What is animal assisted therapy?
The Animal Assisted Therapy (AAT) is a health intervention using pets or other highly trained animals to aid in the rehabilitation and recovery of patients with various health conditions. It involves measures to improve physical, social, emotional or cognitive functioning, with the help of animals as integral part of the treatment. Therapy animals work in a clinical setting such as a hospital or rehabilitation facility and also in schools, nursing homes, and other places.
In other words, we can say, Animal assisted therapy refers to the use of animals as a way to help people cope with and recover from some physical and mental health conditions.
The human relationship with therapy animals can be useful and relatively safe for patients with various problems. Moreover, the security precautions and the careful selection of patients minimize particularly infection-related risks.
Many aspects of AAT still remain unclear, further studies are required.
History of Animal Assisted Therapy
AAT has passed a long way since its first documentation over 150 years ago. Since then, it has impacted the mental and physical health of patients with various chronic and acute conditions.
Many researchers have found that animals can have an overall positive effect on health and improve quality of life.
The positive effect has been linked to the human-animal bond. In prisons, nursing homes, and mental institutions, they used animals to assist people with different disabilities or disorders.
Now a days animals are considered as “agents of socialization” and providers of “social support and relaxation”.
In the late 18th century at the York Retreat in England, a team led by William Tuke first reported the use of the therapy for the mentally ill patients. They allowed patients to wander the grounds with a population of small domestic animals. They believed it as an effective tool for socialization.
In 1860, the Bethlem Hospital in England followed the same method and added animals to the hospital ward. The animals greatly influenced the morale of the patients there.
However, other pieces of literature stated that animal-assisted therapy had started since 1792 in England.
Velde, Cipriani & Fisher also stated that Florence Nightingale had appreciated the benefits of pets in recovering human illness.
After World War I, United States and Germany started formal training of dogs as assistance with a focus on aiding individuals with visual impairments. Following World War II, the prevalence of formal training increased for other supportive roles, such as mobility and hearing assistance.
As early as 460 BC, Hippocrates recognized the therapeutic benefits of horseback riding, referring to its “healing rhythms”. He described how the horse’s natural movement impacts posture, balance, coordination, strength, and sensorimotor systems.
Animals used for AAT (Therapy Animals)
Depending on the function of the therapy, people may choose from various animals, including dogs, horses, and birds.
The most common therapy animals are dogs. Patients getting canine-assisted psychotherapy (CAP) can expand their social networks and improve their social skills. CAP can even promote long-term sobriety. Some other kinds of animals providing AAT include:
- Cats
- Rabbits
- Guinea pigs
- Horses
- Pigs
- Goats
- Dolphins
- Wolves
- Wolfdogs
- Birds
How does AAT works?
Animal assisted therapy can have several goals. These goals will determine how it works. However, the type of therapy depends on the condition and the type of aid that a person needs. Some examples include:
- providing comfort and reducing levels of pain
- improving movement or motor skills
- developing social or behavioral skills
- increasing motivation toward activities such as exercise or interacting with others
The process of animal therapy itself typically involves the animal’s handler, often the owner. The handler brings the animal to each session, and works under a doctor’s guidance.
A number of organizations arrange the handlers training and connecting them to healthcare providers. Many handlers work as volunteers and some are paid. To get approval for therapy use, both the animal and the handler has to go through various certifications with these groups and organizations.
The handler must generally pass an instructional course on people interaction and the types of therapies that they may provide.
The animal also has to go through certain tests including immunization records and physical exams to ensure whether the animal is generally healthy and disease free. They will also have to undergo temperamental and behavioral tests.
In addition, the pair will take obedience training. This rigorous testing and certification ensures the safety and professionalism.
It is notable that a therapy animal is not the same as a service animal and does not have all of the same rights. For example, a therapy dog cannot accompany a handler into a business establishment.
What are the health benefits of animal assisted therapy?
Animal-assisted therapy is not for patients with serious or acute illnesses. AAT is used in common mental health disorders like anxiety, depression, and also mood and eating disorders.
AAT is not the only therapeutic option in most cases. It is a complementary or alternative type of therapy. It should enhance but not replace other types of treatment.
Interacting with professionally trained animals and birds may help people with physical or mental health conditions.
Animals may provide comfort, alert others if someone is in danger, or even perform direct actions to help a person’s condition in need.
AAT acts on a concept called the human-animal bond. By interacting with a friendly animal, people can form a bond with them. This bond can produce a calming state in the persons themselves.
This bond itself may help the person in several ways:
- reducing boredom and loneliness
- increasing movement and activity through walks and play
- providing companionship
- increasing social interactions
- improving mood and general well-being
Therapy animal can help with a variety of emotional and mental health issues including:
- Lowering stress levels
- Lowering anxiety levels
- Relaxation
- Reducing depression
- Reducing loneliness
- Better self-confidence
- Increasing social interactions
- Better social skills
- Better anger management
Interactions with a therapy animal are unique because the animal provides comfort without judgment, without paying close attention to the patient’s emotional levels and stress levels and without responding to any changes. The doctor monitors the patient’s progress which improves the patient-doctor relationship.
Some people going through rehabilitation for a drug use disorder may also respond well and have a greater sense of well-being when working with an animal.
Some general health benefits, disease-specific health benefits, and physical health benefits of animal-assisted therapy are stated below:
Cognitive and neurodevelopmental health benefits
AAT has significant benefits for cognitive diseases such as dementia and Alzheimer’s and neurodevelopmental disorders such as Autism Spectrum Disorder (ASD). Animal-assisted therapy can slow symptom progression and promote verbal communication in dementia and Alzheimer’s patients. The therapy animals provide these types of patients with a calming distraction they can pet, receive comfort from, and establish a trusting connection.
People with ASD, particularly children, after playing or spending time with a trained therapy animal experience improved social skills and awareness, better focus, decreased aggression. Moreover, they fell more happiness. Of course, this success depends on the kind of therapy animal, the animal’s training and the severity of symptoms.
Figure: Children feel more happiness during animal assisted therapy
While dogs are most often used for animal-assisted therapy in psychiatric facilities, they are far from the only kind. Horses are another common therapy animal in equine-assisted psychotherapy (EAP). Some studies have noted that equine therapy (the caring and riding of horses) fosters a sense of responsibility and improves emotional, social, and communication skills in ASD people.
AAT in psychiatric facilities shows the symptoms of chronic mental illnesses, such as schizophrenia decreased. CAP increases self-determination and self-esteem in chronic schizophrenia patients.
Mental Health Benefits
These therapies may improve many important markers of stress and disorder by:
- decreasing anxiety and stress
- decreasing perceptions of pain
- reducing feelings of fear or worry
- increasing feelings of social support
- providing motivation, stimulation, and focus
The therapy may benefit people from different age groups with various conditions.
Together, these factors may make the therapy helpful for aspects of conditions such as:
- dementia
- depression
- anxiety
- autism spectrum disorder
- attention deficit hyperactivity disorder (ADHD)
- schizophrenia
Studies involving the use of therapy horses and dogs have shown that animal therapy might also help alleviate the symptoms of post-traumatic stress disorder (PTSD).
Physical Health Benefits
Some forms of animal therapy may also help in physical conditions, including:
- epilepsy
- heart failure
- pain from cancer treatment
- postoperative recovery
- recovery after a major stroke or another condition that causes a person to lose motor skills
A session with an animal in these cases may motivate the person to continue therapy, boost their mood, and reduce pain sensation. For physical conditions, it may help them move correctly and exercise very often.
In addition, some long-term care facilities may offer animal therapy programs to help improve the mood and general well-being.
Studies found that dog assisted therapy in long-term elderly care centers helped reduce symptoms of depression. The research suggests that the dogs help facilitate social interaction and develop positive emotional responses.
AAT patients playing with their therapy animals get more physical activity in their daily life. A study on chronic heart failure patients in Japan found that AAT increased the amount of assisted walking. Canine-assisted walking not only increases motivation but the patients get it as a pleasant experience.
Feeling happier, calmer and more confident can lead to better physical health. Because of the patients’ relaxation and focusing their attention on the animal AAT reduces the stress levels in the body, lowers blood pressure and heart rates. A session with a therapy animal after surgery particularly on children can also reduce the pain and make recovery easier.
However, more research is necessary to confirm the benefits of animal therapy.
Limitations of Animal Assisted Therapy
There is not much scientific research on using the therapy among adults. Animal therapy may not act as the catalyst providing positive success in therapy sessions. As adults tend not to focus as much on animal as companion, therefore, animal therapy cannot attribute for success in therapy sessions.
Furthermore, some ethical concerns arise when applying animal therapy to youngers. For example, if a child is treated with an animal other than their pet, it can cause some concerns. First of all, the animal may cause discomfort to some children, as well as, frighten them. Secondly, a special bond may be created during therapy between the animal and the child. Therefore, some negative side effects may arise when the therapy discontinues or ends up if the animal does not belong to the child. The child may experience disappointment and possible relapse after therapy discontinues.
What degree the animal itself contributes in the recovery process is not clear.
There are some concerns to animal assisted therapy: First, it may be potentially hazardous to the human patients, and it is harmful to the animals themselves; by taking them out of their natural environment and putting them in captivity for therapy (specially dolphin).
Finally, people may become dependent on the animal and could interfere with the recovery process for PTSD. People may feel they cannot do things without the presence of the animal.
Cost is often a barrier for getting AAT. Small treatment centers may only provide pet therapy involving dogs and cats. Likely, only treatment centers with more resources may be provide equine, dolphin, or wolfdog therapy. The access to AAT also depends on how much you can afford. AAT can be costly, more or less $100 to $300 per session.
Are there risks to animal-assisted therapy?
Although animal-assisted therapy has many proven benefits for people with certain health issues, it may not be right for everyone.
Adverse reactions
Some people may be allergic to the animals commonly used in therapy. For many people, animal therapy with a dog or cat could cause more harm than good.
Moreover, some individuals may simply feel uncomforted with or be afraid of the animals. It would cause them more stress.
Safety issue
Although we may train animals to be calm, tolerant, and loving towards humans, we cannot change their own instincts. Accidents can happen anytime.
Some patients have been injured during dolphin therapy. Wildlife experts argue that the therapy promotes captivity. Dolphins might feel stressed. Wolf- or wolfdog-assisted therapy is similarly criticized.
Hygiene issue
As such, there is some worry about using AAT in hospitals and on elderly, very young, or immunocompromised patients. AAT may involve bacterial infections such as C. difficile and MRSA, as well as allergies and bites. However, the risks seem relatively low due to protocols by the CDC and the facilities. The patient’s health condition, strict adherence to safety and hygiene protocol, and the overall benefits of AAT should mitigate the risk.
Additionally, therapy animals may be carriers of certain infections or diseases.
Ethical Concerns of Animal Assisted Therapy
AAT has been in practice for decades, but still it lacks standardization. So, there are potential risks for both human and the animals involved. There is no clear structural guideline on the use of animals in therapeutic settings. The impacts including stress, injury, and health complications are very much possible to the animal. Research has shown that there are reports of negative interactions between human participant and therapy animals. These include mistreating and teasing the animals by patients and staff at host place. There is a question whether it is ethical to bring animals into AAT settings where the client has a history of violence. Does the benefit outweigh the risk? How much the welfare of animal is considered?
Moreover, animal assisted therapy needs more studies of animal behavior to obtain an understanding of stress signals from the animal. Through understanding the stress signals shown by the animal, handlers can hold a safe and healthy experience during the therapy session to minimize stress. The factors linked to higher stress of therapy animals include limited time for rest, multiple sessions, and long duration of sessions. We should limit the animals to a specific duration and number of sessions, as well as give them access to food, water, rest and proper environmental conditions.
Alternatives of AAT
Animal therapy is a complementary treatment. It is not a basic treatment of any condition. It cannot replace other forms of therapy, such as psychotherapy or physical therapy.
Moreover, this form of therapy may not suit everyone. People not responding well to animal therapy or are not interested in AAT will choose other options. These alternatives may vary depending on the person’s condition.
Summary
Animal therapy aims to help people cope with both physical and mental health disorders. It involves regular sessions with professionally trained animals and their handlers.
Doctors or specialists may recommend and administer animal therapy for various conditions, with different goals in each person.
Some people may not suit animal therapy or have other reasons to avoid it. They can choose alternative therapies.