This is an article I wrote a few years ago for the National Association of Dog Obedience Instructors (NADOI) newsletter. It was the first of a series on Animal Assisted Therapy. One of the great joys in my life is Animal Assisted Therapy and I encourage all dog folk to consider this way of giving back to the community.
“Pet Therapy” … revisited
Susan D. Greenbaum: Copyright 2006
If you ask most people what “Pet Therapy” animals do, they’ll answer, “to make people smile” or “to bring joy to someone’s life”. While that may be true it barely scratches the surface. For several decades the terms pet therapy or pet assisted therapy have been used to describe a variety of primarily volunteer jobs accomplished with an animal and handler. Currently most of the work being done fits into one of these five categories (See Table 1 for quick reference).
Let’s Talk Terms
1. Animal Assisted Activities (AAA)
Animal Assisted Activities usually involves bringing an animal into a chronic care facility like a nursing home or rehabilitation center and having the residents pet and talk about the animal.
Research has shown that the presence of an animal and/or petting the animal can decrease anxiety, decrease blood pressure as well as lowering levels of triglyceride (Barker & Dawson, 1998), cortisol (Dale, 2005), and epinephrine (Altman, 2005). Increases have been reported in levels of serotonin (Warner, 2005), prolactin and oxytocin (Weaver, 2004). Interestingly the act of petting, when separated from the actual animal, does not get the same results. Petting a stuffed animal, for instance, will not have the same effect (Shoshana & Gal, 2003).
AAA, the most widespread of the Therapeutic Animal disciplines, is commonly used to decrease loneliness, encourage socialization and verbalization as well as “make people smile”. AAA is not usually documented or goal oriented and is seldom supervised by a professional. AAA service more people per month than the rest of the disciplines combined.
2. Animal Assisted Therapy (AAT)
AAT encompasses any work that is documented, goal oriented and supervised by a professional. Typically the professional is a Physical Therapist (PT), Occupational Specialist (OT), Speech Pathologist (SP), Recreational Therapist (RT) or Child Life Specialist (CLS).
AAT encompasses any work that is documented, goal oriented and supervised by a professional. Typically the professional is a Physical Therapist (PT), Occupational Specialist (OT), Speech Pathologist (SP), Recreational Therapist (RT) or Child Life Specialist (CLS).
For much of this work the animal handler team will need specific skills. Working with a physical therapist the team may need a “therapeutic tug” where the handler is able to direct the direction, amount of pressure and release of the tug. The dog needs to develop a “straight tug” which involves steady pressure - without jerking or head shaking. Working with an Occupational Therapist, the dog may need skills that involve “leave it” and “take it” or the ability to hold extremely still and wait patiently while the patient attempts to remove a hair scrunchie from the dog’s ear. Teams that work with Speech Pathologists need to be well versed in hand signals so that the handler, situated behind the patient, can signal the dog to complete the patient’s command only when the SP is satisfied with the volume and clarity of the patient’s speech. Teams that work with a Child Life Specialist may need a variety of skills including having the animal walk extremely slowly while the patient “walks” the dog around the hallway (the handler, of course, still has the dog on lead and is controlling the speed and direction). A team that has scent discrimination skills can work with a CLS and patient using letter blocks to help the patient express feelings and emotions. AAT teams often work on medical compliance issues that involve helping a patient learn to cooperate with medical staff. Common issues include working with patients to find ways to take medication, cooperate with dressing changes or work with the respiratory therapist.
AAT teams work with a small number of patients and often work with the same patients repeatedly - over weeks or months. The process is goal oriented and supervised by a professional. The goals, process and results are documented by the professional and, sometimes, by the animal/handler team or AAT provider organization.
3. Animal Assisted Crisis Response (AACR)
AACR received a lot of publicity after the events of 9/11/01 and Hurricane Katrina. AACR can be used to help people normalize the experience of a crisis, ground them when events around them seem out of control and act as a bridge for communication.
AACR received a lot of publicity after the events of 9/11/01 and Hurricane Katrina. AACR can be used to help people normalize the experience of a crisis, ground them when events around them seem out of control and act as a bridge for communication.
AACR animals need to be extremely comfortable in new and often crowded spaces, adaptable to different populations and their handlers need excellent self-evaluation skills in order to protect themselves and their animals from the effects of high levels of stress. These animals will need transportation training (jumping or being lifted from high to low, light to dark and so on) and be acclimated to different types of transportation with other animals – including other species. They should have the ability to urinate and defecate on command and on any surface. They should be acclimated to a crate or carrier so that the animal’s “down time” can be used effectively for rest.
AACR is a relatively new field and working with the varied organizations (Red Cross, Salvation Army, International Critical Stress Foundation, or FEMA for example) is still in the beginning stages. The work these teams are there to accomplish most resembles the work of Animal Assisted Therapy where a professional guides the interaction, the process is goal oriented and documented.
4. Animal Assisted Educational Support (AAES)
There are three main categories of AAE, Humane Education, Bite Prevention and Educational Support programs. Humane Education is where animals are used, primarily in a classroom setting, to educate people on the humane treatment of animals. This is sometimes accomplished in a single session and other times in multiple sessions. Bite Prevention, where a dog is used as part of a presentation, usually to children, is a lesson on how to safely approach a strange dog and how to react as a strange dog approaches them. This is often a one-session lesson. AAES Programs encompasses any program that is “teacher driven” - where the teacher is guiding the educational component. These can include library reading programs where, as part of an overall reading program, children read aloud to the animals to help the child increase his/her confidence and proficiency or fire safety programs where a dog may demonstrate and help the children practice “stop, drop and roll”. AAES Programs are limited only by the imagination of the teacher and animal/handler teams. Conceivably, AAES could be used to help motivate children’s interest in geography (dogs from many countries), math (using a dog that can either do scent discrimination work or one who can bark on hand signal), science (measure the dog, weigh the dog, observe the dog and so on), writing (stories about the dog, from the dog’s point of view and so on), art, music (dogs love songs about themselves!) and so on.
Therapeutic Environment Animals are often owned by a mental health professional and are present in the environment but are usually not coupled with a handler who is specifically working the animal. The animals themselves may or may not have had special training. Examples include a mental health professional who has an cat or dog present in a private office, a fish tank in a hospital waiting room, a ranch where troubled youth work with stock or a resident bird in a nursing home.
With resident animals care must be taken that the animals are treated humanely. There should be a written plan in place for daily care, veterinary care and what will happen to the animal when it is no longer needed or able to be used by the facility. In addition, the plan should include a staff member should be assigned to the animal’s care with appropriate backup plans for the staff member’s vacation, sick leave, weekend coverage as well as what will happen if that particular staff member changes jobs or permanently leaves the facility.
How Do You Decide if Therapeutic Work is a Good Choice for the Dog?
How can we tell whether an animal is appropriate for therapy work? What type of work will the animal do best and enjoy the most?
Generally, dogs that adapt well to changes in their environment, like people of all sizes, ages and ethnicity, and are free of noise and sight phobias make good candidates for all sorts of jobs. All animals need basic manners training – sit/stay, down/stay, stand/stay, walk on a loose lead and so on. Additionally, animals should be taught to keep their feet and their tongue to themselves! While sometimes, it may be okay for a dog to shake hands or lick someone, there will be times it is not appropriate. Either the environment or the individual will not be conducive to that type of behavior. Better to put such things on command “Say Hi!” or “Give a kiss” than have a dog put his foot on an intravenous line or lick a patient who, culturally, may believe that dogs are dirty.
Different animals enjoy different things – not unlike their owners! Some dogs love small children while others are not as comfortable. And some dogs that love small children have a hard time concentrating in the presence of lots of children. Some dogs are intimidated by erratic speak or movement while others are quite at ease. In addition, the type of work in which the dog excels often changes over the life span of the dog. Many animals enjoy some things at one stage in their life and other things in other stages. A young dog may not have the patience to sit very still for long periods of time while a client attempts to do some occupational therapy by tying a bow around the dog’s collar - or may have the training to hold that sit but may not enjoy it. That same dog, when mature, may do a wonderful job and enjoy the work. A mature dog that does beautifully working physical therapy with hospitalized children may enjoy the quieter more sedate work of a library reading program as she ages. (See Table 2 for further information)
The size of the dog may also come into play when deciding what type of work to do. Some physical layouts are difficult for very large breeds. Some floorings may be slick. Some populations cannot control precise hand movements and may, inadvertently, be too rough for toy breeds or dogs with long hair or fur.
What Kinds of Work will the Handler Enjoy?
Each handler should think carefully about the type of work in which they would like to participate. Taking a careful and realistic look, in advance, at how much time and commitment they can give to a volunteer job is important. Thinking realistically about each job saves wear and tear on the animal, handler and program.
Individual or Program?
One of the first decisions is whether to work with a program or on your own. Working on your own has one major advantage – you set your own schedule. Maybe Tuesday mornings are most convenient for you, or Wednesday nights, or Sundays. As long as you and a facility agree on a time you are set to go.
Working with a program has advantages as well. There is someone to take your place when you cannot go and the people you are going to serve are not disappointed. Taking a break, going on vacation or even getting the flu doesn’t effect whether or not the session will take place. If there is a group going with a supervisor, you can get feedback on your work as well as a second set of eyes to help you manage your dog’s stress. Other people can help you add skills and become more comfortable in your interactions. Maybe you can only commit to once a month and the facility wants once a week – not a problem if there is a program that will commit to once a month. Then you can do what works for you and your dog. Life happens and sometimes your ability to meet your commitments may change. Having a program backing you up will help insure that the facility gets what they need without putting additional pressure on you.
What kind of work?
Do you and your dog want to work with adults or children? Are you interested in AAA, AAT, AACR or AAES? What type of work interests you the most (e.g. education, rehabilitation)? What type of population (e.g. geriatric, psychiatric, inpatient)? What about your dog? Sometimes, you have to compromise. You may love working with dementia patients but your dog may not do best working with people with erratic speech and movement. A balance between the handler and animal preference needs to be found. (See Figure 1 for an example of things to consider)
How to Get Started
Most animal/handler teams that work in any of the disciplines have certification through one of the national or regional “Pet Therapy” organizations. These include Bright & Beautiful Therapy Dogs, The Delta Society, The Good Dog Foundation, TheraPet, Therapy Dogs Inc. and Therapy Dogs International. Most organizations won’t certify a team until the dog is at least one year of age.
Certification, through one of the many organizations, will supply the animal/handler team with insurance. You can be held liable for any injury that may occur because of the actions or inaction of you or your dog. The dog doesn’t have to bite anyone! Someone can trip over the dog’s tail. Insurance, in this day and age, is a must.
Be careful to determine that your organization’s insurance actually covers the type of work you want to do. Many organizations only cover Animal Assisted Activities. Many do not cover AAT and some do not cover AACR. Be sure to ask for the organization’s policy, in writing, before starting any work.
Determining what type of work you and your dog would like to do and what type of population you want to work with will help you decide what skills you want your dog to learn. We’ll explore more about that in the next issue!
My Dog Does Pet Therapy!
So the next time you hear someone say, “My dog is a Pet Therapy dog” – ask him or her exactly what he or she means. Using the descriptive terms of AAA, AAT, AACR, AAES and TEA helps educate others as to the many different kinds of work being done. Whether a team participates in an Animal Assisted Activity program at their local nursing home, an Animal Assisted Therapy program working with stroke survivors to gain more strength and control, an Animal Assisted Crisis Response program at the high school working with the senior class after the suicide of a classmate or an Animal Assisted Educational Support program teaching first graders a safer way to approach a strange dog - that team is volunteering their time to serve their community. In the process, they are strengthening the relationship between the public and dogs. Volunteering with your dog is one of the best ways to fight “anti-dog” legislation as well as giving your dog a job, of which, he or she can be proud. So go out and do great work – in whichever discipline is right for you and your dog.
Table 1
Therapeutic Animals – Quick Reference | |
Animal Assisted Activities (AAA) “Animal Assisted Activities (AAA) provides opportunities for motivational, educational, recreational, and/or therapeutic benefits to enhance quality of life. AAA is delivered in a variety of environments by specially trained professionals, para-professionals, and/or volunteers, in association with animals that meet specific criteria.” [1] | Animal Assisted Therapy (AAT) Elizabeth Teal of Giving Paws states: “Animal Assisted Therapy (AAT) is an umbrella term for any goal-directed intervention in which an animal that meets specific criteria is an integral part of the treatment process.” The Delta Society uses this definition: “AAT is designed to promote improvement in human physical, social, emotional, and/or cognitive functioning... AAT is provided in a variety of settings and may be group or individual in nature. This process is documented and evaluated.”[2] |
Animal Assisted Crisis Response (AACR) AACR teams are used to help people normalize the experience of a crisis, ground them when events around them seem out of control or act as a bridge to communication. AACR can be used in instances of natural disaster, domestic violence and other acts of violence. | Animal Assisted Educational Support (AAES) This is a broad category including such diverse programs as Humane Education, Bite Prevention and any other type of education program where the teacher is guiding the educational component. |
Therapeutic Environment Animals (TEA) The presence of the animal(s) is used to help create a therapeutic environment. | |
Table 2
Qualities to Look for in an Animal to Work in the Various Disciplines | |
All animals should be in good health and free of sight and sound phobias and be acclimated to working the specific population | |
Animal Assisted Activities (AAA) AAA animals need good basic manners training with emphasis on holding steady and easy maneuverability. They should walk politely on lead and be able to be maneuvered into position for petting. Animals should be tolerant of moderate levels of noise and crowding and light physical contact. | Animal Assisted Therapy (AAT) AAT animals need good basic manners plus specific skills for the type of therapy in which they work. They should be tolerant of moderate levels of noise and crowding as well as moderate levels of physical contact. They will also need the ability to hold quite still. |
Animal Assisted Crisis Response (AACR) AACR animals should be tolerant of severe levels of crowding, unfamiliar environments and transportation as well as moderate to high levels of noise. They need to be acclimated to various populations. They should be tolerant of moderate to high levels of physical contact. AACR animals need to be tolerant of working with and around animals of other species. AACR animals are often exposed to high emotional levels from the people they work with as well as the moderate to high stress level of their handler. | Animal Assisted Educational Support (AAES) AAES animals need good basic manners training. They should be tolerant of moderate levels of noise, light crowding and light physical contact. Most AAES animals also need to be comfortable with school age children. |
Therapeutic Environment Animals (TEA) Criteria are quite varied. Fish in a tank are not precisely chosen whereas a resident cat should have high levels of physical contact tolerance and have a low level of reaction to common sights, sounds and people. | |
References
Altman, L.K. (2005, November 16). Study Identifies Heart Patient's Best Friend. New York Times Online. Retrieved November 16, 2005 from http://www.nytimes.com/2005/11/16/health/16dog.html?emc=etal
Barker, S. PhD, Dawson & K. S., PhD (1998). The Effects of Animal-Assisted Therapy on Anxiety Ratings of Hospitalized Psychiatric Patients [Electronic version]. Psychiatric Services 49: American Psychiatric Association pp. 797-801
Dale, S. (2005.) Behind-the-Scenes Peek Inside A Vet Conference: Animal Assisted Therapy: Pets As A Prescription. WGN Radio. Retrieved July 21, 2005 from http://wgnradio.com/shows/pet/chennyvegas.htm
Shoshana, S. & Gal, T.J. (2003). Reduction of State-Anxiety by Petting Animals in a Controlled Laboratory Experiment [Electronic version]. Routledge, part of the Taylor & Francis Group, Volume 16, Number 4. pp. 387-395
Warner, J. (2005). Petting a Pooch Can Lift Your Mood Spending Time With Dogs May Help Fight Depression. WebMD. Retrieved October 11, 2005 from http://my.webmd.com/content/article/87/99525.htm
Weaver, J. (2004, April 8). Puppy love – It’s Better Than You Think. MSNBC. Retrieved July 3, 2005 from http://www.msnbc.msn.com/id/4625213/
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