This article describes a unique, innovative, and effective method of psychotherapy using horses to aid in the therapeutic process (Equine-facilitated Psychotherapy or EFP). The remarkable elements of the horse--power, grace, vulnerability, and a willingness to bear another--combine to form a fertile stage for psychotherapeutic exploration. Therapeutic programs using horses to work with various psychiatric presentations in children and adolescents have begun to receive attention over the past 10 years. However, few EFP programs utilize the expertise of masters and doctoral-level psychologists, clinical social workers, or psychiatrists. In contrast, the psychological practice described in this article, written and practiced by a doctoral-level clinician, applies the breadth and depth of psychological theory and practice developed over the last century to a distinctly compelling milieu. The method relies not only on the therapeutic relationship with the clinician, but is also fueled by the client's compelling attachment to the therapeutic horse. As both of these relationships progress, the child's inner world and interpersonal style come to the forefront and the EFP theater allows the clinician to explore the client's intrapersonal and interpersonal worlds on preverbal, nonverbal and verbal levels of experience.

Emerging research suggests that Equine Facilitated Psychotherapy (EFP) may be beneficial for traumatized youth. In addition, complex trauma (i.e., multiple and/or prolonged developmentally adverse traumatic events which are typically interpersonal in nature) treatment research is still growing and there is a need for the development and examination of novel treatments for youth with complex trauma histories. The current article describes a promising EFP model for this population called Equine Facilitated Therapy for Complex Trauma (EFT-CT). EFT-CT embeds EFP practices within Attachment, Regulation and Competency (ARC), an extant evidence-based complex trauma treatment framework for children and adolescents. The authors provide three case studies using both observational data provided by clinicians, as well as longitudinal measures of psychosocial functioning, to illustrate the potential promise of EFT-CT. The article concludes with a discussion about implications for EFP treatment and research.