Guidance on minimum standards for canine-assisted psychotherapy in adolescent mental health: Delphi expert consensus on terminology, qualifications and training

Abstract

Abstract Introduction: Canine-assisted psychotherapy (CAP) is an emerging field that is largely unregulated and at times fragmented. Despite this, CAP shows promise as an innovative intervention for improving adolescent mental health. To ensure safe, ethical interventions incorporating dogs, providers need minimum standards to guide intervention development and subsequent research. Initially, standards should guide the preliminary steps required to prepare for and set up CAP interventions. These should include consensus agreement on the specific training and qualifications of providers, and training/assessment standards for canines to deliver such interventions. Also crucial is establishing clear expectations about treatment goals via use of clinically accurate terminology. Methods: Using Delphi methodology, experts in animal-assisted therapy (AAT) were recruited globally to complete questionnaires in an iterative process designed to establish consensus. Consensus was met when 80% or more experts agreed that an item was either ‘important’ or ‘essential’ and therefore included or ‘unimportant’ or ‘irrelevant’ and therefore excluded from the minimum standards required to develop a CAP group intervention for adolescents experiencing common mental health disorders including depression, anxiety, and adjustment disorder. Results: Over two rounds, consensus was reached to include 34 items and exclude none; 45 items remained unresolved. Standardized terminology was identified that clearly defined the type and scope of the service being provided, delineating psychotherapeutic treatments from informal dog-related interactions. To deliver the CAP intervention, providers must have formal qualifications and licensure/registration in mental health, training and supervision in AAT, and canine-specific training and experience. Important temperament characteristics of working dogs were identified including absence of aggression, and enjoyment working in CAP. Dogs should be formally assessed in obedience and AAT applications, in partnership with a bonded handler. Assessors of dog-handler teams should be independent and have expertise in both canine ethology and AAT. Discussion: These results reinforce the importance of accurate and standardized terminology, and the need for further community education on the role of ‘therapy’ and ‘therapy dogs’. Consensus on the essential content for provider training was not achieved, highlighting the diversity of practice globally. Nevertheless, there was recognition of the need for breadth and depth of knowledge across the domains of mental health, AAT, canine training, and handling dogs for AAT applications. Dogs working independently of a bonded handler were not supported, nor were mental health providers working with an ‘assessed’ dog in the absence of AAT and CAP training. Implications for clinical practice are explored.