Conceptualization of Psychotherapy Incorporating Equine Interactions in the United States

While several systematic and mapping reviews have been published in the last decade on the psychological effects of interacting with horses in therapy services, little has been written about how licensed mental health therapists in the United States should best understand, describe, and conceptually position interactions with horses within their clinical practice. To this end, a healthcare-aligned conceptualization of equine interactions in psychotherapy and counseling is presented. Drawing from competencies and statements published by the American Counseling Association and the Human-Animal Interaction section of the American Psychological Association, the proposed conceptualization describes interactions with horses during psychotherapy as a technique and enhancement to existing treatment approaches, not as a standalone intervention or therapy. Additionally, the conceptualization aligns with legal and ethical responsibilities, and the professional identity of the licensed mental health therapist. The proposed conceptualization emphasizes the importance of using science-based information about horses so that their role and function in psychotherapy sessions can be more accurately understood. The conceptualization is proposed to have positive effects on the day-to-day practice of licensed mental health therapists in areas such as professional communication, treatment planning and provision, and engagement with healthcare processes such as service coding, reimbursement and insurance. The conceptualization could also be of use in research efforts as it clarifies how horse interactions should be understood in the context of treatment, which, in turn, affects research design. Use of the proposed conceptualization may help safeguard clients, other stakeholders, horses, and the licensed mental health therapists who incorporate interactions with horses in the provision of psychotherapy.