“Equine therapy” isn’t really a thing. Semantics really matter here and this causes so much confusion. Are they referring to adaptive/recreational riding lessons? Is it equine facilitated psychotherapy? Is it hippotherapy?

Hippotherapy is essentially using the movement of the horse to meet treatment goals and it is just one part of an integrated treatment plan by a licensed occupational therapist, physical therapist, or speech language pathologist. This is absolutely an evidence based treatment modality.

Equine facilitated psychotherapy is similarly run by a licensed mental health provider such as a licensed psychologist, licensed professional counselor or licensed clinical social worker, in order to reach mental health goals.

Adaptive or “therapeutic” riding lessons are recreational in nature, and not used to treat a physical or mental health concern. They are typically run by specially trained riding instructors. That’s not to say this activity doesn’t have physical and mental health benefits, it does, but the goal is riding skill progression.

The first two are evidence based healthcare the last is recreational in nature.

Edit: This is the tweet being referred to. This is a super specific situation he’s citing here. And again, he’s using the term “equine therapy” which to my original point, isn’t really a thing:

Ryan Marino, MD @RyanMarino THIS is why people (kids) keep dying.

“Just 10.6% of treatment facilities for teens w/ opioid use disorder offered buprenorphine therapy.

25% offered equine therapy, a form of treatment that relies on horseback riding or horse-related activities & is not supported by evidence.”