Effects of animal-assisted therapy on social behaviour in patients with acquired brain injury: a randomised controlled trial

Animal-assisted interventions in adult hospital rehabilitation settings: A scoping review

Animal-assisted interventions (AAIs) have the potential to enhance people's well-being and function and are increasingly being implemented across a range of settings. This scoping review explored how AAIs have been used in adult hospital rehabilitative care. Using JBI and PRISMA-ScR guidelines, a systematic search of four databases was undertaken. Inclusion criteria involved adults, aged >18 years, who had received AAIs in the hospital rehabilitation setting. Twenty-two articles met the inclusion criteria. Results identified two intervention types: visitation activities (n = 8 studies) and structured therapeutic interventions (n = 14 studies). Dogs were the most common animal species. Improvements in social and emotional well-being were reported across both types of interventions, with improvements in ambulation, motor skills, and verbal communication reported by those engaged in structured therapeutic interventions. Implementation challenges included a dependency on volunteer dog-handlers; the need for better recording of interventions in medical records to enable evaluation; and cost, safety, infection control, and animal welfare considerations. Strengthening the planning of AAIs is fundamental for the realization of potential outcomes from human-animal interactions in hospital rehabilitative care.

Putting the Ducks in a Row: Development of a Duck-assisted Green Care Intervention for Persons with Traumatic Brain Injury

Green Care therapies are defined as the engagement of a patient with the nature, exposing patients to a nature based therapeutic setting that may facilitate their recovery. Such therapies became popular at the end of the twentieth century. This therapeutic approach may include therapeutic horticulture, nature therapies, care farming, facilitated exercise, and animal-assisted therapies with farm animals (AATF). This paper describes the processes of planning and creating an AATF-based clinical intervention wherein persons with TBI interacted with ducks (in twice weekly, 1-hour groups) for 12 wk at a TBI rehabilitation facility. The discussion includes site identification, stakeholder engagement, intervention design and human and animal safety procedures. The research methods, theoretical framework, ethical consideration, and risk reduction strategies for human participants and ducks are discussed. Also, description of challenges and blueprints of possible solutions for other researchers interested in developing similar initiatives. This program will serve as a study site for examining effects of AATF-based interventions on self-efficacy, depression, and anxiety in persons with TBI. If the study suggests that AATF interventions with ducks may lead to positive changes, the proposed study will be followed with studies that include larger samples at multiple sites. Findings in this paper may contribute to the implementation science body of knowledge. Because of that, the information in this paper may benefit the researchers outside of the healthcare arena. From that perspective methods described in this paper may help to develop studies that focus on policy development, program expansion, or individual project implementation.

Goldfish or aquatic turtle? Impact of two animal assisted interventions on children's pain, anxiety, and fear during IV catheterization: A randomized controlled trial

PURPOSE

This study aimed to determine the effect of goldfish and aquatic turtle nursing interventions on children's pain, anxiety, and fear during IV catheter insertion.

DESIGN AND METHODS

The randomized controlled trial included 98 children (control group = 32, goldfish group = 33, aquatic turtle group = 33) aged 5-6 years, attending outpatient clinic for blood sampling and catheterisation procedures. Pain was measured using the Wong Baker Facial Pain Scale, anxiety was measured using the Child Anxiety Scale-State, and child fear was measured using the Child Fear Scale, before, during, and after catheterization.

RESULTS

When analyzing the pain, anxiety, and fear findings, no statistical difference was found between the scores of the mother, child, and researcher before the procedure. During the catheterization procedure, the pain, anxiety, and fear scores of the children in the fish and turtle groups increased statistically less than those in the control group. When analyzing the post-procedure findings, the pain, anxiety, and fear scores of the control group were similar to those before the procedure. In the fish and turtle groups, anxiety and fear scores were statistically the lowest (p < 0.05).

CONCLUSION

It can be concluded that animal-assisted practices reduce anxiety and fear during and after the catheterization procedures while diverting attention from pain.

PRACTICE IMPLICATIONS

Goldfish or aquatic turtle intervention improve children's attitudes toward pain, anxiety, and fear during IV catheter insertion. Pediatric nurses could consider incorporating, such as the animal assisted intervention, into their clinical practice to reduce the pain, anxiety, and fear experienced by children during medical/nursing procedures.

Dog-assisted interventions for adults diagnosed with schizophrenia and related disorders: a systematic review

Background

Many individuals diagnosed with schizophrenia and related disorders experience insufficient symptom relief from currently available treatment options. Researching additional venues should be prioritized. This systematic review, designed in accordance with PRISMA, examined the effect of targeted and structured dog-assisted interventions as a supplementary treatment.

Methods

Randomized as well as non-randomized studies were included. Systematic searches were conducted in APA PsycInfo, AMED, CENTRAL, Cinahl, Embase, Medline, Web of Science, and in several sources covering "gray" (unpublished) literature. In addition, forward and backward citation searches were performed. A narrative synthesis was conducted. Quality of evidence and risk of bias were assessed in accordance with GRADE and RoB2/ROBINS-I criteria.

Results

12 publications from 11 different studies met eligibility criteria. Overall, studies showed diverging results. General psychopathology, positive and negative symptoms of psychosis, anxiety, stress, self-esteem, self-determination, lower body strength, social function, and quality of life were among the outcome measures with significant improvement. Most documentation for significant improvement was found for positive symptoms. One study indicated significant deterioration of non-personal social behavior. The risk of bias was high or serious for most of the outcome measures. Three outcome measures were associated with some concerns regarding risk of bias, and three with low risk of bias. Quality of evidence was graded low or very low for all outcome measures.

Conclusions

The included studies indicate potential effects of dog-assisted interventions for adults diagnosed with schizophrenia and related disorders, mostly beneficial. Nevertheless, low number of participants, heterogeneity, and risk of bias complicate the interpretation of results. Carefully designed randomized controlled trials are needed to determine causality between interventions and treatment effects.

Animal-Assisted Psychotherapy for Pediatric Chronic Pain: Case Series of an Open Pilot Study to Test Initial Feasibility and Potential Efficacy

Objective

Chronic pain is a common complaint in children and adolescents, placing an enormous burden on individuals, their families, and the healthcare system. New innovative approaches for the treatment of pediatric chronic pain (PCP) are clearly warranted, as drop-out rates in intervention studies are high and it can be difficult to engage patients with PCP in therapy. Here, animal-assisted interventions (AAIs) might be promising, since there is preliminary evidence for the approach in adults with chronic pain, and AAIs are generally known to foster the therapeutic motivation of patients. To date, however, AAIs have not been examined in pediatric chronic pain.

Methods

The aim of this open pilot study was to examine the initial feasibility of recruitment and potential efficacy of an animal-assisted group psychotherapy (including horses, rabbits, chickens, goats, and a dog), providing case reports of three children with chronic pain. We applied a mixed-methods approach, including the conductance of semi-structured interviews and assessment of quantitative pre-post data with a focus on pain severity, avoidance behavior, pain acceptance, and ability to defocus from the pain.

Results

The three participating girls (age: 9-12 years) reported chronic pain in the head and abdomen. The process of recruitment turned out to be challenging. All three children reported reduced pain-related disability and pain-related distress, as well as an increased ability to accept pain and to defocus from the pain. The qualitative data revealed that patients and their parents had a positive attitude towards AAIs.

Conclusion

Our initial open pilot study is the first to investigate AAIs in the context of pediatric chronic pain. Notably, we had difficulties in the recruitment procedure, mostly due to the Covid-19 situation. Based on three case reports, we found some first indication that AAI approaches might be associated with symptom changes. Future randomized-control studies with larger sample sizes are clearly warranted.

Clinicaltrialsgov Identifier

NCT04171336.

Human-Animal Interaction in Animal-Assisted Interventions (AAI)s: Zoonosis Risks, Benefits, and Future Directions-A One Health Approach

Animal-assisted interventions (AAI)s represent the expression of integrated medicine, according to the One Health approach. Actually, animal-assisted therapies and animal-assisted activities are implemented in hospitals, rehabilitation centers, etc. The efficacy of AAIs is based on interspecific interactions and would be impacted by different factors, such as the characters of both the animal and the handler, a suitable selection of animal species, an appropriate animal educational protocol, the relationship between the handler and the animal, and mutual relationship among the animal, the patients, and members of the working team. AAIs produce many advantages for the patients but could expose them to zoonotic-pathogens transmission. Therefore, positive animal welfare, as preventative medicine to avoid incidents or transmission of zoonosis, is a relevant aspect with implications for human and animal health and wellbeing. This review aims to summarize the current published knowledge regarding the occurrence of pathogens in AAIs and to discuss their relevance in light of health and safety in AAIs participants. In addition, this review will contribute to defining the state of the art of AAIs through a careful benefits/challenges analysis and offers discussion points on the possible future developments according to the One Health approach.

Effects of contact with a dog on prefrontal brain activity: A controlled trial

Background

There is a broad range of known effects of animal contact on human mental and physical health. Neurological correlates of human interaction with animals have been sparsely investigated. We investigated changes in frontal brain activity in the presence of and during contact with a dog.

Methods

Twenty-one healthy individuals each participated in six sessions. In three sessions, participants had contact with a dog, and in three control sessions they interacted with a plush animal. Each session had five two-minute phases with increasing intensity of contact to the dog or plush animal from the first to the fourth phase. We measured oxygenated, deoxygenated, and total hemoglobin and oxygen saturation of the blood in the frontal lobe/frontopolar area with functional near-infrared spectroscopy (SenSmart Model X-100) to assess brain activity.

Findings

In both conditions, the concentration of oxygenated hemoglobin increased significantly from the first to the fourth phase by 2.78 μmol/l (CI = 2.03–3.53, p < .001). Oxygenated hemoglobin concentration was 0.80 μmol/l higher in the dog condition compared to in the control condition (CI = 0.27–1.33, p = .004). Deoxygenated-hemoglobin concentration, total hemoglobin concentration, and oxygen saturation showed similar patterns.

Conclusion

Prefrontal brain activation in healthy subjects increased with the rise in interaction closeness with a dog or a plush animal. Moreover, interaction with a dog stimulated more brain activity compared to the control condition, suggesting that interactions with a dog can activate stronger attentional processes and elicit more emotional arousal than interacting with a nonliving stimulus.

Animals in Animal-Assisted Services: Are They Volunteers or Professionals?

With the increasingly common practice of Animal-Assisted Services (AAS), whether in therapy, coaching, education, or volunteering programs, the concern over animal welfare has also risen. However, no standards have yet been established for good practices to ensure the animal’s mental health. This is largely due to the wide variety of roles played by animals in interventions and the lack of ‘job descriptions’ for the animal in diverse settings. Some professionals call their animal a ‘volunteer’, others mention that some directive guidance is given to the therapy animal, and some assistance animals are highly trained. Misunderstandings could be avoided if the integrated animal were to receive a justifiable label: volunteer or professional. Choosing either one comes with obligations for the owner, handler, or therapist. In this paper, we compare the roles of human volunteers and professionals to the roles of animals involved in therapy. We also demonstrate the obligations that come along with the decision to label animals as such either volunteers or professionals. Furthermore, we make a plea for animal-friendly interventions, whether in a volunteer position or as a professional, in order to stimulate the animal’s cooperation and motivation. Studying dopamine and translating the findings into context-ethograms can provide a way to judge behavior more objectively.

Effects of a Dog-Assisted Social- and Emotional-Competence Training for Prisoners: A Controlled Study

BACKGROUND

Previous research has called for improving psychological interventions and developing new treatments for prisoners. Animal-assisted prison-based programmes have increasingly been used as an approach, but there is a lack of studies investigating the effectiveness of such programmes.

OBJECTIVE

To investigate the effects of a dog-assisted social- and emotional-competence training on the socioemotional competences of prisoners compared to treatment as usual.

METHODS

In a controlled trial, we investigated 62 prisoners that participated in either a 6-month dog-assisted psychotherapeutic programme or the standard treatment. We assessed social and emotional competences before and after the training and at a 4-month follow-up. Data were analysed with linear models.

RESULTS

The prisoners' self-assessed social and emotional competences did not differ. The psychotherapists rated the prisoners' emotional competences in the intervention group higher at the follow-up but not after the training. The psychotherapists did not rate the prisoners' social competences in the intervention group differently but did find them to have higher self-regulation at follow-up and lower aggressiveness after the training than the control group.

CONCLUSIONS

This study indicates that dog-assisted programmes with a therapeutic aim might be beneficial for prisoners. However, the inconsistent results indicate that more research is needed to determine the potential and limits of animal-assisted programmes in forensic settings.

Integrative Model of Human-Animal Interactions: A One Health-One Welfare Systemic Approach to Studying HAI

The Integrative Model of Human-Animal Interactions (IMHAI) described herewith provides a conceptual framework for the study of interspecies interactions and aims to model the primary emotional processes involved in human-animal interactions. This model was developed from theoretical inputs from three fundamental disciplines for understanding interspecies interactions: neuroscience, psychology and ethology, with the objective of providing a transdisciplinary approach on which field professionals and researchers can build and collaborate. Seminal works in affective neuroscience offer a common basis between humans and animals and, as such, can be applied to the study of interspecies interactions from a One Health-One Welfare perspective. On the one hand, Jaak Panksepp's research revealed that primary/basic emotions originate in the deep subcortical regions of the brain and are shared by all mammals, including humans. On the other hand, several works in the field of neuroscience show that the basic physiological state is largely determined by the perception of safety. Thus, emotional expression reflects the state of an individual's permanent adaptation to ever-changing environmental demands. Based on this evidence and over 5 years of action research using grounded theory, alternating between research and practice, the IMHAI proposes a systemic approach to the study of primary-process emotional affects during interspecies social interactions, through the processes of emotional transfer, embodied communication and interactive emotional regulation. IMHAI aims to generate new hypotheses and predictions on affective behavior and interspecies communication. Application of such a model should promote risk prevention and the establishment of positive links between humans and animals thereby contributing to their respective wellbeing.

Effects of animal-assisted psychotherapy incorporating mindfulness and self-compassion in neurorehabilitation: a randomized controlled feasibility trial

Transdiagnostic psychotherapeutic approaches are increasingly used in neurorehabilitation to address psychological distress. Animal-assistance is thought to increase efficacy. The present study evaluates a psychotherapeutic mindfulness- and self-compassion-based group intervention (MSCBI) with and without animal-assistance for patients with acquired brain injury. Patients (N = 31) were randomly assigned to the 6-week intervention with (n = 14) or without animal-assistance (n = 17). Primary outcome was psychological distress at post- and follow-up treatment, secondary outcomes were changes within-session of patients’ emotional states, adherence to treatment and attrition. Psychological distress significantly decreased in both groups from pre- to follow-up treatment with no difference between groups. Patients in the animal-assisted MSCBI group reported significantly higher increases in feeling secure, accepted, comforted, grateful, motivated and at ease during the sessions compared to patients in the MSCBI group without animal-assistance. Adherence to sessions was significantly higher in the animal-assisted MSCBI group. Attrition did not significantly differ between groups. Our results show that both MSCBIs with and without animal-assistance are feasible and effective in reducing psychological distress in patients with acquired brain injury. The significant changes within-sessions mainly in relationship-based emotional states and the higher treatment adherence suggest additional effects of animal-assistance. Animal-assistance might increase acceptability and patients’ commitment to psychotherapy.

Animal-Assisted Intervention and Health Care Workers’ Psychological Health: A Systematic Review of the Literature

Healthcare settings have recently increased the use of companion animals in the workplace to provide emotional support to people with disabilities, but there is limited empirical research on the effects of these programs on healthcare workers. However, it is reasonable to speculate that Animal-Assisted Interventions (AAIs) may have positive effects on health care workers (HCWs) by buffering the negative effects of work-related stress and other occupational psychosocial risk factors. The aim of this review was to examine the beneficial effects of AAIs on the psychological well-being of HCWs. A systematic review was conducted in December 2021 to gain insight into the positive effects of pets on HCWs in the workplace. Searches were conducted in the following databases: Scopus, PubMed/Medline, Web of Science, and Google Scholar, including studies between 2001 and December 2021, and 12 articles were included in the review. The results indicate that implementing the AAI program in a busy clinic is feasible and that the program is accepted by medical professionals because of the immense psychological benefits it provides. However, the healthcare professionals disliked the experimental design that forced them to leave their workplaces at a certain time.

Exploring Animal-Assisted Therapy for Creating Rich Communicative Environments and Targeting Communication Goals in Subacute Rehabilitation

PURPOSE

This study continues our research examining the use of animal-assisted therapy (AAT) for patients with acquired neurogenic communication disorders. AAT pairs an animal/handler team with a licensed therapist during sessions to target discipline-specific goals. Our original study focused on dog/handler teams paired with occupational and physical therapists during inpatient rehabilitation sessions. We documented multiple ways that AAT enriched the communicative environment, increasing the amount, complexity, and voluntariness of patient participation. This study focuses on speech-language pathology sessions, comparing communicative environments during AAT and traditional sessions. We also examined the speech-language pathologists' (SLPs') experiences in learning to plan for and target communication goals for patients during AAT sessions.

METHOD

This interpretive design combines ethnographic methods with participatory action research. We recruited 10 patients from an inpatient rehabilitation unit and two SLPs. We video-recorded 20 speech-language pathology sessions (one AAT and one traditional for each patient) and conducted 26 interviews. We consulted with SLPs on how to incorporate AAT into their treatment during their preparation time and used self-report measures to track changes in their planning time and confidence across the 6-week study.

FINDINGS

Across participants, AAT sessions provided richer communicative environments than traditional speech-language pathology sessions as measured by participant talk time, mean length of turns, and use of interactional discourse resources such as narrative use and playful language. The SLPs were rapidly able to adapt their clinical practice to incorporate AAT and displayed rapid and marked decreases in their initial planning time and increases in confidence.

CONCLUSION

AAT sessions created meaningful, rich, and complex communicative environments in a clinical space for participants to align with others around a shared interest.

Animal-Assisted Intervention in Speech-Language Pathology: Practical, Clinical, and Theoretical Considerations

Interest in animal-assisted interventions within the field of communication sciences and disorders is growing. As more clinicians become interested in engaging in animal-assisted therapy (AAT) and more researchers begin to study its potential benefits, it will be critical for all stakeholders to demonstrate knowledge of the standards and qualifications for service delivery as well as the challenges that must be met in developing an evidence base for clinical practice. This review highlights some of the foundational information relevant to AAT in the context of speech-language pathology.

Effects of animal-assisted interventions for people with dementia: A systematic review and meta-analysis

Animal-assisted interventions (AAIs) are non-pharmacological, cost-effective interventions developed to improve outcomes in patients with dementia; however, the effects remain inconclusive. The purpose of this study was to analyze the efficacy of AAIs for people with dementia. A systematic review and meta-analysis was performed of English-language literature published from January 1, 2001, to July 3,2021, and indexed in the following databases: CINAHL, EMBASE, MEDLINE, PubMed, Web of Science, Cochrane, and PsycINFO. Intervention groups were people with dementia who received AAIs. Study quality was assessed using the Joanna Briggs Institute tool. Among 10 included studies, significant differences in depression levels were identified between the intervention and control groups (p < 0.001). No significant differences in cognitive function, neuropsychiatric syndrome, or independence in activities of daily living were observed between groups. Future research remains necessary to examine the effects of AAIs on depression during different stages of dementia. AAIs therapists may collaborate with healthcare workers to improve AAIs benefits.

Effects of Animal-Assisted Therapy on Gait Performance, Respiratory Function, and Psychological Variables in Patients Post-Stroke

Background: Animal-assisted therapy using dogs is being administered to patients post-stroke for the purpose of recovering psychological and physical activity. Objective: This study was conducted to confirm the effect of animal-assisted therapy using dogs on gait performance, pulmonary function, and psychological variables in patients post-stroke. All outcomes were analyzed using two-way repeated-measure analysis. Methods: In total, 30 post-stroke patients were divided into an experimental group (gait training by animal-assisted activity, n = 15) and a control group (gait training, n = 15). Gait performance (cadence, gait speed, stride length, symmetric index), respiratory pulmonary function (forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP)), and psychological variables (rehabilitation motivation and depression assessment) were measured before and after eight weeks of intervention. Results: Gait performance, respiratory pulmonary function, and psychological variables significantly increased in the experimental group compared to the control group. Conclusion: Based on this study, it was found that animal-assisted therapy using dogs is an effective intervention for recovery of psychological and physical activity in patients post-stroke.

Dog visits in nursing homes - increase complexity or keep it simple? A randomised controlled study

Objective

To compare the immediate response of nursing home residents to dog visits with or without an activity, and the impact of cognitive ability.

Methods

In a randomly controlled trial, 174 nursing home residents were allocated to 12 bi-weekly 10-minute visits: either ordinary dog visits (D, n = 57, 49 analysed), dog visits with an activity (DA, n = 56, 48 analysed), or visits with activity but no dog (A, n = 61, 54 analysed). We recorded frequency and duration of residents’ verbal and physical interactions with the dog and persons. Data were analysed in three periods of four visits (period 1–3) as binomial variables (generalised linear models) or durations (non-parametric statistics).

Results

Both visit type and impairment level affected the likelihood of interacting with the dog (D and DA). In some periods increased cognitive impairment lowered odds of touching the dog in DA visits (period 1: F_1,85 = 5.17, P < 0.05) and talking to it directly (period 1: F_1,90 = 4.60, P < 0.05; period 3: F_1,87 = 5.34, P < 0.05). Throughout, residents talked less to persons during DA visits compared to D and A (P = 0.01–0.05), and level of cognitive impairment correlated negatively with talk duration (P < 0.001). Generally, high cognitive impairment level lowered odds of interacting with (period 1: F_1,89 = 7.89, P < 0.01; period 2: F_1,97 = 6.76, P = 0.01; period 3: F_1,92 = 13.57, P < 0.001) and talking about the activities (period 1: F_1,89 = 13.78, P <0.001; period 2: F_1,88 = 3.27, P = 0.07; period 3: F_1,86 = 3.88, P = 0.05).

Conclusion

Visits without specific activities stimulated residents to interact with the dog, whereas increasing the complexity of dog visits by adding activities resulted in less interaction with the dog for severely impaired residents. The optimal dog visit for the less cognitively impaired residents could include activities and thereby a possibility to interact with the dog in different ways, whereas for severely impaired residents, just being with the dog seems more appropriate.

French handlers' perspectives on Animal-Assisted Interventions

BACKGROUND

Animal-Assisted Interventions (AAI) are well implemented in human healthcare, in France as elsewhere; yet there are still difficulties in characterizing these practices and misconceptions about their mechanisms - little is known about the French practice of AAI and about the human-animal team.

OBJECTIVES

This study aims to characterize AAI by exploring their specificities through French handlers' perspectives.

MATERIAL AND METHOD

An online survey addressed to French handlers working in AAI with mainly one dog was carried out. This research included questions about their practice in AAI (registration status, beneficiaries, and animals) and their background (training in AAI, training in the medico-social field, training in animal behavior). We then examined a phenomenological understanding of handlers' definitions of their practice in AAI, their motivations to work with these approaches, and the expectations of the human-animal team. We used an open coding strategy and created major themes from their answers.

RESULTS

111 handlers participated in this study. The quantitative data highlighted a heterogeneity of handlers' profiles and professional backgrounds, although most profiles had previous training in healthcare. Five themes characterizing AAI emerged from the qualitative analysis: (1) AAI as additional approaches to care settings, (2) AAI as person-centered approaches, (3) the complementarity between handlers and their animal(s), (4) the shared role of mediator, and (5) handlers' beliefs about the human-animal relationship related to their personal experiences. This survey allowed us to understand how the French use AAI and its role in the care system.

CONCLUSION

The benefits of AAI are numerous both for care settings and for the caregivers mainly by making the care more humane. AAI seem to put the wellbeing of beneficiaries and the relationship with the caregiver at the center of the care. The complementarity of the human-animal team is the common feature of these practices and is critical to their success. Future interdisciplinary studies are required to explore the particularities of these interspecific approaches and the differences between countries.

Acceptability of AAI from the Perspective of Elderly Clients, Family Members, and Staff-A Pilot Study

Although animal-assisted interventions (AAIs) are increasingly part of comprehensive rehabilitation and many of its effects are already well described, the methodology for performing AAI depends on the specific patient, animal, and treatment objective. Acceptability of AAI from all involved members is a little explored area. Thus, 214 respondents (32 AAI clients, 146 family members, and 36 healthcare and social care workers; 98 males, 116 females; mean age 46.3 years (±16.5 SD)) completed a list of statements focused on AAI with a dog. This list was distributed directly in nursing homes, retirement homes, and in households with home hospice care. All statements were rated on a Likert scale of 0-3. The results show that AAI is generally very well received, with over 90% of respondents considering AAI to be beneficial. The perception of AAI and trusting the handler with their dog was evaluated very positively, as well as possible concerns about hygiene. The results were in many cases affected by demographic factors of the respondents (age, gender, role in AAI, education, and size of settlement). It seems appropriate in future studies to focus on the attitude of individual groups, and thus advance the methodology of implementing AAI.

Animal-Assisted Therapy Improves Communication and Mobility among Institutionalized People with Cognitive Impairment

Disorders of communication, social relationships, and psychomotricity are often characterized by cognitive impairment, which hinders daily activities and increases the risk of falls. This study aimed to evaluate the efficacy of an animal-assisted therapy (AAT) program in an institutionalized geriatric population with cognitive impairment. The variables evaluated included level of communication and changes in gait and/or balance. We performed a two-arm, parallel controlled, open-label, nonrandomized cluster clinical trial in two nursing home centers from an urban area. Patients in the two centers received 12 weekly sessions of physiotherapy, but the experimental group included AAT with a therapy dog. The study included a total of 46 patients (23 Control Group [CG], 23 Experimental Group [EG]) with a median age of 85.0 years. Of these, 32.6% had mild-moderate cognitive decline (Global Deterioration Scale of Reisberg [GDS] 2-4) and 67.4% severe cognitive decline (GDS 5-6). After the intervention, patients in the CG and EG showed a statistically significant improvement in all the response variables. When comparing both groups, no statistically significant differences were found in any of the Tinetti scale results (measuring gait and balance). However, the communication of patients in the EG, measured on the Holden scale, showed a statistically significant greater improvement postintervention than that of patients in the CG. AAT can be useful as a complementary, effective treatment for patients with different degrees of cognitive decline.

Could Animal-Assisted Therapy Help to Reduce Coercive Treatment in Psychiatry?

For psychiatric patients, compulsory admission and coercive measures can constitute distressing and sometimes traumatizing experiences. As a consequence, clinicians aim at minimizing such procedures. At the same time, they need to ensure high levels of safety for patients, staff and the public. In order to prevent compulsory measures and to favor the use of less restrictive alternatives, innovative interventions improving the management of dangerous situations are needed. Animal-assisted therapy (AAT) is being applied in a variety of diagnoses and treatment settings, and could have the potential to reduce aggression and psychopathology. Therefore, AAT might be of use in the prevention and early treatment of aggression, and might constitute a promising component of treatment alternatives to forced interventions. To our knowledge, no study evaluating the effect of AAT on compulsory measures in persons with psychiatric diseases has been published up to date. This narrative expert review including a systematic literature search examines the published literature about the use of AAT in psychiatry. Studies report reduced anxiety and aggressiveness as well as positive effects on general wellbeing, self-efficacy, quality of life and mindfulness. Although literature on the applicability of AAT as a component of preventive or de-escalating treatment settings is sparse, beneficial effects of AAT have been reported. Therefore, we encourage examining AAT as a promising new treatment approach to prevent compulsory measures.

"There Is a Cat on Our Ward": Inpatient and Staff Member Attitudes toward and Experiences with Cats in a Psychiatric Ward

The aim of this study was to investigate inpatient and staff member attitudes toward and experiences with ward cats, and identify possible mechanisms for how cats affect patient satisfaction in a psychiatric clinic. Thirty-three inpatients diagnosed with depression or psychosis residing on wards with and without cats and 17 staff members working on wards with cats participated in semi-structured interviews using a cross-sectional study design. Data analysis included descriptive statistics and correlations. The results showed that 17 out of 19 inpatients and all the staff members liked having a cat on their ward. Further, 12 out of 14 inpatients on wards without cats would like having a cat on their ward. Inpatient perceptions of the cat’s impact on the ward atmosphere correlated significantly with their emotional relationship with the cat (p = 0.015, r = 0.561), how often they saw the cat (p = 0.002, r = 0.676), and if they liked cats in general (p = 0.041, r = 0.486). Our results highlight the positive attitudes of inpatients and staff members toward ward cats and the potential of ward cats to enhance patient satisfaction. This influence might be mediated by factors such as the frequency of contact, the relationship between each patient and the cat, and each patient’s attitude toward cats in general.