Abstract
For psychiatric patients, compulsory admission and coercive measures can constitute distressing and sometimes traumatizing experiences. As a consequence, clinicians aim at minimizing such procedures. At the same time, they need to ensure high levels of safety for patients, staff and the public. In order to prevent compulsory measures and to favor the use of less restrictive alternatives, innovative interventions improving the management of dangerous situations are needed. Animal-assisted therapy (AAT) is being applied in a variety of diagnoses and treatment settings, and could have the potential to reduce aggression and psychopathology. Therefore, AAT might be of use in the prevention and early treatment of aggression, and might constitute a promising component of treatment alternatives to forced interventions. To our knowledge, no study evaluating the effect of AAT on compulsory measures in persons with psychiatric diseases has been published up to date. This narrative expert review including a systematic literature search examines the published literature about the use of AAT in psychiatry. Studies report reduced anxiety and aggressiveness as well as positive effects on general wellbeing, self-efficacy, quality of life and mindfulness. Although literature on the applicability of AAT as a component of preventive or de-escalating treatment settings is sparse, beneficial effects of AAT have been reported. Therefore, we encourage examining AAT as a promising new treatment approach to prevent compulsory measures.
Highlights
Mental health care has to exert multiple functions: primarily, psychiatry has to offer treatment options to enable patients’ restitution of mental health and an optimal quality of life [1,2,3]
As Animal-assisted therapy (AAT) in psychiatry with the aim of reducing aggression and coercion has to be considered as an emerging field, meta-analyses currently would only be of limited use
The final sample consisted of 11 studies; Table 1 gives an overview of them showing population details, measured symptoms, and type of AAT
Summary
Mental health care has to exert multiple functions: primarily, psychiatry has to offer treatment options to enable patients’ restitution of mental health and an optimal quality of life [1,2,3]. In addition, psychiatry is tasked with the role to protect the patients and others from dangerous situations caused by mental illness, and to provide care for patients that would normally agree with treatment, but are unable to do so due to their impaired judgment [4, 5]. This makes it necessary to be able to resort to coercive measures like compulsory admission, safety measures (e.g., seclusion or fixation), and involuntary treatment, in specific situations [2, 3]. In order to prevent compulsory measures and to favor the use of less restrictive alternatives, innovative interventions improving the management of dangerous situations are needed
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