Animal-Assisted Therapy
- 10 hours ago
- 11 min read
Description, types, research, benefits, risks, training, suggestions for practice
Three sections follow:
Background Material that provides the context for the topic
Suggestions for Practice
A list of Supporting Material / References
Feedback welcome!
Background Material
Description
Animal assisted therapy (AAT) is a sub-category of animal-assisted interventions (AAI). AAI refers to therapy that incorporates an animal with the aim of improving physical and psychosocial health and well-being. Animal-assisted therapy (AAT), animal-assisted education (AAE), and animal-assisted activities (AAA) are the three primary modalities of AAI. During AAT and AAE there is a pre-determined goal to improve a specific aspect of physical, cognitive, emotional, or social functioning (Cameron et al., 2021; Hoagwood et al., 2017). In contrast, AAA are less-formal interventions that aim to improve human wellbeing but are not necessarily individualised or documented. Goals may be general and applied to a wide range of target groups equally. Those delivering the intervention need not be licensed professionals but are still trained and/or certified to work safely with the animal (Jones et al., 2019). The following schema outlines the differences between the various AAI approaches (Etheridge, 2019).
AAT is a health intervention that uses animals such as horses, dogs, cats, and birds as an integral part of the treatment. AAT interventions contribute to individuals’ wellbeing by supporting physical health and improving a person’s cognitive, emotional-affective, and social aspects. This can enhance emotional well-being, reduce anxiety, and decrease stress levels. AAT is structured, goal-directed and individualised. It is measured and documented in a treatment plan, with clear goals for change, measurable objectives, and the expectation of identifiable progress toward the treatment goals.
AAT can be used with individuals or groups. AAT does not depend on any particular psychological theory but can be incorporated into various practice approaches. Animals are chosen because they are perceived as having a therapeutic benefit, enabling a safe and trusting relationship to be created between the person/group and the animal.
AAT is delivered or directed by a qualified or licensed health/human-service professional, who has been trained in the AAT approach in order to work safely with an animal to deliver the interventions. The professional may be the animal handler or there may be a professional plus an animal handler/team.
A typical animal-assisted therapy session lasts 30 to 60 minutes, depending on the therapeutic setting and individual needs. Shorter sessions of about 20 minutes have been shown to yield significant benefits in outpatient environments. Longer sessions, around 50 minutes, are common in structured counselling formats (Bert et al., 2016; Hoagwood et al., 2017; Husson University, 2022; Jones et al, 2019; Koukourikos et al., 2019; Pandey et al., 2024; Psychology Today, 2022).
Types of AAT
Depending on the setting and therapeutic goals, animal-assisted therapy can take various forms.
Canine-Assisted Therapy Trained dogs are used to support individuals with physical, emotional or cognitive challenges. Dogs offer comfort, reduce anxiety, promote social interaction and encourage engagement with therapy.
Equine-Assisted Therapy Horses assist in supporting emotional growth and physical rehabilitation. Interaction with horses—grooming, leading or riding—can help improve balance, confidence, and emotional regulation.
Farm Animal-Assisted Therapy Farm animal-assisted therapy incorporates animals like cows, goats and chickens. Activities like feeding and grooming can boost coping skills, self-efficacy and mental health.
Therapy With Small Animals The calm nature and size of small animals like guinea pigs, rabbits, cats and birds make them ideal for schools, nursing homes and rehab centres as they help reduce anxiety while boosting social engagement and emotional well-being (Husson University, 2022).
Animals can include dogs, horses, guinea pigs, rabbits, cats, birds, dolphins, (Husson University, 2022; Johnson & Tavella, 2020; Koukourikos et al., 2019; Pandey et al., 2024;Psychology today, 2022). Dogs, in particular are commonly preferred for therapy due to the way they bond with humans. Dogs tend to exhibit superior interactions with people compared to other species, benefiting both children and adults (Pandey et al., 2024).
Research Reviews
AAT for youth with or at risk for mental health problems (Hoagwood et al., 2017)
Horses and dogs were the main animals used in the research chosen for this review. The mental health conditions with the strongest evidence were equine therapy for autism and canine therapy for trauma. Five of nine studies for autism showed positive effects favouring the intervention. Four of those used a horse and one study a dog. Three out of three studies for trauma showed positive effects, all using a dog. While this is still a very small number of studies on which to base conclusions, there is at least a signal that a targeted AAT for children’s autism and for trauma is likely to yield positive findings. However, the effectiveness of AAT for children with mental health conditions cannot be determined from these studies. The findings do suggest positive impact under certain conditions, with certain populations, and with clearly delineated procedures.
AAT in mental health treatments for adolescents (Jones et al., 2019)
Seven studies (from a discovered 3985 studies) met the inclusion criteria. These seven studies, involving dogs, examined a range of presenting issues, including mood, anxiety, trauma, anger and disruptive behaviour, self-concept, adaptive functioning and global functioning, and clinical severity of serious psychiatric illness.
The findings support the hypothesis that, in the presence of a friendly animal, humans show increased pro-social and decreased anti-social interactions, a finding consistent with existing literature. However, the general perception in the community that visitation with a canine can improve the symptoms of mental illness without the inclusion of targeted therapy was not supported by this review.
CAP (canine-assisted therapy) improved attendance, disclosure, relationships and communication compared to standard psychological treatments. This is in line with existing literature that suggests that the inclusion of a canine into psychotherapy improves therapeutic alliance, trust and willingness to disclose.
CAP requires additional resources over and above traditional treatments, impacting feasibility in some settings. For example, access to large rooms and outdoor spaces may be of benefit. Facilitator training and/or supervision is required, even when employing external canine and handler teams. Screening, training or assessment of the canines is also required.
Benefits of AAT in mental health (Koukourikos et al., 2019)
The authors conclude their article with a detailed discussion of the benefits of AAT for people with depression, autism, dementia, and schizophrenia, leading to changes in their personality, behaviour and physical health. This discussion is supported with appropriate references. If interested in AAT for these conditions, examine the article—link is in the references below.
AAT: Systematic review (Mandra et al., 2019)
This review found positive effects of AAT in different genders and age groups, extending from pre-school to senility. Different animals were used with the dog predominating, but the horse was common for autism. The article should be consulted for more detail. The authors suggested it is necessary to consider access to and care of the animal and the technical preparation of the professional. These can limit or enhance the effectiveness of the practice.
Mental health therapy using a dog (Cameron et al., 2021)
This study was a 12-month follow-up to a previous animal-assisted intervention study (not AAT as such) at a preschool. Its value for this summary of AAT is an extensive discussion of research around AAT with supporting references. It lists numerous mental health conditions where AAT has been found to be effective. Readers should consult the original article for details (see the references section below). The authors name some of the areas where research has found AAT to be effective:
Autism, behavioural problems and childhood trauma
Major depressive disorder
Overall quality of life with decrease in the sense of isolation, depressive symptoms, and rumination
Anxiety, stress levels and negative affect
Mood and wellbeing
Animal-assisted therapy (Psychology Today, 2022)
This overview of AAT acknowledges that AAT can help many people. However, more rigorous clinical trials are needed to assess its efficacy. Research suggests that some studies of the treatment are methodologically flawed.
AAT and patients’ wellbeing: a review of quantitative and qualitative evidence (Pandey et al., 2024)
The authors suggest that, among the various animals involved in AAT, dogs tend to exhibit superior interactions with people compared to other species, benefiting both children and adults. Their analysis included a final 16 studies. They suggested that overall, AAT positively impacts on the wellbeing and overall functioning of individuals with psychiatric disorders. AAT has the potential to reduce symptoms associated with neurological disorders such as schizophrenia and Alzheimer disease. In particular AAT was effective in reducing stress levels and fostering overall mood and wellbeing through significantly decreasing depression and anxiety levels.
Benefits (Husson University, 2022; Koukourikos et al., 2019)
AAT can positively impact on emotional, cognitive, social, and physical function outcomes for people of all ages.
1. Providing emotional support, comfort and stress relief Experts suggest that when in contact with animals, neurotransmitters such as serotonin and endorphins are released, causing a feeling of happiness and calm while reducing the secretion of stress hormones such as cortisol and adrenaline, a fact that further contributes to lowering blood pressure and heart rate. In addition, patients, as they interact with animals, have the potential to develop care and empathic skills.
2. Learning cognitive self-care skills and improving self-image Patients suffering from mental illness often feel powerless, vulnerable and dependent on other people. With the presence of animals, they become potential caregivers of another entity - the animal - for which they often feel responsible by undertaking activities related to its survival. This contributes to strengthening self-confidence and trust. Undertaking practices related to animal care by elderly patients, raises motivation and stimulates memory, while the discussion on self-care issues takes place with less discomfort during the treatment sessions under the presence of an animal.
3. Cultivating social skills By simple observation of the therapist's relationship with the animal and their interaction, the patient gains information about acceptable and unacceptable, non-social behaviors. As a result, the patient learns how his and her actions affect those who receive them and also practices self-control and self-restraint. The direct positive or negative responses by the animal to the patient’s actions helps the patient to adopt appropriate behaviors. Individuals often feel more comfortable engaging with others when animals are present — which can improve communication and reduce feelings of isolation.
4. Providing opportunities for activity and training Animal-assisted therapy can boost physical activity by encouraging movement through walking, grooming or playing with animals. These interactions also enhance motivation by helping patients engage more actively in rehabilitation or exercise-based treatments.
AAT may help people with a range of health issues, both mental and physical These include:
Depression 1,2,3,4
Stress 1,2,3,4
Alzheimer’s disease 1,2,3,4
Schizophrenia 1,2,3,4
Autism 1,2,4
Anxiety 2,3,4
ADHD 2,3,4
PTSD 2,3
Drug disorder 2,4
Recovery from motor skill loss 1,2
Increased feelings of social support 1,2
Epilepsy 2
Heart failure 2
Decreased perceptions of pain 2
Postoperative recovery 2
1 Koukourikos et al., 2019
2 Johnson & Tavella, 2020
3 Pandey et al., 2024
4 Psychology Today, 2022
Groups Who Can Benefit and How (Husson University, 2022)
Individuals With Mental Health Conditions AAT can assist in easing anxiety, depression and post-traumatic stress disorder (PTSD). The nonjudgmental environment promotes openness and helps build effective coping strategies.
Children and Adolescents AAT programs provide children and adolescents with emotional support, reduce anxiety and enhance social skills. Young people are able to develop empathy, communication skills and confidence.
Older Adults Offering emotional support, reducing loneliness and elevating cognitive function are often the targets for AAT with older adults. It can also alleviate depression and improve social engagement, particularly in individuals with dementia or those residing in long-term care facilities.
High-Stress Environments AAT programs can enhance overall well-being by reducing stress and anxiety and elevating mood in high-stress environments such as schools and workplaces.
Families and Group Therapy Participants In family and group counselling, therapy animals create a calm space that encourages open, collaborative engagement and promote emotional connection among participants. They can help foster trust, improve communication and reduce tension.
Patients in Rehabilitation AAT used with patients in rehabilitation settings can lead to many of the advantages already mentioned above, e.g. emotional support, stress reduction, easing of anxiety, and supporting balance and coordination.
Potential Risks / Ethical Considerations
While the benefits of animal-assisted therapy are well-documented, it's crucial to acknowledge potential risks and ethical considerations as well. Most notably, therapy animals must be properly trained and monitored to prevent stress or harm. Therapists should ensure informed consent, screen for allergies and maintain hygiene standards to safeguard both clients and animals. In addition, any animal, no matter how well trained, can be unpredictable if it becomes scared or distressed. While the risk of an animal harming or biting a patient cannot ever be completely eliminated, in reality, the training animals receive paired with the skill of therapy animal handlers renders this risk rather small (Husson University, 2022).
Specific legislation on the use of assisted intervention animals should also be in place, as in the case in countries such as United States, Canada, United Kingdom, Australia, New Zealand, Japan, Spain, Denmark, Austria, Belgium, Germany, Italy, Norway, Portugal, Ecuador, Nicaragua, Uruguay, Chile, and Argentina (Mandra et al., 2019).
Training
To become an animal-assisted therapist, individuals typically pursue a degree in psychology, social work or a related field, along with specialized training in AAT therapy. Certification programs teach proper animal handling, therapy techniques and ethical standards (Husson University, 2022). An internet search for “Animal Assisted Therapy in ” where is the desired country to access the study will usually provide a number of options.
Suggestions for Practice
Conducting AAT requires specialised training for therapist, animal and, where necessary, the animal handler. Therapists should also have an appropriate primary qualification, such as a degree in psychology, social work or a related allied health field. Specific legislation on the use of animal assisted intervention animals should be in place to ensure safe, ethical conduct of therapy when animals are used (e.g. animals should be properly trained, screened for allergies with hygiene standards in place).
AAT is not a stand-alone therapy. It should be considered a tool to enable the social worker to implement their chosen practice approach more effectively. An animal is included in the therapy because of the benefits it brings to the therapy:
Providing emotional support, comfort and stress relief
Assistance to learn cognitive self-care skills and improving self-image
Cultivating social needs
Providing opportunities for activity and training
These benefits are outlined in the Background Material section above.
AAT can be delivered with individuals or groups.
A variety of animals can be used such as dogs, horses, guinea pigs, rabbits, cats, birds, and dolphins. Dogs appear to be quite common, with horses beneficial for autistic people.
Most research on AAT appears to produce positive results. However, the common theme is that more (and more rigourous) research is needed to establish AAT as a mainstream therapy, especially to determine if the positive impacts are maintained long-term. While stating this, there is an acknowledgement that rigorous research that can be duplicated can be difficult to achieve as much of AAT is qualitative and delivered in a one-to one or small group setting.
AAT has been shown to be beneficial for specific mental health conditions (e.g. depression, stress, schizophrenia, autism, and anxiety—see above for a more extensive list) through its impact on emotional, cognitive, social and physical function for people of all ages.
AAT is one of a number of animal-assisted interventions, many of which have strengths and can bring about positive outcomes for service users. However, social workers who are attracted to AAT may also find the animal assisted activities (AAA) approach may be an appropriate alternative for some situations and/or organisations. While informal in nature AAA is increasingly demonstrating that an appropriate animal can bring about positive change in a person’s wellbeing as the human-animal bond develops.
References
Bert, F., Gualano, M. R., Camussi, E., Pieve, G, Voglino, G. & Siliquini, R. (2016). Animal assisted intervention: A systematic review of benefits and risks. European Journal of Integrative Medicine, 8, 695-706. http://dx.doi.org/10.1016/j.eujim.2016.05.005
Cameron, I., Vraig, A., & McBain, C. (2021). Mental health therapy dog SIRA evaluation 12-month follow-up. Version 1.1. https://www.sira.nsw.gov.au/__data/assets/pdf_file/0010/1059724/MHTD-SIRA-Evaluation-12-month-Report-18.06.2021-002.pdf
Etheridge, H. (2019, July 7). A beginners’ guide to animal-assisted intervention terminology. Pet partners. https://petpartners.org/a-beginners-guide-to-animal-assisted-intervention-terminology/
Hoagwood, K. E., Acri, M., Morrissey, M., Peth-Pierce, R. (2017). Animal-assisted therapies for youth with or at risk for mental health problems: A systematic review. Applied Developmental Science, 21(1), 1 – 13. doi:10.1080/10888691.2015.1134267
Husson University. (2022, July 20). The benefits of animal-assisted therapy: How animals help improve health and well-being. https://www.husson.edu/online/blog/2022/07/benefits-of-animal-assisted-therapy
Johnson, J. & Tavella, V. J. (2020, July 10). What to know about animal therapy. Medical News Today. https://www.medicalnewstoday.com/articles/animal-therapy
Jones, M. G., Rice, S. M., & Cotton, S. M. (2019). Incorporating animal-assisted therapy in mental health treatments for adolescents: A systematic review of canine assisted psychotherapy. PLoS ONE, 14(1), e0210761. https://doi.org/10.1371/journal.pone.0210761
Koukourikos, K., Georgopoulou, A., Kourkouta, L., & Tsaloglidou, A. (2019). Benefits of animal assisted therapy in mental health. International Journal of Caring Sciences, 12(3), 1898-1905. https://www.internationaljournalofcaringsciences.org/Issue.aspx?issueID=53&pageIndex=0&pageReason=0
Mandra, P., Moretti, T., Avezum, L., & Kuroishi, R. (2019). Animal assisted therapy: Systematic review of literature. CoDAS, 31(3), e201080243. doi: 10.1590/2317-1782/20182018243
Pandey, R. P., Himanshu, Gunjan, Mukherjee, R., & Chang, C. M. (2024). The Role of Animal-Assisted Therapy in Enhancing Patients' Well-Being: Systematic Study of the Qualitative and Quantitative Evidence. JMIRx med, 5, e51787. https://doi.org/10.2196/51787
Psychology Today. (2022). Animal-assisted therapy. https://www.psychologytoday.com/au/therapy-types/animal-assisted-therapy
Comments