What is Animal-Assisted Therapy (AAT)?
Animal-Assisted Therapy, at its most basic, means including animals in therapeutic work with humans. There are many ways that animals can be included when working with humans, such as in counselling, teaching/education, rehabilitation, physiotherapy and occupational therapy, disaster relief, as humorous relief, as comfort and to assist in learning life skills, social skills or other key behaviours, to name a few. When a professional incorporates an animal into their therapeutic practice, they find ways of allowing the animal to extend and facilitate their goals, based on their training and theoretical orientation. A counsellor, for example may incorporate the use of a dog to explore and draw out issues of anger or attachment. Physical therapists may use handling of a small animal or grooming a horse in a motor-skills programme, or dog walking in a fitness or strength-training programme. In Animal-Assisted Therapy, the therapist will identify the therapeutic or clinical goals, and use the animal to help them achieve these goals – the Delta Society (USA) defines AAT as goal directed interactions with clearly defined and measurable outcomes. This distinguishes AAT from the less structured Animal-Assisted Activities (AAA). In both cases therapy animals interact with people to produce positive outcomes, however in Animal-Assisted Activities the role of the animal is less defined and so is the outcome. Whilst AAT will have prescribed therapeutic outcomes, AAA may simply aim to achieve a positive environment or help an individual to feel good. This means that Animal-Assisted Activities or AAA do not necessarily need to be overseen by a professional. Visiting a nursing home as a volunteer for example, may be defined as Animal-Assisted Activities or AAA’s, whereas running a social skills programme for at-risk youth may be considered Animal-Assisted Therapy or AAT. There is also an increasing body of evidence in the use of animals in educational settings. Animal-Assisted Education or AAE is the term used to describe the use of animals to achieve educational goals. Collectively, these animal-assisted modalities are known as Animal-Assisted Interventions (AAI).
What is the difference between therapy animals and assistance animals?
Therapy animals need to be distinguished from assistance animals. Assistance animals are registered to provide a particular service to an individual with an illness or disability. The most well known example would be seeing-eye or guide dogs for the blind. There is however, an increasing role for assistance animals, especially dogs. Dogs are now trained to perform a range of physical tasks for people, such as picking up objects, opening doors and alerting to sounds. Dogs have even been trained to detect early signs of seizures or blood sugar changes and are able to alert their owners. Some of these dogs may actually be called therapy dogs (for example under the Pets As Therapy or PAT programme). Assistance dogs can be registered in most Australian states under Guide-Dog or Anti-Discrimination legislation. Because of their important functional and often life-saving roles, assistance animals may be granted ‘public access’, legally allowing them access into public buildings, transport and even restaurants and hospitals, indeed anywhere their humans go. This legal right does not extend to pets or other animals used in AAI programmes. Whilst therapy dogs/pets are able to receive training, registration or certification for insurance or legal purposes, they do not perform life-saving functions and are hence not allowed ‘public access’. Such registration is used to ensure a basic standard of training and reliability for animals and their handlers. For example, a dog certified as a Victorian Canine Association Therapy Dog is assessed as suitable to work with children and elderly individuals, he is not registered as a therapeutic assistance dog that performs a life-saving or health-saving function for his owner. For this reason, he does not have the right to ‘public access’.
What are the types of animals and Animal-Assisted Therapy (AAT) programmes?
Many different animals are used for therapy, from farm animals and horses to domesticated animals such as cats and dogs or small animals such as rabbits and guinea pigs. The different programmes offer different benefits and difficulties. Farm-based programmes are ideally suited to nature-based interventions which explore the notion of life-cycles, care-giving and animal husbandry. These types of programmes are bound to a geographic location, however, and require specialised staffing to manage, e.g. farm hands. As a result they are best suited to residential type programmes. Equine Assisted Therapy (using horses) is a growing specialist field within AAT. Horses are used extensively for ‘riding for the disabled’ and are increasingly being used to assist with confidence building. Like farm-based programmes, transport is comparatively difficult and as a result clients usually go to the animals. Small-animal and baby-animal programmes have increasingly been used with young people experiencing behaviour problems, or with histories of abuse. Learning to handle small animals requires a calm and gentle hand and a great deal of nurturance. These programmes may rely on clients visiting the animals, or if the animals have been domesticated, it is possible for the animals to go to the clients. Drawbacks include the vulnerability of small animals and potential need to provide increased supervision or support to clients who may intentionally or unintentionally harm them. Domesticated animals are likely to be the most transportable of all types of animals used in AAT programmes. This enables them to visit clients in a myriad of situations, for example hospitals, schools and other settings. Whilst other types of programmes may provide many animals to handle, visiting domesticated animals often work in isolation. This potentially exposes them to burn out from over-work. In addition, if working with a group of clients they must be able to ‘share’ the one animal. This may however, offer a learning opportunity for clients in itself. Other: Viewing of animals may also be incorporated into certain settings, such as fish-tanks or aviaries. There has also been some work done examining interaction with dolphins (hippotherapy).
What is the history related to the benefits of AAT?
Historically, the benefits of human-animal interactions were thought to be largely ‘feel-good’ in nature. As early as the 1700’s and 1800’s animals were incorporated into the therapeutic milieu of ‘mental hospitals’ in Europe and England. It was thought that caring for animals would give the patients both a useful function and a chance to learn care-giving and self control – animals were seen to have a calming influence. The 1900’s saw a resurgence of interest in human-animal interactions when an Air Force Convalescent Hospital in the USA saw benefits in farm animals and nature. Here began the study of what has been variously known as pet-therapy, animal-facilitated therapy, animal-facilitated psychotherapy, and pet-facilitated psychotherapy among others – what we now call Animal-Assisted Therapy or AAT. Most of the research of the 1960’s and 1970’s was based on anecdotal cases and relied heavily on simple observations and case studies. In the 1960’s, pioneering psychiatrist Boris Levinson actively incorporated his pet dog in therapy sessions with “disturbed children”. He was perhaps the first person to attempt formal investigation into what he referred to as pet-therapy. He found that animals could be catalytic agents in therapy and could aid in the orientation and connection to reality, particularly for those suffering schizophrenia or autism. Levinson also stated that pet animals in homes could restore healthy communication in the families of disturbed children. He contends that companion (and residential) animals teach responsible, independent behaviours and non-gendered care-giving.
What are the Physical and Physiological benefits of AAT?
By the 1990’s, the notion that animals make many of us feel good was being supported by physiological data. Studies examining heart rate and stress chemicals for example, showed that even relatively brief interactions with a pet (usually dogs) produced measurable beneficial effects. Longer-term interactions, such as pet ownership or companionship have been found to result in positive cardiac outcomes, such as living longer and recovering faster after a heart attack than non-owners. Elderly animal owners were also found to make fewer visits to their doctors, even during times of stress. Interactions with visiting-animals has also been shown to have an impact, as has the mere presence of animals in certain situations. The presence of a friendly dog may assist coping with stressful situations, for example helping adults or children to feel more at ease during doctors’ visits or medical procedures. People have also been found to perform better on mental challenges such as maths problems when a friendly dog is present. Even watching animals may produce beneficial effects, for example a drop in blood pressure (BP) and heart rate when observing birds (aviary) or fish (tropical fish tank). The presence of adult dogs or puppies in nursing homes has had positive impacts on residents suffering Alzheimer’s or other forms of dementia. Studies indicate less overall noise and aggression, decreased heart rates and increases in meaningful verbalisations and social interactions from residents. Some researchers feel these positive physiological impacts can be explained by the fact that animals can fulfil humans’ innate need for attention, affection and affiliation with others. It has been suggested that human-animal interaction results in a positive feedback loop that affects humans’ autonomic and sympathetic nervous systems, thereby reducing stress and anxiety chemicals. Researchers contend that between 5 and 25 minutes of positive interaction with a friendly dog can have positive impacts on BP, plasma triglycerides, skin conductance and various stress chemicals. They even contend that similar benefits may be produced in the dogs. It is likely however, that many of these results rely on a goodness-of-fit between the human and the animal. That is, if pet ownership produces undue stress or responsibilities beyond the capacity of the individual, any positive effects are likely to be ameliorated. Similarly one is unlikely to feel relaxed or at ease when patting an animal they are afraid of, or averse to – for example no measurable drop in blood pressure is found when subjects look at pictures of wild animals, versus positive responses when looking at ‘cute’ animals. The perception of ‘safety’ has also been found to impact positively on BP and stress physiology. The personal history and culture of the individual is also likely to influence this effect. Animals considered dirty, evil, or fierce are unwise matches. To some degree then, benefits are likely to mediated by the degree of attachment between owner and animal. There may also be some impacts associated with physical exertion, although the data to date is inconclusive. Whilst calm interaction has been found to moderate stress, results of active physical interaction are inconclusive.
What are the psychological and emotional benefits of AAT?
Data is also emerging to support the mental health, cognitive, social and emotional benefits of Animal-Assisted Therapy. Research supports AAT as a useful method of stress and anxiety reduction, increased social interactions & motivation, improved mood, reduced aggression and continues to lend support to earlier notions of enhancing rapport and engagement. Studies conducted in adult psychiatric hospitals show a range of benefits to patients. AAT programmes have been found to increase pro-social behaviours and functioning for up to 12 months post the intervention. Other benefits found have been reductions in anxiety, depression and anhedonia and increased functioning and self-esteem. AAT programmes also attract the highest attendance rates and have above-average retention rates. Studies examining patient’s stress prior to medical procedures found that 15 minutes of simple interaction with a dog produces a positive “feel good” response and by 30 minutes shows a reduction in ‘state anxiety’. Studies conducted across a variety of settings support the above findings for adults and children. Dog training AAT programmes run in adult prisons have shown great improvements in self-efficacy via achievement, having a social role or function and thereby improving self-worth and self-esteem. With younger prison populations similar programmes have shown social skill development and cognitive development via learning tasks and impulse control. Research indicates that dog training and animal care programmes (e.g. farm based programmes) facilitate behavioural control for disinhibited or impulsive young people and result in a drop in oppositional and aggressive behaviours. They help develop emotional regulation, self-awareness and skill development further resulting in improved social skills (pro-social behaviours and verbalisations) and empathy (especially in humane education). Farm-based programmes may have additional benefits in that they can explore life-cycle issues including parenting, grief and loss and social/pack behaviours. There is less research focusing on one-to-one counselling based interventions. Anecdotal and case study reports do indicate many benefits such as those listed above. One research project comparing psychotherapy to AAT based counselling with adolescents actually contends that AAT is better than psychotherapy alone in the treatment of depression. Animal-Assisted Therapy programmes can be tailored and applied to various populations and needs. There is a wealth of ideas and research available to those who wish to explore the field.