Types of Equine Therapy: Hippotherapy, EAP & Adaptive Riding

“Equine therapy” is an umbrella, not a single method. Under it are distinct practices that use the horse in different ways—some are clinical healthcare services, others are educational or skills-based. Knowing the differences helps you match the right approach to your goals, whether you’re seeking physical rehabilitation, mental health support, or structured learning in a barn setting.

Hippotherapy (Clinical Use of Horse Movement)

Hippotherapy is a medical treatment strategy used by licensed physical, occupational, or speech-language therapists who incorporate the horse’s movement into a therapy plan. The walking horse provides a rhythmic, multi-directional input that resembles human gait, helping the clinician target balance, core stability, breath support, articulation, and motor planning.

What it looks like: sessions are one-to-one; the therapist shapes stride, tempo, and positions (hands-free tasks, changes of direction) to elicit specific neuromotor or speech outcomes. Documentation aligns with healthcare standards, and goals are measurable.

Good fit for: neurological conditions, developmental motor delays, sensory processing differences, postural control needs, and some speech/language goals in collaboration with SLPs.

Equine-Assisted Psychotherapy (EAP)

EAP is mental health therapy delivered by a licensed clinician who integrates horses to support goals like trauma recovery, anxiety regulation, mood stabilization, and family systems work. Much of EAP happens on the ground through leading, grooming, observation, and structured tasks that surface patterns in communication and emotion.

What it looks like: the horse acts as responsive feedback, not a prop. The therapist tracks arousal, pacing, boundaries, and meaning-making. Riding may be included but isn’t required.

Good fit for: PTSD (including veterans and first responders), depression, anxiety, grief, relational challenges, and youth emotional-behavioral goals.

Therapeutic / Adaptive Riding

Adaptive riding provides individualized riding instruction for people with disabilities. The aim is skill development — steering, transitions, balance — alongside benefits such as confidence, social connection, and recreation. Instructors adapt tack, use mounting ramps or lifts, and may include sidewalkers for stability.

What it looks like: a lesson format with safety accommodations; clear progression of riding skills; emphasis on enjoyment and participation.

Good fit for: riders seeking the physical and psychosocial benefits of learning to ride in a supportive, accessible setting.

Equine-Assisted Learning (EAL)

EAL is goal-oriented education and skills training using horse interactions to build leadership, teamwork, communication, and self-awareness. It is not psychotherapy and is typically delivered by certified facilitators or educators.

What it looks like: ground-based exercises (e.g., leading patterns, group problem-solving with a herd) followed by facilitated reflection—“What worked? What will we try differently?”

Good fit for: schools, youth programs, workplace teams, and individuals pursuing personal growth without clinical treatment.

Equine-Assisted Activities (AAA)

Sometimes called “therapy animal visits,” AAA are quality-of-life encounters with horses that do not set clinical goals. They can reduce isolation, lift mood, and offer positive, structured contact with animals.

What it looks like: brief, supportive interactions—grooming, feeding, walking beside a horse—coordinated with facility staff or community programs.

Good fit for: residents in long-term care, hospital well-being programs, community inclusion initiatives.

Vaulting (Gymnastics on Horseback)

Equestrian vaulting is choreographed movement on a moving horse—think balance, rhythm, and teamwork. Therapeutic vaulting adapts these movements for participants who benefit from dynamic balance and body awareness in a highly supported context.

What it looks like: a horse on a lunge line with a coach; participants mount and perform seated or kneeling positions with spotters and strict safety protocols.

Good fit for: individuals who respond well to rhythmic movement and structured challenges; programs emphasizing motor planning, coordination, and confidence.

Therapeutic Driving (Carriage Driving)

Driving offers a mounted alternative for those who cannot or prefer not to ride. Participants learn to harness, hitch, and drive from a carriage or cart, practicing coordination, sequencing, and upper-body control with the support of a team.

What it looks like: adaptive reins or seats as needed; emphasis on safety checks and clear voice cues.

Good fit for: riders with weight-bearing restrictions, spinal considerations, or balance limitations that make riding unsuitable.

How These Approaches Differ (At a Glance)

• Purpose: medical treatment (Hippotherapy), mental health therapy (EAP), skill-building/recreation (Adaptive Riding), education (EAL), quality-of-life (AAA).
• Leader credentials: licensed healthcare provider (Hippotherapy, EAP) vs. certified instructor/facilitator (Adaptive Riding, EAL, AAA).
• Activities: mounted and/or unmounted depending on goals; groundwork is central in EAP and EAL.
• Outcomes: clinical metrics vs. skills and participation; both can improve confidence and engagement.

Safety, Access, and Horse Welfare

Across types, good programs share the same backbone: a fit-for-purpose environment, adaptive equipment, and a horse-first ethic. Helmets are standard when riding. Mounting ramps or lifts, sidewalkers, and quiet barn time broaden access. Equine partners are carefully selected, well-rested, and given a choice in interactions; their welfare is part of ethical practice and directly affects safety and outcomes.

Choosing the Right Fit

Start with your primary goal and work backward:

• If you need medical treatment for motor, sensory, or speech goals, look for licensed PT/OT/SLP using the horse’s movement (Hippotherapy).
• If you’re seeking psychotherapy, work with a licensed mental health clinician trained in equine integration (EAP).
• If your aim is riding skills and participation, explore Adaptive Riding with a certified instructor.
• If you want leadership or social skills, consider EAL.
• If you’re after positive contact and well-being without clinical goals, AAA may be enough.

Ask programs to explain their model in plain language, describe safety measures and horse care, and, most importantly, show how your goals will be measured and reviewed.

Conclusion

The power of equine work comes from its variety. Whether you’re rebuilding gait patterns, practicing calmer communication, or learning to steer with quiet hands, there’s a path that matches your needs.

Choosing the right type of equine therapy turns a good idea into a purposeful plan — one that respects you, protects the horse, and makes progress you can feel beyond the barn.