Defining pet therapy
Used alongside conventional medicine, pet therapy (also known as animal-assisted therapy / AAT) has gained popularity as part of integrated medical treatments for a variety of different mental and physical health conditions, such as cancer, cerebral palsy, post-traumatic stress disorder (PTSD), and heart disease. Thousands upon thousands of human-animal teams exist across the world, and have raked up hundreds of thousands of service hours, despite inconclusive medical literature findings.
What is pet therapy? Does it work? Are the benefits worth it? And is there any scientific basis for its effectiveness?
These are key questions that appear to come up time and again. Many swear by its positive benefits. Others wonder if study findings have based their methods, and conclusions, on the correct questions to begin with. Perhaps more long-term controlled studies are needed?
There is no doubt that the subject of pet therapy has mixed reviews and falls on either side of a dividing line. Some are pro pet therapy, and believe it serves a beneficial purpose – helping a person to better cope with or recover from mental or physical health symptoms, or perhaps aiding and/or enhancing the life of an individual with special needs, such as those with autism or down syndrome. Others are not entirely convinced its benefits could replace other treatment measures that are proven to work, such as using anti-depressant medication, for instance.
Pet therapy is essentially a guided interaction between a trained animal (and their handler) and a person receiving treatment for a condition or who is in need of health-related assistance. This is done in one of two ways – either on a one-on-one (individual) basis or in a group setting.
The most common animals used are dogs and cats, but therapy may also include a variety of others that aren’t necessarily regarded as the ‘furry friend’ kind. Fish, birds, guinea pigs, alpacas, ponies, horses (and miniature horses), dolphins, monkeys, llamas, rabbits and even bearded dragons have been used for therapeutic reasons.
Therapy animals are typically trained to meet certain screening criteria, which is then useful for allocating an appropriate species to the set out therapeutic goals of an individual’s overall treatment plan (analysis of outcome measures).
Pet therapy is not just about bonding with an animal and feeling happier having spent time together. Pet therapy, or AAT (animal-assisted therapy) involves a set of sessions that are formally structured in order to be integrated into a therapy recipient’s existing treatment plan, aiding in reaching their overall goals. It is personalised according to a recipient’s treatment objectives as directed by a treating medical health professional. Therapy sessions are also well documented and form part of tracking a person’s recovery or healing progress.
Animals are also used for other functions known as animal-assisted activities (AAA). This is a less formalised set up and is generally used for more comforting purposes, recreation and play (casual interactions or visitations in hospitals, nursing homes and therapy environments).
Pet therapy doesn’t rely on an animal to ‘do the work’ for a recipient. A typical session may involve interactions such as walking together (where possible), petting and brushing or learning to physically care for or groom an animal. Pet therapy is an engaging experience, allowing physical contact (touch) through interaction, which often comes with a sense of achievement (a positive accomplishment which is beneficial for many treatment or rehabilitation programmes).
Pet therapy animals are not the same as service animals, such as those assisting emergency personnel with search and rescue or those with mobility challenges and problems with hearing or site. Service animals generally live with an owner who has a physical, or even an emotional disability, and are trained (and registered) to assist with day-to-day living and function.
Pet therapy animals are also trained to provide aid in a traditional therapy setting and are certified to do so. Interactions with these animals have been linked to improving a person’s emotional, social interaction ability (engaging people), physical and cognitive function.
Who can consider pet therapy?
Many animals have a calming effect on human beings, hence one of the reasons keeping pets is so appealing and widespread. Domestic animals, in particular dogs, are viewed as non-judgemental with an accepting nature, and as such are popular animals used for therapy sessions.
Thus far, pet therapy has been linked to the following medically associated instances or conditions:
- Mental health conditions / associated symptoms: Dementia, Alzheimer’s disease, post-traumatic stress disorder (PTSD), depression, schizophrenia, anxiety, or stress.
- Developmental disorders: Autism (autism spectrum disorder), ADHD (attention deficit hyperactivity disorder) and other sensory disabilities. Individuals sometimes find it more comfortable communicating or engaging with an animal. Animals simply don’t know what a person may be dealing with, so there is no perceived judgement when interacting with an animal as opposed to a person.
- Medical treatment procedures and therapies: Chemotherapy, occupational or physical therapy (such as for stroke or Parkinson’s disease recovery, and others requiring rehabilitative work) – many receiving treatment find themselves feeling more motivated to participate in therapy sessions when engaging with a therapy animal.
- Long-term care or outpatient treatment facilities: Nursing homes, hospitals (chronic illnesses such as cancer or heart disease), psychiatric facilities, dental rooms (specifically for children) and private practice consulting rooms.
Other things pet therapy can be useful for include:
- Chronic pain relief
- Addiction treatment
- Various emotional and behavioural problems or disorders
Sometimes pet therapy may be useful for the treatment of trauma, and especially for children or individuals with special needs who find it difficult engaging with other people. For instance, a child may be exposed to the effects of abuse – either witnessed or experienced first-hand. A therapist may consider introducing pet therapy as a way to help make the treatment process appear less scary or even threatening for a child to participate in.
A child may feel more comfortable liaising with a dog and ‘confiding’ their story to the animal instead of an adult they may feel less trusting of or emotionally connected to. An animal is often perceived as ‘less threatening’ in this instance and thus makes a child feel less vulnerable and more comfortable to say certain things, which may be critical for treatment. A therapy animal thus becomes an effective bridge in treatment, quietly allowing conventional methods to continue, but serving a positive purpose.
A sense of purpose, well-being and calm are believed to be some of the most beneficial effects of pet therapy sessions. This is because interacting with animals has been shown to release endorphins (chemicals in the brain), as well as stimulate healthy doses of dopamine and oxytocin (healthy, social inducing hormones).
Endorphins are a group of hormones (peptides) that serve a number of physiological functions. When released (or secreted) in the brain and nervous system, the body’s opiate receptors are activated and this results in a soothing effect (i.e. a pain-reducing or analgesic effect). The soothing effect contributes to a sense of pleasure which eases negative symptoms associated with any physical or mental challenge.
For this reason, pet therapy has gained popularity in the medical field, with a growing number of supporters vouching for the therapeutic contributing effects in treatment plans.
How does pet therapy work?
When a person decides that they’d like to incorporate pet therapy into their specific treatment plan, a selection process for a suitable animal can get under way. It is best to start with a treating doctor or therapist as they will need to be involved in safely incorporating the practice into a treatment plan.
From there a trained handler / volunteer (most commonly an animal’s actual owner) and an animal will be worked into a schedule for regular sessions. These sessions will be guided by a treating doctor or therapist in such a way that best meets treatment or recovery goals. The pet handler will ensure that everyone involved in these sessions is of sound understanding when it comes to the proper handling of the animal, ensuring safety for both a recipient and the therapy animal.
For an animal to become a therapy pet, set requirements will need to be met. These requirements often involve:
- Giving the animal a full physical examination at the vet and ensuring that he or she is properly vaccinated or immunised. An animal must be healthy and free of diseases or illnesses in order to be fit to work as a therapy pet.
- Attend and pass an obedience training course along with the dedicated handler. An evaluation of an animal’s overall behaviour and temperament (response to a handler and others) will also need to be approved.
- A handler will be required to attend and pass an instructional course which teaches positive interaction between the therapy animal and other people.
- Receive a credible certification from a sponsoring organisation.
A therapy animal will need to be able to master basic obedience skills and through training courses, will be tested on their reactions to specific interactive things. This can include being petted by more than one individual simultaneously, being hugged or walking through a crowd of people. Can a therapy animal still respond to their handler when promoted even with an array of distractions? The sounds and smells of therapy or hospital environments are also important for a therapy animal to be familiar with, and comfortable with too.
For a therapy animal to have the desired effect on humans, it must not only be tolerant of interactions, but also enjoy the company of people and the manner in which they are engaged. If an animal has an aptitude for therapy work and enjoys affection, chances are high that the desired beneficial effect of involving them in the first place will likely be achieved.
A handler must also be well aware of maintaining safety and levels of comfort for the animal, to do this they must know their animal very well, and what triggers behavioural or instinctive changes. A handler will need to be alert to things that will likely stress an animal out or spark a behavioural change.
When all requirements have been met, approval for pet therapy may be given. Animals are then assigned according to set needs of individuals who may best benefit from sessions of interaction with them. Type, age, size, breed and inherent nature and instinctive behaviours are usually taken into consideration when determining ‘a match’ for a specific purpose or treatment plan.
A meet-and-greet session may be arranged to introduce both a recipient and the therapy animal. This session is not likely to be an official therapy or treatment session, and as such will take place as an informal meeting. Once a therapy animal and recipient are happy with one another, sessions become structured and more formalised. Treating doctors and therapists may introduce set goals for each session that all involved will be made aware of.
Group sessions can also be arranged as part of a treatment plan. A support group may wish to incorporate a therapy animal into their regular sessions. In this instance, an animal may attend a meeting and be allowed to roam free among the attending group. Many groups find that the calming presence of an animal has a positive effect on attendees, soothing the atmosphere and relaxing all participating. This calming effect can also be a very effective teaching tool, which therapists can harness. When it is noted that interacting with a therapy animal calms anxiety, a therapist can hone in on that sensation, making treatment attendees more aware of it and encouraging them to tap into that feeling when a need arises in other environments and settings where the pet may not be present.
Possible benefits of pet therapy
Studies for therapeutic effect
Pet therapy as a beneficial treatment tool is not a new concept. The idea has been around for more than 150 years and often used to provide a level of social support for the mentally ill. The human-animal bond has existed for far longer. When it comes to medical purposes, however, it was only during the late 1970s that scientific underpinnings were more seriously put to the test to assess this bond.
There have been numerous studies over the years, and these continue today. Research has not halted the business of pet therapy, which continues to involve working animals in the healing process (where treating doctors and therapists allow).
1. Physical health
Research has looked at the physical health benefits of a variety of challenged individuals, ranging from the chronically ill, to the elderly (generally healthy but living in a home or those with dementia and Alzheimer’s). Many studies have focussed on the potential physiological benefits of alleviating stress and anxiety. Just the mere presence of a dog (daily), kept like a pet for a set period of time (e.g. 6 months), allowed to visit a home on a weekly basis, or simply just present during times when performing a stressful task, appears to contribute to lowering blood pressure (or potentially prevent an increase), which in turn alleviates stress or anxiety. Study groups assessing pet owners have noted a lower resting systolic blood pressure (reducing risk for hypertension), and a reduced systolic mean arteriolar and pulse pressure.
The general consensuses from much of the studies done show what most pet owners will all agree to – the presence of a pet (animal) has a pleasing or relieving physiological effect when it comes to stress, which in turn has beneficial physical results. Having a dog also means owners are likely to be more active themselves (although other studies have found that this is not necessarily a given), which adds to health benefits in a physical sense.
Studies have also looked at the potential beneficial effects in those with cardiovascular disease, and whether walking with a dog could improve their exercise capacity with just a 10 to 15-minute stroll several times a week, or even prolong life projections.
Other studies have assessed groupings of individuals with congestive heart failure and whether dog visitations of 12 minutes at a time had any effect on their systolic pulmonary artery or capillary wedge pressures, and serum epinephrine concentration levels. The research compared findings with those of historical samples from previous patients with the condition. Those who were able to walk with a dog and handler could manage to do so twice as far as those from the historical samples.
The trouble with scientific research on pet therapy or simply the involvement of animals for any function relating to interactions with medically challenged individuals, is that no sooner has one study found positive benefits than another achieves results to the contrary. Research group samples have ranged from very small to moderately small. Perhaps large-scale research with very specific criteria could settle the divide.
2. Emotional and mental health
When it comes to research into areas of cognitive disorders and conditions, numerous animal-human bond studies have also been conducted. As is the case with physical findings, research has noted small, but statistically convincing behavioural symptom improvements in an array of animal-assisted interventions.
Many studies have focussed on potential psychological benefits in the elderly and used a variety of animal species, such as dogs, cats, birds and fish (through the installation of fish tanks). Studies have been as basic as caring for a canary versus a plant for a period of three months, to what effect an animal (with a primary purpose to merely socialise) has on a demented elderly individual.
The research looks at social behavioural changes versus how much of an effect on cognition (and mood) an interaction can actually have. Can pet therapy help to alleviate problematic behaviours in individuals with dementia through supervised interactions involving petting, grooming, feeding or play? Some studies have been able to assess improvements with fewer signs of agitation and enhanced social behaviour. Many of the participants were more verbally interactive during an animal-assisted intervention (i.e. the visitation of a dog).
One study exposed 13 nursing home residents with dementia to a mechanical toy dog as part of their research to assess any differences in interactions. Whether a robotic dog which could sit up, wag its tail or respond to a variety of commands, or an actual animal was used, this study found similar responses in the residents – many talking a little more or clapping their hands when the ‘animal’ moved.
Much of the positive feedback regarding mental health benefits stem from more personal, qualitative observations from medical personnel who have been exposed to human-animal interactions (such as nurses). Most agree based on their observations, that pet therapy interventions alleviate boredom or loneliness, and improve social interaction - increasing patient interactivity with an animal and other fellow patients too.
Formal clinical trials using animal interaction with patients suffering from dementia haven’t been able to suggest a clear mechanism for how pet therapy alters vegetative, psychotic or hyperactive behaviours. Findings simply leave a door open for further speculation – is pet therapy, in this sense, merely a created distraction for disruptive behaviour associated with an illness such as dementia? And can it serve as a basis for learning to practice better social behaviours?
Research into the effects using depressed patients and those with schizophrenia, has also had mixed findings. Some studies have noted little effect or change in overall depressive state, but did find a small, but reduced blood pressure reading. Others have found reduced levels of tension and fatigue and even confusion in patients exposed to pet therapy interventions. This has been noted, not only in depressed patients, but also those undergoing treatment for cancer. Simply having a dog in a therapy session resulted in patients rating their levels of anxiety as less severe. Schizophrenic patients (but notably not older patients) have been seen to score better in areas of social contact, meaning that their social skills, ability to communicate and overall cognitive ability did show improvement. This has prompted research teams to conclude that a modest benefit is possible to achieve in patients displaying depressive symptoms. But there is a downside – many with acute psychiatric conditions did appear to become troubled by actions of caring for an animal, with some even grieving their departure from a session (as a person would over the loss of a pet).
It should also be noted that although much research has been done, plenty of the result findings have never been published in a scientific journal. A lot of data has instead been pooled together and published in doctoral dissertations, all noting a ‘medium effect size’.
What can pet therapy potentially achieve?
No matter the contradictions in research findings, there’s little dispute that there is a beneficial human-animal bond, to some degree. Hence, the reason for domesticated animals in the home. An animal interacts with people a little differently than do many human beings. Many animals are non-threatening and their level of affection is remarkably accepting. This enhances a bond and promotes a beneficial relationship. This bond is capable of promoting improved physical and emotional (mental) states through interaction.
Beneficial effects, which have been studied and produced positive findings, irrespective of other research teams assessing the subject according to different criteria, include:
- Improved overall heart (cardiovascular) health (and reduced risk of stroke)
- Improved blood pressure levels
- Improved assisted movement of ill individuals, as well as independent movement (i.e. walking)
- Improved joint movement, balance and overall fine motor skills
- Enhanced motivation to be more mobile or active
- Endorphin secretion (for an improved psychological state) and the hormone, oxytocin (promoting happy feelings)
- Enhanced self-esteem
- Improved social skills, activity participation (a renewed willingness to join in) and verbal communication (including better interaction with others)
- Improved ability to focus (attentiveness)
Pet therapy is most often aimed at achieving the following:
- Reducing depressive symptoms (including anxiety or even grief) and promoting joy (happiness)
• Helping to improve a person’s overall outlook on life (promoting a sense of purpose and quality of life)
- Alleviating feelings of loneliness and isolation, or boredom through companionship
- Promoting healthier levels of self-control
- Aiding in the teaching of nurturing and empathetic skills, especially in children
- Helping to improve the quality of relationships and building of trust (e.g. helping a child to become less fearful or distrusting of their adult healthcare provider or therapist)
- Helping to promote teamwork
- Aiding in the improvement of problem-solving skills
- Improving the treatment relationship between a patient and their healthcare professional, particularly those who are resistant to emotional expression during therapy (psychotherapy / ‘talk therapy’)
- Helping to reduce problematic behaviours
- Working to enhance the effect of conventional medical therapies
- Providing comfort and enjoyment for interaction recipients (and an animal) which is fulfilling
- Aiding in providing a temporary, but positive distraction from more negative challenges
Are there any risks or factors to consider?
Before any animal-assisted therapy session is agreed upon, certain factors are always taken into consideration. These can include:
- Safety – for the animal and all people involved (injuries, such as a fall or bites and scratches, can happen if handled inappropriately or an inappropriate animal for the therapy environment is chosen)
- Sanitation and hygiene
- Possible allergies to certain animals, such as pet dander
- The possibility of patient possessive behaviours (i.e. a reluctance to part with an animal at the end of a session)
- The possibility of attachment problems and grief reactions
- The possibility that recipients will not bond with an animal at all – sometimes due to a lack of a frame of reference or level of curiosity
Since pet therapy is not necessarily whole-heartedly backed by science, there is a gap in the use of set standards for how animal-assisted intervention is conducted. Currently pet therapy sessions are conducted according to treatment and handling mechanics of those professionals involved, much of which is based on personal experience.
The CDC (Centers for Disease Control and Prevention) has yet to receive a report of illness or infection as a direct result of pet therapy in medically controlled environments. With that in mind, training programmes and proper animal healthcare is seemingly working well and not causing problems with using this form of health assistance.
Volunteers or owners of pet therapy animals will also likely incur costs of caring for their animal (food, veterinary care, housing etc.) in their personal capacity, and may need to factor in any potential damage to property their animal may cause during a session.
Pet therapy owners must also maintain open communication with treating healthcare professionals and gain a full understanding of certain behavioural possibilities in patients, especially those in institutions who may be inclined to harm an animal (intentionally or unintentionally). There have been reports of therapy recipients placing cats in a toilet or rubbish bin (garbage bin), and others do not appear too concerned about potentially harming an animal (i.e. running over an animals’ tail with a wheelchair). If possible harmful behaviours can be anticipated, they can be better avoided within a supervised session.
How successful can pet therapy be?
Is pet therapy perhaps more social support?
Social support is something that has been proven as an antidote to stress, anxiety or loneliness. When social support in an animal-assisted manner is integrated with conventional medicine, it can be beneficial for recipients, no matter their health condition or age. There is certainly enough interest in further clinical research. Scientists want to try and establish how it can work, why it may or may not work and discover just how much interaction would provide the most satisfactory results.
The success of pet therapy is dependent on several variables. Most importantly, realistic goals must be set, and expectations from all parties concerned must be clear and achievable. Goals are best set at the beginning of planned, structured treatments, ensuring that all involved are on the same page. It’s a good idea for animal handlers, patients and healthcare professionals to all discuss the timeframe of goal aspirations and when each would like to be achieved. Goals can be adapted as required too.
Pet therapy effectively becomes part of a formalised team effort for healing. Progress will be monitored, and so long as there are clear benefits that do not hamper a person’s ability to heal, pet therapy can integrate well and serve a positive purpose.
Even if moderate, a reduction in levels of stress, depressive symptoms, anxiety, socialisation skills and negative behaviours is something of an achievement that contributes to a bigger picture. Children and adults alike can benefit from integrating pet therapy into treatment programmes.
Companionship and feelings of acceptance can further improve a person’s overall quality of life, and help to provide a more fulfilling existence.
Examples of success
Social support in a structured session can thus achieve positive results. An example could be a child with ADHD with oppositional or defiant behaviours who may benefit from holding an animal on a regular basis for a timed session (up to 1 hour). Goals can be set which allow the child to learn things such as patience (perhaps having to wait to hold an animal or sharing and taking turns to hold the animal), impulse control, and how to work with others. For a child with ADHD these types of integrated therapy goals can be quite an achievement and allow a treating therapist an opportunity to use AAT as part of toolbox that teaches the child how to transfer these learnings to everyday life.
Another example may be with the use of horses. Aside from bonding and relationship-building benefits, riding horses or simply just walking one around a pen can be used to reap physical advantages. Those with poor muscle memory or who need to re-build core strength can also benefit from using horses as part of their healing plan. Adolescents and adults with PTSD have also been seen to improve just by walking a horse around a pen.
Speech therapists have also been known to incorporate pet therapy into their treatment plans, especially with autistic children who have difficulty engaging with people. Many have noted improvements in speech using pet therapy as part of treatment, and not just focussing on achieving goals in a highly formalised way. Core life skills can also be easier to learn and adopt in other areas too.
More examples - Research studies have noted the following positive effects too:
- Rabbits versus toys: Petting a rabbit versus their toy forms resulted in the living creature alleviating levels of stress and anxiety in a controlled group study.
- Dining with fish: A fish tank / aquarium was set up in the dining area of an Alzheimer’s facility. Study findings reported that residents appeared to eat better, which show improved overall nutrition, became more attentive, less prone to pacing around during meal times and overall, appeared to be less lethargic – just from the presence of brightly coloured fish swimming around.
- Dogs as trusted companions: A research team assessed a group of children who struggled with reading and found that doing so became less problematic when done in the presence of a trained dog and handler. Once anxiety reduced, the attitude of the children changed and they were able to read aloud comfortably to a dog.
- Learning to socialise with guinea pigs: One study involved the use of guinea pigs as a tool to assist children with social skill difficulties. Social interactions often leave children feeling very stressed, especially those with conditions such as autism. The guinea pig encouraged behavioural changes – children smiled or laughed a little more, and appeared to engage with others in the room with greater ease in comparison to when the guinea pig was not present. This resulted in fewer signs of stress among the children in the sessions.
Bottom line, pet therapy does have some associated medical benefit
Pet therapy has been around for quite some time and it would appear that the practice is here to stay. It has been continuously gaining acceptance all over the world. It’s not yet sufficiently backed by clinical evidence (sample sizes may need to be larger in order to attain more reliable results, with long-term follow-up studies), but it’s not entirely frowned upon either. AAT is certainly gaining better understanding through a growing amount of anecdotal research findings, which supports that pet therapy is far more than just about petting or grooming an animal and feeling happy about the interactive experience.
Used in carefully structured and professionally guided treatment plans, it can be one beneficial tool in a complete healing process. It’s not for everyone, and it doesn’t need to be, but it can be useful, with many already benefitting from the mere positive presence of an animal that does not come across in an intrusive manner (which human beings often show a reluctance towards).
1.National Center for Biotechnology Information Search database. 16 November 2014. The Benefit of Pets and Animal-Assisted Therapy to the Health of Older Individuals: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4248608/ [Accessed 26.07.2017]