BACKGROUND: Mental ill health among children and adolescents has increased worldwide. Mental health difficulties from a young age are associated with school absence and educational underachievement. A holistic perspective of treatments besides medical treatment is essential Thus, there is a need for research regarding equine-assisted intervention (EAI).

PURPOSE: The present study aimed to understand the outcomes of an equine-assisted intervention for children and adolescents with mental ill health from the perspectives of parents and close relatives.

METHODS: This study used a qualitative research design informed by Charmaz's Grounded Theory, with a purposive sample including six in-depth interviews.

RESULTS: The theory "building up bit by bit" was constructed, explaining the recognition that their children/adolescents were built up bit by bit and created a stronger self-identity. The participants referred to changes in the child's or adolescent's way of being and emotional regulation, which constituted building blocks leading to the child's or adolescent's increased Harmony, enhanced Self-identity, and improved Capability.

CONCLUSION: Parents and close relatives experienced that their child or adolescent was built up bit by bit and gained a stronger foundation to stand on. This led to increased harmony in everyday life with stronger self-worth, better performance, and reduced school absenteeism.