Dolphin-Assisted Therapy: Claims versus Evidence

Selected Methods of Therapeutic Interactions With People With Mild Symptoms of Autism Spectrum Disorder

In this review we present the behavioral aspects of interaction in people with autism spectrum disorders (ASD), taking into account some aspects of pharmacotherapy. In the treatment of people with ASD, an individual approach to emotional, social and cognitive functioning is very important. The specificity of symptoms and their severity in people with ASD results from deficits/disfunction of various areas of the brain and is associated with different levels of intelligence. This manuscript considers selected methods of interaction with ASD patients with normal IQ. Due to the different ways of functioning, these people often find it difficult to adapt to social expectations. The most important thing is to understand their perception of themselves and the world around them in order to support them in coping with the daily challenges. Due to the increasing problem, more and more attention is being focused on early detection of ASD, what allows to intervene as fast as possible and in consequence affect the quality of life of people with this dysfunctions. However, participants with mild autism symptoms are still difficult to diagnose in the practice. The effectiveness of the therapy depends largely on the cooperation of educational institutions. It is also necessary to contact specialist clinics, including a mental health counseling center. However, in the case of children and adolescents, the cooperation between the therapist and their parents is the basis. Systemic family therapy is also important in adults with ASD. An overview of the methods of therapeutic interactions in ASD, what may be helpful in diagnosing of mild ASD, were presented in our manuscript.

Animal Interaction Affecting Core Deficit Domains Among Children with Autism: A Meta-Analysis

Animal-assisted intervention (AAI) has garnered public interest and has been implemented for youth with autism spectrum disorders-a practice supported by anecdotal evidence. While investigations of AAI for children with autism have been conducted, the extant literature is characterized by significant variability in methodology and practice. The present meta-analysis examines the aggregated effects of equine AAI on adaptive functioning among children with autism. Results indicated that interacting with an equine specifically during AAI produced small-to-medium effects (g = 0.40) on the adaptive functioning of children with autism. Recommendations are made for future research on this topic.

Third time's the charm or three strikes you're out? An updated review of the efficacy of dolphin-assisted therapy for autism and developmental disabilities

CONTEXT

Dolphin-assisted therapy (DAT) is a popular form of animal-assisted therapy for autism spectrum disorders and other psychological conditions.

OBJECTIVE

In this review, our third, we analyze the most recent DAT studies in terms of construct and internal validity criteria to determine if there is empirical support for DAT.

METHOD

To ensure a systematic review, we searched for peer-reviewed studies on DAT by submitting relevant search terms to Google Scholar from 2007 to 2020, conducted a further search of all DAT papers in several peer-reviewed journals, and reviewed reference sections of DAT articles to ensure a thorough review of the literature between 2007 and the present.

RESULTS

The DAT literature continues to be marked by several weaknesses in both internal and construct validity that preclude confident inferences regarding the intervention's efficacy.

CONCLUSION

There is still insufficient evidence that DAT has therapeutic value.

Virtual Reality Relaxation for Patients With a Psychiatric Disorder: Crossover Randomized Controlled Trial

Background

Virtual reality (VR) relaxation is a promising mental health intervention that may be an effective tool for stress reduction but has hardly been tested in clinical trials with psychiatric patients. We developed an easy-to-use VR self-management relaxation tool (VRelax) with immersive 360° nature videos and interactive animated elements.

Objective

To investigate the immediate effects of VR relaxation on negative and positive affective states and short-term effects on perceived stress and symptoms in patients with a psychiatric disorder, compared to standard relaxation exercises.

Methods

A randomized crossover trial was conducted in 50 patients receiving ambulatory treatment for anxiety, psychotic, depressive, or bipolar disorder. Participants were randomly assigned to start with VRelax or standard relaxation and used both interventions for 10 days at home. They completed 8 visual analog scales of momentary negative and positive affective states before and after each session. Global perceived stress and psychiatric symptoms were measured before and after both intervention periods. Treatment effects were analyzed with multilevel mixed model regression analyses and 2-way analysis of variance.

Results

Both VRelax and standard relaxation exercises led to a statistically significant immediate improvement of all negative and positive affective states. Compared to standard relaxation, VRelax resulted in a significantly greater reduction of total negative affective state (change 16.2% versus 21.2%; t₁₆₈₄=−2.02, 95% CI −18.70 to −0.28; P=.04). Specifically, VRelax had a stronger beneficial effect on momentary anxiety (t₁₆₈₄=−3.24, 95% CI −6.86 to −1.69), sadness (t₁₆₈₄=−2.32, 95% CI −6.51 to −0.55), and cheerfulness (t₁₆₈₄=2.35, 95% CI 0.51 to 5.75). There were no significant differences between short-term effects of the two treatments on global perceived stress and symptoms.

Conclusions

If the results of this trial are replicated and extended, VRelax may provide a much-needed, effective, easy-to-use self-management relaxation intervention to enhance psychiatric treatments.

Trial Registration

Netherlands Trial Register NTR7294; https://www.trialregister.nl/trial/7096

Reassessing public opinion of captive cetacean attractions with a photo elicitation survey

Background

Captive cetacean attractions are growing in number globally, their operators citing entertainment, education, and conservation as benefits. Those for and against developing such attractions claim public support. Previous public opinion research, however, shows little consensus, partly due to the introduction of biases in study design that influence participants' responses. Those involved in, or concerned with, developing and licensing these attractions need to better understand what drives the lack of consensus to take socially-acceptable decisions.

Methods

We reviewed previous research on public opinion of cetacean captivity, noting possible sources of bias. Survey question wording can be a major source of introduced bias, so we used an open-ended photo elicitation approach. We showed tourists in the Turks Caicos Islands (N = 292) images of a marine mammal park (MMP) killer whale show and a swim-with-the-dolphins (SWTD) attraction and asked for their qualitative comments on the potential development of each. They also indicated how likely they would be to visit each on a Likert scale.

Results

Respondents were generally against visiting MMP killer whale shows, with 60.9% not likely to visit. SWTD attractions were more popular; 60.3% were likely to visit. For SWTD, USA residents were more likely to visit; older respondents and those staying in all-inclusive resorts were less likely. Those staying in all-inclusive resorts were also less likely to visit MMP killer whale shows. The great majority of qualitative comments centred on either entertainment value or animal welfare concerns. There were very few, if any, comments on the education or conservation value of these attractions.

Discussion

Our findings contradict several previous studies on public opinion of captive cetaceans that did not use photo elicitation. The support shown for MMP killer whale shows in this survey was well below that claimed by studies conducted on behalf of captive cetacean attraction operators. Opposition to SWTD was also noticeably lower than that found in surveys conducted with wild cetacean tourism participants. This difference can likely be attributed to the different survey populations and settings, but this variation is also very likely attributable to researcher-introduced bias. While photo selection can introduce bias, photo elicitation reduces reliance on pre-scripted questions and responses, and seems to effectively reduce other forms of bias. Allowing open-ended responses, where participants responded to an image, seems to have given a more representative understanding of what is at the forefront of the public's mind than closed questioning. These conclusions, among others made in this study, suggest that development decisions for captive cetacean attractions are being made on imprecise data. Going forward, data collected via responder-led, open-ended, bias-minimising approaches should at least be considered when informing such decisions.

Pinnipeds and PTSD: An Analysis of a Human-Animal Interaction Case Study Program for a Veteran

The objective of this study was to examine the impact of a pinniped (grey and harbor seals) facilitated human-animal interaction pilot program on the self-reported PTSD-like symptoms of a veteran. This study analyzed preexisting, deidentified data that represented the participant's scores on the Post-Traumatic Stress Disorder Checklist (PCL-5). The PCL-5 was completed as part of a pilot program operated in partnership between the Veteran and Military Affiliated Research Center (VMARC) and a local aquarium. Scores on the PCL-5 were collected prior to (T1), midway (T2), and immediately after (T3) completion of the Project Seal to Heal program. Changes in the scores of each item were reported for the participant, for aggregated items that represented different clusters of PTSD symptoms, and for overall scores. Results revealed decreased scores in 11 of the 20 PTSD symptom-related items, improvement in the sum scores for each criteria symptom cluster, and a 15-point decrease in the overall PCL-5 score, indicating clinical significance. These results serve as a call to motivate future research investigating pinniped interactions with veterans who have PTSD in order to determine therapeutic clinical application and outcomes.

Neuroplasticity, limbic neuroblastosis and neuro-regenerative disorders

The brain is a dynamic organ of the biological renaissance due to the existence of neuroplasticity. Adult neurogenesis abides by every aspect of neuroplasticity in the intact brain and contributes to neural regeneration in response to brain diseases and injury. The occurrence of adult neurogenesis has unequivocally been witnessed in human subjects, experimental and wildlife research including rodents, bats and cetaceans. Adult neurogenesis is a complex cellular process, in which generation of neuroblasts namely, neuroblastosis appears to be an integral process that occur in the limbic system and basal ganglia in addition to the canonical neurogenic niches. Neuroblastosis can be regulated by various factors and contributes to different functions of the brain. The characteristics and fate of neuroblasts have been found to be different among mammals regardless of their cognitive functions. Recently, regulation of neuroblastosis has been proposed for the sensorimotor interface and regenerative neuroplasticity of the adult brain. Hence, the understanding of adult neurogenesis at the functional level of neuroblasts requires a great scientific attention. Therefore, this mini-review provides a glimpse into the conceptual development of neuroplasticity, discusses the possible role of different types of neuroblasts and signifies neuroregenerative failure as a potential cause of dementia.

How to prove that your therapy is effective, even when it is not: a guideline

AIMS

Suppose you are the developer of a new therapy for a mental health problem or you have several years of experience working with such a therapy, and you would like to prove that it is effective. Randomised trials have become the gold standard to prove that interventions are effective, and they are used by treatment guidelines and policy makers to decide whether or not to adopt, implement or fund a therapy.

METHODS

You would want to do such a randomised trial to get your therapy disseminated, but in reality your clinical experience already showed you that the therapy works. How could you do a trial in order to optimise the chance of finding a positive effect?

RESULTS

Methods that can help include a strong allegiance towards the therapy, anything that increases expectations and hope in participants, making use of the weak spots of randomised trials (risk of bias), small sample sizes and waiting list control groups (but not comparisons with existing interventions). And if all that fails one can always not publish the outcomes and wait for positive trials.

CONCLUSIONS

Several methods are available to help you show that your therapy is effective, even when it is not.