Canine-Assisted Interventions in Hospitals: Best Practices for Maximizing Human and Canine Safety

The role of animal-assisted programs in physical health improvement of children and adolescents with special education needs - a systematic review

Programs involving animals in therapeutic programs are becoming increasingly prevalent. These programs can vary greatly in their approach, scope, and objectives, and they can significantly impact the development of healthy children and those with various disorders. In this systematic review, we sought to investigate the psychological ramifications of animal-assisted activities (AAA), therapies (AAT), and interventions (AAI). We searched for relevant studies using the EBSCO Discovery Service search engine across 85 databases, utilising appropriate keywords. Our search generated 262 results, of which 21 were selected for inclusion after title and abstract screening, as well as full-text analysis. Our findings indicate that dogs and horses are animal-assisted programs' most commonly used animals. Additionally, autism, cerebral palsy, and ADHD were found to be overrepresented in these programs. Furthermore, the length of sessions and overall program duration exhibited considerable variation, regardless of patient age or disease type. The principal measures centred on the physiological variables related to the nervous system and motorium-related indicators. The studies were generally of exceptional methodological soundness. Frequently, the studies narrowed their scope to a single segment or just the child or adolescent, but the outcomes lacked contextual interpretation. Expanding the range of studies by comparing psychological and physiological indicators and conducting follow-up analysis with a longitudinal design would be beneficial.

Guidance on Minimum Standards for Canine-Assisted Psychotherapy in Adolescent Mental Health: Delphi Expert Consensus on Health, Safety, and Canine Welfare

As interest in animal-assisted therapy (AAT) and canine-assisted psychotherapy (CAP) grows, there are increasing calls for the management of related health, safety, and welfare concerns for canines, providers, and clients. Existing health and safety guidelines lack empirical support and are, at times, contradictory. Welfare is increasingly prioritized; however, tools to monitor and manage welfare are underutilized and under-reported. The aim of this study was to provide expert consensus on the minimum health, safety, and welfare standards required to develop and deliver a CAP group program to adolescents experiencing common mental health disorders. Diverse AAT experts were recruited globally. Using Delphi methodology, over two rounds, 40 panelists reached a consensus agreement to include 32 items from a possible 49 into the minimum standards. Health and safety measures included risk assessment, veterinary screening, preventative medicine, training in infection control, and first aid. Welfare measures included training in welfare assessment, documentation of welfare, and flexible, individualized responses to promote wellbeing. Intestinal screening for parasites and the prohibition of raw food were not supported. Flexible and individualized assessment and management of canine welfare were supported over fixed and time-limited work schedules. Clinical practice implications are discussed, and recommendations are made.

Human-Animal Bond Generated in a Brief Animal-Assisted Therapy Intervention in Adolescents with Mental Health Disorders

BACKGROUND

The human-animal bond is crucial for the proper development of animal-assisted therapy (AAT) sessions. However, in specific cases such as in AAT focused on psychiatric patients who are admitted to acute units, there is only a short period of time available to establish this bond.

OBJECTIVES

To assess the degree of HAB generated after two AAT sessions in adolescents admitted to acute psychiatry units.

METHODS

A prospective multicenter cohort study aimed at adolescents aged 13 to 17 years admitted to the acute child and adolescent psychiatry unit of three hospitals.

INTERVENTION

Two weekly 1 h group sessions of AAT with therapy dogs.

MAIN OUTCOME

The Center for the Study of Animal Wellness Pet Bonding Scale Survey (CSAWPB).

RESULTS

One hundred and fourteen adolescents participated. A positive perception of the dog was generated, achieving a good level of bonding and attachment.

CONCLUSIONS

The results obtained make it possible to affirm that a short period of time is enough to establish a good HAB between patients and therapy dogs. This study aims to contribute to the study of non-pharmacological interventions as a complement to pharmacological treatments in adolescents with mental health disorders.

Reactivation of a Hospital-Based Therapy Dog Visitation Program during the COVID-19 Pandemic

This study examined human−animal interactions during the reactivation of a hospital-based therapy dog program during the COVID-19 pandemic. Data were collected from human−dog interactions at an academic medical center in Virginia. Interaction length, participant role, age group (pediatric or adult), and observed gender were recorded. Handler adherence to human and animal safety protocols (donning personal protective equipment (PPE), using hand sanitizer, and limiting visit length) was measured. Observations from 1016 interactions were collected. t-tests and analysis of variance were conducted. Most visit recipients were healthcare workers (71.69%). Patients received longer visits than other participants (F(4880) = 72.90, p = <0.001); post hoc Bonferroni analyses (p = 0.05/4) showed that patients, both adult (M = 2.58 min, SD = 2.24) (95% C.I = 0.35−1.68) and pediatric (M = 5.81, SD = 4.38) (95% C.I. 3.56−4.97), had longer interaction times than healthcare workers (M = 1.56, SD = 1.92) but not visitors (p = 1.00). Gender differences were not statistically significant (t(552) = −0.736), p = 0.462). Hand sanitizer protocols were followed for 80% of interactions. PPE guidelines were followed for 100% of visits. Most interactions occurred with healthcare workers, suggesting that therapy dog visits are needed for this population. High adherence to COVID-19 safety protocols supports the decision to reactivate therapy animal visitation programs in hospitals. Challenges to safety protocol adherence included ultra-brief interactions and crowds of people surrounding the dog/handler teams. Program staff developed a “buddy system” mitigation strategy to minimize departures from safety protocols and reduce canine stress.

Race, Zoonoses and Animal Assisted Interventions in Pediatric Cancer

Emerging evidence accumulates regarding the benefits of animal-assisted interventions (AAIs) in facilitating pediatric cancer treatment and alleviating symptomatology through positive changes in the patients’ emotional, mental, and even physical status. A major concern expressed by healthcare providers and parents in implementing AAIs in hospital settings is the transmission of disease from animals to patients. Immunocompromised children, such as pediatric cancer patients are at increased risk for pet-associated diseases. Furthermore, existing disparities among the racial and ethnic minority groups of pediatric cancer patients can potentially exacerbate their risk for zoonoses. This literature review highlights the most common human infections from therapy animals, connections to the race and ethnic background of pediatric oncology patients, as well as means of prevention. The discussion is limited to dogs, which are typically the most commonly used species in hospital-based animal-assisted therapy. The aim is to highlight specific preventive measures, precautions and recommendations that must be considered in hospitals’ protocols and best practices, particularly given the plethora of benefits provided by AAI for pediatric cancer patients, staff and families.

Canine-Assisted Interventions and the Relevance of Welfare Assessments for Human Health, and Transmission of Zoonosis: A Literature Review

CAIs (canine-assisted interventions) include "canine-assisted therapy" in which a therapist sets client-oriented goals, 'canine-assisted activities' with recreational goals for clients, and 'canine-assisted education/learning' in which teachers or coaches create learning goals for students or clients. CAIs vary in nearly every way; their only common trait is the involvement of dogs to respond to human need. However, the benefits of involving dogs are highly dependent on the animal's health and behavior. A dog exhibiting negative behavior or an unwell dog might pose a risk, especially for CAI target groups, specifically individuals with immunosuppression, chronic illness, children, elderly, etc. Therefore, positive animal welfare as preventative medicine to avoid incidents or transmission of zoonosis is an attractive hypothesis, with implications for human and animal, health and well-being. This review aims to summarize the current published knowledge regarding different aspects of welfare in CAIs and to discuss their relevance in the light of health and safety in CAI participants. As method for this study, a literature search was conducted (2001-2022) using the Prisma method, describing issues of dog welfare as defined in the Welfare Quality® approach. This welfare assessment tool includes 4 categories related to behavior, health, management, and environment; it was, therefore, applicable to CAIs. Results indicate that dogs working in CAIs are required to cope with diverse variables that can jeopardize their welfare. In conclusion, we propose regular welfare assessments for dogs in CAIs, which would also protect the quality of the CAI sessions and the clients' safety and well-being.

Handlers' Representations on Therapy Dogs' Welfare

While research on the benefits of animal-assisted interventions is beginning to build a significant body of work, studies on the well-being of therapy dogs are still in their infancy. Since handlers are the people responsible for their therapy dog's welfare, we interviewed 111 French handlers through an online questionnaire. Our results underlined that (i) therapy dogs' welfare is multidimensional when physical and psychological welfare, a balance between work and dog life and the settings and interactions of sessions are all taken into consideration. (ii) The response of our handlers emphasized that considering therapy dog welfare is important for the quality and safety of AAI. (iii) Three categories of risks factors were highlighted: the spatio-temporal framework (planning and environment), the interactions with beneficiaries and the handler themselves. It is particularly important that handlers talk about the negative impact of interactions with beneficiaries since they are at the heart of AAI, however there are few studies focusing on interactions as a stressor for dogs in this practice. Moreover, since there is a potential for positive bias in the handlers' representations, it is important that they be trained to identify and manage the stress in their dogs. Future research is particularly needed on the impact of interactions during sessions on therapy dog welfare.

Development of Desirable Behaviors in Dog-Assisted Interventions

Simple Summary

In a recent paper, Hall et al. encouraged professionals of canine training to share their observations and procedures with researchers in the field of dog learning and cognition, with the goal of coordinating knowledge and make better use of time and resources. In response to this invitation, here, we present an integrative method for the training of dogs that take part in animal-assisted interventions (AAI). This method has been developed taking into account the needs observed during nearly 30 years of interventions for the cognitive, relational, functional, and emotional improvement of the users. This method focuses on the dog, developing in the animals the necessary skills for their inclusion in dog-assisted interventions from a constructivist perspective, while guaranteeing their well-being during the training and the execution of their tasks.

Abstract

Dog-assisted interventions (DAI) are those that include specially trained dogs in human health services. Often, the training methods employed to train animals for DAI are transmitted between trainers, so the latest scientific research on dog learning and cognition is not always taken into account. The present work aims to evaluate the impact that the main theories on the evolution of the dog have had both in promoting different training methods and in the relevance of behavior in the evolution of the skills of actual dogs. Then, an integrative method for the training of dogs is presented. This method takes into account the research on dog learning mechanisms and cognition processes, and effectively promotes the development of desirable behaviors for DAI during the dog’s ontogeny.

Perspectives on facility dogs from pediatric hospital personnel: A qualitative content analysis of patient, family, and staff outcomes

An increasing number of children's hospitals feature full-time resident facility dogs, which are specially trained to work alongside pediatric healthcare professionals to improve the patient experience. This qualitative study aimed to describe the role that facility dogs play in the lives of patients, families, and hospital staff. A total of N = 73 pediatric healthcare professionals that worked with 46 facility dogs across 17 children's hospitals in the US completed a set of open-ended questions in an online survey. Responses were analyzed via a conventional thematic analysis and organized into themes and sub-themes. Facility dogs were described to benefit pediatric healthcare professionals' daily lives through improving stress and wellbeing, staff relationships, and job-related morale. Negative impacts included increased burdens and responsibilities in the workplace. Facility dogs were also described to benefit patients and families by helping build rapport, providing a comforting presence and positive resource, and normalizing the hospital environment. In conclusion, facility dog programs were found to be a promising complementary intervention to benefit both staff as well as and patients and families. Future research is warranted to examine short-term and long-term implications of facility dog programs for staff, patient, and family wellbeing.

The New Era of Canine Science: Reshaping Our Relationships With Dogs

Canine science is rapidly maturing into an interdisciplinary and highly impactful field with great potential for both basic and translational research. The articles in this Frontiers Research Topic, Our Canine Connection: The History, Benefits and Future of Human-Dog Interactions, arise from two meetings sponsored by the Wallis Annenberg PetSpace Leadership Institute, which convened experts from diverse areas of canine science to assess the state of the field and challenges and opportunities for its future. In this final Perspective paper, we identify a set of overarching themes that will be critical for a productive and sustainable future in canine science. We explore the roles of dog welfare, science communication, and research funding, with an emphasis on developing approaches that benefit people and dogs, alike.

Enhancing the Selection and Performance of Working Dogs

Dogs perform a variety of integral roles in our society, engaging in work ranging from assistance (e.g., service dogs, guide dogs) and therapy to detection (e.g., search-and-rescue dogs, explosive detection dogs) and protection (e.g., military and law enforcement dogs). However, success in these roles, which requires dogs to meet challenging behavioral criteria and to undergo extensive training, is far from guaranteed. Therefore, enhancing the selection process is critical for the effectiveness and efficiency of working dog programs and has the potential to optimize how resources are invested in these programs, increase the number of available working dogs, and improve working dog welfare. In this paper, we review two main approaches for achieving this goal: (1) developing selection tests and criteria that can efficiently and effectively identify ideal candidates from the overall pool of candidate dogs, and (2) developing approaches to enhance performance, both at the individual and population level, via improvements in rearing, training, and breeding. We summarize key findings from the empirical literature regarding best practices for assessing, selecting, and improving working dogs, and conclude with future steps and recommendations for working dog organizations, breeders, trainers, and researchers.