The Efficacy of Dog Assisted Therapy in Detained Drug Users: A Pilot Study in an Italian Attenuated Custody Institute

Drop-out rates in animal-assisted psychotherapy - Results of a quantitative meta-analysis

INTRODUCTION

Animal-assisted psychotherapy is an emerging field with great potential and growing popularity. However, empirical research on its effectiveness is insufficient, and consistent evidence about patients' commitment is missing. The present meta-analysis addresses this gap by systematically comparing drop-out rates in animal-assisted psychotherapy and by relating the resulting across study drop-out rate to across study drop-out rates reported in meta-analyses on conventional psychotherapy.

METHOD

Fifty-seven studies published until August 2022 were identified as eligible for meta-analytic comparison, that is, they conducted animal-assisted psychotherapy on at least one group of psychiatric patients and reported drop-out rates. Potential moderating influences of the type of animal and patients' disorder were considered, as well as multiple other demographic and study design variables.

RESULTS

The across study drop-out rate in animal-assisted psychotherapy was 11.2%. This was significantly lower than the across meta-analyses drop-out rate of conventional psychotherapy (d = -.45, p = .0005). Although effects of moderator variables could not be evaluated statistically due to too small and heterogeneous data sets, descriptive results suggest influences of the type of animal and patient disorder. However, study quality ratings identified serious shortcomings regarding proper research design, most critically concerning the report of effect size measures, the use of standardized intervention plans and Open Science practices.

CONCLUSION

Drop-out constitutes a major problem of psychotherapeutic research and practice. By proposing that the inclusion of an animal in the psychotherapeutic setting can enhance patients' commitment and by outlining challenges and opportunity of animal-assisted psychotherapy, this meta-analysis offers a starting point for future research in this evolving field.

Exploring dog ownership in the lives of people with substance use disorder: a qualitative study

BACKGROUND

Recovery from substance use is commonly seen as a process of integrating social relationships and creating a sense of meaning in one's life. Dog owners describe a close relationship with their dog that impacts many aspects of their everyday life. Yet for individuals with substance use disorder (SUD), little is known about how dog ownership could affect their lives. The aim of this study was to explore how people living with SUD experience and describe their everyday life when owning a dog.

METHOD

Eight semi-structured in-depth individual interviews were conducted with people having personal experience of living with SUD and owning a dog. Data were gathered and analysed using qualitative content analysis.

RESULTS

The analysis yielded four categories, reflecting different aspects of dog ownership. Living with SUD and owning a dog was primarily something positive in their life. People increased their social connections personally and within society. They felt a belonging which gave a sense of agency and purpose, and they developed structure in their day and boundaries to their environment. Dog ownership, however, could hinder access to services which was found to be challenging for some participants.

CONCLUSIONS

The owning of a dog can lead to changes that parallel those of a recovery process. This finding adds to the research on the connection that dogs can provide and shows how pertinent this can be particularly for vulnerable persons such as those with SUD.

A transdiagnostic meta-analysis of acute augmentations to psychological therapy

At least half of all patients with mental health disorders do not respond adequately to psychological therapy. Acutely enhancing particular biological or psychological processes during psychological therapy may improve treatment outcomes. However, previous studies are confined to specific augmentation approaches, typically assessed within single diagnostic categories. Our objective was to assess to what degree acute augmentations of psychological therapy reduce psychiatric symptoms and estimate effect sizes of augmentation types (for example, brain stimulation or psychedelics). We searched Medline, PsycINFO and Embase for controlled studies published between database inception and 25 May 2022. We conducted a preregistered random-effects meta-analysis (PROSPERO CRD42021236403). We identified 108 studies (N = 5,889). Acute augmentation significantly reduced the severity of mental health problems (Hedges' g = -0.27, 95% CI: [-0.36, -0.18]; P < 0.0001), particularly for the transdiagnostic dimensions 'Fear' and 'Distress'. This result survived a trim-and-fill analysis to account for publication bias. Subgroup analyses revealed that pharmacological, psychological and somatic augmentations were effective, but to varying degrees. Acute augmentation approaches are a promising route to improve outcomes from psychological therapy.

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.

The Efficacy of Animal-Assisted Therapy in Patients with Dual Diagnosis: Schizophrenia and Addiction

The objective of the study was to evaluate the efficacy of an animal-assisted-therapy (AAT) program in patients diagnosed with schizophrenia-spectrum disorders and substance-use disorders in residential treatment in order to intervene in the remission of negative and positive symptoms and improve quality of life and adherence to treatment, favouring the clinical stabilization of patients who participate in the AAT program, within the context of a mental-illness-treatment device. This was a quasi-experimental prospective study with intersubject and intrasubject factors. The sample comprised 36 patients (21 in the experimental group and 15 in the control group) who were evaluated at three time points (in the 3rd, 6th, and 10th sessions). The program lasted 3 months and consisted of 10 sessions that were implemented once a week, with a maximum participation of 10 patients per group. The participants were evaluated with the Positive and Negative Syndrome Scale (PANSS) for schizophrenia and the Life Skills Profile-20 (LSP-20) questionnaire. We observed a decrease in the positive symptoms of psychosis (F: 27.80, p = 0.001) and an improvement in functionality (F: 26.70, p < 0.001) as the sessions progressed. On the basis of these results, we concluded that AAT seems to be valid as a coadjuvant therapy as part of the rehabilitation processes of patients diagnosed with schizophrenia and addiction-spectrum disorders (dual diagnosis).

The Research of Standardized Protocols for Dog Involvement in Animal-Assisted Therapy: A Systematic Review

Dogs are considered the most important species involved in animal-assisted therapy (AAT), and the scientific literature focuses on the benefits linked to the involvement of dogs in various therapeutic areas. In this study, we carried out a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, exploring the scientific literature from the last 5 years (2016-2021) on three databases (PubMed, Scopus, and Web of Science) to highlight the characteristics of the dogs involved in AATs. Based on the scientific literature relevant to such dogs, we considered different parameters (i.e., number, age, sex, breed, temperament, methods of choice and training, health status, research goals, and activities with dogs) to include studies in our paper. After screening 4331 papers identified on the searched databases, we selected 38 articles that met the inclusion criteria. Analysis of the included articles showed that the characteristics of the dogs were neglected. Our findings indicated a lack of information about the dogs, as well as the absence of standardized and univocal criteria for dog selection, training programs, and health protocols.

Cynotherapy in cancer pain management: a pilot study

OBJECTIVES

This was a pilot study to evaluate the feasibility and impact of a single dog-assisted therapy (cynotherapy) session in reducing pain and emotional distress in oncological outpatients compared with typical waiting room experience (control).

STUDY DESIGN

Quasi-experimental before-after controlled study.

SETTING

Chronic pain outpatient clinic of a tertiary cancer center.

PARTICIPANTS

Adult oncological patients able to consent and without medical contra-indication.

METHODS

All participants completed self-reported questionnaires including a numeric rating scale for pain and distress thermometer at admission and immediately before departure from the clinic.

RESULTS

Eighty-one patients were enrolled over a ten-month study period, 41 in the cynotherapy group and 40 controls.Improvement was greater in cynotherapy than control group for pain (median difference score -1.0 versus 0.0, p = 0.037), distress levels (median -1.0 versus 0.0, p = 0.017), and depression (median -1.0 versus 0.0, p = 0.030). The proportion of patients with a clinically relevant improvement in pain (reduction ≥2 points) was approximately twofold in the cynotherapy group when compared to controls, although not statistically significant (39% versus 20%, OR = 2.53, 95% CI 0.86-8.02, p = 0.088).The mean satisfaction rate was 9.3/10 and no negative occurrences were reported.

CONCLUSION

A single session of dog-assisted therapy can provide immediate improvement in the perception of pain and distress for chronic cancer pain in an outpatient setting, with high satisfaction rates and no negative occurrences. This non-randomized pilot study points towards the clinical relevance of implementing cynotherapy at a cancer pain clinic and developing a larger scale, more directed study.

Cortisol Levels of Shelter Dogs in Animal Assisted Interventions in a Prison: An Exploratory Study

Simple Summary

Animal Assisted Interventions (AAI) are growing in popularity among professionals of psychological therapies due to their clear benefit for human health. However, to date, little attention has been paid to the welfare of the animals involved in the interventions. In this study we evaluated the potential impact of such activities on the welfare of dogs living in a kennel, which had weekly interactions with inmates held at a prison. To assess their stress levels, we analyzed their physiological response to a stressful situation by measuring the cortisol levels in saliva samples. We found a significant decrease in cortisol concentration at the end of the AAI program measured in the dogs’ living environment (i.e., kennel), which suggests a positive effect of the AAI activities on the welfare of kennel dogs. The results also suggest that transportation from the kennel to the prison could be perceived as a stressful event since it significantly increased dogs’ cortisol levels. Therefore, particular care should be taken in the management of this phase.

Abstract

Previous studies regarding the Animal Assisted Interventions (AAI) have mainly focused on the beneficial effects of human–animal interactions on human health; whereas the impact of such activities on the welfare of the animals involved has received limited attention. So far, few studies have addressed this issue by evaluating the physiological and behavioral reactions of therapy dogs during the interventions. The aim of this study was to evaluate the potential effect of AAI on the cortisol levels of shelter dogs. Five dogs participated in weekly AAI working activities with adult inmates held at a prison of the South of Italy for two months. Saliva samples were collected every two weeks in three conditions: at the kennel (baseline), after transportation and at the end of the working sessions. The results revealed a significant decrease in the cortisol baseline at the end of the AAI program, suggesting that the activities carried out with humans and in a different environment could improve the welfare of dogs housed in kennels. Moreover, we found that transportation significantly increased subjects’ cortisol levels, suggesting that it is a critical phase that deserves particular care.

Effects of Dog-Based Animal-Assisted Interventions in Prison Population: A Systematic Review

BACKGROUND

Animal-assisted interventions, in concrete dog-assisted intervention, have been introduced in prisons to reduce recidivism as well as to improve the well-being of prisoners. Therefore, the aim of the present systematic review is to provide an up-to-date analysis of the research on the effects of dog-based animal-assisted therapy in prison population.

METHODS

An electronic search of the literature was performed, and 20 articles were included. The PRISMA guideline methodology was employed.

RESULTS

Included studies involved a total of 1577 participants. The vast majority of protocols included activities related with dog training, dog caring, or activities, which included vocational or educational components. Duration of dog-based therapies ranged between 60 and 120 min, with the frequency being between 1 and 3 days/week. Statistically significant improvements in prisoners were observed in 13 studies.

CONCLUSIONS

Dog-based animal-assisted therapy may improve anxiety, stress, recidivism, and other social variables in male or female inmates.