Behavioral Observations of Dogs During Animal-Assisted Interventions and Their handlers’ Perceptions of Their Experienced Level of Stress

Background: Animal assisted therapy (AAT) is therapeutic intervention designed to help patients engage in meaningful life activities.1 Therapy dogs are used in healthcare settings to engage patients in motion, self-care, mental health, motivation, social responses, pain management, and fine motor skills.2 While there is research on the benefits of AAT with children and adults in inpatient settings, there is a lack of information on the benefits and satisfaction of AAT in student-run free clinics (SRFC).
 Methods: Occupational therapy (OT) students, volunteer clinicians, trained therapy dog teams, and patients receiving OT services at the Community Aid, Relief, Education & Support (CARES) SRFC participated in a pilot AAT program. All participants completed a specially designed survey via REDcap immediately following AAT sessions. Surveys focused on the patient’s pain and stress levels, benefits of AAT, and patient satisfaction.
 Results: Ten patients participated in the AAT pilot program alongside thirty-seven students and 4 therapy dog teams. 100% of patients responded therapy dogs helped them reach their goals, 93.8% of handlers and clinicians agreed the dog was a valuable addition to therapy sessions, and 100% of OT students agreed AAT is an important tool for therapists to use in clinical settings. 67.6% of patients reported a decrease in stress and 41.2% of patients who were experiencing pain reported a decrease in symptoms. Students, handlers, and clinicians reported benefits with AAT including range of motion (79.7%), fine motor skills (68.1%), and motivation (68.1%).
 Conclusion: AAT was successfully integrated into CARES SRFC based on feedback and data collected from participants. AAT had a visible impact on patients, students, handlers, and clinicians. Future research on the use of AAT in a SRFC should include a larger sample size and consider how to better define the specific impact of AAT on populations and conditions commonly seen in a SRFC.

Applied child psychologists and behavioral consultants often use systematic behavioral observations to inform the psychological assessment and intervention development process for children referred for attention and hyperactivity problems. This article provides a review of the 2010 version of the eCOVE classroom observation software in terms of its utility in tracking the progress of children with attention and hyperactive behaviors and its use in evaluating teacher behaviors that may impede or promote children’s attention and positive behavior. The eCOVE shows promise as an efficient tool for psychologists and behavioral consultants who want to evaluate the effects of interventions for children with symptoms of ADHD, ODD, mood disorders and learning disorders; however, some research-based improvements for future models are suggested. The reviewers also share their firsthand experience in using eCOVE to evaluate teacher and student behavior exhibited on a television show about teaching urban high school students and during a movie about an eccentric new kindergarten teacher. Rich examples are provided of using strategic behavioral observations to reveal how to improve the classroom environment so as to facilitate attention, motivation and positive behavior among youth. Broader implications for enhancing the use of systematic behavioral observations in the assessment of children and adolescents with attention disorders and related behavioral problems are discussed. Key issues are examined such as the use of behavioral observations during psychological consultation to prevent the previously found gender bias in referrals for ADHD. Using behavioral observations to enhance differential diagnosis is also discussed.

Studies have reported that exposure to pet therapy (PT) can reduce physiological and subjective stress and anxiety levels. The aim of this meta-analysis is to examine the efficacy of PT as a method for reducing physiological stress levels (blood pressure and heart rate) and subjective stress and anxiety scores (self-reported stress/anxiety). Further, we examined the effects of sample characteristics and modifications to the PT (different age groups and health status of participants across samples, whether a stressor was present, and individual versus group PT) as potential moderators of the relationship between PT and stress reactivity. Our searches incorporated articles published from May 2017 and earlier in PsycINFO, MEDLINE, and PubMed. This meta-analysis included 28 articles with 34 independent samples and contained a total of 1,310 participants. Using a random effects model, we determined that significant differences occurred in heart rate, self-reported anxiety, and self-reported stress after PT exposure compared with before PT. However, we did not detect significant differences in blood pressure after PT. Sample characteristics and modifications to the PT significantly moderated the effect of PT on stress responses. Our results suggest that PT can be an effective program for reducing stress reactivity.

Background Animal assisted intervention (AAI) is a popular type of non-pharmacological psychosocial intervention, which has a potentially positive effect on physical, psychological, and social functioning for people with dementia. However, there is a lack of evidence regarding the experiences and factors of implementing AAI, and its impacts on people with dementia in different contexts. This review aims to synthesise key stakeholders’ experiences and perceptions of AAI for people with dementia in community settings. Methods We systematically searched Medline, CINAHL, Embase, Scopus, Web of Science, PsycINFO and AgeLine for potentially eligible studies. Thematic analysis was used to synthesise the data from included records. We assessed the methodological limitations using an adaptation of the Critical Appraisal Skills Programme (CASP) and used GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) to assess confidence in the review findings. Two Patient and Public Involvement (PPI) contributors were involved to enhance the quality and relevance of the research. Results We included 14 reports and developed three analytical themes, incorporating a gardening analogy: planting-connecting with animals, growing-engaging in AAI, and nurturing-making AAI work, with 15 key findings. Our review highlights that positive experiences, growing connections, and potential benefits were perceived within AAI. A multicomponent AAI can provide various sensory inputs, attributing to a rich experience. Flexible and individualised AAI tailoring to people’s needs and preferences is important. Additional training and education for staff are necessary to facilitate the intervention, reduce risks, and nurture connections. Conclusion This review describes people’s experiences and perceptions of AAI for people with dementia, and provides recommendations on development and implementation of AAI, with moderate to high confidence in its findings. It is important to consider the factors that influence the implementing AAI identified in this review, to facilitate engagement and long-term impacts in future interventions.

Introduction In healthcare simulation, the appropriate level of stress produced through physiological and psychological arousal is necessary for effective experiential learning. While beneficial stress promotes learning, excessive stress inhibits learning. Animal Assisted Interventions may be a viable method to support learners experiencing excessive stress post-simulation. Animal Assisted Interventions have been used therapeutically with positive effects though there is an absence of research on Animal Assisted Interventions in healthcare simulation. This study investigates the efficacy of an Animal Assisted Intervention compared to an intervention control to reduce negative affective arousal post-simulation. Methods Primary Care Paramedic, Animal Health, and Respiratory Therapy students were recruited for the study. The study utilized an experimental design. After a simulation, known to induce stress and potentially negative affective arousal, participants were randomly assigned to an Animal Assisted Activity with a Canine or to Diaphragmatic Breathing. Negative affective arousal was measured post-simulation and post-intervention using a Visual Analogue Scale. Results Forty-five students participated in the study. Pre-intervention scores showed moderate levels of anxiety, stress and confusion. Both interventions led to a significant decrease in emotional affect. Participants in the Canine condition reported significantly lower levels of Anxiety compared to the Breathing Condition. Participants and facilitators expressed positive emotions related to the canine’s presence. Conclusions The presence of a canine was well received by all, and Animal Assisted Interventions can fit seamlessly into the post-simulation period to reduce anxiety after a simulation. Animal Assisted Activities may be best utilized for simulations known to be emotionally distressing and intensive.

Simple SummaryThe words used to communicate farm animal welfare to non-specialists may be more important than knowledge of welfare itself. Framing research finds that human perception is influenced, not by what is said, but by how something is said. By increasing the emphasis placed on animals having positive experiences, positive animal welfare changes the framing of farm animal welfare. Yet, we do not know how such framing of animal welfare may influence the perceptions of key animal welfare stakeholders. In response, this study uses qualitative interviews to explore how citizens and farmers frame positive animal welfare and what this means for the effective communication of this concept. This study finds that ‘positive’ evokes associations with ‘negatives’ amongst citizens. This leads them to frame positive animal welfare as animals having ‘positive experiences’ or being ‘free from negative experiences’. Farmers rely more on their existing frames of animal welfare and integrate positive welfare into this. As such, most farmers frame positive welfare as ‘good husbandry’, a smaller number frame it as ‘proactive welfare improvement’, and a small number frame it as an ‘animal’s point of view’. The implications of such internal frames for effectively transferring positive welfare from science to society are further discussed.Human perception can depend on how an individual frames information in thought and how information is framed in communication. For example, framing something positively, instead of negatively, can change an individual’s response. This is of relevance to ‘positive animal welfare’, which places greater emphasis on farm animals being provided with opportunities for positive experiences. However, little is known about how this framing of animal welfare may influence the perception of key animal welfare stakeholders. Through a qualitative interview study with farmers and citizens, undertaken in Scotland, UK, this paper explores what positive animal welfare evokes to these key welfare stakeholders and highlights the implications of such internal frames for effectively communicating positive welfare in society. Results indicate that citizens make sense of positive welfare by contrasting positive and negative aspects of welfare, and thus frame it as animals having ‘positive experiences’ or being ‘free from negative experiences’. Farmers draw from their existing frames of animal welfare to frame positive welfare as ‘good husbandry’, ‘proactive welfare improvement’ or the ‘animal’s point of view’. Implications of such internal frames (e.g., the triggering of ‘negative welfare’ associations by the word ‘positive’) for the effective communication of positive welfare are also presented.

Guinea pigs are often involved in animal-assisted therapy (AAT) but there is little knowledge about the effects of human contact on guinea pigs involved in AAT. The aim of this study was to investigate effects of availability of a retreat, presence of conspecifics, prior experience with AAT, and human interaction on indicators of welfare in guinea pigs involved in AAT. Guinea pigs of both sexes and different ages (n=20) were assigned to a randomized, controlled within-subject trial with repeated measurements. Each guinea pig was tested in four settings: (I) therapy with retreat possibility with conspecifics, (II) therapy with retreat possibility without conspecifics, (III) therapy without retreat possibility, and (IV) setting without human interaction. We measured changes in eye temperature, as a proxy to infer stress levels, at 5-s intervals with a thermographic camera. All sessions were video recorded and the guinea pigs’ behavior was coded using continuous recording and focal animal sampling. For the statistical analysis we used generalized linear mixed models, with therapy setting as a fixed effect and individual guinea pig as a random effect. We observed a temperature increase relative to baseline in settings (I) therapy with retreat with conspecifics present and (III) therapy without retreat. The percentage of time a guinea pig was petted was positively correlated with a rise in the eye temperature independent of the setting. Time spent eating was reduced in all therapy settings (I-III) compared to the setting without HAI (human animal interaction) (IV). In the setting with retreat (I), guinea pigs showed more active behaviors such as locomotive behavior or startling compared to the setting without retreat (III) and the setting without HAI (IV). When no retreat was available (III), they showed more passive behaviors, such as standing still or freezing compared to therapy with retreat (I). Based on our results we identified the behaviors “reduced eating”, “increased startle” and “increased freezing” as indicators of an increased stress level. Petting the guinea pigs was correlated with a rise in the eye temperature and might be a factor which can cause stress. Our results support the suggestion that guinea pigs involved in AAT should have a retreat possibility, should have access to conspecifics, and should be given time to adapt to a new setting. In this way, stress might be reduced.

The university campus environment is unique and complex, with students and staff members experiencing increasing levels of stress and anxiety over time. One intervention being used internationally to alleviate stress and anxiety is an Animal Assisted Intervention (AAI). This research aimed to explore Australian university students' and staff members' perspectives on an AAI prior to implementation. This study used an explanatory mixed methods approach. Student participants were recruited through posts on a university's subject sites and via social media. University staff member participants were recruited through emails from managers or department newsletters. Data were collected through an online anonymous survey and subsequent semi-structured interviews. Quantitative data were analysed with SPSS and qualitative data were analysed via thematic analysis. Data included 344 survey responses and 45 semi-structured interviews. Survey responses indicated a large majority of participants believe an AAI could promote health on campus. This was due to the range of benefits participants felt an AAI could have on campus (such as reducing stress and anxiety, providing opportunities for a break from work or study, social benefits, and enhancing the university environment). In interviews, participants suggested an AAI could contribute towards a positive university environment and help promote other services on campus; provided it considers those not interested in participating. SO WHAT?: If implemented sustainably, an AAI has potential to contribute towards a positive university environment for both staff and students, by potentially reducing the high rates of stress and anxiety the university community are currently experiencing. An AAI could also help to raise awareness of other health services on campus, further contributing towards promoting positive mental health and wellbeing.

Simple SummaryAnimal Assisted Interventions (AAI) are growing in popularity among professionals of psychological therapies due to their clear benefit for human health. However, to date, little attention has been paid to the welfare of the animals involved in the interventions. In this study we evaluated the potential impact of such activities on the welfare of dogs living in a kennel, which had weekly interactions with inmates held at a prison. To assess their stress levels, we analyzed their physiological response to a stressful situation by measuring the cortisol levels in saliva samples. We found a significant decrease in cortisol concentration at the end of the AAI program measured in the dogs’ living environment (i.e., kennel), which suggests a positive effect of the AAI activities on the welfare of kennel dogs. The results also suggest that transportation from the kennel to the prison could be perceived as a stressful event since it significantly increased dogs’ cortisol levels. Therefore, particular care should be taken in the management of this phase.Previous studies regarding the Animal Assisted Interventions (AAI) have mainly focused on the beneficial effects of human–animal interactions on human health; whereas the impact of such activities on the welfare of the animals involved has received limited attention. So far, few studies have addressed this issue by evaluating the physiological and behavioral reactions of therapy dogs during the interventions. The aim of this study was to evaluate the potential effect of AAI on the cortisol levels of shelter dogs. Five dogs participated in weekly AAI working activities with adult inmates held at a prison of the South of Italy for two months. Saliva samples were collected every two weeks in three conditions: at the kennel (baseline), after transportation and at the end of the working sessions. The results revealed a significant decrease in the cortisol baseline at the end of the AAI program, suggesting that the activities carried out with humans and in a different environment could improve the welfare of dogs housed in kennels. Moreover, we found that transportation significantly increased subjects’ cortisol levels, suggesting that it is a critical phase that deserves particular care.

Objective: Animal-assisted therapy (AAT) has the potential to improve the symptomology, negative emotions, and level of well-being in older adults, as well as patients with mental illness. However, there remains limited evidence supporting the treatment efficacy of AAT in middle-aged and older adults with schizophrenia. Therefore, this study implemented a randomized controlled trial to assess the efficacy of a 12-week AAT psychological intervention with dogs for middle-aged and older patients with chronic schizophrenia in a clinical setting.Method: Patients, age ≥ 40 years, with chronic schizophrenia were allocated randomly to either the AAT group or control group. Patients in the AAT group received an additional hour -long AAT session every week for 12 weeks. Patients in the control group received the usual treatment plus an hour long non-animal related intervention. All patients were assessed based on primary outcome measures before and after the 12-week intervention, including the Positive and Negative Syndrome Scale (PANSS), Depression Anxiety Stress Scales Assessment (DASS), and Chinese Happiness Inventory (CHI).Results: Patients who received AAT had greater improvements in the PANSS and DASS-stress subscale scores than the control group (p < 0.05). The effect was small (success ratio different, SRD = 0.25) for the PANSS and the DASS-stress subscale (SRD = 0.15). There were no significant differences in the change scores of the CHI between the AAT and control groups (p = 0.461).Conclusions: AAT seemed to be effective in reducing psychiatric symptoms and stress levels of middle-aged and older patients with schizophrenia. AAT could be considered as a useful adjunctive therapy to the usual treatment programs.

Background Anxiety disorders are one of the most common mental health disorders experienced by children, and they have a negative effect on social, academic, and health functioning. While traditional psychotherapy has focused on methods such as cognitive behavioural therapy and parental anxiety management to treat these children, interest is growing in animal-assisted therapy (AAT) as a therapeutic modality, and recent research suggests the benefits of AAT within the realms of psychotherapy for children with anxiety. Aim This review aimed to perform a critical appraisal of the available literature relating to dog-assisted psychotherapy for children with anxiety and investigate the effectiveness of this therapy method in reducing anxiety. Method This structured literature review was guided by the 12 steps recommended by Kable et al. (2012). The search was conducted in August and September 2021 through the databases ScienceDirect, PsycInfo, and PubMed to locate published peer-reviewed literature on the therapeutic benefits of including a dog in psychotherapy sessions for children with anxiety. After critical appraisal, 10 articles were included in the review. Results General agreement exists that dog-assisted therapy can boost positive emotions and reduce anxiety levels in children, and that interacting with dogs and experiencing their unconditional acceptance help reduce children’s stress and physical pain levels as well as stress in families. The key themes that emerged from this review included the human–animal bond, children’s attachment styles, hospitalisation and environmental considerations, the AAT methods used, and the effects of AAT. Conclusion This review revealed many benefits of the presence of a therapy dog during psychotherapy sessions, including reducing anxiety, increasing positive emotions, and enabling social interactions for children with anxiety. Counsellors and psychotherapists can feel confident to undertake the required training and implement the necessary systems to accommodate a therapy dog in their therapeutic setting in order to support children with anxiety. It is noteworthy that the positive effects of dog-assisted therapy were not consistent throughout the literature, and most research studies focused on children in hospital settings. Therefore, further research is required regarding the effectiveness and clinical implications of the nature, type of intervention, length, and duration of dog-assisted therapy.

Animal-assisted therapy (AAT) is an intervention in which the animal acts as a co-therapist. It has been mainly used in the context of patients with dementia, showing positive effects on psychological symptoms, but its potential as a physiotherapy treatment for patients with neuromuscular disorders, amyotrophic lateral sclerosis (ALS) in particular, has not yet been investigated. The aim of the study was to evaluate the impact of AAT, specifically of dog-assisted therapy, on motor functions and psychological status in patients with ALS. This study was a randomized controlled pilot study. The study was carried out at the Rehabilitation Unit NEuroMuscular Omnicenter (NEMO) of Arenzano, Genoa. Sixty hospitalized ALS patients were enrolled. All patients ran a regular two-weeks neurorehabilitation program twice a day. For three days a week, in place of the morning traditional treatment, the AAT group performed a rehabilitation session with a simultaneous interaction with the therapy-dog, while the control group performed a traditional rehabilitation session. The outcome measures were the Timed Up and Go Test, the Short Physical Performance Battery (SPPB), the Six Minutes Walk Test, the Ten Meters walking Test and the Hospital Anxiety and Depression Scale. Both groups showed an amelioration in motor scales. However, SPPB subscales as well as HADS scores showed a statistically significant improvement only in the AAT group (P values from <0.0001 to 0.0004). Additionally, across almost all motor and psychological measures, post-treatments values were significantly better for the AAT group (P values from <0.0001 to 0.01). The obtained results not only suggest that AAT is comparable to traditional physiotherapy treatments, but also evidence that this type of treatment has greater beneficial effects on motor and psychological symptoms in patients with ALS. This study provides first evidence that AAT is a powerful rehabilitation strategy in patients with ALS, improving both motor and psychological symptoms, and therefore possibly ameliorating quality of life.

Animal assisted interventions (AAI) have become increasingly popular in Western countries during the last fifty years, attracting a lot of attention both from the general public and the scientific community. In Italy, similarly to other countries, this evolution has been accompanied by the diffusion of associations delivering AAI. What is the current state of AAI in Italy? How many realities are dealing with AAI? What professionals and animals are involved? The results of the questionnaire here reported have the objective to answer these questions, outlining a snapshot of the distribution and the main features of AAI within Italian territory. According to the 208 respondents, the sector has seen a remarkable expansion over the last twenty years. AAI providers are located mainly in the North and Centre of the country, the majority of them are arranged in associations or AAI specialized centers and work mainly with dogs and equids in animal assisted activity (AAA) programs addressed to disabled people and children. The picture of the sector still appears fragmented in particular regarding team of professionals involved and their training; nonetheless, the recent set up of national guidelines by the Italian authorities has the objective of standardizing the field and defining best practices for each type of intervention.

The stress on dogs and their handlers during animal-assisted therapy in a prison programme was evaluated using questionnaires and measurement of the dogs’ saliva cortisol concentrations before and after the sessions. Their handlers were volunteers who underwent training classes with their pet dogs. Overall, the dogs did not show serious signs of stress in the programme, which was also the impression of their handlers. In most cases, the dogs’ saliva cortisol values decreased following their participation in the sessions. There was an association between the dogs’ stress levels and the handlers’ self-reported stress. In 11% of cases, the dogs were evaluated as stressed during the session, but their saliva cortisol values did not change significantly from before to after the session. Some handlers might have misconstrued their dogs’ behavioural states. Improvement of the dogs’ welfare may be achievable through giving feedback to the handlers to more accurately evaluate their dogs’ behaviours, by strengthening the selection of appropriate units and classes prior the programme, by developing a programme and handling methods less burdensome to the animals, and by enhancing the aftercare of animals when they are stressed in a session. Achievement of these goals would also strengthen the bonds between dogs and handlers, contributing to a more effective programme for clients.

To date, investigations of the welfare of therapy dogs have focused largely on examining physiological and behavioral measures that could indicate if the animal is experiencing stress or distress. However, this approach does not fully address the definition of welfare which is often described as existing on a continuum from negative (or stressful) to positive. With therapy dogs, it would be worth addressing if they experience positive emotional affect while working since the quality and efficacy of animal-assisted interventions for the human recipient is likely to be influenced by the animal's emotional state during the interaction. The purpose of this review is to articulate how objective measurements of the HPA axis and measurements of behavioral observations and standardized questions can be used to evaluate positive welfare in therapy dogs. A potentially relevant indicator of positive welfare is the peripheral concentration of the neurohormone oxytocin, which has been found to increase in systemic circulation within a variety of species during positive social and affiliative contexts, including during human-dog interaction. Oxytocin is also a negative-feedback regulator of the Hypothalamic-Pituitary-Adrenal (HPA) axis, which culminates with the production of the stress hormone cortisol. Cortisol is widely used as a physiological indicator to assess negative welfare states in animals, including therapy dogs. Observable behavior during interactions with humans that may convey enjoyment could provide indicators of positive welfare in dogs such as engagement in play, or human-directed affiliative behaviors including leaning against, nudging, or licking the patient. However, in assessing positive welfare, it is also critical to consider that all animal behavioral displays and physiological responses are dependent on the dog's individual (and breed) temperament. Temperament directly drives how the animal copes and responds to its current physical and social environment, including during stressful situations such as when therapy dogs interact with unfamiliar humans in novel healthcare settings. Coupled with both positive and negative physiological and behavioral welfare indicators, questionnaire data can provide further context to, and enhance interpretations of, therapy dog welfare assessment results. Overall, to date, no studies have measured all of these factors to assess therapy dog welfare.