Roberta Caiazza and horse
Developmental, Education, Sport and Exercise

‘When life was unbearable, horses helped us through’

Roberta Caiazza on a personal journey to equine therapy.

15 November 2022

Everything happens for a reason. 2019 wasn’t a great year for me, but I stumbled upon a Groupon voucher for a horseriding lesson. I’ve not looked back since.

Often, we hear about people catching ‘the horse bug’: riding, cleaning, or just petting horses, it doesn’t matter what type of interaction. I just can’t get enough of being around these majestic animals. It was a peculiar experience: I’m not usually one for relying on anything specific to feel better, but increasingly it seemed that I was able to think more clearly when in a stable or in a field with them. I wasn’t loving life at that time, yet I could feel calm and relax, engage in meaningful interactions with the horses and make sense what was happening around me.

After a few months of spending every free minute at a riding centre I decided to take my experience to a next level. I took time off work and went travelling around the Altai Mountains in Kazakhstan, on a horseback. Everyone on that trip, in one way or another, shared my experience. When life was unbearable, horses helped us through.

I went head first into the equine world. Bought my own horse, enrolled on horsemanship courses, and read, watched and listened to anything I could in order to develop a better understanding of horses and the unique relationship we have with them. As a clinical psychologist I am always eager to understand why we behave in a certain way, and why we react to the world the way we do.

Equine Assisted Therapy

In early 2020 I completed the EAGALA model qualification (Equine Assisted Growth and Learning Association) and in October 2020 I set up Cavallo Therapy and equine assisted therapy integrated service, where I work alongside horses and equine behaviourist offering 1:1 and group session of EAP (equine assisted therapy). At the moment my EAP practice is developing alongside my NHS role of Consultant Psychologist. I am lucky enough to be able to dedicate one day per week, and some evenings, to further develop my interest. The team includes myself, an Equine Expert, my own horse and other therapy horses.

When life was unbearable, horses helped us through.

A Cavallo Therapy EAP session consists of a therapy session carried out with the aid of myself (clinical psychologist) and an equine expert and two or more horses loose in a horse arena. During this time clients are supported in interacting on the ground with the horses, and exploring both verbally and non-verbally their issues (no riding is involved). The entire arena is available to use. Humans engage with the horses – they can do by simply choosing to pet them or groom them, or work more collaboratively by creating tasks to complete together or by following the horses around. All of these activities create a narrative that clients then can choose to explore further. The sessions are structured around Acceptance and Commitment Therapy model and are guided by the client-horse interaction.

During this time both myself and the equine expert try not to interfere with the natural interaction that occurs. When clients invite discussion, Socratic questioning is used to help identify and process the elements played out during the session, while the use of the Acceptance and Commitment Therapy principles allows clients to build and understanding and acceptance of their difficult life experiences with the aim to develop a compassionate and kinder relationship with them.

The practice has had a great uptake. Over the last two years we have been able to support people with a variety of needs, from complex presentation of PTSD to anxiety and depression, as well as younger adults with severe trauma issues. We have also worked with groups and corporates in team building sessions. The general feedback has been how powerful the therapeutic experience has been. Clients appear to be more opened and trusting a lot faster than in the usual therapy setting. I love working in the NHS but I have been able to develop even more as a Clinical Psychologist: my whole ability in working with the non-verbal and the ‘unsaid’ that happens in the therapeutic setting has totally changed. I feel more aware, present and in tune with my clients.

Mirroring the herd

One interesting aspect of the EAP work is not only being prepared for the client but also being prepared for the horses and the environment. There is much power in having to take care of such large and powerful animals before the therapeutic work starts. Anyone that has had some interaction with horses is well aware that they are flight animals. They react to and interact with the surroundings, even the smallest of changes around them. This in turn makes us facilitators (Psychologist and Equine expert) become extremely present in the moment and mindful of anything that happens.

We all become part of a herd (a heard, maybe): we experience a sense of belonging and psychological safety where we are able to explore the reality we are in. The sessions in themselves require a lot of work from all the parties involved, and nothing can be ignored. The horse will mirror behaviours, which makes it very difficult for our clients to avoid what is happening for them emotionally in that given moment. If something is happening for you, it’s happening for the horse, and it will manifest in the way they react to you.

I believe that working with horses has made me a more aware clinician, more open and non-judgemental of what happens in the therapy space.

Despite the hands-on evidence of the positive impact EAP has on clients, it is still hard to put into concrete terms the mechanisms that promote change and wellbeing. I am actively working towards the development of evidence-based practice that is
backed by research as well as clinical experience. Often, I have found both colleagues and clients being sceptical of this type of work. I’ve had to advocate for the importance of working outside of the conventional therapy settings and modalities. Having more scientific evidence would certainly be a benefit and a vehicle for promoting the validity of such interventions.

As a member of the British Psychological Society I am a firm believer that it is important and vital for our profession to be dynamic and creative, to pursue our ideas and to develop through shared knowledge, clinical practice and collaborative work. I would love to think that the future will bring be more awareness of the impact that horses have in therapeutic setting.

I hope that more clinicians will share their practice and knowledge to develop specialised models that cover the entire lifespan.

I believe that working with horses has made me a more aware clinician, more open and non-judgemental of what happens in the therapy space. It has taught me to allow clients to use their own way to explore their narrative and needs, while working together towards wellbeing. I dream of expanding my practice and developing therapeutic models that will address specific complex presentations, with more clinicians trained in this approach. I would love to be able to develop a wellness centre with access to a variety of non-mainstream therapies, but with a main focus on EAP as a tailored intervention to support the recovery of those clients that struggle with therapy at the moment.