Animal Assisted Therapy

Morse and Field observed that the impact of animal-assisted therapy on patients could be described by eight themes: motivation increases with animal interaction; patients benefit physically from animal interventions; reminiscence and alertness are promoted by interactions with animals; AAT enhances emotional well-being; improved social interaction was observed during AAT sessions; AAT presents opportunities for nurturing; patients partake in animal caretaking responsibilities; AAT creates a comfortable, ‘home-like’ environment (as cited in Velde et al., 2005, p. 45-46). Studies have also found significant improvements in anxiety, depression, stress, life-satisfaction, loneliness, socialization, self-esteem, and physical functioning after interventions
with animals in many different patient populations (Barker & Dawson, 1998; Cipriani et al., 2013; Dumont, 2014; Fick, 1993; Fike et al., 2012; Gregg, 2012; Keino et al., 2009; O’Haire, 2010; Morrison, 2007; Pet Partners, n.d.; Sams, Fortney, & Willenbring, 2006; Shubert, 2012; Velde et al., 2005).
Practice of Animal-Assisted Occupational Therapy Animal-assisted therapy to date is most often used in the treatment of mental disorders.
Therefore, it is necessary to develop AAT models specifically for use by occupational therapy professionals within an occupational therapy practice in order to differentiate animal-assisted occupational therapy (AAOT) from other AATs and AAIs. Velde et al. (2005) suggest application of the Lifestyle Performance Model of occupational therapy which concentrates on five domains of life: societal contribution, intrinsic gratification, responsive environment, self-care and self-maintenance, and reciprocal relationships (p. 47). To incorporate this model of occupational therapy into therapeutic work with animals, the roles an animal could play in each of the five domains would need to be considered in relation to each patient
individually. Due to the nature of occupational therapy involving meaningful occupations, an animal’s role in therapeutic modalities would also be required to be a meaningful intervention.
This would correspondingly delineate animal-assisted occupational therapy from simply an animal-assisted activity taking place within occupational therapy. According to Witt, in order for animal-assisted therapy to also be occupational therapy, an intervention plan that is specifically OT must be developed, the therapy conducted and its results must be documented, and the therapy professional must posses the education and training necessary for conducting animal-assisted interventions (as cited in Velde et al., 2005, p 46). Occupational-based activities could include pet ownership and pet care. Within the context of the Lifestyle Performance Model, animal interventions relating to each of the five domains of life could include the following: contributing to animal welfare in the domain of societal contribution; activities with the animal that are satisfying to the patient in the domain of intrinsic gratification; creating an environment that is conducive to the presence of and interaction with an animal in the domain of responsive environment; maintaining the physical environment for the animal in the domain of self-care and self-maintenance; animal-related interactions involving sharing objects and/or conversation in the domain of reciprocal relationships (Velde et al., p. 47).
Populations that Can Benefit
from Animal-Assisted Therapy Animal-assisted therapy is used in many different settings, to help treat many different diagnoses, and among many different patient populations (Cipriani et al., 2013, p. 215). Among those individuals who show potential to receive significant benefit from AAT are children, adults, the elderly, military personnel and individuals within the workplace.
Children
Children are one patient population that AAIs have been shown to benefit (Morrison, 2007, p. 56). Some of the specific areas that have received positive results regarding AAT treatment effectiveness in children include inpatient cardiology patients, developmental disorders, autism spectrum disorder, attachment issues, and ADHD (Dumont, 2014; Keino et al., 2009; Morrison, 2007; O’Haire, 2010; Shubert, 2012). A study conducted by Katcher and Wilkins examining children with ADHD and conduct disorder and the effectiveness of 6-month animal-assisted interventions compared to outdoors programs indicated that children participating in AAIs exhibited an increase in attendance, cooperation, and more engagement in learning, as well as a decrease in antisocial and violent behavior (characteristics typical of children with conduct disorder) (as cited in O’Haire, 2010, p. 230). Further evidence of the effectiveness of the use of AAIs with children is seen in Keino et al.’s (2009) study of psycho-educational horseback riding (PEHR) and children with pervasive developmental disorders—after participating in a PEHR program, the children’s social and communication behaviors improved (p. 85). One possible explanation for these improvements is that the children’s interpretation of a safe and secure environment around the horse lead to improved verbal expression; in children with conduct disorder it is not uncommon for their negative behaviors to improve when they have a positive interpretation of their environment (Keino et al., p. 87).
Adults
Research of animal-assisted interventions has demonstrated that animals can have a protective effect against stress and stressful events and improve physical and psychological health. Specifically, psychiatric patients have exhibited reduced physiological symptoms associated with anxiety, stress, and depression, and increased socialization, associated with participating in AAT (Knisely et al, p. 30-33). Friedmann’s study also revealed that an animal’s presence in a situation resulted in calmer reactions to the situation and individuals’ perceptions that the situation was less stressful, compared to their perceptions of situations in which an animal was not present (as cited in O’Haire, 2010, p. 228).
Elderly
As life expectancies increase, the number of elderly increases and therefore the number of elderly in care facilities also increases. There is great potential for AAT to be beneficial in these settings, as Fick (1993) observes, “the elderly [in care facilities] often withdraw from social activities and place more importance on the nonhuman environment, they have great potential for gaining from the companionship that animals have to offer” (p. 529). Research to date suggests that the use of AAIs with elderly residents of nursing homes and long-term care facilities maybe be of benefit to patients due to an association with decreased depression, anxiety, and loneliness, and increased social interaction and lower blood pressure (Knisely et al., 2012, p. 33). Morrison (2007) likewise notes studies revealing very significant improvements in life satisfaction scales conducted with elderly nursing home patients involved in AAIs (p. 55). A study conducted by Banks and Banks revealed that animal-assisted therapy used with elderly patients individually showed a statistically significant reduction in loneliness, however, patients receiving AAT in groups of 2-4 individuals did not show a significant reduction (Knisely et al., p. 33). This speaks to the effects of the human-animal versus human-human bond—only the human-animal bond showed significant results. The lack of significance in the results examining the facilitation of human-human socialization could stem from the elderly patients already knowing each other, while the therapy animal was a novelty, and/or from characteristics such as hearing loss and incompatible backgrounds between the patients (Knisely et al., p. 33). Specifically regarding elderly patients with Alzheimer’s Disease and/or dementia, a study conducted by Kongable et al. found that while animal-assisted therapy resulted in no significant cognitive differences from the control group, patients with close attachments to pets did have significantly fewer mood disorders than patients without attachments to pets (as cited in Knisely et al, 2012, p. 33). Studies also found increased socialization among Alzheimer’s patients who participating in AAIs (Knisely et al., p. 33).
Military Personnel As Knisely et al. (2012) observes, “the accumulating evidence supporting the effectiveness of AAT in mediating the physiological stress response, reducing anxiety and depressive symptoms, and increasing social behaviors in civilian populations underscores the need for testing these effects with military populations” (p. 33). Both active duty soldiers and veterans can benefit from AAIs. In 2007, army occupational therapists began including therapy dogs in Combat Operational Stress Control (COSC) units (Smith-Forbes et al., 2012, p. 282). “Combat stress is the emotional and physiological stress experienced as a result of exposure to the inherent dangers and demands of serving in a combat environment” (Smith-Forbes et al., p. 279). COSC units are geared toward preventing, identifying, and managing negative reactions from combat stress. Occupational therapists are common members of COSC unit prevention teams (Smith-Forbes et al., p. 279). The motivation for adding therapy dogs to the units in 2007 was to aide in breaking down the stigma attached to mental healthcare (Krol, 2012, p. 46). Not only did the dogs act as ‘social lubricants’ making the prevention teams more approachable, they also normalized the setting for many patients who had pets at home, and acted as conversation starters about patients’ own pets which could lead to similar discussions about patients’ human experiences (Gregg, 2012, p. 55). For instance, a patient struggling with the loss of a comrade might fight it easier to talk about his/her situation if the conversation stemmed from discussion about the loss of a pet, motivated by seeing the therapy dog. Beck et al. (2012), the first to examine AAT with OT Life Skills programs, discovered that:
“the use of AAT in conjunction with OT Life Skills programs as an intervention for wounded service members in a garrison environment. Despite the primarily nonsignificant results, there is anecdotal evidence that supports the value of the intervention with service members” (p. 42). As of April 2012, more than 200 disabled veterans had received assistance dogs to aide in activities of daily living (Krol, 2012, p. 50). The Washington Humane Society’s Dog Tags program at Walter Reed Army Medical Center pairs wounded warriors with homeless dogs in order to help rehabilitate both parties. The dogs receive socialization and enrichment to help them become more suited for adoption, and the veterans receive socialization and education in dog training (Alers & Simpson, 2012, p. 70; Washington Humane Society, 2010, para. 1). Active duty service members as well as veterans can benefit from AAIs.
Individuals in the Workplace Griffin reports anecdotal evidence that organizational support, such as companies allowing animals in the workplace or in a nearby care facility, has positive benefits such as lower turnover rates for employees and more production and satisfaction in employees (as cited in Knisely et al., 2012, p. 34). Similarly, in a survey conducted by The American Pet Products Manufacturers Association, 73% of respondents reported the belief that having pets in the workplace creates a more productive environment, and 96% reported the belief that pets create a more positive work environment compared to the environment in the absence of pets (Knisely et al., p. 34). These results provide evidence for the case of AAIs being a benefit to individuals in the workplace.