ABSTRACT 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 1. increased Harmony. 2. enhanced Self-identity, and 3. 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.