Equine-assisted psychotherapy and learning

Domain XV · Nature, philosophy, social & rites of passage

What it is

Equine-assisted psychotherapy (EAP) is not a separate psychotherapy with its own theory of change. It is a setting and a set of practices in which a licensed mental health professional, working within their own scope of practice, incorporates horses into psychotherapy or counselling. US consensus…

Format

• EAP is a model and a set of standards rather than a manualised protocol; the published sources give no fixed phase sequence, session count or session length. Eagala calls its model "both a set of standards and a facilitation style". The structure below is the working sequence a psychotherapist…
• Roles and format (sourced).

Who practises it, and how they are trained or regulated

• Team: a licensed mental health professional (MH) responsible for the client's emotional process and psychological safety, and an equine specialist (ES) responsible for observing horse behaviour and managing physical safety; each keeps their own professional boundaries.
• Referral and suitability: is EAP indicated for this client, and is it within your licence, training and insurance? Goals: decide fit; screen medical, allergy, phobia, trauma-with-animals and immune-status risks (IAHAIO asks professionals to screen for allergies and risk factors and apply exclusion criteria, e.g. for immunosuppressed people). Move on when the client consents to the specific setting and risks and the…
• Orientation sessions: safety briefing by the ES, first observation of the herd, low-demand contact. Move on when the client can stay regulated enough near horses to engage with a task.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• vague answers on welfare or licensure. Working when you can answer all eight points in writing.
• fall risk; mounting without the client's clear choice. Working only as judged by the trained team.
• notes that describe horses but not clinical change. Working when progress is visible against goals.
• programmes offering 'hippotherapy' without PT, OT or SLP. Working when roles are clear to the family.
• immunocompromised clients not disclosed; allergy symptoms. Working when the routine runs without reminders.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.