|dc.description.abstract||Equine-assisted activities and therapies (EAAT) are one type of complementary and/or alternative treatment for persons with mental illness. Various approaches have been used to improve individual's self-esteem, self-efficacy, and overall health (Bizub, Joy, & Davidson, 2003; Burgon, 2003; Klontz, Bivens, Leinart, & Klontz, 2007). However, literature on the psychosocial benefits of EAAT is fragmented and often lacks rigor (Anestis, Anestis, Zawilinski, Hopkins, & Lilienfeld, 2014; Bachi, 2012). Moreover, occupational therapy is underrepresented in the literature despite its roots in mental health. Therefore, this study uses a systematic mapping review to ascertain theories, interventions, and outcomes within literature on EAAT specific to individuals with mental health concerns. Findings from the study were examined through the perspective of a conceptual framework specific to occupational therapy, the Model of Human Occupation, which consists of three subsystems: volition, habituation, and performance capacity. Specifically, this conceptual framework was used to identify how occupational therapy may address occupational performance deficits with horses and the equine environment. Current theories, interventions, and outcomes within the literature suggest horses and the equine environment may be used to improve aspects of volition, such as self-efficacy and self-esteem, habituation, and performance capacity. Occupational therapy using horses and the equine environment may be particularly well-suited for adolescents who have eating disorder or who have experienced abuse considering the high frequency at which this population is studied. In conclusion, there is great potential for occupational therapy to develop unique interventions that focus on occupational performance deficits using the equine environment.