OCCUPATIONAL THERAPY AND ANIMAL ASSISTED THERAPY

Jamie Morris, BS, OTS Department of Occupational Therapy Loma Linda University

LEARNING OBJECTIVES
Understand the difference between animal assisted activity and animal assisted therapy Identify how to incorporate AAT into OT practice Demonstrate appropriate use of AAT with case studies and visiting dogs

ANIMAL ASSISTED ACTIVITY (AAA)

Definition: Activities that involve animals visiting people
-Lange, Cox, Bernert, & Jenkins, 2006/20076

ANIMAL ASSISTED THERAPY (AAT)

Definition: Involves a health or human service professional who use an animal as part of his/her job.
-Lange, Cox, Bernert, & Jenkins, 2006/2007

CLARIFICATION POINT
The term pet therapy should be avoided because it is inaccurate and misleading. This term was widely used several decades ago to refer to animal training programs. The currently preferred terms suggest instead that the animal is a motivating force to enhance treatment provided by a well-trained person.
-Delta Society, 2008

EARLY RESEARCH ON AAT

1792: Quaker society recognizes the therapeutic use of animals for those with illness 1919: US military promoted use of dogs for psychiatric patients 1961: Recognition of human-pet bonding noted by Dr. Boris Levinson 1990: Creation of Eden Alternative, a longterm care facility that includes animals

EARLY RESEARCH
Improvements in: Blood pressure Mental health symptoms Heart rate Skin temperature Arousal levels Medication intervention

CURRENT RESEARCH
Improvements primarily in mental health symptoms Decrease in anxiety Increase in socialization No change in blood pressure Increases in neuro-hormone levels

They found that students who were in the classrooms with the dog exhibited greater information processing and greater empathy toward animals than those in the control group. Moreover, teachers in the study reported a decrease in the amount of aggression and an increase in societal behavior in the children exposed to the dog. -Lange, Cox, Bernert, & Jenkins, 2006/2007

JAZZ AND CHAMP

Instant bond just seemed to get it Proprioceptive input and tactile input: Relaxation, calming, decreased anxiety
*Please also visit: www.jazzkmg.blogspot.com

FIELDWORK CASE EXAMPLE

Senor X 60+ year old male, brain injury patient Primary symptoms: balance, dizziness, socially inappropriate behaviors Intervention Activities: brushing, fetch, keep away, tug

POST-INTERVENTION OBSERVATIONS
Maintained edge of chair balance No complaints of dizziness Socially appropriate comments and behaviors for three consecutive days Remained calm during sudden fire emergency

ANIMALS AND OCCUPATION

Areas of Occupation: Functional mobility Care of pets Community mobility Health management/maintenance Sleep preparation Sleep participation Education participation Play participation Leisure participation Social participation

CLIENT FACTORS AND AAT

Mental Functions Higher-level cognitive Perception Emotional Sequencing Sensory Functions Vestibular functions Proprioceptive functions Touch functions Neuromusculoskeletal Joint mobility Joint stability Muscle endurance Control of movement Gait patterns Cardiovascular system function Speech functions Voice functions Body structures

INCORPORATING AAT INTO OT PRACTICE

The animal is used as any other therapeutic media/tool is used Used to address any client factors or areas of occupation needing to be addressed

INTERVENTION OPTION:
Stroke patient: Place the animal on the affected side and complete a brushing activity Addresses neglect, sensation changes, and mobility

INTERVENTION OPTION:
Autistic child: Have the student take the animal for a walk during recess Addresses social participation and community mobility

INITIATING AAT
Option 1: Pet Partner Team A volunteer pet partner team Typically do AAA Therapist guides the Pet Partner Team in activities to address patients therapy goals

 Option 2: Therapist Team Therapist goes through pet partner training and registration Utilizes animal in therapy to address goals just as any other tool

OT PERSPECTIVE
Praveen Injeti, OTR/L
Loma Linda University, Behavioral Medical Center Program: Group format All ages: children, adults, and geriatric Begin session: discussion about animals Activity: Introduce pet partner team End session: reflection and discussion about experience Practice Model: SI, client-centered approach, psychoanalytical approach OT role: Guide session Reignite roles in the client Give a reality base

Role of the Animals: Transference in regards to emotion Occupations come after roles have been re-established. The animals aid in the reconnection with roles and reality. Reconnect with the self so that acceptance of the the self can happen. Case Example: Catatonic client Dog came close and waited until the client reached to pet him

YOU CAN TEACH SOMEONE TO WALK, TALKBUT WE CANT TEACH SOMEONE HOW TO FEEL.
-Praveen Injeti

HOW TO CREATE AN AAT TEAM

Delta Society Recognized nationally Connect you to a team Connect you to trainings Resources for therapists

COMMON CONCERNS ASSOCIATED WITH AAT

Zoonotic infections Research: No zoonotic infections were reported in 3,281dog visits to 1,690 hospitalized patients during a 5year period. A childrens hospital reported no increase in the rate of zoonotic infections or any other adverse incidences in the first 2-year period.
-Cole, Gawlinski, Steers, & Kotlerman, 2007

Delta Society: Zoonotic infections Strict rules regarding placement of animals Use of draw sheets, towels, and gloves Department Policies Aid in registration, research, and guarantees regarding liability insurance for registered teams

ITS A CHEMISTRY BETWEEN AN ANIMAL AND HUMAN

-PRAVEEN INJETI

REFERENCES
Cole, K., Gawlinski, A., Steers, N., & Kotlerman, J. (2007). Animal-assisted therapy in patients hospitalized with heart failure. American Journal Of Critical Care, 16(6), 575-586. Delta Society (2008), Student manual: Pet partners team training course, Delta Society: Bellevue, WA Fournier, A., Geller, E., & Fortney, E. V. (2007). HUMAN-ANIMAL INTERACTION IN A PRISON SETTING: IMPACT ON CRIMINAL BEHAVIOR, TREATMENT PROGRESS, AND SOCIAL SKILLS. Behavior & Social Issues, 16(1), 89-105. Johnson, R., Meadows, R., Haubner, J., & Sevedge, K. (2008). Animal-assisted activity among patients with cancer: effects on mood, fatigue, self-perceived health, and sense of coherence. Oncology Nursing Forum, 35(2), 225-232. Lange, A. M., Cox, J. A., Bernert, D. J., & Jenkins, C. D. (2006). Is Counseling Going to the Dogs? An Exploratory Study Related to the Inclusion of an Animal in Group Counseling with Adolescents. Journal Of Creativity In Mental Health, 2(2), 17-31. doi:10.1300/J456v02n0203 Sockalingam, S., Li, M., Krishnadev, U., Hanson, K., Balaban, K., Pacione, L., & Bhalerao, S. (2008). Use of animal-assisted therapy in the rehabilitation of an assault victim with a concurrent mood disorder. Issues In Mental Health Nursing, 29(1), 73-84. Velde, B. P., Cipriani, J., & Fisher, G. (2005). Resident and therapist views of animal-assisted therapy: Implications for occupational therapy practice. Australian Occupational Therapy Journal, 52(1), 43-50. doi:10.1111/j.1440-1630.2004.00442.x