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Psychologists have been using animals in therapy for a long time. Because, well, for many people, few things are better than cuddling up with an adorable dog or cat.

But these animals aren't the only option. In fact, there's a whole separate kind of animal-assisted therapy that stars a less-common companion: horses. Although research is ongoing, early evidence has shown that equine therapy seems to help with everything from cerebral palsy to autism.

And these treatments aren't just like dog-based therapy, but with bigger animals. Instead, equine therapy seems to be special because horses exist in a class all their own. Equine therapy is also called hippotherapy — which makes sense if you know that “hippopotamus” translates to "river horse." And although most studies on it have involved children, it seems to be a good fit for adults, too.

Regardless, what this therapy entails can vary quite a bit. Sometimes, people are taught about horses and their training, but more often, it involves actually caring for animals and learning riding skills. Some language-learning therapies even involve both.

Like, you might take a spelling quiz while riding a horse as it steps over bars on the ground, saying a letter for each step — and the trainer will stop the horse if you miss. Or you might retell a story by visiting spots in an arena that represent turning points in the plot. Often, the therapy is tailored to exactly what it's trying to target.

Take autism, for example. One randomized trial followed 15 kids who spent time in an equine therapy group, and they learned things like grooming and riding. And in the end, they showed improvements in typical social functioning and motor abilities compared to 13 kids in a control group that didn't get therapy.

Another, similar study tried equine therapy with 19 kids and compared them to a control group of 15 who were on a wait list. In this case, the therapy involved training on how to mount a horse, riding skills, and games like Simon Says. That's the one where someone gives commands, but you're only supposed to do them if they say “Simon says…” first.

And in the study, the kids improved their sensory processing, were less distractible, and picked up on more social cues. But what's a horse doing to help with this? Well, one feature of autism is that you have a hard time focusing your attention on different sensory inputs when stimulation is coming from different directions.

But riding a horse is something that can occupy a lot of senses — and focuses them on one coherent experience. It combines things like vestibular sense, which is your sense of your head's orientation, and proprioception, your sense of where your body is and where it's moving, along with other touch-based sensations. And that gives someone practice regulating sensory input.

Horses also respond to commands, so kids who have trouble with verbal communication can learn with immediate feedback. Horses might provide similar benefits to kids with ADHD, too — although the research there is especially limited, so it's hard to say anything for sure. Meanwhile, equine therapy for cerebral palsy looks a bit different.

Cerebral palsy develops when some kind of injury happens before the brain fully develops, usually leading to cognitive or motor impairments. A lot of the time, it affects one side of the body more than the other, which means there's a bigger risk of more severe problems as kids' bones grow and they learn to walk. And again, hippotherapy has measurable benefits here:.

When patients have had horses as part of their therapy, they've been shown to improve their posture, and also show more symmetry in their muscle responsiveness. But in this case, it's about the physical experience, not necessarily the sensory one. When you ride a horse, it's a bit of a workout for your ability to balance.

So patients need to be making constant adjustments to their posture in response to the horse's motion. Finally, some treatments aren't about the sensory or the physical benefits: They're about the emotional ones. Like, for patients with post-traumatic stress disorder, or PTSD, equine therapies have been shown to reduce trauma symptoms and anxiety.

Here, it's possible that the level of benefits is about the same as with office-based therapy. But some therapists argue horses are especially helpful. Mostly, horses are hypervigilant to their environment, which might be something a patient with PTSD can relate to.

And seeing that giant animal respond to your commands can help people recover a sense of control, too. Equine therapy can even help people boost self-esteem or cope with social stress. But although there are all kinds of horse-based therapies out there, equine therapy doesn't seem ideal for everything.

If your concern is your mood or subjective well-being, it looks like dogs — or another more typical therapy animal — might come out on top. But equine therapy seems to work best if you're treating someone with more medical symptoms. Unfortunately, though, this type of therapy isn't that widely available.

Keeping horses is expensive, so depending on where you live, it might be hard to come by. And some researchers have pointed out that this research is pretty limited, too: It suffers from things like small sample sizes and sometimes-missing control groups — meaning people who got therapy weren't compared to a group that didn't. So while it might be a helpful option when it's available, we'll need more research to really know what's going on.

But so far, things seem encouraging. Thanks for watching this episode of SciShow Psych! If you want to learn more about conventional animal-assisted therapy and why it works, we've got an episode about that, too.

Turns out, it's not just helpful because dogs are really cute! [♪ OUTRO].