Choosing an equine program starts with clear language. Many terms sound alike but mean different things. This guide explains the main categories in plain language, so you can decide what fits your goals.
Ready to choose a program? Start with our short Decision Guide: Is This For Me?
Quick Orientation
People use “equine-assisted therapy” as a catchall, yet the work splits into two broad paths:
- Clinical services with licensed health professionals where the horse is part of health care.
- Learning, recreation, or skills programs that are not medical treatment.
The sections below give you clear, working definitions.
What “Equine-Assisted Therapy” Often Means (EAT)
“Equine-assisted therapy” is an umbrella phrase. Many readers use it to mean any horse-based help, though professionals often prefer more precise terms. When you see EAT in everyday use, it usually points to equine services that support health, behavior, or learning. To avoid confusion, ask a provider which specific service they offer and who delivers it.
In a sentence: EAT is a broad, everyday label, not a single standardized service.
Hippotherapy
What it is: A licensed physical, occupational, or speech therapist uses the horse’s movement as a clinical tool to address specific therapy goals. The therapist plans and documents treatment, selects the horse and positions, and integrates mounted and off-horse activities into a therapy plan.
Who leads it: A licensed PT, OT, or SLP, often with additional training in the use of equine movement.
Primary purpose: Clinical change, for example better balance, postural control, breath support for speech, or sensory regulation.
What to know: Sessions may be billed under the relevant therapy discipline. Medical screening and goal tracking are part of care.
Educational-only note: If you are considering hippotherapy, talk with your clinician about safety, medical history, and fit.
Adaptive or Therapeutic Riding
What it is: Adaptive riding lessons that teach horsemanship and riding skills while accommodating physical, cognitive, or sensory needs. The focus is participation, confidence, and skill development, not medical treatment.
Who leads it: An instructor trained to adapt lessons for different abilities, often through organizations such as PATH International or CanTRA.
Primary purpose: Riding skills, independence, and enjoyment, with possible secondary health or social benefits.
What to know: Because this is instruction, not healthcare, it is typically paid out of pocket or through scholarships rather than health insurance.
Equine-Assisted Learning, and Equine-Facilitated Psychotherapy
These two terms sit side by side, yet they differ in purpose and who leads them.
Equine-Assisted Learning, EAL
What it is: Structured, horse-centered activities that build life skills such as communication, teamwork, problem solving, leadership, and self-awareness. Activities are usually on the ground, not riding.
Who leads it: Educators, coaches, or facilitators trained in EAL methods. They are not providing medical or mental health treatment.
Primary purpose: Personal growth and practical skills for school, work, or daily life.
Equine-Facilitated Psychotherapy, EFP
What it is: Mental health treatment in which a licensed clinician integrates equine interaction into psychotherapy. Sessions may be on the ground or mounted, depending on goals and safety.
Who leads it: A licensed mental health professional, for example a psychologist, clinical social worker, or counselor. An equine specialist often supports horse welfare and safety.
Primary purpose: Psychotherapy goals such as trauma recovery, anxiety and mood management, emotion regulation, or relationship skills.
Educational-only note: If you are considering EFP, consult your mental health clinician about risks, benefits, and coordination of care.
How They Compare, At a Glance
- Medical treatment: Hippotherapy, yes. EFP, yes as mental health treatment. Adaptive riding and EAL, no.
- Who leads: Hippotherapy by licensed PT, OT, or SLP. EFP by a licensed mental health clinician. Adaptive riding by trained riding instructors. EAL by facilitators or educators.
- Primary goal: Hippotherapy, clinical function. EFP, mental health. Adaptive riding, riding skills and participation. EAL, life and social skills.
- Billing: Hippotherapy and EFP sometimes integrate with health coverage, policies vary. Adaptive riding and EAL are usually private pay or scholarship.
- Typical activities: Hippotherapy, mounted and unmounted therapy tasks using horse movement. EFP, psychotherapy tasks with horse interaction. Adaptive riding, riding lessons with adaptations. EAL, ground-based team and problem-solving activities.
How to Decide What Fits You
Start with your top one or two goals in your own words. If you want clinical changes such as better balance, core strength, articulation, or sensory processing, hippotherapy is likely. If your main goals are emotional healing or mental health, look for EFP with a licensed clinician. If riding, independence, and confidence light you up, adaptive riding is a good match. If you want teamwork, leadership, or social communication without medical treatment, explore EAL.
Next, consider practical fit. Are you comfortable around horses and barn environments, can you attend weekly, and does the program’s safety culture make you feel at ease? Visit a center, watch a session, and notice how staff handle both people and horses. Your impression of safety and respect matters.
Feeling ready to compare options near you? Check our Program Vetting Checklist
Note: Any choice that involves medical or mental health goals should include guidance from a qualified clinician.
Common Misunderstandings
- “EAT covers everything.” It is more accurate to ask which specific service is offered.
- “Therapeutic riding is therapy.” It supports well-being, yet it is instruction, not licensed healthcare.
- “All programs bill insurance.” Coverage depends on service type, credentials, and policy.
- “Riding is required.” Many effective activities happen on the ground, especially in EAL and EFP.
Safety, Horses, and Welfare
Quality programs protect participants, horses, and staff. Expect helmets when mounted, calm and appropriately conditioned horses, clear rules, trained volunteers, and transparent incident reporting. Welfare-positive practice looks like quiet handling, respectful spacing, and horses that get rest, turnout, and good care.
Educational-only note: If you have medical concerns such as seizures, recent surgery, heart or breathing conditions, or hip and spine issues, seek medical advice before participating.
Next Step and Learn More
Next step: Read Is Equine-Assisted Therapy Right for You? for a gentle, practical decision path.
Learn more: Visit Safety and Standards in Equine Programs to know what to expect at a quality center.
NOTE: This article is educational only. It does not replace medical or mental health advice. Always consult a qualified clinician about your specific situation.
