Animal Assisted

Therapy
Tiffany Gray
Holly May
Louise Orozco
Kelsey Spranger
Nicole Triplett

What is animal assisted therapy

(AAT)?

Utilization of animals as a
therapeutic modality to
facilitate healing and
rehabilitation of clients with
disabilities or acute or chronic
ailments (Young & Koopsen,
2011, p.191)

Animal assisted therapy (AAT)

is a therapeutic modality that
can increase positive health
outcomes and promote quality
of life (Young & Koopsen, 2011,
p.191)

Benefits of animal assisted therapy

Relieves stress and depression

Reduction in anxiety

Increase in prosocial behavior

Decreases pain

Pets offer ongoing comfort and companionship

Improves cholesterol and blood fat levels

Improves strength, endurance, ROM, balance, and sensation

A visit with a therapy animal can evoke pleasant memories,

reduce loneliness, and provide the opportunity for unconditional
acceptance (Young & Koopsen, 2011, p.193).

Why choose AAT?

We selected AAT because

animals offer great therapeutic
effects for patients

Animals are nonjudgmental

Animals build conversation

between the patient and
healthcare provider (Young &
Koopsen, 2011, p.193).

People of all ages can benefit

from AAT including family
members

How does AAT impact a patients

spirituality?

Cognitive, physical, psychosocial, and spiritual benefits of AAT have been shown to
include increased attention, orientation, and mobility (Young & Koopsen, 2011, p.
191)

Pets are always there for people and do not judge or talk back

Animals can give a person a sense of comfort without any judgement

Some believe that animals are actual healers which give them a sense of hope.
Interactions with animals promote positive emotions and enhance healing and
recovery (Ernst, 2012, p.54).

Patients who participate in a visit with a therapy animal show a reduction in both the
negative mental and physical effects of the sympathetic nervous system (Ernst,
2012, p. 55).

Literature Review: Ernst

Individual or group based

AAT is becoming more prevalent

In one survey pf psychologists almost 50% reported that theyve prescribed a

pet for their patients p. (57).

Benefits

Decreases SNS stimulation

Decreased anxiety
Reduced blood pressure
Lowered stress hormone release
Increased feelings of safety
Improved cooperation and participation

Ernst, L. S. (2012). Animal-assisted therapy: Using animals to promote healing.Nursing 2012, 42(10), pp. 5458. doi: 10.1097/01.NURSE.0000418610.30948.68

Literature Review: Ernst

Safety

Hand washing
Healthy medical and behavioral history
Certification and exposure
Basic obedience skills
Well groomed

Research Limitations
Specific statistics
Possible bias

Ernst, L. S. (2012). Animal-assisted therapy: Using animals to promote healing.Nursing 2012, 42(10),
pp. 54-58. doi: 10.1097/01.NURSE.0000418610.30948.68

Literature Review: Marcus

Objective: to prove the perceived

reduction of pain and discomfort of
cancer treatment after therapy
dog visit.

Method: 30 patients receiving nonpalliative cancer treatment

assigned to 1 of 3 15 minute
treatment groups:

1. Therapy dog with handler that does not

interact with patient.

2. Visit from friendly volunteer.

3. Quiet time with reading materials.

Results: 70% of time patients

cancer treatment perceived easier
after dog visit, 50% easier after
friendly volunteer, 20% after
reading time.

Limitations: Study limited to dogs

only as therapy animals. Small
test group (30 patients).

Literature Review: Creagan et al

Objective: To prove the length and

quality of life of select patients
with pet ownership.

Method: 309 patients with

advanced cancer receiving
outpatient chemotherapy.

Results: Patients with pets

reported less stress overall. Most
described their pets as being of
tremendous value during their
cancer (Creagan et al, 2015,
p.102).

Limitations: Study was small (309

patients). Study was about pet
ownership, not formal AAT. Study
does not specify types of animals.

Conclusions

Animal Assisted Therapy has become more and more popular as an alternative
healing modality
AAT has many spiritual & physical benefits
AAT is a non-invasive alternative healing modality

AAT is delivered by a trained professional and has benefits beyond typical pet
visitation programs
Develop client specific goals & interventions
Physical improvements including decreased blood pressure & pain, improved endurance,
strength & ROM
Spiritual improvements including decreased anxiety & stress, reduced loneliness,
increased comfort & hope, and presence of unconditional love & acceptance

AAT is a chosen therapy because it can be used for all age groups in a range of
health care settings including schools, long term care facilities and even intensive
care units. Most commonly used animals are dogs and cats. In addition to the
physical and spiritual benefits, AAT helps build rapport between health care
providers and clients (Young & Koopsen, 2011, p. 191-198).

References

Ernst, L. (2012). Animal-assisted therapy: Using animals to promote healing 42(10),

pp. 54-58. doi: 10.1097/01.NURSE.0000418610.30948.68

Therapy Animals. (n.d.). Animal-assisted therapy and activities. Retrieved from

http://animaltherapy.net/

Young, C., & Koopsen, C. (2011). Spirituality, health, and healing: An integrative
approach (2nd ed.). Sudbury, MA: Jones and Bartlett.

Parshall, D. P. (2003). Research and Reflection: Animal-Assisted Therapy in Mental

Health Settings.Counseling & Values, 48(1), 47-56

Marcus, D.A. (2013). The science behind animal-assisted therapy. Current Pain and
Headache Report. 17(4), 1-7. doi 10.1007/s00916-013-0322-2

Creagan, E.T., Bauer, B.A.,Thomley, B.S., & Borg, J.M. (2015). Animal-assisted
therapy at Mayo Clinic: The time is now. Complementary Therapies in Clinical
Practice. 21.101-104. Retrieved from: http://dx.doi.org/10.1016/j.ctcp.2015.03.002

Annotated Bibliographies

Ernst, L. S. (2012). Animal-assisted therapy: Using animals to promote healing.Nursing 2012, 42(10), pp. 54-58. doi:
10.1097/01.NURSE.0000418610.30948.68

The author, Lorraine S. Ernst, has her MS, RN, and AHN-BC, and works as an RN coordinator and clinical specialist at St.
Barnabas Medical Center.

The article,Animal-assisted therapy: Using animals to promote healing, looks at how animal-assisted therapy or AAT can be
used in the acute care setting as well as how this type of program can be used in other facilities. Ernst provides a little bit of
background information stating that rabbits were used as early as 1792 to promote a sense of calm in patients and in
1867 animals were used to promote comfort and relaxation in patients with epilepsy (2012, p. 55). In the article, Ernst
explains the benefits of AAT and describes some steps to take in order to implement AAT at a facility. Some of the benefits of
AAT listed in the article include: decreased anxiety, reduced NSN stimulation, reduced BP, lowered stress hormone release,
increased feelings of safety, and improved cooperation and participation in the patients own recovery. For implementing
AAT in a facility, Ernst explains how the Association for Professionals in Infection Control and Epidemiology (APIC) have
guidelines and that there is no evidence in significant amounts that correlates the spread of infections between the animals
and patients. She lists the steps to take to implement a program like AAT in a facility.

There does seem to be a little bit of bias in the article as Ernst only states why AAT should be implemented in facilities and
does not state any reasons where it would not be appropriate or list any possible negative effects of AAT. Omissions of
statistics on the benefits of AAT where noted. The intended audience seems to be health care workers with the capability of
implementing such program at their facility. There were no special features such as graphs and charts; however, there was a
picture of a dog on the front page.

Annotated Bibliographies
Continued

Parshall, D. P. (2003). Research and Reflection: Animal-Assisted Therapy in Mental Health Settings.Counseling & Values, 48(1), 4756.

http://0-web.b.ebscohost.com.libcat.ferris.edu/ehost/detail/detail?sid=d411ef6e-bcf9-41e9-856d-004287c1a87a
%40sessionmgr115&vid=0&hid=101&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#AN=507856219&db=eft

As many other articles I read started out about the history of AAT and its uses, so did this article. This article considered a lot of the
history on this subject a little sketchy and noted facts starting at 1600-present about the use of AAT. MANY studies were
discussed noting mostly positive outcomes and scenarios for people with different health problems including, hypertension, cardiac
disease, stress, depression, etc One specific example was about a dog who was brought into a nursing home which broke up the
monotony from day to day and gave the residents a sense of responsibility while helping care for him. All treatment plans before
initiating AAT begins with treatment goals. (this is where we could include AAT in the assessment of ones spirituality)

This article continues on to cultural, ethical, and legal considerations regarding gender, race, age, and preference of animals. One
suggestion is that it is not ethical to use only AAT and to exclude other treatments that have been proven successful. AAT is clearly
beneficial in some cases, but more research needs to be done. It seems evident that at this point AAT should be used as a
supplement to other proven methods (Parshall, 2003).

The Delta Society defines animal-assisted therapy (AAT) as "the use of trained animals in facilitating patients' progress toward
therapeutic goals" (Parshall, 2003).

A groundbreaking study was published in 1980 (Barker & Dawson, 1998). In this study of 92 cardiac outpatients, it was found that
those who were pet owners lived longer than those who did not have a pet (Parshall, 2003).

therapy dogs should be licensed by a credible agency such as Canine Companions for Independence, Therapy Dogs International, or
Delta Society Pet Partners.

This article is written by a counselor who provides many examples of studies and encounters with the use of AAT.

Annotated Bibliographies
Continued

Marcus, D.A. (2013). The science behind animal-assisted therapy. Current Pain and Headache Report. 17(4), 1-7. doi
10.1007/s00916-013-0322-2.

Author is Dawn A. Marcus and she is a member of the Department of Anesthesiology, University of Pittsburgh (article does not state
her role).

This article breaks down the science of the benefits achieved by AAT. The experiments are limited to dogs only as therapy animals.
There are many conditions represented: "including pervasive developmental disorders, cardiovascular disease, psychiatric
disorders, Alzheimer's disease, cardiovascular disease, psychiatric disorders, and cancer" (Marcus, 2013, p.1). The article specifies:
"Physiological changes have been identified in both humans and the dogs visiting them that support subjective impressions of
reduced distress, decreased pain, and mood enhancement" (Marcus, 2013, p.1). In addition, the article defines mirror neurons as
being one of the reasons that the dogs seem to be empathic to the patient. Mirror neurons are defined as neurons that train the
brain to "learn" by watching someone else perform a task. The article uses various studies to postulate that humans feel more
cheerful by observing the cheerful behavior of the therapy dog.

Marcus breaks down the scientific benefits that occur during and after a therapy dog visits a patient. "Significant pain reduction has
been reported for acute and chronic pain after visits typically lasting about 10-20 min. In addition to pain reduction, therapy dog
visits in these studies were also associated with significant decreases in stress, mood disturbance, and fatigue" (Marcus, 2013, p.2).
Marcus also states that stress hormones are decreased, specifically epinephrine andnorepinephrine, and there is an increase
ofendorphinlevels. Also, blood pressure is reduced, "with changes occurring over a range of 5-24 min (average time = 15min)"
(Marcus, 2013, p.2). Interestingly, patient and dog are not the only ones that benefit from AAT. "Healthcareworkers receiving
therapy dog visits may also experience measurable reductions in stress markers that persist after the worker is no longer in contact
with the dog" (Marcus, 2013, p.2). However, as the patient experiences stress reduction from the visit, the dog does not. In fact,
the dog'scortisollevel does not drop, which indicates that the dog views the experience as a work scenario. "Despite these data
demonstrating a mild stress response performing therapy dog visits, ethicists have concluded that, on balance, the benefits to dogs
from serving as therapy dogs support utilizing animal-assisted therapy" (Marcus, 2013, p.4). This is in part based on the social
nature of dogs. The article also discusses studies in which the patient either spends quiet time alone, or has a visit from a friendly
volunteer, or has a therapy dog visit in which the handler does not interact with the patient. The results of the studies are that pain
is reduced the most after the therapy dog visit. All in all, the article does not seem to feature any biases, with the exception of dogs
being the only animal featured. There are 3 graphs featured: one being pain reduction after dog therapy visits. The two others are
serum chemical markers that decrease or increased based on the dog visits.

The audience the article seems to focus on is healthcare workers treating patients with chronic or acute pain.

Annotated Bibliographies
Continued

Creagan, E.T., Bauer, B.A.,Thomley, B.S., & Borg, J.M. (2015). Animal-assisted therapy at Mayo Clinic: The time is now.
Complementary Therapies in Clinical Practice. 21.101-104. Retrieved from: http://dx.doi.org/10.1016/j.ctcp.2015.03.002.

This is a short article discussing the importance of pets and animal-assisted therapy to the healing process for chronically ill
individuals. The authors reveal no biases, although the tone of the article is a bit more informal than the typical journal study
article. The abstract states: "The animal-human bond refers to an emotional, almost existential, relationship between animals
and people" (Creagan....et al, 2015, p.101). Also, the article opens with a patient who presented in an ER with "shortness of
breath, clinical deterioration, fever, and confusion", this patient becomes very insistent upon returning home to "Max" who the
hospital staff assumed to be a family member or friend. In reality, Max was the patient's German Shepherd who the patient
eventually returned home to. The article draws the conclusion that Max was the patient's motivation for living and reason to
work at getting healthy.

This article breaks down the benefits of owning pets with study data. This portion does not specify AAT, but rather pet
ownership in general. The authors write of Mayo Clinics 2 different AAT programs: Dr Jack, a miniaturePinschertherapy dog
and Caring Canines program, which is a team of therapy dogs. Lastly, the article addresses the limitations of AAT. "The frail,
elderly, and isolated individual is not well served by bringing a 125 pound Golden Retriever into the home. Although definitive
studies are ongoing to measure the value of pets in people's lives, a realistic perspective must be maintained. Animal-related
allergies, phobias, and stress are concerns that cannot be ignored" (Creagan...et al, 2015, p.103).

The authors disclose no conflicts of interest and there are no graphs, pictures, or charts.

http://0-www.sciencedirect.com.libcat.ferris.edu/science/article/pii/S1744388115000249 (link to article)