The Paraendurance takes place in the countryside along trails where the competitions are tested, judged and regulated by the FISE which is affiliated to the International Equestrian Federation (FEI) which, in turn, recognizes the FISE as the only representative of Equestrian Sports in Italy. The main goals for the riders who practice Paraendurance are: to facilitate socializing, to stimulate the awareness of one’s surroundings, to favor personal gratification, to get used to physical fatigue in order to train and better motion efficiency, to improve mingling and communicating with others through the care and attention given to one’s own horse. The therapeutic use of the horse in the rehabilitation of mental disorders basically implies that the relationship in itself becomes the functioning instrument. This relationship is largely based on becoming aware of the other being different from one’s own self which puts into motion the process of “taking care of” by acquiring a deep ethological knowledge that will allow a true and correct communication with the horse. The psychic effort involved in reasoning out someone’s else mind functioning takes the name of meta-cognition, but in dealing with psychotic or cognitive disorders this ability fails. On the other hand, the relationship with the horse, the level of being in tune with it and the ability to understand it represent the main focus in building a successful combined pair within a discipline such as the Endurance. It is at this point therefore, that the Paraendurance becomes a logical sport evolution for the rehabilitation treatment of many disorders and in particular the ones of psychic natures.