Guide to Equine Assisted Therapy

Approximately one in five adults and one in seven children and youth suffer from mental health disorder over their life span. Yet, available treatments for mental health problems are only moderately effective, and about half of those who need treatment are not benefitted by current treatments, and many don’t even seek them.  Equine-assisted therapy is a novel, experiential treatment approach showing significant promise for adults, children and youth across a range of mental health problems. These treatments use a horse (or horses) to facilitate communication and mindful awareness of thoughts, emotions and behaviors in an experientially oriented approach via groundwork or riding. Interactions with horses have shown to foster emotional regulation, self-confidence, reflection, and insight, by which well-being is facilitated. The current book describes the rational for these treatments, add to the knowledge about recent progress in applying them to posttraumatic stress disorder (PTSD), anxiety, attention deficit hyperactivity disorder (ADHD) and more, and analyze the nature of the bonding between humans and equines which makes these relationships so therapeutic and healing.

Yuval Neria, PhD is Professor of Clinical Medical Psychology at Columbia University, Departments of Psychiatry and Epidemiology, and Director of Trauma and PTSD at the New York State Psychiatric Institute (NYSPI).  Professor Neria has led and collaborated on numerous studies in trauma and PTSD. He has studied prisoners of war and war veterans, civilians exposed to terrorism and disasters, and recently people affected by the COVID-19 pandemic.

In his lab, Neria’s team is focused on studies aiming to identify brain markers for trauma, PTSD, and resilience. By using advanced multimodal imaging approaches, his lab has developed innovative methods to characterize deficits in fear and reward processing, systematically mapping PTSD biotypes, and has successfully identified biomarkers of clinical improvement in PTSD patients undergoing a range of therapeutic approaches.

To address major gaps in availability of mental health treatments for service members and their family members, he founded the Columbia-NYP Military Family Wellness Center, where both veterans and family members can receive free, evidence-based care to address their PTSD, depression and anxiety problems. In addition, he has co-founded and co-directed with Prof. Prudence Fisher the Man O’ War Project dedicated to developing and test the efficacy of equine assisted therapy for PTSD. 

Prof. Neria, a decorated veteran, is a lifelong admirer of horses. Together with his wife and children he has established a small horse farm in the state of New York where they raise three horses and two rescued donkeys.

Prudence Fisher, PhD is Professor of Clinical Psychiatric Social Work (in Psychiatry) at Columbia University and Research Scientist at New York State Psychiatric Institute (Child and Adolescent Psychiatry). Prof. Fisher’s main research focus has been on development and testing of assessment measures for youth. Acknowledged as an expert in mental health assessment, she collaborates or consults with investigators at Columbia, at other universities in the US and abroad, and with federal and state agencies and regularly serves as a reviewer for academic journals, typically for studies focusing on assessment issues. She was instrumental in the development of numerous versions of the Diagnostic Interview Schedule for Children, among the most widely-used diagnostic interviews for youth mental disorder, and co-authored other widely used measures (e.g., Children’s Global Assessment Scale (CGAS), the Columbia Suicide Severity Rating Scale (C-SSRS)).

Although she always had a love for horses and had horses as a child, it wasn’t until 2015, that Dr. Fisher was introduced to the world of Equine Assisted Therapy and realized its potential for helping individuals with PTSD, and with mental health and life problems. With Prof. Yuval Neria, Prof. Fisher is Principal Investigator on the Man O’ War Project under which they developed, manualized and tested an equine-assisted therapy (EAT) protocol for veterans with PTSD (EAT-PTSD) and they continue to provide the treatment to veterans in the greater NY metropolitan area through the NYP-Military Family Wellness Center. Together, Prof. Fisher and Neria are capitalizing on their earlier work with a mission to advance the field of EAT. Prof. Fisher works with groups who want to implement the EAT-PTSD at their own sites and, with Prof. Neria, is developing an innovative on-line training modules for EAT-PTSD, making it accessible to a greater number of interested EAT providers.

Allan Hamilton MD, a Harvard-trained brain surgeon, is a leading figure in the field of Neurosurgery. His extensive expertise is further demonstrated by his professorships in Radiation Oncology, Psychology, and Electrical and Computer Engineering at the University of Arizona. The State of Arizona recently honored him with its highest academic accolade, naming him a Regents Professor of Surgery. He has held significant roles, such as the Chief of the Division of Neurosurgery and Chairman of the Department of Surgery. Currently, he is the Director of the Artificial Intelligence Division in Simulation, Education, and Training for the Health Sciences.

He has had a life-long love affair with horses. He was raised by a grandfather who was an Austrian cavalry officer and a rider in the Spanish Riding School of Vienna. Allan has studied horsemanship with some of the luminaries of natural horsemanship, including being mentored by Monty Roberts and working with John Lyons, Clinton Anderson, Pat Parelli, and Ray Hunt. He is the author of six books, including two award-winning books on horses: Zen Mind, Zen Horse: The Science and Art of Training Horses, and Lead with Your Heart: Lessons from a Lifetime with Horses. Zen Mind, Zen Horse was awarded the Nautilus Gold Award for nonfiction.

He has been a well-known horse trainer in the U.S. and abroad for more than thirty years and teaches at the Equine Sciences Center at the University of Arizona. His work with horses was featured in Playing with Magic, an award-winning, full-length documentary film by Emmy-award-winning director Wayne Ewing.

Dr. Hamilton and his wife's efforts have led to the establishment of some of the largest EAT programs globally, including a nationwide program in the Republic of Ireland and a national program in the U.S. for adolescents in the juvenile justice system. Dr. Hamilton, a decorated Army Veteran who served in Operation Desert Storm, has been a vocal advocate for improved methods for diagnosing traumatic brain injury in veterans returning from war zones. His dedication to these causes has led him to serve on White House medical advisory panels under three presidents and to be appointed to the Joining Forces Initiative to Improve the Health and Wellness of Veterans in 2012 by First Lady Michelle Obama.