Why do many people find interactions with horses so healing? Beyond physical benefits like improving muscle tone, balance and coordination, and pelvic mobility, psychologists say simple experiences like grooming or walking alongside horses boost emotional regulation, foster social connection, build empathy and trust, and reduce stress.

While equine-assisted psychotherapy (EAP) is widely recognized for helping patients, a growing body of clinical experience and emerging research reveals another profound outcome: It is helping heal the therapists themselves.

Practitioners speaking with Medscape News Europe suggest that horses can slow the pace of a session, sharpen observation, and help clinicians stay present. These effects were echoed in a recent study published in BMC Complementary Medicine and Therapies, in which 10 experienced clinicians were interviewed, finding that working with horses deepens therapeutic presence and anchors therapist participants to the present moment.

“If you work in psychology or mental health, I believe you have to be in the here and now,” said Carlos Hernández Izquierdo, MA, MSc, an equine-assisted services specialist, educator, clinical psychology practitioner, founder of Equability Malta, and lecturer at the Czech-based nonprofit, Svítání Academy.

Hernández Izquierdo, who is based in Malta, referred to the concept as “horse time.”

“We’re used to measuring things in human time or society time; it’s like we want everything now. But sometimes horses say no, meaning that the therapist has to be patient, self-aware, and have enough self-control to wait.” The personal result, he told Medscape News Europe, is reduced stress.

Alessia Caruso, a neuro and psychomotor therapist specializing in animal-assisted interventions and animal-assisted therapy for children with developmental disorders at ASST Grande Ospedale Metropolitano Niguarda in Milan, Italy, agreed.

“Working with horses has taught me how to observe and not ask,” said Caruso. “The environment encourages therapists to allow things to unfold; to happen organically and naturally.”

Restoration and Burnout Prevention

The sessions also promote authenticity within the therapists themselves.

“We don’t feel judged by the horse. There’s a beauty of feeling comfortable, of having contact, and being reminded to not think about what needs to be done later,” said Hernández Izquierdo.

“Perhaps you can be more yourself in that environment. As therapists, we’re more at ease. We play a bit more,” added Nicolas Emond, DESS, psychologist and equine-assisted therapist, and CEO at Institut de Formation en Equithérapie in Paris, France.

The recent study suggests that this sense of play and horse companionship shield therapists from burnout, in turn building resilience and promoting job retention.

This protective benefit comes at a critical time for healthcare providers. “The mental health crisis among our health workers is a health security crisis, threatening the integrity of our health systems,” Hans Henri P. Kluge, World Health Organization (WHO) regional director for Europe, warned in a press statement.

He cited key findings from a WHO survey in the European Union, Iceland, and Norway highlighting how work conditions drive depression and suicidal ideation, with 1 in 3 doctors and nurses reporting having work-related depression and more than 1 in 10 having thought about ending their lives or self-harming.

Co-Therapists in the Field

Maria G. Liapi, a psychologist  and specialist in psychoeducational therapy with horses in Athens, Greece, explained why she — like many therapists in the field — chose to train and work with horses to enhance her clinical practice.

“The horse is a mirror of humans,” she told Medscape News Europe. “They show us they understand body language and communicate with us about the client. They behave differently when they understand a person’s specific characteristics,” she said, adding that this is invaluable when working with nonverbal clients, such as those with autism.

“The horses give us signs,” Hernández Izquierdo agreed. “You can confirm the client is self-regulating or relaxing because of the reaction of the horse. They provide an indicator of how things are progressing.”

By sharing the load, a horse’s presence appears to make it easier to engage with patients and accelerate the therapeutic process.

“The horse is a huge motivator and facilitator,” said Caruso. “It’s easier for horses to engage the child and make it look like a game. The environment and the horse make the sessions lighter,” she said.

Field Challenges and Research Needs

While EAP therapists sang the praises of their work, they also voiced concerns that the field is not uniformly recognized as legitimate by the medical community, and awareness is low among physicians, limiting referrals. Cost is another issue; maintaining and training horses requires major investment and commitment.

Emond added that he worries about the practice expanding into the wellness arena.

“What’s changing, especially in France, is that people who want to work with horses don’t feel the need to have serious backgrounds in medical psychology and acquire specific education. Their approaches are more experimental, the experiences they provide have less structure and fewer rules and ethical considerations for outcomes,” he said.

The dearth of evidence-based research is also prohibitive, which is something the Federation of Horses in Education and Therapy International is trying to change through its journal and international conferences — facilitating scientific collaboration across 45 member countries.

For EAP clinicians, passion drives practice. While patient breakthroughs remain central, horses provide a dual benefit: they are not merely clinical assets, but equal partners in the therapeutic process who actively help heal the healers.

Liapi reported running a private EAP practice in Greece. Caruso reported no relevant financial interests.

Liz Scherer is a health and medical journalist who frequently reports on EU and Canadian health news.