Equine assisted therapies are growing in popularity as a modality for treating various mental health and developmental challenges. Many of these challenges require focused work on the development of empathy, perspective taking, and attunement to self and others. This study examines the participants’ experiences and understanding of empathy as it relates to self, humans, and equine partners via structured qualitative interviews with four therapy participants. The interviews conducted for this study demonstrated a distinct common understanding of empathy as the ability to take perspective based on the human’s or animal’s own orientation in the world; an understanding that developing empathy within the context of equine therapy was emotionally laborious and required significant work and emotional engagement on the participant’s behalf. The interviews indicated that the participants’ perceived the horse as emotionally neutral in therapeutic interactions. Furthermore, the study indicated that a central component to the perceived success of this modality of therapy was a parallel process in relationship between the facilitator/client dyad and the client/equine dyad.