Animal-assisted Therapy Research Articles

A Logic Model of a Dementia-specific Program of Equine-assisted Activities

Abstract Insufficient descriptions of what comprises animal-assisted interventions and why and how they are presumed to work pose significant challenges to their replication and further scientific development. The purpose of this study was to construct a comprehensive research-based logic model describing a promising program of equine-assisted activities for older adults with Alzheimer’s disease and related dementias. Logic models can advance scientific development of innovative programs by elucidating their critical elements. Employing the qualitative method of directed content analysis, we conducted secondary analyses of previously collected interviews of five providers and fieldnotes of each programmatic session. Employing quantitative direct observational methods, we conducted secondary analysis of eight previously collected hour-long videotapes of four older adults with dementia during the program. The resulting logic model from our secondary analysis of mixed methods data elucidated the program’s purpose, assumptions, programmatic activities, and outcomes, plus congruent linkages across these elements. These findings can guide replication of the program in multiple research and practice contexts and support its future scientific development. Next research steps include evaluating short- and long-term outcomes beyond participants’ direct experiences of the program, clarifying the program’s optimal dosages, and ensuring fidelity of its implementation. This logic model may also help to inform scientific development of other animal-assisted interventions.

A Social-Emotional Learning Program for Suicide Prevention through Animal-Assisted Intervention.

Simple SummaryYouth suicide is a global public health problem. According to data from the World Health Organization (WHO), suicide is the fourth leading cause of death in the age group between 15 and 29 years, after injuries due to traffic accidents, tuberculosis, and interpersonal violence. For this reason, the reduction of mortality by suicide is one of the WHO’s priority objectives. Here we describe a pilot study evaluating the OverCome-AAI program, a pioneering animal-assisted intervention for preventing suicidal behavior. After the intervention, the young people showed reductions in suicidal behavior and non-suicidal self-harm, as well as a greater predisposition to seek help. Mental pain was less intense, although no changes in symptoms of hopelessness or depression were found. The results of this pilot study suggest that the inclusion of specially prepared and trained animals can promote socio-emotional learning for preventing suicidal behavior in high-risk populations.The aim of the study was to carry out a pilot implementation and evaluation of the OverCome-AAI program, a pioneering program for the prevention of suicidal behavior through animal-assisted interventions for young people with high risk factors for suicidal behavior. The study sample consisted of 30 adolescents (11 boys and 19 girls) aged between 14 and 17 years (Mean age = 15.50, SD = 1.60) from the Basque Country (Northern Spain). After the intervention, subjects presented reductions in suicidal ideation, suicide plans, and non-suicidal self-harm, as well as a greater predisposition to seek help. A reduction in the intensity of mental pain was also found, although no differences were observed in indicators of hopelessness and depression. The preliminary results obtained in this pilot study suggest that the OverCome-AAI program may be effective in reducing suicidal behavior and non-suicidal self-harm in young people in residential care who present high risk factors for suicide.

Exploration of non-pharmacological interventions in the management of behavioural and psychological symptoms of dementia.

Behavioural and psychological symptoms of dementia (BPSD) are considered integral parts of dementia. While pharmacotherapy is reserved for severe symptoms of BPSD, the associated adverse effects can be detrimental. Therefore, non-pharmacological intervention is recommended as the first line of treatment in the management of BPSD. This study aimed to explore the non-pharmacological approaches for the management of BPSD and the strategies and barriers to implementing them in secondary care facilities in Malaysia. A qualitative study design was employed. Data were collected through observations and semi-structured interviews of 12 caregivers and 11 people with dementia (PWD) at seven secondary care facilities. Observations were written in the field notes, and interviews were audio-recorded and transcribed. All data were subjected to thematic analysis. Some personalised non-pharmacological interventions, such as physical exercise, music therapy, reminiscence therapy and pet therapy, were conducted in several nursing care centres. Collaborative care from the care providers and family members was found to be an important facilitating factor. The lack of family support led to care providers carrying additional workload beyond their job scope. Other barriers to non-pharmacological interventions were cultural and language differences between the care providers and PWD, inadequate staff numbers and training, and time constraints. Although non-pharmacological approaches have been used to some extent in Malaysia, continuous education and training of healthcare providers and the family members of PWD is needed to overcome the challenges to their successful implementation.

Effects of animal-assisted interventions for people with dementia: A systematic review and meta-analysis

Animal-assisted interventions (AAIs) are non-pharmacological, cost-effective interventions developed to improve outcomes in patients with dementia; however, the effects remain inconclusive. The purpose of this study was to analyze the efficacy of AAIs for people with dementia. A systematic review and meta-analysis was performed of English-language literature published from January 1, 2001, to July 3,2021, and indexed in the following databases: CINAHL, EMBASE, MEDLINE, PubMed, Web of Science, Cochrane, and PsycINFO. Intervention groups were people with dementia who received AAIs. Study quality was assessed using the Joanna Briggs Institute tool. Among 10 included studies, significant differences in depression levels were identified between the intervention and control groups (p < 0.001). No significant differences in cognitive function, neuropsychiatric syndrome, or independence in activities of daily living were observed between groups. Future research remains necessary to examine the effects of AAIs on depression during different stages of dementia. AAIs therapists may collaborate with healthcare workers to improve AAIs benefits.

The Effect of Dog Videos on Subjective and Physiological Responses to Stress

ABSTRACT Research indicates that animal-assisted therapy programs can reduce stress responses. However, animals are not always permitted in public settings. Thus, alternative forms to the physical presence of an animal could be beneficial. The objective of this study was to determine (1) whether exposure to an active-dog video can help improve subjective and physiological responses to stress more than a tranquil-dog video, (2) whether exposure to dog videos can improve subjective and physiological stress responses more than nature videos, and (3) whether exposure to dog (and nature) videos can improve subjective and physiological stress responses more than a control video. Participants (n = 103; female = 78, male = 25) completed a stressful task and were randomly assigned to watch one of five videos: active dog (dog playing with a toy), tranquil dog (dog lying down quietly), active nature (fast-paced waterfall in a forest), tranquil nature (slow-moving stream in a forest), or blank screen (control video; a video of a black screen). Improvements in subjective (i.e., decrease in stress, anxiety, negative affect, and/or increase in happiness, relaxation, positive affect) and physiological (decrease in heart rate and blood pressure) responses to the stressor were examined. This study found no evidence that the active-dog video improved subjective or physiological responses more than the tranquil-dog video. However, this study found evidence that dog videos can decrease subjective anxiety and increase positive affect more than nature videos. Similarly, this study also found that dog videos can decrease subjective anxiety and increase happiness and positive affect more than can the control video. The effects of the dog videos and nature videos (and control video) on the remaining subjective measures and all physiological responses did not differ. Together, the results show some evidence that dog videos may be better at improving subjective anxiety, happiness, and positive affect responses than nature and/or control videos. However, the results did not show evidence that dog videos could alleviate any physiological responses more than the other videos. Practical applications of these findings include how to improve subjective anxiety and affect responses in public settings (e.g., universities) when animals are not allowed.

Attitude of dental practitioners and parental acceptance in using Animal-Assisted Therapy (AAT) in behaviour management of pediatric patients

Aim: To evaluate the acceptance of Dentist, Parents and child to therapy pets, child’s choice of pet and to analyse attitude of dentist towards animal-assisted therapy in the paediatric dental et-up as an aid to improve behaviour of the child during the dental treatment. Materials and Methods: A descriptive cross-sectional survey was conducted among 60 children and their parents and 108 dentists. Chi-square test was used to determine the association of independent variables with each of the main outcome of interest. Results: The consent to the presence of pet was given by 56.67% parents (p=0.0359, Significant) Children who chose dog as their preferred pet were 46.67% those who chose cat as their preferred pet were 25% (p=0.049, Significant) Almost 76% Dentist agreed that AAT helps in behaviour management for Pediatric dentist (p=0.0001,S). Conclusion: Animal-Assisted Therapy (AAT) can prove to be a good behaviour management technique and can be a part of the exclusive Pediatric dental clinic. Keywords: Animal-assisted therapy, Pediatric Dentist

The role of connection in the efficacy of animal-assisted therapies: A scoping review

INTRODUCTION: There is an undeniable connection between humans and animals, with the relationship between the two being well documented across the centuries of history and storytelling.METHODS: This article outlines a scoping review of the literature and research exploring the history, efficacy, and currency of animal assisted therapies (AATs) as they have developed in recent decades within human services and social work programmes.FINDINGS AND IMPLICATIONS: Archaeological research suggests a mutualistic relationship has existed between canines and humans dating back 140,000 years evolving to deepened connections between animals and behaviourally modern humans including 15,000 years of animal domestication. These connections have generated relationships where animals both work for and with humans, assuming diverse roles ranging from service animal to companion pet, from livestock to live entertainment, from symbolic idol to science experiment and, as demonstrated in this article, as co-therapist or therapeutic medium in psychotherapeutic, human services and social work practice processes.

Effects of Dog-Assisted Therapy on the Physical Function and Communication Skills of Adults with Autism: A Study Protocol for a Controlled Study

Background and Objectives: Despite the scientific evidence of the positive effects of animal-assisted therapy (AAT) in adults with autism spectrum disorder (ASD), it is not still considered an evidence-based practice for this population. The proposed study will aim to evaluate the effects of a dog-assisted therapy program on gait, posture, and communication skills. Materials and Methods: A total of 24 adults with ASD will participate in this non-randomized controlled trial. The experimental group will involve 12 participants who will receive AAT for 10 weeks, at two sessions per week. The focus of these sessions will be conducting different activities and physical exercises, facilitated by dogs. The control group will receive treatment as usual. The outcome measures will be the ability to walk and climbing stairs, balance, risk of falls and communication skills. Conclusions: The role of dogs as facilitators of the movement may lead to relevant benefits in the gait, posture and communication skills of adults with ASD, improving their ability to perform activities of daily living.

A Stakeholder-Engaged Approach to Development of an Animal-Assisted Intervention for Obesity Prevention Among Youth With Autism Spectrum Disorder and Their Pet Dogs.

Stakeholder involvement in research has been demonstrated to increase the effectiveness, validity, and quality of a study. This paper describes the engagement of a stakeholder panel in the development and implementation of an animal-assisted intervention (AAI) assessment and program for children diagnosed with Autism Spectrum Disorder (ASD). Canines for Autism Activity and Nutrition (CAAN) aims to promote physical activity and wellness among children diagnosed with ASD by integrating activities with their pet dog during the child's ongoing Applied Behavioral Analysis (ABA) in-home therapy sessions. Feedback from stakeholders guided program development at each stage of the research process, including this publication. Utilizing a stakeholder-informed approach was essential for the development of assessment tools, program materials, and program design. Methods that may assist others to effectively partner with stakeholders to implement an AAI among children diagnosed with ASD or related disorders are described.

Dogs as Therapeutic Partners, Not Therapeutic Tools: Ethical Considerations for AAT in the Correctional Setting

Although the benefits of animal assisted therapy for people are well established, the ethical considerations for the welfare and safety of the non-human animals involved are not. Without an accrediting body responsible for creating and overseeing national standards, therapy animal organizations are forced to create their own guidelines, creating inconsistencies within the field. Based on interviews conducted with therapy teams who have worked with Parenting, Prison &amp; Pups (PPP), a parenting program provided to incarcerated jailed women that is integrated with the use of animal-assisted therapy (AAT), this article explores the extent of ethics training offered for AAT teams and will examine how agencies and handlers promote and ensure the safety of canine partners, especially in a correctional setting. The research suggests that specific protocols put forth by individual AAT organizations, which can provide for a national model, can afford for the safety and comfortability of canine partners, especially in a corrections environment, but implies that in order to maintain consistency and increase therapy team professionalism, national standards are a necessity. Guidelines are specifically essential for mental health professionals, who lack guidelines from their own accrediting bodies’ code of ethics, and may incorporate non-human therapy partners into their work settings, without proper supervision.

Animal-assisted activities in the classroom for students with emotional and behavioral disorders

Educators working with students with emotional and behavioral disorders (EBD) often search for high-interest approaches to enhance evidence-informed practices already in place. The integration of animal-assisted activities (AAA) may be a novel and flexible approach with the potential to support a variety of student goals, in particular for students with emotional or behavioral challenges. We provide a brief overview of AAAs across therapeutic, medical, and educational contexts followed by suggestions to design, implement, and monitor an AAA in one’s classroom.

Lack of Effects of the Presence of a Dog on Pain Perception in Healthy Participants-A Randomized Controlled Trial.

Animal-assisted interventions (AAIs) have been shown to be effective in the treatment of pain. Studies suggest that relationships with animals can have comparable qualities to relationships with humans and that this enables animals to provide social support. Further, the presence of an animal can strengthen the therapeutic alliance between patients and treatment providers. This suggests that the analgesic effects of AAI might be mediated by social support from an animal or by strengthening the alliance between the patient and the treatment provider. To test these assumptions, we examined the effects of the presence of a dog on experimentally induced pain in a pain assessment and a pain therapy context. Hundred thirty-two healthy participants were randomly assigned to the conditions “pain,” “pain + dog,” “pain + placebo,” or “pain + placebo + dog.” We collected baseline and posttreatment measurements of heat-pain tolerance and the heat-pain threshold and of the corresponding subjective ratings of heat-pain intensity and unpleasantness as well as of participants' perceptions of the study investigator. The primary outcome was heat-pain tolerance. The presence of the dog did not influence the primary outcome (“pain” vs. “pain + dog”: difference = 0.04, CI = −0.66 to 0.74, p = 0.905; “pain + placebo” vs. “pain + placebo + dog”: difference = 0.43, CI = −0.02 to 0.88, p = 0.059). Participants did also not perceive the study investigator to be more trustworthy in the presence of the dog (“pain” vs. “pain + dog”: difference = 0.10, CI = −0.67 to 0.87, p = 0.796; “pain + placebo” vs. “pain + placebo + dog”: difference = 0.11, CI = −0.43 to 0.64, p = 0.695). The results indicate that the mere presence of a dog does not contribute to pain reduction and that the analgesic effects of AAI that previous studies have found is not replicated in our study as AAI did not increase perceived social support and had no effect on the alliance between the participant and the treatment provider. We assume that the animal most likely needs to be an integrated and plausible part of the treatment rationale so that participants are able to form a treatment-response expectation toward AAI.Clinical Trial Registration: This study was preregistered as a clinical trial on www.clinicaltrials.gov (Identifier: NCT0389814).

Can Dog-Assisted Intervention Decrease Anxiety Level and Autonomic Agitation in Patients with Anxiety Disorders?

Few studies have explored the influence of an Animal-Assisted Intervention on patients with mental disorders. We investigated it’s impact on anxiety symptoms. We divided 51 patients with anxiety symptoms into two groups—treatment group, that went for a short 15–20 min’ walk with a dog, his handler and a researcher and control group, that went for a walk only with a researcher. We used State-Trait Anxiety Inventory (STAI), Visual Analogue Scale (VAS) of fear, Beck Depression Inventory (BDI), Ford Insomnia Response to Stress (FIRST), Brief symptom Inventory (BSI) and VAS of satisfaction after trial to assess. We also checked the resting blood pressure and resting heart rate before and after performing psychological tests while sitting. We have obtained full data of 21 people from the research group and 26 people from the control group. After the intervention, the treatment group reported lower anxiety levels as a state (Mean (M) = 34.35; Standard Deviation (SD) = 6.9 vs. M = 40.94; SD = 8.6) and fear (M = 1.05; SD = 1.0 vs. M = 2.04; SD = 2.2) than the control group. After a walk with a dog, trait anxiety (M = 34.35; SD = 6.9 vs. M = 46.3; SD = 9.6), state anxiety (M = 48.9; SD = 7.2 vs. M = 53.9; SD = 7.8), fear (M = 1.05; SD= 1.0 vs. M = 2.57; SD = 2.3) and resting heart rate (M = 71.05; SD = 12.3 vs. M = 73.67; SD = 13.1) decreased significantly, while walking without a dog only reduced state anxiety (M = 47.24; SD = 11.0 vs. M = 40.94; SD = 8.6). Multivariate analysis of variance showed that after the walk, state anxiety was significantly lower in the treatment group than in the control group, F(1.35) = 6.706, p <0.05, η2 = 0.161. Among those who walked with a dog, the intervention also led to significant decreases in fear and resting heart rate, F(1.44) = 11.694, p < 0.01, η2 = 0.210 and F(1.45) = 8.503; p < 0.01; η2 = 0.159, respectively. For anxious patients, a short walk with a dog is more beneficial than a walk without one. We found significant positive effects of a dog’s company on vegetative arousal and mental comfort. This is another study confirming the possible therapeutic effect of the animal on anxiety symptoms. Further research is required, especially in the large groups of patients, as recommendations on the use of Animal Assisted Interventions (AAI) are needed.

Evaluation of a new animal assisted intervention service for an adult intensive care unit

Introduction An animal assisted intervention (AAI) is an intervention between an animal and a patient during a medical, nursing or therapeutic procedure. It humanises patient care, reduces suffering and loneliness and improves mood. It is a developing service within critical care environments. The current research of AAI in critical care is limited. Method The AAI was provided by a registered pets as therapy (PAT) volunteer and their dog collaborating with intensive care unit (ICU) staff. After the AAI the patient, visitor or staff member completed an electronic questionnaire using the Survey Monkey application on an iPad. The questionnaire comprised of 10 questions of mixed methods design. The aim of this service evaluation was to ascertain if the AAI service was feasible and safe. The service evaluation would also measure the impact of the service on patients, visitors and staff. The overall objective of the service evaluation was to determine if the service should continue and to identify areas for development. Results 47 questionnaire responses were obtained from 2 groups of responders: (1) patients and visitors; and (2) staff. There were no concerns in relation to the dog’s presentation, welfare, cleanliness or handling highlighted by responders. A 10-point Likert scale was used with free text options for comments. 83% of patients and visitors rated the level of enjoyment of the AAI as a maximum score; whilst 70% of staff rated a maximum score for level of enjoyment of the AAI for the patient. 75% of patients and visitors rated the AAI as extremely beneficial. Emergent themes were identified from the qualitative data. These were: mood; distraction; dog and handler; AAI; recommendations, impact and infection control. The first 5 themes were shared between the 2 groups of responders. Discussion and conclusion The data collected demonstrated that providing the service was feasible and safe. Overall, there was a positive response to the service from all responders. This evaluation supports similar findings from the limited research base and highlights areas for future service development.

Animal-Assisted Interventions for Children with Advanced Cancer: Child and Parent Perceptions.

Background: The burden of relapsed/refractory childhood cancer takes an immense toll on ill children and their caregivers, jeopardizing quality of life. Animal-assisted interventions (AAIs) have shown promising benefits for children with chronic conditions and their families. Little is known about child and caregiver perspectives on AAI participation for children with advanced cancer.Objective: To explore perspectives of children with advanced cancer and their caregivers on experiences with AAIs.Design: Cross-sectional qualitative design.Setting/Subjects: Participants were children (n = 9) aged 5 to 17 years with relapsed or refractory cancer and their parents (n = 12) from one academic children's hospital in the southeastern United States. Participants completed approximately weekly 15-minute AAI sessions with a trained dog and handler during oncology clinic visits or hospitalizations for up to 12 weeks.Measures: Semistructured interviews were carried out after completion of each family's final AAI session to assess child and parent perceptions of AAIs. Qualitative content analysis identified themes.Results: Five themes emerged: (1) positive aspects, (2) negative aspects, (3) preferred changes, (4) pet ownership, and (5) value of the study. Twenty (95%) participants shared positive aspects of AAIs. The only negative aspect reported was too little time with the dog.Conclusion: Children with advanced cancer and their parents perceive AAIs as desirable with few requested changes. Further studies are needed to fully evaluate impact of AAIs.ClinicalTrials.gov Identifier: NCT03765099.

Effects of the multimodal intervention program including animal-assisted therapy on depression and self-esteem among university students.

This study aimed to investigate the effects of the multimodal group intervention that combined animal-assisted therapy (AAT) and integrated play therapy (IPT) on depression and self-esteem in undergraduate university students. The subjects were 40 students attending animal-related and social welfare departments of universities located in a metropolitan city. The multimodal intervention program was conducted for eight sessions (twice a week, 60 min each) in the experimental group. Data analysis was conducted using the independent sample t-test, ANCOVA, and paired sample t-test for pre- and post-test. Therefore, the multimodal intervention program applying AAT and IPT showed positive effects on depression and self-esteem in university students. Based on these results, this study proposed the operation of multidisciplinary education and practical and policy utilization methods to reduce depression among university students and help improve their self-esteem.

Terapia asistida por animales: un análisis cienciométrico

Animal Assisted Therapy (AAT) is the use of animals for human therapeutic purposes, that is, an animal is selected that after being trained will interact for long periods with the patient and perform exercises supervised by professionals. The objective of this study was to carry out a quantitative analysis of the scientific production on AAT in the period 2000 to 2019 in order to answer some questions, such as: Has the work on AAT been increasing over the years? Which authors, institutions, scientific journals, and countries stand out in these publications? What are the most used organisms in AAT and the target audience in the selected studies? Using the Scopus database, 853 scientific articles published on TAA in the researched period were collected. The study revealed that publications on AAT showed an upward trend ranging from 8 studies in 2001 to 137 in 2019. Dogs (303 studies) and horses (59 studies) were the most used animals in AAT in the articles surveyed. Thus, the characterization and quantification of scientific production on Animal Assisted Therapy demonstrated an important tool to assess the dissemination of this therapeutic method worldwide.

2021 AAHA Working, Assistance, and Therapy Dog Guidelines.

The guidelines are the first comprehensive consensus report on veterinary healthcare recommendations for working, assistance, and therapy dogs. This category of canine patients includes a broad assortment of animals, some with well-defined functions and others that provide a more generalized support role. The guidelines discuss recommendations for dogs trained for protection, odor/scent detection, service functions for people with diagnosed disabilities or physical limitations, emotional support, and therapeutic intervention. Although the term is often used to describe dogs providing animal-assisted activities, true therapy dogs provide goal-directed therapy, often under the supervision of a healthcare professional such as an occupational therapist or psychologist. Many working dogs undergo extensive training and have rigorous physical demands placed upon them. These factors make working, assistance, and therapy dogs inherently valuable and impose a need for a high level of primary veterinary care as described in the guidelines. Because working dogs have a particularly close relationship with their handlers, a trust relationship between the practice team and the working-dog client is imperative.

Recognizing and Mitigating Canine Stress during Animal Assisted Interventions.

Animal-assisted Interventions (AAI) proliferated rapidly since clinicians and researchers first noted the positive effects animals have on people struggling with physical and mental health concerns. The intersection of AAI with the field of animal welfare evolved from considering animals’ basic needs, such as freedom from pain, to recognition that animals experience nuanced emotions. Current conceptualizations of the various roles of companion animals as an adjunct to treatments for humans emphasize not only the animals’ physical comfort and autonomy, but also their mental well-being and enjoyment of AAI activities. However, numerous challenges to effective monitoring of animals involved in AAI exist. This article focuses specifically on dogs, highlighting factors that may lead handlers and therapists to miss or ignore canine stress signals during human-animal interactions and offers strategies to recognize and ameliorate dogs’ distress more consistently. The primary goals of this discussion are to summarize the current thinking on canine well-being and to highlight practical applications of animal welfare principles in real-world AAI settings. The paper highlights contextual factors (e.g., physical setting, patient demand), human influences (e.g., desire to help), and intervention characteristics (e.g., presence or absence of a dog-specific advocate) that may promote or inhibit humans’ ability to advocate for therapy dogs during AAI activities. Deidentified examples of each of these factors are discussed, and recommendations are provided to mitigate factors that interfere with timely recognition and amelioration of canine distress.

The overview of utilizing complementary therapy to relieve stress or anxiety in emergency department patients: animal-assisted therapy, art therapy, and music therapy

The Emergency Department could be a stressful environment for patients. Anxiety and depression may develop due to the atmosphere, in addition to patients’ concerns for their health conditions. The condition could potentially affect the experience of the patient in the Emergency Department and the quality of life after the visit. Pharmacological therapy could be administered to the patients. However, adverse effects may be associated with the treatment. Less aggressive complementary treatment approaches are presented in this article. Controlled clinical trials and randomized pilot studies of different complementary therapies, including animal-assisted therapy, art therapy, and music therapy, were conducted. The complementary therapies discussed in this article showed positive outcomes for patients with hospital-induced anxiety and has no adverse effect reported. Hence, hospitals may consider introducing complementary therapies, such as those mentioned in this study, to improve the patients’ experiences in the Emergency Department