Mainstreaming animal-assisted therapy

Animal-Assisted Interventions for Autism Spectrum Disorder: A Systematic Review of the Literature from 2016 to 2020

In the last five years, the literature on animal-assisted intervention (AAI) for Autism Spectrum Disorder (ASD) has doubled in size from 42 studies prior to 2015 to 85 studies (cumulative total assessed in 2020). Horses remain the most commonly researched animal for AAI, followed by dogs. The most commonly researched outcome was social interaction, across 21 studies. Though the quantity of studies has increased, issues with methodological rigor remain. Results highlight the need for a continued focus on methodological rigor as well as refining the structure of animal-assisted interventions, addressing the welfare needs of the animals involved, and continuing to establish an evidence base of both significant and nonsignificant findings for AAI for individuals with ASD.

Using Pet Therapy to Decrease Patients' Anxiety on Two Diverse Inpatient Units

BACKGROUND

The physical benefits for patients who spend time with a therapy dog have been reported, including decreased anxiety. Pet therapy has decreased anxiety in various hospitalized patient populations. The human-animal bond is the foundation for the positive interaction therapy dogs create.

AIMS

This study's purpose was to explore the use of pet therapy as an intervention to decrease patients' anxiety levels on two diverse inpatient units: Behavioral Health (BHU) and Pediatrics (PEDS).

METHODS

This was a quantitative study using a convenience sample, with systematic assignment to the experimental and control group. The State Anxiety Scale (SAS), a 6-item, Likert-type Short Form version of the State-Trait Anxiety Inventory, was used with adults and children; a Pediatric Emoji Method was constructed to assist children with the SAS. After consent, both groups completed the SAS pretest. Intervention patients then spent up to 15 minutes with a therapy dog and handler. The SAS posttest was completed 1 hour later by the experimental and control group. Descriptive and inferential statistics were used, including an independent samples t test, paired-sample t test, Wilcoxon signed rank tests, and Spearman correlation coefficients.

RESULTS

Findings revealed that the therapy dog visitations had a positive effect on lowering anxiety supporting the hypothesis. Both the PEDS and BHU participants experienced a significant decrease in their anxiety level following the dog visits.

CONCLUSION

Patients on the BHU and PEDS units benefitted from their visit with a therapy dog by experiencing a decrease in their anxiety level.

An Overview of the Available Intervention Strategies for Postural Balance Control in Individuals with Autism Spectrum Disorder

BACKGROUND

Postural instability is a prevalent issue among individuals with autism spectrum disorder (ASD) that affects the development of their perceptual-motor skills and social functioning. Visual and somatosensory processing deficits, hypotonia, basal ganglia dysfunction, and anxiety are some of the concurrent disorders in individuals with ASD. Nevertheless, a definite management protocol for postural instability in ASD has not been introduced yet. Hence, we aim to shed light on the available intervention strategies for postural instability in individuals with ASD.

METHODS

Even though several studies have been conducted on the effects of various interventions for balance control in individuals with ASD, no study has compared their efficacy, limitations, and clinical implications.

RESULTS

This review discusses diverse proposed interventions contributing to ASD postural instability, including martial arts, water-based interventions, animal-assisted therapies, trampoline, balance training, vestibular therapy, transcranial direct current stimulation, sports, play, and active recreation for kids (SPARK), and square-stepping exercise (SSE).

CONCLUSION

Enhancing motor skills, cerebellum function, and sensory input integration were some of the main mechanisms of these interventions to improve balance control in ASD. Some interventions, such as water-based exercises and video games, were enjoyable for children with ASD and could raise their treatment adherence. In most studies, small sample sizes and the lack of a control group represented their major limitations. Therefore, future well-designed randomized controlled trials are required to assess the effects of available interventions on postural control in ASD.

A Reflection on the Current Status of Animal-Assisted Therapy in India

The field of animal-assisted therapy is advancing quickly throughout the world gaining popularity as a complementary therapy. Several countries, especially in the East, are still in their nascent phase in utilizing animal-assisted therapy and a more realistic presentation of their status should drive them towards effective initiatives to promote the field. The primary objective of this paper is to throw light on the current scenario of animal-assisted therapy in India. The relevant databases such as Scopus, Google Scholar, Proquest, PubMed, and JSTOR were searched to identify the research literature. The organizational websites, news, and blog articles, as well as institutional repositories, were explored to maximize the evidence. A total of 24 articles were found which included published research articles as well as unpublished conference papers. Results found a dearth of practice and research throughout the country indicating an urgent need to direct steps in promoting the growth of the field. The contemporary issues in the implementation of animal-assisted therapy such as cultural and religious beliefs, lack of awareness, lack of practising organizations and therapists warrant immediate attention. Reducing the research and practice gap alongside focusing on creating awareness, changing public perception, introducing coursework in educational institutions, the publication of evidence-based research will help in the acceptance and growth of this novel therapeutic field.

A Systematic Literature Review of Animal-Assisted Interventions in Oncology (Part I): Methods and Results

Animal-assisted interventions (AAIs) use human-animal interactions to positive effect in various contexts including cancer care. As the first installment of a 2-part series, this systematic literature review focuses on the research methods and quantitative results of AAI studies in oncology. We find methodological consistency in the use of canines as therapy animals, in the types of high-risk patients excluded from studies, and in the infection precautions taken with therapy animals throughout cancer wards. The investigated patient endpoints are not significantly affected by AAI, with the exceptions of improvements in oxygen consumption, quality of life, depression, mood, and satisfaction with therapy. The AAI field in oncology has progressed significantly since its inception and has great potential to positively affect future patient outcomes. To advance the field, future research should consistently improve the methodological design of studies, report data more completely, and focus more on the therapy animal’s well-being.

Exploring Dog-Assisted Interventions in Higher Education: Students' Attitudes and Perceived Effects on Well-Being

Both, in the transition to university and during it, students experience a multitude of different changes. Thus, it is no surprise that many students in higher education report suffering from mental health problems. To address their concerns, animal-assisted interventions (AAIs) have gained more and more attention over the past few years. Nonetheless, AAIs have neither yet been used nor researched at German universities. Two studies were carried out to address this issue. In Study I, 709 university students answered a questionnaire evaluating their attitude towards dogs, AAIs and interest in its use at their home university. In Study II, 27 students participated in a dog-assisted intervention (DAI) in which they were allowed to interact with a qualified dog for 15 min. To gain information about their well-being, blood pressure was measured and the Basler Befindlichkeitsskala had to be answered before and after the intervention. Results showed a positive attitude among German students toward dogs, AAIs, and the use of DAIs at their home university. Although an effect on physical well-being could not be found, results showed that a 15-min DAI can improve students’ psychological well-being. Thus, higher education administrators should consider using DAIs as a way to improve student well-being.

Dog training intervention improves adaptive social communication skills in young children with autism spectrum disorder: A controlled crossover study

LAY ABSTRACT

There is some evidence that using therapy dogs for children with autism spectrum disorder generally results in improved social communication skills and reduced behavioral problems. However, well-controlled studies that examine its effectiveness are scarce. This study examined the effectiveness of a "Dog Training Intervention." The study included 73 participants diagnosed with autism spectrum disorder (61 males, 12 females) with age range of 2:10-7:6 years (M = 4:10 ± 1:0) who attend autism spectrum disorder-specific special education schools. The study population was divided into two groups. Each group received the dog training intervention during one part of the school year (first half or second half) in addition to the standard interventions provided by the special education school settings. The dog training intervention was given twice weekly for 4 months within the school setting. The group that received the dog training intervention first showed a significant increase in adaptive social and communication skills in comparison to the second group that did not receive the intervention in this period. This improvement was maintained after the dog training intervention. The second group, which received intervention at the second half of the year, showed improvement in communication and socialization adaptive skills only during the period in which they received the dog training intervention. The positive impact on social communication adaptive skills of the dog training intervention among young children with autism spectrum disorder suggests that dogs may serve as an effective model for establishing social interaction. Dog training intervention appears to be an effective adjunct treatment to the interventions provided in special education schools for young children with autism spectrum disorder.

Interaction and Emotional Connection with Pets: A Descriptive Analysis from Puerto Rico

Simple Summary

The coexistence of humans with pets, and the type and quality of interactions that derive from it, is a growing line of research that covers many scientific disciplines: veterinary sciences, education, psychology, biological sciences, sociology, neuroscience, etc. In this article, we analyze both the characteristics of care for pets and the feelings and emotions involved in the human–pet relationship in the population of Puerto Rico. The sample has been of 1436 people. The most representative results of the research show how pets have a positive impact on the mental health of their owners, because of the emotional connection established, which leads them to experience mainly feelings of love, joy and peace.

Abstract

The study of human–animal interactions has become a prominent research field. The presence of pets in our daily lives has meant a change in the perception of our relationship with pets. One of the new lines of research that has opened up in this area analyzes the possible physical, emotional, and psychological benefits of a human–animal bond. In this context, two main objectives were pursued in this study, whose sample (N = 1436) was investigated in Puerto Rico: (PO1) determining the characteristics of the owners and the care of the pets within Puerto Rican society and (PO2) to analyzing the benefits of living with pets for health and personal well-being, especially at the psychological level. We sought to identify the feelings that arose in pet caretakers as a result of human–animal interactions. The methodology used, which was descriptive and not experimental, was based on a questionnaire of 86 questions with a Likert scale. After the descriptive analysis was undertaken through a frequency analysis, a binary logistic regression was carried out to establish whether the feelings and emotions of the subjects toward their companion pets were determined by sociodemographic variables and were related to the type of coexistence with their pets. The two main results from this study are as follows: for most owners, their pets are very important beings, and those who establish an emotional connection with their pets experience love, joy, and peace. Pets are part of human life through very intense relationships and interactions that, in most cases, increase personal welfare by providing improvements to the human–animal biopsychosocial system. In this sense, a relationship with a pet has a positive impact on the mental health of the owner. Pets are a part of our family lives and are regulators of the most elementary feelings and emotions in humans.

The impact of service dogs on children, youth and their families: A systematic review

BACKGROUND

Having a service dog can help to increase independence and well-being among people with a disability or a chronic health condition. Although there has been an increasing use of service dogs among children and youth their impact has not yet been synthesized.

OBJECTIVE

The purpose of this article was to conduct a systematic review assessing the impact of service dogs on children, youth and their families.

METHODS

Systematic searches of seven international databases from 1985 to 2020 led to 29 studies meeting our inclusion criteria. Using a narrative synthesis review approach we analyzed these studies regarding their sample characteristics, methods, results and quality of evidence.

RESULTS

There were 29 studies in our review that included 1121 children and youth (or parents representing them) that spanned across six countries over a 32-year period. Although the outcomes of the impact of service dogs varied across the studies, 23/29 of them reported an improvement in at least one of the following: physical health (i.e., diabetes management, seizure management, mobility), psychological health (i.e., quality of life, safety, behavior, stress, anxiety, self-confidence and independence), social well-being (i.e., social interactions, school and work) and dog-owner-bond. Children, youth and their parents also described several challenges in owning a service dog.

CONCLUSIONS

Our findings highlight that service dogs have potential to provide many benefits for children, youth and their families. Further research, including more rigorously designed studies, is needed to fully understand their impact.

A Systematic Literature Review of Animal-Assisted Interventions in Oncology (Part II): Theoretical Mechanisms and Frameworks

Animal-assisted interventions (AAIs) can improve patients' quality of life as complementary medical treatments. Part I of this 2-paper systematic review focused on the methods and results of cancer-related AAIs; Part II discusses the theories of the field's investigators. Researchers cite animal personality, physical touch, physical movement, distraction, and increased human interaction as sources of observed positive outcomes. These mechanisms then group under theoretical frameworks such as the social support hypothesis or the human-animal bond concept to fully explain AAI in oncology. The cognitive activation theory of stress, the science of unitary human beings, and the self-object hypothesis are additional frameworks mentioned by some researchers. We also discuss concepts of neurobiological transduction connecting mechanisms to AAI benefits. Future researchers should base study design on theories with testable hypotheses and use consistent terminology to report results. This review aids progress toward a unified theoretical framework and toward more holistic cancer treatments.

Parent Perceptions of Psychosocial Outcomes of Equine-Assisted Interventions for Children with Autism Spectrum Disorder

This research explored parents' perceptions of the psychosocial outcomes of their children's experience of receiving equine-assisted interventions (EAI). Participants were the parents of six children (aged 3-14) diagnosed with autism spectrum disorder. Five semi-structured interviews were conducted and the transcript data was analysed using Interpretative phenomenological analysis. Four super-ordinate themes emerged from the analysis: (1) child's improved self-concept and enhanced emotional well-being, (2) child's improved self-regulatory ability, (3) social benefits for the child, and (4) unexpected outcomes. EAI was perceived by the parents as having several levels of psychosocial benefits for their children. These benefits may also extend to parents and family through ecopsychological and "flow on" effects associated with the children's involvement in EAI programs.

Evaluation of an equine-assisted therapy program for veterans who identify as 'wounded, injured or ill' and their partners

The aim of this study was to evaluate outcomes of an equine-assisted therapy program for Defence Force veterans and their partners across the psychological domains of depression, anxiety, stress, posttraumatic stress, happiness, and quality of life, as well as compare the outcomes of an Individual and Couples program. A non-controlled, within-subjects longitudinal design was utilized with assessment at three time points (pre-intervention, post-intervention, and three months follow-up). Between-subjects analysis with two groups was also conducted to compare the outcomes of the Individual and Couples programs. Participants were recruited from ten programs in 2016 with a total of 47 veterans and partners from both an Individual program (n = 25; veterans only) and a Couples program (n = 22). Outcome measures included the Depression Anxiety Stress Scale-21, Posttraumatic Stress Disorder Checklist for DSM-5, Oxford Happiness Questionnaire, and Quality-of-Life Enjoyment and Satisfaction Questionnaire-Short Form. Paired samples t-tests revealed that within both the Individual and Couples programs, there were significantly fewer psychological symptoms and significantly greater levels of happiness and quality of life at post-intervention compared to pre-intervention. Reduced psychological symptoms were maintained at the three months follow-up for participants of the Couples program only. Independent samples t-tests revealed participants in the Couples program reported significantly less symptoms of depression, stress, and posttraumatic stress disorder (PTSD) at follow-up compared to participants in the Individual program. These results indicate there may only be meaningful benefits for equine-assisted therapy in the reduction of depression, stress, and PTSD symptoms for veterans, if partners are integrated into the intervention.

The use of animal-assisted therapy in combination with physical therapy in an inpatient rehabilitation facility: A case report

BACKGROUND

Animal-assisted therapy (AAT) is a growing form of intervention in the field of rehabilitation often with the goals of decreasing pain, anxiety, and depression. There is a lack of literature on the use of AAT in inpatient rehabilitation facilities (IRF).

PURPOSE

This intrinsic case report describes the use of AAT in combination with physical therapy (PT) in the treatment of a middle-aged female status-post spinal surgery.

MATERIALS AND METHODS

This patient was treated with standard of care physical and occupational therapy in an IRF with the addition of AAT within 32% of the therapy sessions. AAT sessions focused on sitting and standing tolerance, standing balance, endurance, ambulation, stair negotiation and kitchen mobility. Clinical measures included the 6 Minute Walk Test (6MWT), the Functional Independence Measure (FIM) total score and the FIM motor subscale score.

CLINICAL FINDINGS

From admission to discharge from the IRF, change was noted in the areas of sitting tolerance, total FIM score, the motor subscale score of the FIM, and on 6MWT distance. Due to other therapies simultaneously occurring, no conclusions on AAT as a treatment can be made. AAT did provide more opportunities for this patient to engage in therapeutic activities.

CONCLUSION

AAT was used during PT, in attempt to facilitate participation and distract from pain in order to work on therapeutic activities and achieve the patient's functional goals. This case report can be used as a model for other IRF therapy programs interested in AAT, can provide information about a therapeutic modality and hopefully will inspire future rigorously designed research studies.

Animal-Facilitated Therapy Program: Outcomes from Caring Canines, a Program for Patients and Staff on an Inpatient Surgical Oncology Unit

BACKGROUND

Animal-facilitated therapy (AFT) is a complementary medicine intervention. To the authors' knowledge, no study has investigated the benefits of an AFT program in an adult surgical oncology setting.

OBJECTIVES

The purpose of this study is to assess the effects of an AFT program on patients and staff on a surgical oncology unit.

METHODS

A quasiexperimental design was used for the patient group, and a pre-/post-test design was used for the staff group. The intervention involved the AFT program being fully integrated on a surgical inpatient unit. Outcomes included patient-reported symptoms and quality-of-life (QOL) outcomes for patients, as well as professional QOL for staff.

FINDINGS

QOL indicators improved for all patients, and the level of energy at follow-up was significantly higher in the AFT group after adjusting for baseline. For staff, compassion satisfaction was high and burnout was low.

Who let the dogs out? Therapy dogs in clinical practice

OBJECTIVES

Animal-assisted therapy (AAT) is a growing field in Australia, and therapy dogs are becoming increasingly common in clinical settings. This paper aims to highlight the current issues facing AAT in Australia and to make recommendations on how to progress the field. We acknowledge that there are several ways that therapy dogs may enhance treatment outcomes for clients, such as reductions in stress and acute anxious arousal, and improvements in engagement and rapport. These psychological and physiological advantages, however, may not be sustained once interaction with the dog ceases. Clinicians require adequate training and support to develop and implement interventions that are based on sound theoretical foundations, and take advantage of the adjunctive benefits of animal presence.

CONCLUSIONS

A series of recommendations are made for the professionalisation of AAT, including the development of consensus definitions, clinical governance, accreditation, research and evaluation.

The feasibility of brief dog-assisted therapy on university students stress levels: the PAwS study

BACKGROUND

Pet therapy is becoming increasingly popular and is used in a variety of ways from encouraging communication in older adults to improving wellbeing in those with serious mental illness. Increasingly Universities have been offering pet therapy to students in an effort to reduce stress. However, little evidence currently exists to support the effectiveness of reducing measurable stress levels after a standalone drop-in unstructured session. The University of Sheffield's Counselling Service works in partnership with Guide Dogs for the Blind to give students access to calm, well-trained animals for informal group stress relief.

AIMS

To assess the feasibility of implementing and evaluating unstructured group interventions with a Guide Dog in training within the university student population.

METHODS

One hundred and thirty-one students who attended pet therapy at the University Counselling Service were recruited on a voluntary basis to take part in the research. Stress, measured on the state trait anxiety inventory, and blood pressure were taken before and after a 15-min intervention.

RESULTS

All measures showed a statistically significant reduction immediately after the intervention.

CONCLUSION

Short interactions with a Guide Dog in training appear to reduce stress in University students. A controlled study is required to investigate further.

Research on animal-assisted intervention and autism spectrum disorder, 2012-2015

Including animals in autism intervention is growing in both research and practice. A systematic literature review was conducted to collate and synthesize all empirical research on animal-assisted intervention (AAI) for autism published from 2012 to 2015. Findings from 28 included studies revealed that AAI programs generally include one animal per participant with a total contact time of approximately 10 hours over the course of 8 to 12 weeks. Research methodology is diverse and though limited in many cases, has improved over the last few years. The most commonly reported outcome was increased social interaction, which was unanimously significant across 22 studies. The need for further research is highlighted, calling for a focus on refining AAI techniques, identifying optimal circumstances for positive change as well as individuals who may not benefit, and independent replication of high quality studies to move AAI from an enrichment activity to an evidence-based practice for autism.

Current Perspectives on Therapy Dog Welfare in Animal-Assisted Interventions

Research into the effects of animal-assisted interventions (AAIs) has primarily addressed human health outcomes. In contrast, only few publications deal with the therapy dog experience of AAIs. This paper provides an overview on potential welfare threats that therapy dogs may encounter and presents the results of a review of available studies on welfare indicators for therapy dogs during AAIs. Previous investigations used physiological and behavioral welfare indicators and dog handler surveys to identify work-related stress. Research outcomes are discussed in the light of strengths and weaknesses of the methods used. Study results suggest that frequency and duration of AAI sessions, novelty of the environment, controllability, age and familiarity of recipients modulate animal welfare indicators. However, this review reveals that currently, clear conclusions on how the well-being of dogs is influenced by the performance in AAIs are lacking due to the heterogeneity of programs, recipient and session characteristics, small dog sample sizes and methodological limitations. This paper further aimed to identify unresolved difficulties in previous research to pave the way for future investigations supporting the applicability of scientific findings in practice.

Effects of Interactions With Animals On Human Psychological Distress

CONTEXT

Human-animal interaction (HAI) is widely used as a method of reducing psychological distress. However, research findings in support of HAI have not kept pace with the widespread prevalence in practice.

OBJECTIVE

I review and synthesize the quantitative evidence for the influence of HAI on psychological distress and outline future directions for research.

RESULTS

The evidence suggests that HAI has a small-to-medium effect on distress but does not clarify whether animals account for the treatment effects. Research also has not determined whether positive effects observed in circumscribed HAI programs extend to companion animal ownership.

CONCLUSION

HAI research needs to address methodological limitations and expand the focus beyond treatment outcome studies. By increasing our understanding of the processes through which HAI reduces distress, the circumstances under which it is most effective at doing so, and the influence HAI has on the animals, we can enhance the impact of HAI.

Animal-Assisted Interventions in Dutch Nursing Homes: A Survey

OBJECTIVES

Animal-assisted interventions (AAI) have become more and more popular in nursing homes in the past decade. Various initiatives for using animals in nursing homes have been developed over the years (eg, animal visiting programs, residential companion animals, petting zoos) and, on the whole, the number of nursing homes that refuse animals on their premises has declined. In this survey, we aimed to determine how many Dutch nursing homes offer AAIs, what type of interventions are used, and with what aim. We also focus on the use of underlying health, hygiene, and (animal) safety protocols.

METHODS

Using an online Dutch nursing home database, we invited all listed (457) nursing home organizations in the Netherlands (encompassing a total of 804 nursing home locations) to participate in our digital survey, powered by SurveyMonkey. The survey consisted of a total of 45 questions, divided into general questions about the use of animals in interventions; the targeted client population(s); and specific questions about goals, guidelines, and protocols. The results were analyzed with SPSS Statistics.

RESULTS

In the end, 244 surveys, representing 165 organizations, were returned: 125 nursing homes used AAI in one way or another, 40 did not. Nursing homes that did not offer AAI cited allergy and hygiene concerns as the most important reasons. Most nursing homes offering AAI used visiting animals, mostly dogs (108) or rabbits (76). A smaller number of nursing homes had resident animals, either living on the ward or in a meadow outside. Almost all programs involved animal-assisted activities with a recreational purpose; none of the participating nursing homes provided animal assisted therapy with therapeutic goals. Psychogeriatric patients were most frequently invited to participate. A total of 88 nursing homes used alternatives when animals were not an option or not available. The most popular alternative was the use of stuffed animals (83) followed by FurReal Friends robotic toys (14). The sophisticated robot seal Paro was used in 7 nursing homes. A large percentage (80%) of nursing homes that worked with animals did not have AAI-specific health protocols or animal welfare and safety protocols underlying the animal activities or specific selection criteria for the selection of suitable animals.

CONCLUSION

Most of the participating Dutch nursing homes offer AAI in recreational programs (animal-assisted activities) for psychogeriatric clients (using visiting animals, especially dogs). Most nursing homes do not have specific AAI protocols for animal welfare, hygiene, and safety during animal activities, nor do they employ specific selection criteria for participating animals and their handlers.

Incorporating Pets into Acute Inpatient Rehabilitation: A Case Study

PURPOSE

The use of animals in various healthcare settings dates as far back as the 19th century, and is still a widely practiced intervention even today. The use of animals in the acute rehabilitation setting is a common practice that benefits both the patient's therapy progression and allows the opportunity for financial reimbursement for the facility. As acute rehabilitation facilities continue to cope with ever changing rules and guidelines, the use of alternate modalities can help the facility overcome difficult challenges while focusing on the needs of the patients. The use of animal assisted therapy is illustrated with a stroke patient at an acute rehabilitation facility who benefited from implementing a pet therapy regimen when regular therapy modalities were not helping.

CLINICAL RELEVANCE

Incorporating animal assisted therapy in acute rehabilitation settings is described to obtain greater satisfaction for patients and staff and to facilitate reimbursement for rehabilitation settings.

Psychosocial Equine Program for Veterans

Nearly half of all combat veterans suffer from serious psychological disorders and reintegration issues. Veterans shy away from typical talk therapy and are seeking alternative treatments. Equine-facilitated mental health therapy has shown promise in treating veterans with depressive and anxiety disorders and reintegration issues. This article reports on an institutional review board-approved pilot program designed to address the mental health needs of veterans. Furthermore, this article discusses future directions for evolving development of equine treatment programming.

Applying One Health to the Study of Animal-Assisted Interventions

The use of animal-assisted interventions in therapeutic programs is a growing phenomenon. Animal-assisted interventions (AAIs) involve a variety of species (dogs, cats, horses, domesticated birds, etc.) in primary health care. Despite their increasing application in a wide range of therapeutic services, the empirical evidence base of AAIs is limited. The authors of this paper propose that the public health framework of One Health can be adapted to advance AAI research. One Health's perspective on the environment is primarily ecological. The environmental impact on the human-animal interactions within AAIs, however, incorporates social, cultural, political, and economic factors. The environment has received minimal attention in AAI research. The authors discuss how this framework has been used in their prior AAI research and work with Indigenous people. Applying this framework to AAIs may guide future AAI research.

Setting the One Health agenda and the human-companion animal bond

“One Health”, also called “One Medicine”, began as an initiative advocating greater integration of human and animal medicine, in the 1800s. This concept has recently come to prominence, driven by the recognition that 75% of the newly emerging infectious diseases will arise from animal reservoirs, and that successful control and prevention will require a coordinated human medical and veterinary approach. Consequently, many One Health discussions have centered on the surveillance of animals in order to anticipate the potential emergence of new zoonotic diseases. An area that has been given only cursory mention, are the many ways that small companion animals benefit individual, community and possibly world health. The goal of this paper is to briefly review some of the evidenced-based data concerning the benefits of having companion animals in our lives, focusing on four major areas; cancer, heart disease, autism spectrum disorder (ASD), and the potential positive economic effects of the human-companion animal bond on One Health. Heart disease and cancer are the two leading causes of morbidity and mortality in the world, while ASD is a growing concern, not only for its individual effects, but also for its effect on family units, educational institutions, and its social implications for the community. In addition, these diseases can greatly affect the national and global cost of healthcare, as well as the economic output of a nation. It is therefore important to include and build on the concept of the Human-Animal Bond (HAB) as it relates to healthcare in these areas.

Animal-Assisted Activity: Effects of a Complementary Intervention Program on Psychological and Physiological Variables

Animal-assisted activity is the use of trained animals for the therapeutic, motivational, or educational benefit of patients. Subjects of this study were 218 patients hospitalized on the mental health unit of a community hospital with an existing, complementary animal-assisted activity program. Half of the patients participated in a 1-hour session of animal-assisted activity. The other half, who served as a comparison group, participated in a 1-hour stress management program. It was hypothesized that an animal-assisted activity program would improve ratings of depression, anxiety, and pain and the associated physiological measures of stress and discomfort. Self-report ratings of depression, anxiety, and pain were collected before and after treatment sessions, and blood pressure, pulse, and salivary cortisol were measured. There were significant decreases in depression ( P < .0001), anxiety ( P < .0001), pain ( P < .0001), and pulse ( P < .04) after animal-assisted activity program, comparable to those in the more traditional stress management group.

Animal-Assisted Intervention in Dementia

There is a need to develop nonpharmacological treatments and methods which can serve as alternatives or complements to medications in dementia care. Previous research indicates that animal-assisted intervention (AAI) can be beneficial. The purpose of the present pilot project was to evaluate effects of AAI on quality of life (QoL) in people with dementia in four Swedish nursing homes. A pretest/posttest research design was used. Twenty people (12 women, 8 men; aged 58 to 88) were included. Nine people completed the intervention which comprised 10 training sessions with a certified therapy dog team. QoL improved in the expected direction after the intervention ( p = .035). Even though the effects of AAI may not be discernible over longer periods of time, there are still immediate effects which can promote better QoL for people living with dementia diseases.

Effects of animal-assisted therapy on behavioral and/or psychological symptoms in dementia: a case report

BACKGROUND

Recently, interest in nonpharmaceutical interventions in dementia care has increased. Animal-assisted therapy has been shown to be one promising intervention but more knowledge is needed. The present article reports on a pilot study involving an 84-year-old woman with vascular dementia who was systematically trained with a therapy dog team for 8 weeks.

METHODS

A quasi-experimental longitudinal interventional design with pre-post measures was used. Data were collected on 3 occasions. Descriptive statistics were used for data analysis.

RESULTS

Some effects on the woman's ability to walk and move were identified. In addition, some effects in the woman's cognitive state were observed.

CONCLUSIONS

Physical, psychological, and/or social training with certified therapy dog teams can have effects on behavioral and psychological symptoms in people living with dementia. Further research is needed.

Impact of animal-assisted therapy for outpatients with fibromyalgia

OBJECTIVES

Animal-assisted therapy using dogs trained to be calm and provide comfort to strangers has been used as a complementary therapy for a range of medical conditions. This study was designed to evaluate the effects of brief therapy dog visits for fibromyalgia patients attending a tertiary outpatient pain management facility compared with time spent in a waiting room.

DESIGN

Open label with waiting room control.

SETTING

Tertiary care, university-based, outpatient pain management clinic.

SUBJECTS

A convenience sample of fibromyalgia patients was obtained through advertisements posted in the clinic.

INTERVENTIONS

Participants were able to spend clinic waiting time with a certified therapy dog instead of waiting in the outpatient waiting area. When the therapy dog was not available, individuals remained in the waiting area. OUTCOME MEASURES.: Self-reported pain, fatigue, and emotional distress were recorded using 11-point numeric rating scales before and after the therapy dog visit or waiting room time.

RESULTS

Data were evaluated from 106 therapy dog visits and 49 waiting room controls, with no significant between-group demographic differences in participants. Average intervention duration was 12 minutes for the therapy dog visit and 17 minutes for the waiting room control. Significant improvements were reported for pain, mood, and other measures of distress among patients after the therapy dog visit, but not the waiting room control. Clinically meaningful pain relief (≥2 points pain severity reduction) occurred in 34% after the therapy dog visit and 4% in the waiting room control. Outcome was not affected by the presence of comorbid anxiety or depression.

CONCLUSIONS

Brief therapy dog visits may provide a valuable complementary therapy for fibromyalgia outpatients.