Equine therapy uses horses to help treat clients with mental health issues. It began in the 1960s helping those with physical disabilities but was found to also benefit clients emotionally and psychologically. Several prominent organizations like EAGALA and EFMHA were formed to establish standards and certify professionals in this field. Equine therapy sessions can involve structured activities with horses to illustrate metaphors or allow the horse's natural behaviors and responses to clients to provide insight. Interpreting horse behavior requires an understanding of horses' social structure and communication as herd animals. While approaches differ, equine therapy is now used to treat various conditions from eating disorders to trauma.

1. Equine Therapy: An Inside Look
Claire Dorotik, M.A.
Even if your experience with horses is only a passing interest, you have most
likely felt what those having a long history with horses already know: there is something
about horses that is just good for the soul. As the awareness of this powerful effect of
horses on people has grown, those in the mental health field have also begun to turn to
horses to help with a variety of issues their clients are experiencing. What has grown
out of this interest is what is now known as equine facilitated psychotherapy, or equine
facilitated learning.
A Short History
As early as 1969, the North American Riding for the Handicapped Association
(NARHA) recognized the physically therapeutic impact of riding for those with physical
disabilities. With promising results, the interest in this approach grew, and NARHA soon
expanded to it present size of more than 800 member centers, over 3,500 certified in-
structors and 6,500 members. The benefit horses can offer was soon realized to extend
beyond the physical realm, and a number of organizations offering both psychotherapy
and learning partnering with horses began to emerge. Among the first of these was the
Equine Assisted Growth and Learning Association (EAGALA), which as a nonprofit or-
ganization, now offers certifications in either equine assisted psychotherapy, or equine
assisted learning. Soon thereafter, linda Kohanov wrote her bestselling book, The Tao
of Equus, and with an healthy following, started Epona Equestrian Services. Recog-
nized as a pioneer in the field, Kohanov offers workshops, apprenticeships and leader-
ship programs for those interested in incorporating the intuitive nature into the personal
of professional lives. With these two prominent organizations in place, longtime expert
in the filed of equine facilitated psychotherapy, and NARHA professional, Barbara Rec-
tor, introduced the healing benefits of horses to Sierra Tucson, an exclusive drug and
alcohol addiction center. The first center of its kind to partake in this ground breaking
approach, Sierra Tucson soon also became recognized as a pioneer in the world of ad-
diction recovery. With professional respect now turned in her direction, Rector partnered
with NARHA to found the Equine Facilitated Mental Health Association, (EFMHA), itself
an innovative organization in it’s quest to provide professional standards for what had
now become quite a popular field. In 2005, EFMHA presented the first set of nationally
recognized standards from which equine professionals working in mental health would
now have to adhere to.
However, as the excitement about horses offering healing to humans grew, and a
burgeoning opportunity was realized, many smaller organizations quickly opened their
doors to offer certifications and workshops as well. Not recognized by NARHA, EA-
GALA, or any governing body, these young organizations added to what remains a con-
tentious debate about the safety protocols needed to protect the uninformed clients from
potential injury.
And the interest in equine therapy has not escaped the educational field with
smaller colleges such as Prescott College, in Arizona, and Bethany College, in West
Virginia both offering certification programs, and in the case of Prescott College, a full
Marriage and Family Therapist licensure track program in equine facilitated psychother-
apy, and learning.

2. Today, although both horse people and mental health professionals have a host
of options in incorporating horse healing into their practice, only NAHRA/EFMHA offer
nationally recognized standards in the field.
An Inside Look:
So what is it that really happens in an equine therapy session? Well, just as there
are a number of ways to approach training a horse, several different methods of equine
assisted therapy are in existence. Some organization, such as EAGALA prefer the use
of recognized exercises or activities to be performed with the horse, which purportedly,
provide the client with an experience from which a metaphor for life can be drawn. For
example, a client who quickly become frustrated while trying to halter a horse, would be
asked if he/she also feels this way when faced with a challenging situation in life. On of
the most classic of these exercises, used exclusively for clients battling eating disor-
ders, is called, “Temptation Alley,” and involves the patient attempting to guide a horse
through an aisle way lined with hay and grain. As the client struggles to prevent the
horse from eating, a horse professional and psychotherapist, working in concert, will
help the client draw from this experience, information about how she handles her eating
disorder.
While activities with the horse can be effective learning tools, organizations, such
as EFMHA, and EPONA have shied away from this approach, and instead advocated
the acceptance of the horse as a sentient being, offering unique and powerful insights of
his own. To this end, both of these organizations have advocated more education
around a comprehensive understanding, and accurate interpretation of horse behavior.
Although both a horse professional and mental health expert are still recognized as the
norm by these two organizations, the mental health professional should now have a
more complete understanding of horse behavior.
However, in terms of just what this understanding entails, EFMHA and EPONA
part ways. As EPONA promulgate the idea that horses mirror people’s behavior, there-
by reflecting back to the client what he/she brings to the session, EFMHA, encourages
understanding the horse’s responses from the perspective of a herd animal. What this
means to EFMHA, is interpreting the horse’s behavior as if it existed in a herd of fellow
horses. For example, a horse circling closely around a client, would be interpreted as it
would a horse circling closely around another, which depending on the physical posture
and additional nonverbal behavior of the horse could mean either protection of domi-
nance. Clearly, this approach requires the presence of a skilled practitioner well versed
in equine behavior, and equine psychology.
Despite the disparity in approaches, there is no debate about the efficacy or uti-
lization of equine facilitated psychotherapy, and it is now advocated for everything from
eating disorders, depression, anxiety, childhood behavioral problems, corporate leader-
ship, and team building.
So perhaps by now you are wondering if you should attempt your own version of
“Temptation Alley,” watch to see if your horse is mirroring you, or simply wonder what
his behavior might mean among his herd mates. Well, for this, I have offered some tips
to take to the barn.
Take To The Barn Tips:

3. As any activity with horses can be inherently dangerous, be sure to use caution,
and work with a safe horse, when attempting any of these activities.
Round Pen Play:
This activity involves working with your horse loose among a herd of horses.
Preferably done in a smaller area -- such as a round pen or small turnout, close the pen
securely, remove your horse’s halter and step back. Notice, does your horse immediate-
ly run off, or does he follow you? Giving him some time, watch to see just what his re-
sponses are. Does he allow other horses to approach you, or does he want to stay near
you? Is he disinterested and carefully scanning the ground for scraps of hay? Is he curi-
ous about you? Afraid? How does he respond to the other horses with you in the vicini-
ty?
Interpreting how your horse responds to you among the herd can reveal many
things. If, for example your horse is submissive by nature, and he looks to you for reas-
surance, he sees you as a secure base. On the other hand, if your horse is willing to al-
low the other horses to come close to you while remaining disinterested, he is most like-
ly experiencing a hesitancy in connecting with you, and is respecting a need for space --
in relationships -- within you.
Who Owns the Space?
To attempt this activity, first find something around the barn that you horse is like-
ly to spook at. Now holding the lead line loosely, attempt to walk him past it. Does he
spook toward you? Does he force you to move out of your space? Or is he careful not to
step on you even though afraid?
As for horses, space is interpreted as safety, with a protective mother often mov-
ing her foal to evade something threatening in the environment, and dominance, with a
stronger horse refusing to concede space to a weaker one, a horse that spooks toward
you, forcing you out of your space, could mean either he feels the need to ensure his
own safety when with you, or he sees you as a weaker member of the herd, from which
he will not give space. On the other hand, if your horse is respectful of your space
when spooked, he likely sees you as safe, and strong.
While you have probably experienced the therapeutic effects of “escaping to the
barn,” on numerous occasions, perhaps by looking a little deeper at your horse’s re-
sponse to you, you can learn just what you might be under the surface. And maybe, you
will uncover just what you were running from.
Follow up Links:
Certified Therapy Horse Association
http://ctha.us/
Equine Assisted Growth and Learning Association
http://www.eagala.org/

4. North American Riding for the Handicapped Association
http://www.narha.org
Equine Facilitated Mental Health Association
http://www.narha.org
American Hippotherapy Association
http://www.americanhippotherapyassociation.org/
Bethany College
http://www.bethanywv.edu/index.php?cID=4859
Prescott College
http://www.prescott.edu/academics/map/CounselingandPsychologyEquineAssistedMen-
talHealth.html
Epona Equestrian Services
http://www.taoofequus.com
Claire Dorotik, M.A. is a licensed marriage and family therapist specializing in trauma, weight
loss, eating disorders, addictions, and dual diagnosis. Claire utilizes equine facilitated psy-
chotherapy from a psychoanalytic perspective to offer clients a unique method to understand
themselves. Claire has written extensively on the topics of the psychology of weight loss,
food and substance addictions, trauma, and equine therapy. Her first three books, ON
THE BACK OF A HORSE: Harnessing the healing Power of the Human-Equine
Bond, NO SECRET SO CLOSE: A True Story of a Father’s Murder, A Moth-
er’s Betrayal, A Family Torn Apart, and The Horses That Turned It All Around, and
ALL KIDS ARE BORN THIN: A Parent’s Guide To Understanding and Prevent-
ing Childhood Obesity, are now available on Amazon Kindle. Further information on
Claire, or her upcoming books, can be found at www.clairedorotik.com, or www.greathorse-
books.com.