Introduction
Pet owners know that interactions with animals can have positive effects on a person’s psychological condition and well-being. Despite the limited number of forms of communication accessible to animals, they easily become good companions for vulnerable individuals. This paper explores the topic of animal-assisted therapy (AAT), which is among the applications of the aforementioned common truths to healthcare and reviews the research-proven benefits of AAT.
Definition
AAT can take multiple forms and is used in different populations, which is why it does not have a very narrow definition. In a broad sense, AAT is understood as health interventions “to improve physical, social, emotional or cognitive functioning, with animals as an integral part of the treatment” (Bert et al., 2016, p. 696). Unlike visitation interventions, in which animals visit certain facilities and interact with their residents, AAT also involves animals’ active participation in goal-directed interventions and treatment sessions (Bert et al., 2016). As the definition suggests, AAT has multiple uses and can support health in different domains and patients with physical and mental impairments.
Background/History
AAT has a long history and can be linked to multiple spiritual concepts. In the remote past, animist worldviews were extremely popular, and animals were regarded as the servants of people’s protective spirits in Native American and Eurasian cultures (Şahin et al., 2018). Between the seventeenth and the eighteenth centuries, the public perception of domestic animals changed. Pet-feeding practices became popular among upper- and middle-class communities, and compassion for animals became taught to children (Şahin et al., 2018). In the nineteenth century, pets, including rabbits, sheep, and apes, became welcome in mental health facilities in the United Kingdom (Şahin et al., 2018). In the twentieth century, Sigmund Freud noticed that dogs could increase patients’ psychological comfort during therapy sessions, and New York Convalescent Hospital implemented the first animal therapy sessions for wounded soldiers (Şahin et al., 2018). In the second half of the twentieth century, animal therapy became a popular innovative practice. A series of organizations to promote the use of horses and dogs in disabled and elderly patients was established (Şahin et al., 2018). As of now, AAT is widely used in rehabilitation and health promotion programs.
Specific Training and Special Considerations
Healthcare specialists and even animals participating in AAT interventions should meet training requirements to maximize patient safety. As for AAT practitioners, training requirements depend on the form of AAT and the patient populations that they are going to serve. For instance, to use AAT in psychotherapy, it is necessary to have relevant formal education and additional training covering communication with particular populations, including the elderly or individuals with disabilities (Charry-Sánchez et al., 2018). As for therapy animals, specific training and certification can be received from Delta Society International (Charry-Sánchez et al., 2018). To work with patients, therapy animals should receive all necessary vaccinations without delays, have no incidents of aggression towards people in the past, and demonstrate obedience and a good understanding of commands (for dogs).
Regarding special considerations, safety precautions are among the most important concepts. In equine-assisted interventions that involve riding, falling from horses and the resulting injuries are not extremely rare (Charry-Sánchez et al., 2018). To minimize risks, the best possible safety measures, including safe riding equipment and an excellent understanding of animal psychology and techniques to manage anxiety in horses, must be implemented. The risks of unexpected breakdowns exist during interactions with any animals, including dogs, which is why thorough behavioral observations of animals are required.
How AAT Works and Its Benefits
AAT sessions conducted by properly trained animals and their owners are aimed at meeting individualized treatment goals and supporting recovery from disease and improvements in psychological well-being. According to the systematic review by Bert et al. (2016), AAT is currently used in various settings, including hospitals, drug treatment centers, assisted living facilities, and palliative care facilities. Regardless of the setting, AAT interventions are supposed to encourage patient-animal interaction during treatment and counseling sessions to make use of the positive health effects of the animal-human bond (Bert et al., 2016). AAT is considered effective in multiple conditions since interaction with animals has positive effects on behaviors (Bert et al., 2016). In particular, it can promote a sense of safety, the opportunity to get distracted from stressful situations, the ability to build trust-based relationships, and better communication skills.
Modern research on the health benefits of AAT in different populations is abundant. In psychiatric patients with schizophrenia, depression, and eating/mood disorders, AAT using dogs has been shown to lead to increases in self-esteem and self-determination and reductions in aggression (Bert et al., 2016). In pediatric patients, including cancer patients, structured AAT sessions can cause reductions in pain and a sense of loneliness and increases in self-esteem and socialization (Bert et al., 2016). In post-stroke patients, certain positive effects of equine-assisted therapy on motor function restoration and rehabilitation have been demonstrated (Charry-Sánchez et al., 2018). According to recent research, in patients with brain injuries in the process of neurorehabilitation, AAT sessions increase satisfaction with treatment, mood, and engagement in communication (Hediger et al., 2019). Thus, AAT can be used to facilitate treatment and recovery in patients with both mental and physical conditions.
Contraindications
Despite the health benefits of AAT, three main groups of patients should not receive animal-assisted interventions due to underlying risks. The first contraindication is the presence of allergies to animals, and it can be avoided by choosing species and breeds that do not cause allergic reactions. Next, vulnerability to zoonotic infections, for instance, the presence of immune system impairments, is an important contraindication (Bert et al., 2016). Finally, the presence of phobias in particular animals should be considered to weigh the benefits and risks of AAT in individual cases.
Integration into Nursing Practice
Regarding their integration into nursing practice, animal-assisted interventions are becoming increasingly popular in facilities providing nursing care services. In nursing homes and palliative care facilities, they usually take the form of unstructured interactions with animals and activities with therapeutic dog teams aimed at reducing anxiety (Akard et al., 2019; Bert et al., 2016). In pediatric patients with life-threatening conditions, dog-assisted interventions are aimed at supporting the positive effects of nursing and medical care and can promote better interactions between patients and multidisciplinary care teams (Akard et al., 2019). Being patient advocates, nurses can play multiple roles in the implementation of AAT in healthcare facilities, including interactions with registered therapy animal teams and educating patients on the benefits of AAT.
Conclusion
In summary, AAT is a popular complementary type of therapy that uses positive health effects of interaction with animals to support health improvement in patients. The known benefits of AAT are numerous and include increases in self-esteem and mood, reductions in aggression and pain, and the willingness to engage in communication. From the considerations of safety, animals to be used in therapy should receive certification from trusted organizations and prove their obedience and non-aggressiveness.
References
Akard, T. F., Hendricks-Ferguson, V. L., & Gilmer, M. J. (2019). Pediatric palliative care nursing. Annals of Palliative Medicine, 8, 1-11. Web.
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(5), 695–706. Web.
Charry-Sánchez, J. D., Pradilla, I., & Talero-Gutiérrez, C. (2018). Animal-assisted therapy in adults: A systematic review. Complementary Therapies in Clinical Practice, 32, 169-180. Web.
Hediger, K., Thommen, S., Wagner, C., Gaab, J., & Hund-Georgiadis, M. (2019). Effects of animal-assisted therapy on social behaviour in patients with acquired brain injury: A randomised controlled trial. Scientific Reports, 9(1), 1-8. Web.
Şahin, S., Kose, B., & Zarif, M. (2018). Animal-assisted therapy in occupational therapy. In M. Huri (Ed.), Occupational therapy – therapeutic and creative use of activity (pp. 91-106). IntechOpen.