Horses may help therapists reduce burnout risk, study finds

Horses used in psychotherapy may help protect clinicians from burnout while also supporting patients, according to researchers at the Norwegian University of Science and Technology. The finding matters because therapists often work under heavy emotional strain, and many mental health services leave clinicians working alone with complex cases.

The study, published in BMC Complementary Medicine and Therapies, examined why experienced psychiatrists and psychologists bring horses into therapy. Charlotte Fiskum, an associate professor of psychology at NTNU who led the research group, said the presence of a large, warm animal changes the therapy setting in ways that are hard to reproduce in an office.

Lead author Norunn Kogstad, a psychiatrist and Ph.D. research fellow, conducted 10 in-depth interviews with therapists who had extensive psychotherapy experience and at least a decade of work with equine-assisted therapy, according to NTNU. The clinicians told researchers that horses helped patients express difficult emotions and gave therapists a way to steady themselves during challenging sessions.

How horses change the session

Fiskum said office-based, one-to-one talk therapy can feel threatening for some patients, and conversation alone does not work equally well for everyone. In the therapists’ accounts, horses offered a shared focus that helped patient and clinician build trust and approach difficult topics.

The researchers said horses can also help regulate emotion in the room. According to Fiskum, therapists described using the horse’s behavior and presence to manage both their patients’ reactions and their own thoughts and feelings during therapy.

Fiskum said burnout remains a serious concern for therapists, whose days are often mentally demanding and busy. She said therapists need support from managers, time for reflection, peer support and good working conditions, while adding that a horse can serve as useful help in some clinical settings.

Why horses may be useful

NTNU said previous studies have found mental health benefits from spending time with animals, including horses and dogs. The university also said equine-assisted therapy has shown positive results for patients dealing with confidence, relationships, self-regulation and substance abuse.

Fiskum said many animals can support therapy, but horses have traits that make them especially useful. Because horses are prey and herd animals, she said, they are socially aware and highly sensitive to body language and their surroundings.

According to Fiskum, horses may react visibly to a person’s emotions by moving away, vocalizing or signaling that they do not want contact. A relaxed horse may seek closeness, such as resting its head on a person’s shoulder or nudging for attention, and therapists can use a patient’s response to those moments to learn about patterns in social interaction.

Fiskum said this can support approaches such as cognitive therapy, where a patient’s interpretation of the horse’s behavior may reveal negative thought patterns. She described work with horses as a small-scale setting for observing bonding and social contact, because the animal does not judge a patient’s appearance, education or past actions.

Limits and availability

Equine-assisted therapy may involve time in a stable, groundwork with a horse, sitting on a horse led by the therapist or riding, though NTNU said most of the work happens on the ground. Fiskum said she has also studied horses in substance abuse treatment and described an interviewed adult patient who cried beside a horse after years of suppressing feelings.

Fiskum said therapy should be flexible enough to match what patients experience as safe. She noted that equine-assisted therapy requires resources and is not available everywhere, while dogs can also help anxious patients and some patients bring their own dogs to sessions for comfort.

According to NTNU, equine-assisted therapy is available at Oslo University Hospital and through private providers. The study was conducted with the Lundehagen Center for Psychotherapy and Research, led by Kogstad.

This story draws on original reporting from Medical Xpress.