Hippotherapy and equine therapy in Madrid

Equine-assisted therapy is a psychological or neuropsychological intervention delivered with the help of a horse, working towards individual clinical goals. Hippotherapy is narrower: it uses the horse's three-dimensional movement as a physical treatment and is delivered by physiotherapists or occupational therapists. Adapted riding is not therapy at all — it is sport, with the adaptations each person needs.

At PSICAB, in Madrid, we deliver equine-assisted therapy: every session is led by a psychologist registered with the Official College of Psychology of Madrid, lasts about 45 minutes, is individual, and has a technician handling the horse throughout. We work with autism, acquired brain injury, developmental delay, attention difficulties and emotional wellbeing, from childhood to adulthood.

Hippotherapy, equine-assisted therapy and adapted riding

These three terms are not synonyms, and the difference matters when you are choosing and paying for a service. It is not about the horse: it is about the goal and about who leads the session.

Hippotherapy uses the movement itself as the treatment. At walking pace a horse transmits a three-dimensional movement —forwards and back, up and down, and rotational— very close to human gait. The person does not steer or carry out tasks: they receive that movement and respond to it, while the therapist modulates the effect by changing position, rhythm or route. It is delivered by physiotherapists or occupational therapists with specific training.

Equine-assisted therapy is what we do at PSICAB. Here the horse is not only a source of movement: it is a relational mediator. The person takes part actively —grooming it, leading it, asking things of it, carrying out tasks while mounted— and that activity is the psychologist's working material.

Adapted riding is sport, and that is not a lesser thing: having your own sport and a skill to show is exactly what many people need. It can reach competition level, since para-equestrian is a Paralympic discipline. What it does not have is a clinical treatment plan, so it should not be bought expecting clinical results.

Who we work with

Therapy at PSICAB is built around individual goals, so the diagnosis is never the whole question. These are the profiles we see most often.

Autism (ASD)

Much of the social difficulty in autism comes from how unpredictable human communication is: irony, double meanings, a face that changes mid-sentence, the implicit demand to make eye contact. A horse removes almost all of that layer. Its communication is physical, direct and consistent, the consequence is immediate and always the same, and it carries no reproach. Add the organising effect of rhythmic movement on the sensory system, and a child who refuses to enter a consulting room but asks to go to the stables, and you have the two things clinical work needs: regulation and engagement.

Acquired brain injury and stroke

Rehabilitation after a stroke or a head injury mostly happens in a room, with a table, a screen and repeated exercises. It works and it is essential, but what is trained at a table does not always transfer to real life, and months of repetition are exhausting. The horse adds a real environment —noise, uneven ground, an animal that responds— where attention, executive function and postural control are demanded at once. It complements neurorehabilitation; it never replaces it.

Developmental delay

With global developmental delay and rare conditions, goals are set around everyday function: communication, autonomy, body awareness, following instructions and tolerating change. Progress is recorded session by session and reviewed with the family.

Attention and executive function

On a horse you cannot switch off. Attention has to be sustained, shifted when the environment demands it, and divided between two tasks at once. Planning a route, anticipating what the horse will do and inhibiting an impulsive response all have immediate, real consequences, which a desk exercise cannot reproduce.

Emotional wellbeing

Anxiety, low self-esteem and behavioural difficulties are frequent reasons for coming, in children and in adults alike. Caring for an animal that responds to how you arrive is a direct, unsentimental way to work on regulation.

What a session looks like

A session lasts about 45 minutes, is always individual, and follows the same structure every time: arrival and preview, work with the horse from the ground, mounted work if appropriate, a fixed closing routine and feedback to the family. That predictability is not a detail — for many people it is the condition for being able to work at all. The five steps are set out on our main English page.

Two professionals are present in every therapy session: the registered psychologist who directs the intervention, and a technician who handles the horse and safety. A helmet is compulsory, mounted work is always at walking pace, and the horses are selected and habituated to adapted equipment, unexpected noise and sudden movements.

What the evidence says, and what we do not promise

Research into equine-assisted interventions is promising but still limited. It is strongest in hippotherapy for cerebral palsy, where several trials have shown improvements in gross motor function and postural control. In autism, controlled trials point to improvements in social behaviour, irritability and hyperactivity, with small samples and very different protocols. In cognitive rehabilitation after brain injury, the evidence is thinner than in motor work.

So, plainly: equine therapy does not cure autism, does not replace speech therapy, occupational therapy, physiotherapy or medical follow-up, and cannot promise results or timescales. Anyone who tells you otherwise is telling you more than the evidence supports. What we do offer is written goals, a registered psychologist in charge of every session, and an honest answer at the free assessment.

Sessions are available in English. Just tell us when you get in touch and we will arrange it.