The relationship of early life adversity and physiological synchrony within the therapeutic triad in horse-assisted therapy. In any therapeutic setting, the outcome depends in part on the therapeutic alliance, characterized by mutual understanding, empathy and trust among the participants. This also manifests through physiological synchronization (PS) processes involving breathing, heart and brain. This study examined the dynamics of heart rate variability (HRV) synchronization patterns during horse-assisted therapy. We explored the correlations between the therapist's horse preference, levels of early life adversity (ELA), and PS relationships within and across dyads of participants, therapists, and therapy horses....