Experiencing trauma can lead to a variety of chronic and acute symptoms, including post- traumatic stress disorder (PTSD), anxiety, depression, substance abuse, and poor social skills. Given the variety of causes for trauma incorporating individualized treatment options is important for efficacy. Equine assisted mental health (EAMH) - a team approach incorporating equines, clients, and practitioners - has been successful in treating those who have experienced trauma, including veterans and individuals with PTSD, at-risk youth, victims of sexual violence, and children who have been neglected. Although researchers and practitioners understand some about how EAMH treatment results in positive outcomes for these individuals, little is known about the communicative processes that support them. The current study included 19 in-depth interviews with EAMH therapists and practitioners to explore the role of equine communication (i.e., congruence, ongoing positive regard, and empathy) as a communicative process that is integral to the facilitation of EAMH as individualized therapeutic treatment. Using tenets of patient-centered communication (PCC) and principles of client-centered therapy, implications for human-horse communication in therapeutic contexts and client-centered care are discussed.