Therapeutic Riding lessons involve many non-traditional riding exercises, therefore specialized training for the horse is required. This training consists of working with the horse in specific ways to foster a highly developed sense of cooperation, patience and trust of the team members. In addition, in order to accommodate the physical differences of therapeutic riders, the horses are taught how to accept riders mounting from blocks or a ramp, and how to stand still during mounting and dismounting. They also learn how to accept riders with less balance, trunk control, and spasticity (abnormal muscle tone) than most riders.

Because lessons may involve a variety of exercises during the lessons, the horses are also taught to accept riders who remove their feet from the stirrups, or change directions to sit sideways, on their stomach or even backwards during a lesson.