# What is Equine Therapy? A UK Guide
Equine therapy has been growing steadily as a subject of clinical interest and public curiosity. The term covers several distinct approaches — some involving riding, some not — and understanding what each one actually entails matters before you decide whether it might be right for you or someone you care about.
This guide covers what equine therapy is, what happens during a session, what conditions it has been used for, what the research says, and how to find a qualified practitioner in the UK.
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Two different things share the same name
The phrase "equine therapy" gets used for two genuinely different approaches, and it's worth being clear about the distinction before going any further.
Equine-assisted psychotherapy (EAP) is a ground-based therapeutic intervention. You don't ride. A licensed mental health professional and a qualified equine specialist work together with the client and one or more horses in an enclosed space. The focus is on the therapeutic relationship — the horses respond to what's happening emotionally in the session, and that response becomes the material for the work. It's used primarily for psychological conditions including PTSD, trauma, anxiety, depression, addiction and eating disorders.
Therapeutic riding is riding-based, and is used mainly for physical, neurological and developmental conditions. Riding for the Disabled Association (RDA) is the principal UK body. Sessions are led by trained instructors rather than mental health professionals, and the benefits — improved balance, posture, muscle tone, coordination and confidence — come from the physical experience of being on a moving horse.
Both are legitimate, both are useful, and both are growing in the UK. But they are not interchangeable. If someone is looking for support with PTSD or anxiety, EAP is the relevant one. If the concern is physical rehabilitation or developmental support, therapeutic riding is usually the right conversation to have.
This guide focuses on EAP. The therapeutic riding and RDA guide covers the second category in full.
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What happens in an equine-assisted psychotherapy session
Most people expect to be riding. In EAP, you're not.
The horses move freely in an arena or outdoor space. You might be asked to observe them, to approach one, to groom it, to lead it through a simple task, or to set up an obstacle and guide the horse through it. The specific activity is less important than what happens around it — how you respond to the horse, how the horse responds to you, what emerges in the doing of it.
Horses are highly attuned to non-verbal emotional signals. They respond to tension, calm, confidence and anxiety without having any interest in the story behind those feelings. A horse doesn't know or care what happened to you. It responds to how you are in the moment. That's what makes the interaction therapeutically interesting — and sometimes unexpectedly confronting.
Throughout the session, the mental health professional and the equine specialist observe and facilitate. They'll often ask reflective questions about what you noticed, what happened when you approached the horse, what it felt like when it moved away or came closer. The conversation that follows is the therapy. The horse provides the occasion for it.
Sessions typically last 60 to 90 minutes. Most programmes run over six to twelve weeks. The EAGALA model — the most widely used EAP framework internationally, with certified practitioners in the UK — requires both a licensed mental health professional and a qualified equine specialist to be present at every session.
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What conditions it's used for
EAP has been used for a broad range of psychological and behavioural conditions. The most researched applications include:
PTSD and trauma — the most documented use, particularly with military veterans and survivors of abuse. The ground-based, non-verbal nature of EAP suits people for whom conventional talking therapy is hard to access — those who struggle to articulate what happened, feel shame or guilt about it, or find the clinical setting itself a barrier.
Anxiety and depression — the most common referral pathway in UK community settings. Interaction with horses has been consistently associated with reduced anxiety and improved mood in the existing literature.
Addiction and recovery — a number of UK residential recovery programmes incorporate EAP as a complement to established treatment.
Autism and neurodevelopmental conditions — the non-verbal, sensory and relationship dimensions of working with horses can suit some autistic individuals well.
Eating disorders — EAP has been used in some specialist treatment programmes, though the evidence base here is less developed than for PTSD or anxiety.
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What the research says
The research on EAP is genuinely promising, and it's important to say both parts of that sentence.
For PTSD specifically, studies have found that therapeutic horseback riding can produce a statistically significant decrease in symptoms — including insomnia, flashbacks and panic attacks — after three weeks, with clinically significant improvement after six weeks. One study found an 87.5% likelihood of a lower PTSD score after a six-week programme.
For anxiety more broadly, a 2019 review of human-animal interaction studies found that over 90% of therapists reported positive outcomes for clients. EAP sits within this evidence domain.
The honest caveat, which serious practitioners will tell you directly, is that the evidence base is still developing. Most studies have small sample sizes. Few are randomised controlled trials. The UK Psychological Trauma Society notes that the evidence is generally hindered by these limitations, and that more rigorous research is needed before EAP can be placed alongside established therapies in terms of clinical confidence.
That doesn't mean it doesn't work. The evidence consistently points in a positive direction and client-reported outcomes are strong. It means EAP should be approached as a complement to professional treatment rather than a replacement for it — and that a good practitioner will tell you exactly that.
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What to look for in a practitioner
EAP is not a regulated profession in the UK in the way that psychotherapy and counselling are. This makes checking credentials genuinely important.
The main things to look for:
EAGALA certification — the Equine Assisted Growth and Learning Association trains and certifies both mental health professionals and equine specialists in its model. Certification requires training hours, supervised practice and ongoing continuing education.
Qualified mental health professional — the person facilitating the therapeutic work should hold a recognised UK qualification in counselling, psychotherapy or clinical psychology, registered with BACP, UKCP or the BPS. This is not optional. EAP delivered without a qualified mental health professional present is not the same intervention.
Transparency — a good practitioner will be clear about what EAP is and isn't, will not make extravagant claims about outcomes, and will discuss how it fits into any existing treatment you're receiving.
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What it costs in the UK
EAP is not routinely available on the NHS, though some NHS partnerships with community providers exist, particularly in veterans' mental health services. Private sessions typically cost between £60 and £120 per session. Group programmes tend to be lower cost or subsidised. Some charities — including Warrior Equine, which works specifically with armed forces, veterans and emergency services — offer EAP at reduced or no cost.
If cost is a barrier, it's worth asking your GP or mental health professional whether they know of funded programmes in your area.
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Finding a practitioner in the UK
The EAGALA website has a practitioner search function where you can filter by location. Saddl lists over 70 equestrian venues across the UK with equine therapy provision — search equine therapy venues near you to find what's available in your county.
When you make first contact, ask how sessions are structured, who the mental health professional is and what their qualifications are, and what the programme involves week to week. Any practitioner worth working with will welcome those questions.
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If you're struggling with your mental health right now, these UK services can help. Samaritans: 116 123 (free, 24 hours). Mind: 0300 123 3393. PTSD UK: ptsduk.org. Crisis text line: text SHOUT to 85258.