may be feeling that. This particular client pointed out that one of the horses had walked away from the other, and the horse left alone felt scared and nervous. This provided me with insight into how the client has felt since being removed from her family and guided the structure of further interventions. Though this client was guarded with me, her interaction with the horses was the complete opposite. For instance, when taught to communicate with the horse in order to walk her around the arena, the client was very attuned with the horse's feelings. The horse started to turn, without the client directing her to, to which the client responded, "Oh, do you want to go that way? Okay, we can go that way," while rubbing the horse's nose. She then noted, "I don't want her to feel trapped." That sentiment offered insight into how the client was feeling within her current circumstances, as well as provided a chance to further the discussion about how the horse may feel.

At the beginning of each session, we begin by brushing the horse and catching up on the previous week. During this time, this client is often tearful when articulating her desire to return home. Without fail, the horse she is brushing turns around and nudges her, looks at her or acknowledges in a meaningful way how the client is feeling. She has since formed an amazing relationship with a horse at NCTRC and is quite possibly one of the most open and honest clients I’ve encountered. Through EFP, this client has been able to form a trusting relationship—first with a horse, and then with me. The progress she’s made is truly remarkable.

Equine Facilitated Psychotherapy has completely transformed the way I approach my clinical practice and my lifelong relationship with horses. EFP is a growing presence in the mental health field, and one that—if you have the opportunity—I highly recommend finding out more about.  

File under: The Art of Psychotherapy, Musings and Reflections