Hippotherapy and therapeutic riding

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

What it is

Hippotherapy is not a psychotherapy, and the psychotherapist does not deliver it. The AHA defines hippotherapy as the "purposeful manipulation of equine movement as a therapy tool" to engage sensory, neuromotor and cognitive systems toward functional outcomes. It is a treatment tool used within…

Format

• The sources describe programme processes, not a psychotherapy protocol. No source gives a typical number or length of sessions for the psychotherapist's work; the USU Extension guide notes that equine-assisted programmes range from hours-long retreats to weekly sessions over several months.

Who practises it, and how they are trained or regulated

• Hippotherapy (AHA 2023): the licensed therapist leads a team (equine professional, horse handler, sidewalkers and aides) and decides whether to include hippotherapy through a risk-benefit analysis reached by consensus among patient, guardian, therapists, horse expert and physician; precautions call for further investigation and monitoring, contraindications rule it out; the horse is selected for movement,…
• Hippotherapy is not a psychotherapy, and the psychotherapist does not deliver it. The AHA defines hippotherapy as the "purposeful manipulation of equine movement as a therapy tool" to engage sensory, neuromotor and cognitive systems toward functional outcomes. It is a treatment tool used within occupational therapy, physical therapy or speech-language pathology, by licensed OTs, PTs and SLPs working within their…
• Therapeutic riding is now called adaptive (therapeutic) riding or adaptive/therapeutic horsemanship: a non-therapy service that teaches riding and groundwork adapted for people of diverse abilities, delivered by qualified equine professionals (for example a PATH Intl. Certified Therapeutic Riding Instructor, CTRI, described by PATH as a voluntary, entry-level credential) with a team of volunteers. Its aims are…

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 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?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• 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

• skills that only appear at the barn. Working: reports from home or school.
• unexpressed grief, a sense of abandonment. Working: the ending is named and marked.
• parental over-investment, guilt, marital strain. Working: realistic shared expectations.
• idealisation of the horse as the only source of relief. Working: richer self-description.
• blurred roles, client discomfort, insurance gaps. Working: roles are explicit and agreed.

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.