Insights into the processes underpinning Equine-based therapy: A qualitative study with Mental Health practitioners in South Africa

This study explored how equine-based therapy was implemented and facilitated within therapeutic contexts across South Africa. Drawing on qualitative data from fifteen mental health practitioners across South Africa, the study highlighted the collaborative roles of mental health professionals, equine specialists, and horses in facilitating healing amongst those presenting with mental health distress. Thematic analysis revealed five core themes: therapeutic process, setting, practitioner-client-horse engagement, pre-session check-ins, client orientation, and session facilitation. Practitioners emphasized the importance of using nature-based settings, experiential learning, and metaphorical reflection to foster emotional regulation, self-awareness, and relational insight for their clients. The study underscored the horse’s intuitive responsiveness to human emotion, offering clients immediate, embodied feedback that enhanced therapeutic outcomes. Despite the growing recognition of the efficacy of equine-based therapy in treating trauma and mental health distress, its integration has remained fragmented due to a lack of understanding of its processes and varying terminology and gaps in training. This study positions equine-based therapy as a complementary intervention that can support mental health and well-being. Grounded in collaborative, strengths-based, and client-centred approaches, equine-based therapy offers transformative potential for vulnerable populations and mental health practitioners alike.