Therapeutic riding was defined in the 1960s by a German physician and physiotherapist group. In Germany, riding is used as a means to help people with a wide variety of disabilities ranging from those for correcting position, slight pain in the hips to those who have difficulty riding independently.
Because the purpose of riding is for medical therapy, the focus is more on what stimulation the horse gives to the rider than on the riding skills. While the rider is on the horse, a physiotherapist observes them and gives instructions to the person leading the horse or the riding instructor how they want the horse to go. Which is why it is important that the physiotherapist involved in therapeutic riding is an experienced rider themselves and has knowledge about horses.
It is also noteworthy that sometimes the method where the physiotherapist rides together with the rider on the same horse is taken.
Since the 1980s, Germany has established a system where if a qualified instructor is involved in the therapeutic riding session, the costs can be covered by medical insurance. Following this in the 90s, many other European countries have adopted similar systems as well.

Riding as a competitive sport for the disabled has been actively pursued in the United States for some time, and events and competitions have been held throughout the country. These competitions are organized and run according to a set of rules. These rules are designed to safely conduct equestrian activities and also promote health through interacting with horses. They also back up and encourage the riders to "overcome" their disabilities and develop riding skills.
In 1996, dressage became an official sport at the Atlanta Paralympic games. This triggered the movement around the world to promote competition riding for the disabled. Through this experience, people found that having a visible goal such as placing in a competition was a good way to motivate riders to stay interested in the sport. Achieving skills makes a rider proud to be in front of an audience, and the desire to get there is a strong factor to keep riders focused on their lessons which allows more than a skill set to be acquired.

Horses at times help us to learn more than just riding. In the field of education, everything from caring for the horse to stable management becomes an important factor. The "clients" learn the value of life and to care for those who cannot speak. Through these activities, emotions and a sense of responsibility are developed. The psychological/therapeutic factor comes in place naturally by learning to live with animals.
Depending on the "client's" disability, activities can be chosen to fit their state. Riding does not necessarily mean equestrian sports, it can also be games or trekking in the fields. Even if the "client" is not able to pursue learning riding skills, they can still enjoy sitting on a horse and taking a walk outside or simply sit on a horse and be led around the ring. Games also can be created to suit the rider's skill set so that they are able to enjoy the stimulation of being on or with a horse.
In educational riding, the role of the education professional becomes important. Advice and comments from professional such as counselors, psychologists (school psychologists etc.), and case workers are helpful and are essential in achieving the desired effect for each "client".

2. Leader
The person who holds the lead rope and takes control of the horse is called the "leader". They should be someone besides the instructor so that the instructor can be left to concentrate on the session as a whole. The role of the leader is to carefully control how the horse moves and also to watch over the horse's condition throughout the lesson.
Depending on the rider's skills, the leader will lead but leave it to the rider to control how and where the horse should go. At all times, they are to make sure that things are safe, and if necessary will take control of the horse and do things such as slow it down or turn it in another direction.

3. Side helpers
"Side helpers" are essential when holding a riding session for a disabled rider. Most of the time, these team members are volunteers. The side helpers are the people who stand closest to the rider, and assist the rider as necessary. It is important that they have a thorough knowledge of how the particular rider mounts/dismounts. They should also speak to the instructor and/or physiotherapist to learn about the rider's physical condition and to understand what to do and not to do when supporting the rider.
A difficult but important part of being a side helper is to "not over assist" the rider. If the rider can position themselves well on the horse, then the side helper would no longer support them by putting their arm around the back of the rider. They might move their hand down to the rider's thigh, then to their heel, and then gradually to just walking next to the horse. Just walking next to the horse is still an important way to support the rider incase something happens, and the side helpers should always be focused on how they can help to maintain safety.

4. Callers
If the rider is visually impaired, "callers" become an effective way of helping the rider to get a sense of space within the riding arena. A common way of doing this is to situate people at the alphabet markers of a dressage ring and for them to then repeatedly call out the alphabet letter as the rider comes near.
Callers must clearly and loudly call the alphabet they are assigned to. However they must be careful not to call too loud since it may give a freight to the horse or make the instructor's instructions difficult to hear.
The rider should concentrate on what the instructor is saying and try to get a sense of the callers as just being something placed on the track just as the actual alphabet markers are. To achieve this result, it is important that the callers do not speak other words, and concentrate on calling out the letters at a steady pace almost mechanically.