Therapeutic horseback riding is a growing industry that is quickly gaining traction as a non-medicinal treatment for trauma and anxiety. This activity can be enjoyed by people of all ages, improving their physical, mental, and emotional well-being.

In this article, we will be discussing the different benefits of therapeutic horseback riding, who can benefit from it, and the best places to try it out.

What is Therapeutic Horseback Riding?

Therapeutic horseback riding is a treatment for individuals with challenges or special needs that utilizes mounted equine activities and the equine environment to promote physical and mental well-being.

While the name implies the act of riding a horse, it can also incorporate working with the horse on the ground, grooming, and putting tack on the horse.

In therapeutic riding programs, a team works together to assist the individual in riding the horse. The team is typically made up of a certified therapeutic instructor, a horse handler, and one or more side-walkers. The instructor directs the lesson while the handler leads the horse and side-walkers flank the horse and rider.

equine therapy

During a therapeutic riding session, the individual is guided in controlling the animal such as asking the horse to start walking from a halt, change directions, make circles, or navigate around and over small obstacles like cones and ground poles.

Handlers ensure that the horse moves in the direction and speed it is intended to while side-walkers stay close in case the rider loses their balance or tries to dismount early.

Types of Equine Therapy

Therapeutic riding is just one of a few types of equine-assisted activities and therapies available to persons with challenges or special needs. Other types that may or may not involve riding the horse include:

  • Hippotherapy – equine-assisted physical, occupational, or speech therapy
  • Equine-assisted learning – equine-assisted experiential learning approach for developing life skills
  • Equine-assisted psychotherapy – equine-assisted social, cognitive, emotional, or behavioral therapy
  • Interactive vaulting – an activity where an individual practices movement and balancing challenges on and around the horse
  • Therapeutic carriage driving – an activity where an individual controls the horse by driving from a carriage seat or in their wheelchair in a modified carriage

Who Can Benefit from Therapeutic Horseback Riding?

Adults and children with physical, cognitive, or emotional challenges can benefit from therapeutic riding. From active-duty military personnel to children with cerebral palsy to seniors with dementia, all can potentially build independence and strength through the healing power of horses.

Mounted therapy sessions and activities can be specially tailored to benefit people with the following conditions:

  • Autism spectrum disorder 
  • Attention deficit disorder
  • Anxiety disorder
  • Alzheimer’s and dementia
  • Amputations
  • Depression
  • Developmental delay or disability
  • Down syndrome
  • Cerebral palsy
  • Epilepsy or seizure disorder
  • Hearing impairment
  • Multiple sclerosis
  • Muscular dystrophy
  • Paralysis
  • Post-traumatic stress disorder
  • Speech impairment 
  • Spina bifida
  • Spinal cord injury
  • Stroke
  • Substance abuse
  • Terminal illness 
  • Abuse or trauma
  • Visual impairment
  • Weight control disorder

What Is the Best Breed of Horse for Therapy?

Not every breed of horse is fit to become a therapeutic riding horse. To be accepted into a therapy program, horses must meet specific requirements including the possession of a gentle and tolerant temperament, trainable and willing personality, and low flight response.

Some breeds, like Arabians and Thoroughbreds, are “hotter” by nature and may not be able to meet the criteria for a therapy horse even with rigorous training and practice.

Additionally, therapeutic riding horses need to have clean and smooth gaits (walk, trot, canter) as well as a certain type of conformation (the way the horse is put together) to allow for a safe and physically beneficial riding experience. Regardless of breed, the horse should also be sound and in outstanding health.

Stock horse breeds and small draft horse breeds make the best therapeutic riding horses. These breeds have similar characteristics such as a quiet temperament and average size that predispose them to being excellent horses for riding therapy.

The specific horse breeds preferred for mounted therapy activities are:

  • American Quarter Horse
  • American Paint Horse
  • Appaloosa
  • Haflinger
  • Norwegian Fjord (Fjord horse)
  • Gypsy Vanner (Gypsy horse, Irish cob)

One breed stands out from the crowd, however, and that is the American Quarter horse. This widely available, mellow, and friendly breed is the most accepted breed of horse into therapeutic riding programs.

Benefits of Therapeutic Horseback Riding

Improved Balance and Strength

Horseback riding requires the rider to sit up straight and balance using the back and core muscles. This effect is exaggerated when the saddle is replaced with a bareback pad, which is common practice in therapeutic programs.

Therapeutic riding, bareback or otherwise, is proven to increase strength and balance, which can lead to an improvement in fine motor skills and even speech.

Improved Coordination and Range of Motion

Controlling a horse is dependent on coordination. The rider’s legs ask for upward transitions while the hands work independently to direct the horse to change directions or slow down.

Therapeutic riding lessons often incorporate other activities to build coordination and range of motion like picking up items from barrels or pinning a picture to the arena wall. These activities require the rider to bend and stretch to reach the barrel or wall while keeping their hips square on the horse.

Reduced Irritability and Hyperactivity

Some theorize that individuals diagnosed with autism experience a reduction in irritability when exposed to therapeutic horseback riding because it allows them to use non-verbal communication, often their preferred means of communication, to control a large animal.

Others theorize that the horse’s rhythmic stride has a calming effect on the brain. Still, others suggest that the routines that occur during riding lessons as well as the horse’s natural tendency to prefer routine match with the needs and preferences of autistic individuals.

Improved Social Skills

Therapeutic riding can aid in social skills by offering the individual an opportunity to interact and work with new people as well as animals. The individual might also develop a bond with the instructors, handlers, and side-walkers while learning respect and patience for animals.

Improved Confidence 

Horses are large, powerful animals that can be intimidating to be around. Learning the skills needed to successfully interact with and ride horses are huge accomplishments. For some, it can be an opportunity to overcome fear while boosting confidence and self-esteem.

Improved Mood

How and why animals, including horses, emotionally uplift us is not entirely understood. Perhaps the unique thing about animal companionship is that it comes free of judgement. For those with physical, cognitive, or emotional challenges this could be a radical change from their daily lives.

Which Organizations Offer Equine Therapy

The Professional Association of Therapeutic Horsemanship International (PATH Intl.) is a credentialing organization for accrediting centers and certifying instructors and specialists of equine-assisted services. There are 873 PATH Intl. member centers and 4,776 credentialed professionals in the United States and around the world that can be found in the Member Center Directory on the PATH Intl. site.

Additionally, the Certification Board for Equine Interaction Professionals (CBEIP) promotes

independent certification for mental health professionals or educators who

incorporate horses into their therapy, education, and coaching practices. The directory for certified equine interaction professionals can be found on the CBEIP site and reflects all providers currently certified.


How much does horseback riding therapy cost?

The cost of horseback riding therapy varies. Generally, you can expect to pay anywhere from $30 to $100+ for a single therapeutic riding lesson. An accredited program with certified instructors will cost more than a non-accredited program with uncertified instructors. Similarly, a private lesson will cost more than a group lesson.

Does insurance cover horseback riding therapy?

Some insurance providers will cover therapeutic horseback riding while some may only cover therapeutic riding programs that incorporate hippotherapy (equine-assisted physical, occupational, or speech therapy) or equine-assisted psychotherapy. You can be certain that insurance providers will only cover accredited programs with certified instructors and handlers and that a doctor’s prescription will probably be necessary.