Therapeutic and Adaptive Horsemanship — A Practical Guide

Updated: June 2026 · Informational purpose.

Therapeutic and adaptive horseback riding includes various modalities in which the horse is used as a tool to improve the quality of life for people with physical, intellectual, or sensory disabilities, as well as individuals with specific rehabilitation or developmental needs. In Spain, there have been specialized centers for decades, and the discipline is becoming increasingly recognized.

Modalities within the concept

Hippotherapy

A neurophysiological treatment that utilizes the horse's three-dimensional movement at a walk to stimulate the patient's nervous system. The user sits on the horse (sometimes with assistance), and the horse's movement acts upon their body. Primary application: individuals with cerebral palsy, multiple sclerosis, stroke, or incomplete spinal cord injuries.

Therapeutic horseback riding

The practice of horseback riding adapted for people with disabilities. The user learns to ride by following adapted techniques. Application: individuals with intellectual disabilities, autism spectrum disorder, learning difficulties, or behavioral problems.

Adaptive equestrian sports

Competitive horseback riding for people with physical disabilities. Para-Equestrian is an Olympic discipline (Paralympic Games) in dressage, driving, and other modalities. Categories Grade I-V based on the degree of disability.

Equine-assisted therapy

A psychological modality where the horse is used in sessions without necessarily riding. Application in therapies for emotional problems, anxiety, depression, or trauma. Usually coordinated by a psychologist.

Therapeutic vaulting

Gymnastic exercises on the horse at a walk, assisted by an instructor. It works on balance, coordination, self-esteem, and social skills.

Documented benefits

Benefits vary according to the modality and individual case. Some effects observed in scientific literature:

Physical benefits

Improvement in muscle tone and posture.
Greater balance and coordination.
Stimulation of proprioception.
Improvement in joint mobility.
Reduction of spasticity in some cases.

Cognitive and emotional benefits

Improvement in attention and concentration.
Increase in self-esteem and self-confidence.
Reduction of anxiety.
Integrated sensory stimulation.
Development of social skills.

Social benefits

Integration into group activities.
Affective bond with the horse.
Relationship with instructors and other users.
Sense of personal achievement.

The horse in therapeutic horseback riding

The horses used in therapy require specific characteristics:

Very stable and predictable temperament.
Tolerance for noises, unusual movements by the rider, and adapted equipment.
Appropriate size for the center's user profile.
Regular gaits, especially a very steady walk.
Excellent health, with no pathologies that limit their use.
Regular work to maintain physical condition.

Not all horses are suitable. Selecting and training therapeutic horses takes time and experience. Some centers train their own horses for years before incorporating them into sessions.

Professionals involved

Therapeutic horseback riding sessions usually require the coordination of several professionals:

Doctor or rehabilitation specialist. Provides the medical indication for treatment.
Physiotherapist or occupational therapist. Defines treatment objectives and strategy.
Therapeutic riding instructor. Conducts the session on the horse.
Assistants. Support the rider on the horse when they cannot maintain their position independently.
Psychologist or educator. In assisted therapy modalities with an emotional or cognitive focus.

Centers in Spain

Spain has a significant network of therapeutic riding centers:

Fundación CRECER (Madrid, Valencia, and other provinces).
Centro de Equitación Terapéutica Fundación Nido Águila.
Asociación Catalana de Equitación Terapéutica.
Asociación Andaluza de Equitación Terapéutica.
Cinetic equino (various provinces).
Multiple municipal or private centers in practically all provinces.

The Spanish Federation of Adaptive and Therapeutic Equestrianism (FEEAT) or equivalent structures can provide guidance on accredited centers in each area.

How to get started

If you want to be a therapeutic riding user

Consult with your reference medical or rehabilitation team to see if it is indicated.
Identify nearby centers with specifically trained professionals.
Visit the center to see the facilities and horses.
Initial assessment session.
Session plan with defined objectives.

If you want to train as a professional

There are trainings available at various levels:

Introductory courses lasting several weeks.
Specific university master's degrees.
International training (HETI - Federation of Horses in Education and Therapy International).
Combination of riding instructor certification plus specific courses.

If you own a center and want to incorporate this modality

It requires specific training for staff, adaptation of facilities (ramps, supports, accessible arena), selection of suitable horses, and, usually, certification or accreditation.

Adapted equipment

Some specific elements of therapeutic horseback riding:

Adapted saddles. With lateral supports, a front handle, and adjustments for better user support.
Special stirrups. Closed, with a wide footbed and systems that prevent the foot from getting stuck.
Surcingles with handles. So that assistants can stabilize the user.
Adapted bridles. Usually bitless or with very soft bits.
Adapted helmets. With closure systems that facilitate a secure fit.
Loading platforms. For access by people with reduced mobility.

Cost and access

Therapeutic horseback riding sessions have very variable costs depending on the center and the modality:

Individual sessions: €25-80 depending on the center.
Group sessions: €15-40.
Annual or semi-annual programs with discounts.

In Spain, some regional disability services or the associations themselves may offer subsidies, scholarships, or coordinated programs that facilitate access.

What therapeutic horseback riding is NOT

It is not a miracle cure. The effects are progressive and depend on the case.
It does not replace conventional medical treatment.
It is not just "taking a ride on a horse." The sessions have defined therapeutic objectives.
It does not work the same way in all cases. Each person responds differently.