Equine-facilitated cognitive processing therapy (EF-CPT), one of many types of equine-assisted activities and therapies, is a manualized intervention based on a modification of the well-established cognitive processing therapy (CPT) model. The format of the intervention involves 12 sessions that are structured with a flexible curriculum that brings the client through the identification of their thoughts, skills development for the management of symptoms, and development of new frameworks for understanding responses and actions. Facilitated by a trained and licensed mental health professional, EF-CPT provides a viable alternative to office-based didactic therapies, and evidence continues to develop regarding the mechanisms of action, populations for whom success is most likely, and cost–benefit analyses. This chapter provides a broad introduction to this intervention, including an introduction to grounding literature and populations with whom CPT was centered to treat, an overview of how the manual was created, and a discussion of best practices for therapists who work with the model.