Equine Therapy Horsecare Standard … research project



by Cryshtal Avera


The health, happiness, and welfare of therapy horses is not overseen by an organization that exists outside of certifying organizations or through a specialized team within certifying organizations in the industry of equine therapy.  Equine therapy is offered for many types of diagnoses of human clients to include physical, emotional, mental, and those without diagnoses available but who are not thriving.  Also, the field of equine therapy includes Equine Assisted Learning (EAL) where teams and individuals are partnered with horses to offer learning in areas such as leadership and team cohesiveness.  This research began with an inquiry into whether therapy horses experience burnout and what the definition of burnout is for therapy horses.  Experts and facilitators with many hours of experience with horses in sessions as well as outside of sessions feel strongly that therapy horses experience burnout through inconsistent handling by volunteers and staff, being in sessions for too long and working too often without breaks from the therapy to be with their herd and decompress, improper nutrition, stall or stable living versus herd living.  Behaviors such as becoming stoic and in essence shutting down emotionally, simply getting through because they are so affected by the stresses of the humans in their environment are some of the most common symptoms cited by facilitators in the industry of equine therapy.  The inquiry into whether therapy horses experience burnout revealed central research using data from within the industry is challenging because there is no central organization or team within certifying organizations that is setting standards of care or monitoring lifestyle of therapy horses.

 Problem Statement

Equine-assisted activities/therapies (EAA/T) is a comprehensive term for all equine activities and therapies designed for people with disabilities or diverse needs. Some examples of EAA/T include: Therapeutic Riding, Equine Facilitated Learning, Therapeutic Driving, Vocational Rehabilitation, Hippotherapy, and Equine Facilitated Psychotherapy.  EAA/T offers support and healing to people with physical, social, mental, and stress disorders among others. (Horseshelpinghumans.org, 2007).

The Equine Assisted Growth and Learning Association (EAGALA) model is a therapy system where the horse is viewed as the therapist and a trained, professional team consisting of an Equine Specialist and Mental Health Specialist monitor the session while the horse and the client interact.  The horse’s intuition is celebrated and acknowledged as the essential piece in equine therapy.  The EAGALA model is a ground based model meaning there is no riding in EAGALA sessions.  The Professional Association of Therapeutic Horsemanship International (PATH Int’l) offers therapeutic riding lessons.

Horses present symptoms of stress physically and emotionally (Survey of 74 participants in the equine therapy industry, 2016).  Ulcers are a commonly suspected symptom of stress in therapy horses.  Therapy horses exhibit other signs of stress such as pinned ears, stomping feet, and biting at people when the saddle is being put on.  Other signs of stress are subtle and are believed to be mistaken as horses accepting treatment; these signs are horses who simply stand and show no reaction or sign of engagement.  These horses are often believed to be in a positive state of mind but in actuality are shut down, accepting their fate and tuning out everything around them.  Physical manifestations of stress in these horses such as ulcers and depleted immune systems are observed.  In many cases, therapy organizations rescue horses and incorporate them into the therapy program.  Rescue horses often have experienced cruel treatment at the hands of humans prior to being saved and are susceptible to being stressed based on an expectation of treatment they have received in the past.

Therapy licensing organizations such as PATH and EAGALA have outlined the importance of horses on the therapy team and the welfare of the horses as a top priority, however there are no clear expectations and systems for accountability in either of these or other equine therapy licensing organizations.  Therapy horses that are happy and in optimal physical health offer optimal outcomes to therapy clients.  Though horses are the most necessary member of any equine therapy team, there is no system in place for ensuring these animals are healthy and happy within large licensing organizations or externally within the equine therapy industry.

Question: How can the equine therapy industry measure horse happiness and stress levels?  How can the stress of therapy horses be prevented or reduced once assessed, considering the lack of one central organization or body?

Main Research Objective:  To assist in bringing attention to the need for a system that measures horse welfare and horse happiness in the equine therapy industry and help find realistic options for implementing some form of educational accountability program therapy organizations must adhere to regarding the welfare of the horses.

Research Objectives

The objective of this proposal is to research the definition of burnout in therapy horses from experts and publications within the equine therapy industry.  Data will be collected about therapy horses during therapy sessions as well as the lifestyle of therapy horses to include amount of time given outside of therapy, whether the horses are stalled or live in herds, and nutrition programs of therapy horses.  Also, the effects of stress in the session environment due to the therapeutic nature of the programs as well as the physical stressors due to handling and riding therapy will be researched as well as whether there are strategies to assist therapy horses in finding stress relief such as massage and other bodywork modalities, energy work such as Reiki, etc.  The core focus of this research will be the absence of an organization or team within certifying organizations that sets the standard for health of therapy.  A proposal for next steps and options for further research on whether there is a need for teams within certifying organizations or a separate central therapy horse health organization will be presented after careful consideration of the research and needs based on the data gathered.

Literature Review

Logan, D., King, J. P., & Fischer-Wright, H. (2008). Tribal leadership: Leveraging natural groups to build a thriving organization. New York: Collins.  Shared core values along with clear roles and structure in a supportive culture are key elements discovered in a study of multiple thriving organizations.  The welfare of therapy horses is highlighted as an important factor by certifying organizations.  However, there is no group, team, or organization within equine therapy industry that identifies core values of horse care and horse welfare or tracks how therapy horses are affected emotionally and physically.  A team or organization with a sole purpose to monitor therapy horse welfare and set standards that incorporated a supportive culture with clear core values and structure such as indicated in Tribal Leadership would likely be effective.

Henry, D. (2015). It’s for the horses. Rusty Bucket Press.

ISBN 13: 978-069242114, ISBN 10: 0692421149.  Dutch Henry is an advocate of the horse.  Many years of experience with horses has given Dutch the opportunity to understand the perspective of the horse and recognize that whole health requires physically, mental, and emotional health.  A quality living environment preferably with a herd in a pasture, simple forage-based feeding program are two key elements to a horse being healthy and happy.  Dutch also points out the need for emotional support as an important part of advocating for the horse.   Bodywork, stretching, and energy release therapy are all discussed with details on how and why these are important ingredients in a whole-horse healthcare program.  This is one resource that could be used in aiding the design of a team or organization’s standards of care for therapy horses.

Short article on instrumentalizing therapy horses by Ilka Parent, EAGALA Mental Health Specialist Minds-N-Motion notes Friday, May 27th, 2016.  Observations based on years of experience in trauma based equine therapy inspired this article where Ilka shares recollections of horses getting physically ill and being emotionally affected when not allowed to choose whether to remain in a therapy session.


Information gathered from inquiries of industry organizations and experts, quality internet sources, scholarly articles, and books was utilized to structure an overall assessment of physical and emotional health of therapy horses and a proposal for further research needs.

Research of current horse health programs within therapy organizations and review of studies done on horses used in therapy and the effects on them was undertaken.  Data from experts in the industry on horse burnout and stress and data on strategies being used in the industry to prevent burnout of therapy horses was collected from 74 participants.  Information from industry professionals on equine therapy certifying organizations regarding whether there are considerations of programs being created to oversee health and happiness of therapy horses was gathered.

Data Collection

Seventy four participants completed the survey instrument provided in the data analysis section of this report between July 11th, 2016 and July 12th, 2016 via www.surveymonkey.com.  Participants were garnered through use of a facebook group for EAGALA practitioners and a facebook group for PATH Equine Managers.  Most participants held certifications through equine therapy organizations, predominantly PATH, international and EAGALA.  Volunteers, farm managers, and property owners made up less than one percent of the respondent group.

The survey was conducted in a non-controlled environment through online participation and no verification of certification or experience was employed.  The survey was anonymous so as to encourage participants to answer honestly and be candid.

Data Analysis

Data was collected through the survey instrument on www.surveymonkey.com and exported via the options of charts and tables offered through http://www.surveymonkey.com.  Comment sections were provided for participants in most of the questions and this data was analyzed by review of the individual responses and synthesizing the results.

Question 1 Symptoms of therapy horse burnout

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Q1:  Additional comments by survey participants described signs and symptoms of therapy horse burnout such as avoidance, biting or nipping, aggression, and running away from handlers in the paddock or pasture rather than be brought in.  These observations are important to the research because horses are clearly communicating they do not want to participate in each of these occurrences.  Aggressive behaviors represent the decision to fight and behaviors such as running away or not coming to handlers represent the decision to get away, commonly known as flight in horses as prey animals.  The candid responses provided to this question indicate horses are communicating their wishes and present an opportunity for further discussion on how they can be heard.  Input provided on this subject offers opportunity to better understand the horses’ point of view and points to support of the recommendation by many in the industry to give horses a choice whether to participate or not.

Question 2 Horse care standards / horse health programs

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Q2:  This question shows that many individual equine therapy organizations have set up official horse health programs with continuity and follow up and a secondary majority have unofficial horse health programs based on shared handling skills and team perspective.  Question 8 shows that the certifying organizations provide guidelines but do not follow up or provide ongoing support regarding horse care standards.  This question is useful to the research because it provides an opportunity to recognize there is useful data available on horse health programs that are working in the field and could benefit everyone.  Therapy horses would benefit greatly from having this data collected and dispersed.  Health problems from stress or burnout could be prevented much more often if the industry had a team or organization that consistently obtained feedback and data on horse health programs where optimal health and happiness are the results as well as data collected on programs where consistent health problems or burnout symptoms and behaviors are observed.

Question 3 Burnout observed in therapy session types

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Q3:  Additional comments by participants revealed observances in both riding therapy and EAP, specifically stating burnout symptoms were observed with large groups or bereavement groups.  Handling of horses was cited as a cause observed where volunteers have continued to touch horses after being asked to give the horses their space and were nipped.   This question is important to the research as it shows that riding therapy may be more stressful on horses than therapy where no riding is involved.  Further inquiry is recommended to assess all variables such as the potential for claustrophobia being felt by the horses with side walkers around which may be causing stress.  Also, the energy of each person and potential for stress and anxiety with more people around as well as the possible lack of choice the horse may have on whether to participate or not may be contributing variables that contribute to burnout behavior therapy horses.  Further research with a foundation in observing horses to find what the causes of burnout in riding therapy are is recommended.

Question 4 Client population and burnout observed
Q4. In which client population(s) do you observe burnout in therapy horses? Please choose all that apply.
Answer Options Response Percent Response Count
None 17.6% 12
Trauma 35.3% 24
Physical diagnoses 52.9% 36
Men 35.3% 24
Women 35.3% 24
Children and/or teenagers 67.6% 46

 Q4:  Participants provided elaboration on this question describing observations of clients under high stress or level of client intensity causing potential burnout or stress in the therapy horses rather than a specific population.  Domestic violence groups and trauma victims were two group situations that were cited where horses were observed to have a stress reaction most consistently.  Also, having multiple people around handling the horses such as more sidewalkers or handlers in riding therapy was cited as one example where burnout has been consistently observed.  This observation provides more insight into question 3 inquiry regarding the potential for side walkers to cause claustrophobia to be triggered in horses in riding therapy sessions.  Further inquiry into this subject is recommended with the consideration to find strategies that allow horses to give feedback on side walkers and help organizations find ways to help side walkers approach horses in a way that does not trigger feelings of claustrophobia, anxiety, or agitation.  Recommendation for further research on allowing horses to choose is recommended  and may result in implementing techniques such as removing side walkers that horses show they do not approve of as one strategy.  Further study of horse psychology and experiential research is recommended in accompaniment.

Question 5 Organization strategies to overcome burnout

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Q5:  Rest and pasture turnout with the herd were the most commonly cited strategies from participants that help horses remain healthy and happy.  Other strategies provided which were not listed in the question were trail rides and listening to the horses, allowing them to communicate their needs.  Further strategies given were T-Touch therapy, having a clear boundary set where clients no longer interact with or watch the horses once the session is done so the horses can be left alone, days off, Parelli 7 games, and smudging or cleansing the space energetically.  This question is important for the research because it shows that consistent observations such as lack of standards in handling are key factor in causing stress for therapy horses.  Further inquiry on this subject is merited in consideration of the fact that many organizations rely heavily on volunteers.

Question 6 Equine therapy organization certifications of respondents

Q6:  Sixty-nine participants responded to this question and 5 participants skipped the question.  Six responses showed certifications from the following organizations; some hold multiple certifications:  3 certifications with Canada Therapeutic Riding Association (CanTRA), 3 certifications with Certified Horsemanship Association (CHA) which is not an equine therapy organization but may be useful for equine specialists in the field, 1 certification with ESMHL (specialty certification through PATH, International), 1 certification with American Riding Instructor Association (ARIA) which is not an equine therapy certification but could be a useful accompanying certification for equine specialists in the equine therapy field, and 1 certification with Trauma Focused Equine Assisted Psychotherapy  (TF-EAP).  Results of this question show the vast majority of participants are EAGALA or PATH certified.  This survey, therefore, collected valuable feedback from both riding therapy and therapy styles where the horse is not ridden.  Feedback in comments throughout the survey indicated that health concerns and burnout symptoms are seen more often in horses that are part of riding therapy programs.  Comments also indicated that PATH, International provides more detailed guidelines and support for members on healthcare standards for therapy horses.  Further inquiry into details of health issues and behavioral indicators of unhappy horses who participate in riding therapy would be useful based on survey results with a focus on feedback from PATH facilitators in the industry.  Follow up research that focuses on horse health care standards in riding therapy and observations in the industry would be useful in assisting facilitators and organizations to prevent health decline and to have happy horses.  Health issues and behavioral feedback from horses indicating they are unhappy could be largely preventable if data were to be collected from experts in the field and shared on a consistent basis in a way that supports a collaborative, team mentality.

Further research focusing on riding therapy horse care standards and symptoms of burnout as well as that of therapy horses who are not ridden is recommended.

Consistent feedback through this survey showed lack of consistency in handling by staff and volunteers in all styles of equine therapy appear to stress or agitate horses.

Further inquiry is recommended into the number of facilitators certified within organizations outside of PATH, International and EAGALA into how many facilitators are certified with smaller organizations and feedback on standards of care within those organizations to be able to collect a realistic perspective from the industry as a whole and create a resource that reflects input from all while simultaneously functioning as a team that fosters a culture with shared values and a team mentality, encouraging collaboration and partnership within the industry as a whole.

Question 7 Role of respondents within equine therapy certification

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Q7:  Equine Specialist and Mental Health Specialist are roles certified in EAGALA and Therapeutic Riding Instructor is the role certified through PATH, International.  This data shows the majority of participants are horse professionals with certifications in the equine therapy industry which indicates that the valuable input is based not only on observations in the field but is also based on foundation experience and education with horses beyond the equine therapy industry.  Notable feedback provided in this survey from two participants is that the equine professional certifications should have more stringent requirements regarding education and experience before becoming certified.  Inquiry into how equine professionals in the equine therapy industry could be better prepared before becoming certified is recommended as one variable that may increase consistency in horse care standards within the industry of equine therapy.

Question 8 Support and standards by certifying organizations

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Q8:  This question did not offer the option for further comment and, based on participant input, should have.  Data reflects that PATH, International provides some detailed guidelines as well as support whereas EAGALA offers guidelines without specific details or follow up support.  Synthesis of input from PATH and EAGALA certified practitioners, which were the large majority of participants in this survey, indicates further discussion amongst the two certifying organizations with heavy emphasis on input from facilitators in the field could provide valuable results regarding the standard of care and support offered to equine therapy practitioners and organizations.

Question 9 Horse handling style observations

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Q9:  Seven participants selected other and provided horse handling strategies such as holding classes teaching the first 4 games of the Parelli Natural Horsemanship program which is utilized as their horsemanship standard, utilizing a 4-H program as the volunteer base, and having the same staff and volunteers on a consistent basis as having a positive effect on the horses.  One participant stated that having a standard handling style is difficult for paid staff and volunteers and that volunteers receive conflicting information from staff when there is no clear handling standard, which causes stress for the horses.  Further inquiry into this subject is recommended with the assessment that valuable solutions can be garnered through gathering input from practitioners in the field.  Data collected here indicates that the handling style is not as important as the consistency in handling styles amongst individual organizations regarding horse health and happiness.  Creation of a team or organization that collects data from within the industry consistently to utilize input on handling styles and recommends multiple options for organizations with clarity that having consistency is key, is recommended.

Question 10 Experience and recommendations from participants

 Q10:  Forty-three respondents provided input for this question.  The results revealed the valuable experience and contribution to this subject that facilitators and operators in the field of equine therapy have to offer.  The observation that a need for further guidance and standards regarding the subject of horse care in equine therapy was strongly iterated.  The following causes of symptoms of burnout observed in horses were listed consistently:

  • No time off or not enough time off
  • Not getting any time or enough time in a herd setting with no human interaction
  • Long session days or multiple sessions back to back on session days
  • Young horses with not a lot of life experience
  • Good therapy horses being over-utilized
  • Lack of consistent, detailed routine for all volunteers and staff
  • Lack of consistent handling style by all volunteers and staff
  • Horses being treated like machines
  • Bad saddle fit
  • Lack of awareness of warning signs by handlers and staff

Other valuable input offered showed a belief of a need for better training of Equine Specialists in EAGALA and higher standard of requirements for Equine Specialists.  A log tracking horse use, nutrition, vet and farrier care, and other notable information was cited as an important way to ensure consistency in horse care per organization.  Participants also largely agreed that horse care standards are objective and may be different based on region regarding nutritional needs, needs related to weather, etc.  Many participants use T-touch by Linda Tellington Jones as a strategy to help their therapy horses be healthy and happy and, due to the high number of this being listed independently, further inquiry into the benefits of T-touch would be useful.

Ulcers were the highest listed health concern observed by participants and listed independently.


This research has shown that invaluable information is available through operators in the field and there is a common desire for more standards, guidelines, and support regarding horse health and happiness in equine therapy.  EAGALA and PATH, International operators were the large majority of participants.  Comments showed that both EAGALA and PATH International offer general guidelines on horse care but PATH, International offers further support, though not enough is offered within the industry.  Education for horse professionals in the field on an ongoing basis and higher standards for certifying horse professionals in the field of equine therapy was a common observation along with the feeling that standards should be provided with follow up support with the perspective that horse care is an objective subject dependent on key variables.  Specific symptoms and signs of burnout and preventative strategies have been summarized with the applicable questions in the data analysis section of this research paper. 


Inquiry into signs and symptoms of burnout, preventative strategies, and basic horse care needs with a goal of healthy and happy horses in the equine therapy industry on an ongoing basis, utilizing the expertise and experience of operators in the field, is needed to create a more detailed support system focused on the care and handling of therapy horses.  This research has highlighted the genuine desire for more support and clarity on the subject of horse care by the facilitators and operators within the industry as well as the valuable knowledge and input available.  Strong recommendation for a team effort focused on uniting operators, facilitators, and certifying organizations by creating a mission statement based on a desire for unity is the result of this research (Logan, King, & Fischer-Wright, 2008).

Horses need consistent movement, a simple diet with no grain and a natural lifestyle to thrive.  Ulcers among other health issues are a symptom of a less than natural lifestyle seen in the equine therapy industry as well as the horse industry in general due to humans treating horses like humans rather than providing a lifestyle and care based on the way the horse was designed to live (Henry, 2005).

Too often in equine therapy, horses are placed in situations where they are restricted physically and are treated in a way that does not allow them to maintain their integrity (Parent, 2016).  Horses are often not allowed to choose not to participate.  The genuine desire to give the client what is intended to be an opportunity for healing is likely the reason for requiring horses to participate when their behavior has shown they clearly are unhappy and do not want to be there.  This is one aspect of horse care standard inside sessions that needs to be thoroughly visited, utilizing input from operators in the field.  Many have expressed, through this research, the belief that horses as sentient beings should always be given the opportunity to express opinion and to choose whether they want to take part in a particular activity.  The consistency of observations from those who utilize this strategy which shows positive outcomes for the horse’s health and happiness makes it worthy of further inquiry.

Individuals and programs participated in the survey instrument who have already begun work on this subject and are compiling data and researching horse needs in the equine therapy industry and should be considered key collaborators as part of the ongoing process.

Horsesandhumans.org is an organization focused on scientific research of equine therapy and how humans and horses are affected with a goal to support positive outcomes and should be contacted for a potential partnership in further research on the subject of horse care standards of therapy horses.


About EAA/T. (n.d.). Retrieved July 26, 2016, from http://www.horsesandhumans.org/About_EAAT.html

Henry, D. (2015). It’s for the horses. Rusty Bucket Press.

Logan, D., King, J. P., & Fischer-Wright, H. (2008). Tribal leadership: Leveraging natural groups to build a thriving organization. New York: Collins.

Parent, I. (2016, May 29). Instrumentalizing horses. Retrieved July, from https://www.linkedin.com/pulse/instrumentalizing-horses-ilka-parent

[Survey of 74 participants in the equine therapy industry]. (2016, July 25). Unpublished raw data.







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