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The evolving field of Equine-Assisted Psychotherapy (EAP) is centered upon the therapeutic benefits inherent in the nature of horses. Quantitative and qualitative studies suggest that EAP can improve self-efficacy (the belief in one’s own abilities to achieve goals and influence outcomes), self-competence, self-awareness, and emotion regulation, while decreasing depression, anxiety, negative affect, and maladaptive behaviors. Overall, there is a paucity of research in this area; future studies would benefit from more rigorous methodology. In addition, examining the neurobiological underpinnings of attachment theory, nervous system regulation, and emotion regulation capacities that directly relate to EAP might reveal subtler yet potentially significant explanations for its benefits.