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Can Equine Therapy Improve Infant Attachment?

equine therapyAttachment patterns can have a profound affect on a person’s sense of wellbeing, ability to modulate stress, and certainly relationships. When attachment is secure, an infant will demonstrate a significantly lower level of cortisol, lower heart rate responses, and increased levels of oxytocin around the primary caregiver, which translates to a feeling of trust for this caregiver, and is later generalized to a basic sense of trust in people. A secure attachment pattern in adulthood then supports support seeking behaviors in times of stress or crisis, as well as the maintenance of healthy, stable relationships.

However, attachment patterns are not always secure, and the dysregulation between the mother and child begins in infancy. While the typical therapeutic response to an insecure attachment pattern is play therapy, a recent study investigated the effect of Equine Assisted Activity (EAA) on mother-child dyads which demonstrated dysregulation in attachment.

20 toddlers (age 1-2) and their mothers who showed dysregulation in their interaction or attachment with their child or risk factors in their background such as parental mental disorders, substance abuse, child abuse and neglect, domestic violence were investigated. One group of ten dyads was exposed to eight weekly sessions of Equine Assisted Activity (EAA, N=10) the control group of ten dyads to eight weekly sessions of a play-based early intervention. Both treatments focused on promoting a secure mother child bond, and sensitive caregiving of the mother.

Data collection, conducted one week before the first EAA-session were obtained via the Adult Attachment Projective, (AAP), the Strange Situation Test, and the CARE-Index. The same data were obtained in a post-test one week after the end of therapy, however, a questionnaire on how much the mothers liked the therapy, on what they did not like, observed changes in her child etc. was substituted for the AAP. Several questionnaires investigating the caregiving representation of the mothers towards their child, perceived developmental irregularities/behavior problems of the child, and background information on the delivery of this child, mental health problems of the mother, and similar were also taken.

While both interventions, EAA and a usual play-therapeutic approach, improved the mother-child relationship with regard to attachment and caregiving over the course of eight therapy sessions, the data demonstrated one advantage of the EAA: mothers of boys improved more with regard to their compulsive caregiving than in the control group. Researchers observed that the boys were clearly very active in the EAA and the mothers learned that controlling them via caregiving, tended to lead to tension in the mother-child relationship. The play therapy context did not provide the same possibility for the child to explore distance from the mother, or for the mother to allow the child his space.

Interestingly, only EAA showed improvement in the physiological measures cortisol, heart rate and heart rate variability. Additionally, contact and physical closeness seems to be more positively perceived in EAA, and was linked to more physiological relaxation (higher HRV, decrease in cortisol/smaller increase).

The researchers postulated that an increase in oxytocin during EAA facilitated this tolerance and mutual benefit of the mother-child closeness, as oxytocin is positively correlated with friendly communication and interaction, relaxation, and trust.

Concluding the study, the researchers said, “Even though the different activity levels in the groups make an interpretation more difficult, the physiological measures point to an advantage of EAA, setting the stage for more positively perceived communication and interaction. Overall, all mothers preferred the EAA, the EAA-group enjoyed the experiences with the horse, and our data point to advantages of EAA for communication and interaction of the mother-child dyad. Also, the motivating factor of EAA should not be underestimated when working with clients of this background. To achieve significant changes in the psychological measures on caregiving and attachment, to really change attachment and caregiving towards more security in those, mainly at-risk, dyads within only 8 therapy sessions was a great success.”.

For more information on this study, or others like it, visit:


Andrea Beetz, Kurt Kotrschal, Kerstin Uvnäs-Moberg, Henri Julius. Basic neurobiological and psychological mechanisms underlying therapeutic effects of Equine Assisted Activities (EAA/T).   

HHRF Grant 2011 – Public Report

Toddler on horseback photo available from Shutterstock

Can Equine Therapy Improve Infant Attachment?

Claire Dorotik-Nana, LMFT

Claire Dorotik-Nana LMFT is a licensed marriage and family therapist specializing in post-traumatic growth, leveraging adversity, and other epic human achievements. Claire has written multiple continuing education courses for Professional Development Resources, Zur Institute, and International Sport Science Association. Claire has also authored multiple books, including:
Leverage: The Science of Turning Setbacks into Springboards and On The Back Of A Horse: Harnessing The Healing Power Of The Human-Equine Bond. For more information about Leveraging Adversity or Claire, visit

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APA Reference
Dorotik-Nana, C. (2012). Can Equine Therapy Improve Infant Attachment?. Psych Central. Retrieved on January 29, 2020, from


Last updated: 6 Nov 2012
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