Motivation and emotion/Book/2013/Animal assisted therapy and emotional health and well-being

Animal assisted therapy:
What is AAT and what are its effects on emotional health and well-being?

Multimedia presentation (5 min)

Overview

Animals have long been known to provide a natural bond of care and loyalty for human-beings, even those animal that may not have an owner (Hines, 2003). The importance and understanding of this natural bond has been around for many years. Health benefits of physiological measures were recognised first, however more recently animals have been linked to psychological well-being and self-help (Fine, 2000). Numerous health care professionals are using animals in practice. Counsellors, psychologists and occupational therapy to name just a few, have long been using animals to increase emotional, mental and physical well-being for many of their patients and this is currently on the rise (Hines, 2003). The use of this therapy has helped many individuals in improving their overall quality of life. AAT can involve either one individual with a professional therapist or in a group setting, thus the animals should be able to handle all types of session conditions and people regardless of age or issue. Often they have to pass a number of tests to be classified as a true AAT provider e.g. obedience training (Fine, 2000).

AAT engages with a large variety of animals, the most common involves dogs, cats and horses (equine) therapies. This type of therapy works beyond an ordinary relationship than that of the family pet. It has been found that the presence of an animal in therapy will motivate trust, involvement, decrease anxiety levels along with many more psychological benefits (Chandler, 2001). There are many individuals who suffer mental, emotional and social issues around the world and in Australia. With the involvement of AAT these issues can be eliminated or emotional health and well-being can be enhanced.

This book chapter will look at AAT history, different types of animals used in AAT, relevant theories that aid in the mechanisms that underlie the ability of animals in promoting emotional healthy and well-being in humans.

History

The introduction of animals into our lives is not a new occurrence, dating back to prehistoric times. Human animal connections have long been documented, from eating animals for daily survival through to breeding and caring, animal bonds have only grown (Connor & Miller, 2000). If we look back over time we can see cave drawings depicting man and wolves sharing a campsite, even wolf remains were found beside humans dating back nearly 500,000 years old (Hooker, Freeman & Stewart, 2002).

The first documented report of animal therapy was in the middle-ages, ninth century town of Gheel Belgium Belgium . Here they provided therapeutic care for families involving disability, through education and care of farm animals and how to integrate this into their lives. In England 1792, the Quakers owned the York Retreat. It was a facility that went against the severe traditional techniques of drugs and restraints used in hospitals for the insane. Quakers implemented small animals like rabbits and birds to teach the patients control (Hooker et al., 2002).

FUN FACT: In ancient Egypt if a pet dog died, the owner was identified by shaving off their eyebrows, smearing mud in their hair, and would mourned out loud (Ikram, 2005).

The renowned Florence Nightingale documented in her personal journal that a “small pet animal” could be an “excellent companion for the ill” (Hooker et al., 2002). In the United States in 1919 it was Franklin K. Lane who proposed we use dogs with patients in the St. Elizabeth’s Hospital which was located in Washington D.C (Chandler, 2001). In the 1940’s the Pawling Army Air Force Convalescent Hospital in New York City, used ‘Pet therapy’ to help veterans suffering from injuries, fatigue and to promote leisure (Chandler, 2001).

In 1962 Boris Levinson become the first trained psychologist to use AAT. It was a mistake that one day Levinson’s dog Jingles followed him into one of his private sessions with a child who was normally withdrawn but with his dog around the child was able to forget and open up (Levinson, 1969). Levinson eventually went on to discover this worked for many of his patients and continued to do it, calling it ‘Pet Therapy’ in 1964. Levinson’s work for AAT was expanded on in the 1970’s when Elizabeth and Sam Corson started to integrate animals into hospital settings, collecting data at the same time which was another first because AAT had never been fully recorded (Hooker et al., 2002). They found the benefits of physical, mental and social context to be positive and their over all well-being was improved.

Throughout the 1980’s published nursing journals started to document the amazing progress that AAT added to health organisations over the world, especially the physical benefits (Chandler, 2001). In 1990 the well-known organisation called the Delta Society formed their pet partners program (in 2012 the delta society renamed their to Pet Partners, to really get their purpose out there), known best for their quality in training and extraordinary AAT team work (Pet Partners, 2012). This encourages the use of small animals, horses, dogs, cats and farm animals to me[grammar?] implemented into the variety of health care facilities and even prisons.

AAT was found to dramatically enhance the lives of all involved (patient, handler and therapist) and from the 1990’s has only become more profound in the use of medical facility’s and university AAT research programs.

What is animal assisted therapy

Animal Assisted Therapy (AAT) includes the positive involvement between a human-animal connection, through certain therapy processes (Chandler, 2005). AAT helps to aid in the recovery of individuals who may be suffering terrible mental or physical issues, involving an animal can change the outcome dramatically through the variation of ‘normal’ psychology dynamics (Chandler, 2005).

AAT is believed to be an excellent addition to ‘normal’ therapy types, even showing that it can increase pro-social behaviour (Perkins, Bartlett, Travers & Rand, 2008). Most animals can be implemented into any initial therapy session that already exists, including an individual and/or group setting. Keeping in mind that who ever chooses to use this practice has gone through all the correct training and credentials for this therapy type (Chandler, 2005). Through either touch, play, learning, care giving and grooming, humans and animals seem to have this magical bond, which can be explained by Wilson (1984) book showing the Biophilia hypothesis suggesting that human beings feel the need to connect with other living things.

There are a number of health professions who have incorporated AAT, these being counselling and psychology agencies, nursing- hospitals, nursing homes, occupational therapy, speech therapy, detention centres, prisons and rehabilitation centres (Gammonley, 1997). In order to be a qualified AAT health professionals need to go through the following processes; obedience training and social skill development for the animal, uphold a healthy relationship with all staff members involved, therapy skilled training with the animal and handler, basic knowledge of risk management and disease, judging the right type of AAT for each individual client, applying goals and interventions and finally being able to correctly assess the therapies progress for the client (Chandler, 2001). It is the “newest” form of therapy that may soon run psychology etc. in the future. Here are two great examples explained and found on the Pet Partners(2012)website.

Example 1

"A woman recovering from a stroke has limited standing and walking tolerance. A physical therapist uses the presence of a dog to motivate the client by placing the dog on a raised table and asking the client to stand while stroking or brushing the animal’s back and head. To increase the client’s ambulation skills, the therapist has the client walk the dog for short distances around the facility grounds"(Pet Partners, 2012).

Example 2

"A volunteer brings her cat to a rehabilitation center to work with an occupational therapist and a child who has difficulty controlling fine motor skills. To improve the client’sfine motor skills , the therapist has the child manipulate buckles, clasps on leashes, collars, and animal carriers. The child also opens containers of treats for the cat and feeds small pieces of food to the cat. In an animal-assisted therapy session designed to improve a client’s ability to sequence events, i.e. a therapist teaches a client the steps of brushing a dog. Motivated by the opportunity to brush the dog himself, the client remembers the steps, and the therapist has the client recite the order of events aloud as he goes through the actual sequence"(Pet Partners, 2012).

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Different types of animal assisted therapy

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AAT includes a mixture of animals that help out the clinician, handler and client. Therapy with animals is thought to be so unique that it is believed to be greater than any other counselling program (Trotter, Chandler, Goodwin-Bond & Casey, 2008).

Some of these include small animal therapy (rabbits, hamsters, fish), farm animals (cows, sheep, chickens and sometimes llamas), bird therapy and dolphin therapy. However the most commonly used animals for therapy involve dogs, cats and horses (equine) (Fine, 2000).

Dog therapy

“

Acquiring a dog may be the only time a person gets to choose a relative.
-Unknown

”

The exceptional use of dog therapy or canine therapy was first recognised by psychotherapist Levinson in the beginning of the 1950s with his own dog, Jingles (Perkins, Bartlett, Travers & Rand, 2008). It has been recognised that contact with a dog increases positive mental thoughts for all involved (Sacks, 2008), teaching clients how to recognise their own feelings and how to control these feelings. Therapy with a dog can involve a client petting the dog, either playing or walking with them and learning to give out commands (Arkow, 1998). This takes the attention away from the client so they can more freely provide feelings and information. Sacks (2008) a psychologist shares a personal view to supports this. When working with a client and her trained therapy dog she recognised that the client became a warmer, gentle, more spontaneous individual who was able to attain more information which may not have been provided if the dog wasn’t involved. Sacks further states that it’s more than just a nice part of a personal life, but for those who don’t have many/ good human connections, the bond of human-dog is “ a vital, reciprocal, interpersonal relationship… It is a source of survival” (Sacks, 2008). There are many areas of health that dog therapy works with, these being; dementia, Alzheimer's, anxiety, depression, attachment issues, autism and emotional behavioural disorders (Arkow, 1998).

Cat therapy

Cat therapy is one of the best types of AAT for group settings. Very similar to dog therapy, however it is implemented for those individuals that are allergic to and/or fear dogs (this is the same for dog therapy, used if individuals are allergic or fear cats). Used in mainly medical institutions and hospitals, visiting a numerous amount of clients in one day (Zwierz, Przyk, & felinoterapii, 2012), each cat has to be one year or older in order to be apart of AAT. The cats used need to be able to adjust to all circumstances, even involving other cats or dogs. To become and or continue being qualified in cat therapy, each cat has to come with an up-to-date medical certificate showing all relevant vaccinations and worm checks (Zwierz et al., 2012). Where it is important that there hygiene is also kept up to date e.g. washes regularly, maintain claws and grooming (Zwierz et al., 2012). These are not only to look after the animal but for the best interest for the many patients they may help especially those in hospitals which are likely to have weak immune systems. Cat therapy has been used for many elderly people who have lost loved ones and are lonely, children with emotional disorders, arthritis, depression, Alzheimer’s, multiple sclerosis, hearing and eye disorders.

Equine therapy

Also known as Equine Therapy, Horse Therapy and / or Equine-Assisted Psychotherapy involves the integration of horses and patient in a therapeutic setting, facilitated by a set of rules and goals (Trotter et al., 2008). The Greeks were the first society to use horses for their therapeutic abilities (Favali & Milton, 2010). Usually including a licensed professional, horse professional and client.[grammar?] Those that are involved are able to improve their emotional well-being and many other difficulties that they may be experiencing internally or externally (Trotter et al., 2008). It involves feeding, leading, mounting- riding, haltering ultimately being in close contact with the horse while therapy techniques are being conducted. These simple actions can help reach the goals of equine therapy sooner; these being improved self-esteem and control, responsibility, respect for themselves/others and improve problem solving (Trotter et al., 2008). Chandler(2005) further suggest that unlike other animal therapies or counselling, being able to actively ride or be on a horse helps clients to express and address issues more freely while gaining trust quickly. Hart (2000) supports this;

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The horse offers a peak experience, perhaps unmatched by any other, with a totally unique physical experience while in a joyous social environment.

”

Benefits come from the fact that like other animals horses are very good at reflecting the emotions of humans while in each other proximity, they are not judgmental, do not look at clients ‘histories’ like people are able to do. Equine therapy has been most effective when dealing with individuals suffering from mood disorder, loss, depression, eating disorders, addiction, autism, Aspergers, ADHD, mentally handy capped and behaviour issues (Trotter et al., 2008). The most popular organisation in Australia,is Riding for the disabled (See External links below).

FUN FACT: It costs $30,000 to train a guide dog. (Association for the blind of WA, 2013).

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AAT benefits

Having emotional health and well-being means that as an individual you have a positive balanced life, positive self-worth, happiness and are content in all you do.

Physical problems in individuals can often lead to psychological problems e.g. depression, low self-esteem, anxiety and more (Wells, 2009). Once these issues are addressed the psychological problems are reduced or eliminated. Physical benefits of AAT consist of; reduction in stress, blood pressure, heart rate and weight maintenance or loss (Wells, 2009).

Well-being

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The physical benefits are clear and can be measured relatively easy, which can often contribute to psychological health of individuals.

Low self esteem and self worth are association to those with psychological and emotional issues (Wells, 2009). When an animal of AAT follows through with instructions or direction from a patient, who originally doesn’t experience respect or isn’t listened to by others, is finally able to be themselves and express their true feelings and wont be judged upon (Wells, 2009). This gives patients a new outlook on life and their situation. Thus, an increase in positive emotions and self-concept. Something that not all humans provide.

Often individuals lack emotional connections to others, but through AAT this can be turned around. Dogs and other animals can help as a buffer to socialise (Wells, 2009) with the ‘outside’ world. Even in therapy those individuals who find it hard to talk originally, find it easier to communicate with therapist and others involved with the presence of an animal (Wells, 2009). When walking with an animal in public it appears to draw unknown individuals towards you, thus further ‘outside’ communication(Wells, 2009). This is probably the best benefit for a disabled individual, who would find it harder to get out and socialise with people.

Case study: As referenced in Walls (2009), Hunt, Hart, and Gomulkiewicz (1992) completed a case study on an woman who either went to a park with first a turtle or a rabbit and then by herself just blowing bubbles (Hunt et al., 1992). What they found was that many more strangers interacted with her, than when she was alone.

By employing an animal into your life like this, you are reducing the sense of isolation that is parallel to the lack of social context (Wells, 2009). Animals reflect human emotions better than some humans do, they have a sense to connect to us and feel the need to enhance our well-being.[factual?]

Theories to explain AAT

Only in the last few years have theories of AAT been investigated, the results suggest many play a part in AAT effectiveness. Such as Cognitive theory, Biophilia hypothesis, Learning theory and Social roles theory, with the most renowned as Attachment theory and Exchange theory (Netting, Wilson, & New, 1987; Zilcha-Mano, Mikulincer, & Shaver, 2011).

Exchange theory

This theory suggests that individuals will only engage in relationships if they receive benefits in return, and these benefits must overshadow all costs (Netting et al., 1987). For those that suffer physical or emotional issues, to them AAT provides them with confidence, happiness, autonomy, safety and social buffers (Netting et al., 1987). Providing patients with a positive well-being and emotional health, thus greater benefits.

Attachment theory

This concept proposes that an attachment relationship, if present, allows the present feelings of safety and positive self-worth (Zilcha-Mano et al., 2011). If very few or none of these relations occur, then the individual will not have a health emotional state on life. Once an individual builds an attachment to an animal of AAT, this animal fills the missing connection that is needed to function normally through life (Zilcha-Mano et al., 2011).

Tips to find the right AAT for you

Note: To get in direct contact with Australia’s Delta Society-Pet partners for further AAT help and information call: (02) 9797 7922 or email: info@deltasociety.com.au (National office) and the website link is http://www.deltasociety.com.au/. There are currently 18 branches around Australia to cater for your needs.

Have you tried all types of therapy? Have you recently had an operation, and finding it hard to get out of bed? Do you suffer from stress and anxiety and need help to relax? Well then, you have realised AAT is for you, but how do you know which animal is for you? Once you have found your nearest branch of AAT help it is important for you and your clinician to find the right animal for you. Which can be figured out by following the steps provided in the table below.[grammar?] These steps will help you and your clinician figure out your specific needs (Palmer-Nash, 2010).

Table 1

Steps to find the right AAT animal.

Steps	Description
1. Identify if you are scared or like animals	If you do continue, if you don’t and possible experience anxiety or post-traumatic stress disorder but want to attempt AAT inform your clinician and you can starts prolonged exposure therapy or systematic desensitization therapy and once this is controlled you can commence AAT.
2. Find an animal to suit your therapy	If you need emotional support? Then you will need a small-medium animal(small dog or cat), if you've suffered e.g. a stroke or suffer epilepsy? you will need a larger animal or larger breed of dog to support you (Palmer-Nash, 2010).
3. Find animal that suits your character	If you are older or slow paced, having an animal that is high paced and full of energy can only add to your exhaustion and stress e.g. Jack Russell dogs. If scared of heights, choosing equine therapy will be wrong for you, for being up on a horse may cause you more problems (Palmer-Nash, 2010).
4. Make time	AAT can take some time and should be consistent to achieve results, therefore don’t start therapy if you plan to go on a holiday for a month in the first week of therapy, write down and schedule therapy time (Palmer-Nash, 2010). Get started!!

FUN FACT: AAT animals can travel with people on buses, trains, planes and even cruise ships. (Pet Partners, 2012)

Conclusion

Animals have long enhanced human emotional health and well-being. The natural bond that forms between human and animal goes a lot further than physical benefits. AAT helps in the areas of depression, anxiety phobias, stress, dementia, autism, attachment issues, emotional behavioural disorders, arthritis, hearing and eye disorders, ADHD, eating disorders, addiction problems and the list goes on.

[grammar?]If you’ve used other therapy types that haven’t worked? or need that extra motivation? AAT is the recommend therapy for you.

Quiz

References

Association for the Blind of WA. (2013). Guide Dog FAQs. Retrieved from the Association for the Blind of WA website: http://www.guidedogswa.com.au/

Arkow, P. (1998). ‘Pet Therapy’:A Study and Resource Guide for the Use of Companion Animals in Selected Therapies. Colorado Springs, CO: Humane Society of the Pike Peak Region.

Chandler, C. (2001).Animal-assisted therapy in counseling and school settings. ERIC Clearinghouse on Counseling and Student Services. 1-2 http://www.counseling.org/resources/library/ERIC%20Digests/2001-05.pdf

Chandler, C., K. (2005). Animal assisted therapy in counseling. New York: Routledge.

Connor, K., & Miller, J. (2000). Animal-assisted therapy: an in-depth look. Dimensions of Critical Care Nursing, 19 (3), 20-26.

Favali, V., & Milton, M. (2010). Disabled horse-rider's experience of horse-riding: A phenomenological analysis of the benefits of contact with animals. Existential Analysis, 21 (2), 251- 262.

Fine, A. (2000). Handbook of animal-assisted therapy: Theoretical foundations and guidelines for practice. San Diego, CA: Academic Press.

Hart, A. M. (2000). Methods, standards, guidelines, and considerations in selecting animals for animal assisted therapy. In A. Fine Animal assisted therapy San Diego, CA: Academic Press, 81–114.

Hines, L., M. (2003). 'Historical Perspectives on the human-animal bond'. American Behavioral Scientist, 47(1),7-15.

Hooker, S.D., Freeman, L.H. & Stewart, P. (2002). Pet therapy research: a historical review. Holistic Nursing Practice, 17, 17-23.

Hunt, S., J, Hart, L., A, & Gomulkiewicz, R. (1992). Role of small animals in social interactions between strangers. Journal of Social Psychology, 132, 245 – 256.

Ikram, S. (2005). Divine creatures: Animal mummies in ancient Egypt. New York: American University of Cairo Press.

Levinson, B. M. (1969). Pet oriented child psychotherapy. Springfield, IL: Charles C. Thomas.

Netting, F., E, Wilson, C., C & New, J., C. (1987). The Human-Animal Bond: Implications for Practice. National Association of Social Workers, 60-64.

Palmer-Nash, A. (2010). Tips for selecting a therapy animal. Retrieved from the Life website: http://www.examiner.com/health-and-fitness

Pet Partners. (2012). Touching Lives, Improving Health . Retrieved from Pet Partners website: http://www.petpartners.org/page.aspx?pid=320

Perkins, J., Bartlett, H., Travers, C., & Rand, J. (2008). Dog-assisted therapy for older people with dementia: A review. Australian Journal of Ageing, 27 (4), 177-182.

Sacks, A. (2008). Personal View: The therapeutic use of pets in private practise. British Journal of Psychotherapy, 24 (4), 501-521.

Trotter, K., S, Chandler, C., K., Goodwin-Bond, D., & Casey, J. (2008). A comparative Study of the Efficacy of Group Equine Assisted Counseling With At-Risk Children and Adolescents. Journal of Creativity in Mental Health, 3 (3), 254-284.

Wells, D., L. (2009). The effects on Animal on human health and well-being. Journal of Social Issues, 65 (3), 523-543.

Wilson, E., O. (1984). Biophilia. Cambridge: Harvard University Press. ISBN 0-674-07442-4.

Zilcha-Mano, S., Mikulincer, M, & Shaver, P., R. (2011). Pet in the therapy room: An Attachment perspective on Animal-Assisted Therapy. Attachment and Human Development, 13 (6), 541-561.

Zwierz, T. R., Przyk, O. N., & Felinoterapii, A., D. I. (2012). Therapeutic role of animals in human life–examples of dog and cat assisted therapy. Ecological chemistry and engineering a,19 (11), 1375-1381.

External links