The State of Animal-Assisted Interventions: Addressing the Contemporary Issues that will Shape the Future

The feasibility of wildlife immersion experiences for Veterans with PTSD

Introduction

Animal-assisted interventions (AAI) offer potential physical and psychological health benefits that may assist Veterans with post-traumatic stress disorder. However, more feasibility studies are needed regarding intervention details, adverse events, reasons for study withdrawal, and animal welfare.

Methods

This mixed methods feasibility trial involved a modified crossover study in which Veterans with PTSD/PTSD symptoms were provided a series of 8 nature and wildlife immersion experiences to evaluate feasibility and preliminary efficacy. The sample included 19 Veterans with PTSD/PTSD symptoms who were followed for a mean of 15.1 weeks. The intervention was comprised of a baseline forest walk, assisting with wildlife rehabilitation, observation in a wildlife sanctuary, and bird watching. Post study bird feeders were provided for sustainability.

Results

This AAI nature/wildlife immersion intervention was feasible, acceptable, and safe to administer to Veterans with PTSD/PTSD symptoms with appropriate support. Logistical and relational facilitators were identified that supported the wildlife immersion activities. Participants reported greatly enjoying the activities. Attention to animal welfare and care was an important ethical foundation that also contributed to feasibility.

Discussion

AAI immersion experiences with wildlife are feasible and can safely be administered to Veterans with PTSD/PTSD symptoms. Logistical and relational facilitators are important to support nature and wildlife immersion activities.

Effectiveness of animal-assisted therapy and pet-robot interventions in reducing depressive symptoms among older adults: A systematic review and meta-analysis

BACKGROUND

Systematic reviews suggest that animal-assisted therapy (AAT) and pet-robot interventions (PRI) achieve a reduction in mental health variables such as depressive symptoms. However, these systematic reviews include both randomised and non-randomised studies, which prevents an adequate assessment of the effect of confounding variables.

OBJECTIVE

This systematic review and meta-analysis aimed to evaluate the comparative effectiveness of AAT and PRI through randomized controlled trials (RCTs) in reducing depression in older adults.

METHODS

Our study is a systematic review. We searched three databases of scientific articles: SCOPUS, Web of Science and PubMed. We included studies that their population was older adults, aged 65 years or older, with or without a clinical condition, clinical diagnosis based on mental examination/test or documentation from medical records, accredited by the facilities' staff. We included trials in which the comparator was a passive intervention or an active intervention. We used the Cochrane risk-of-bias tool for randomised trials (RoB 2) to assess the risk of bias for each study. Our study was registered in PROSPERO (CRD42023393740).

RESULTS

Twenty-three studies were included in this systematic review. However, only 19 trials were included in the meta-analysis. At the overall risk of bias level, 78.9% of the studies were at high risk of bias (n = 15). We found that AAT (g= -0.72; 95%CI -1.13 to -0.31; p = 0.001) has a moderate and statistically significant effect as an intervention to reduce depressive symptoms in older adults. However, the PRIs do not show a significant effect on reducing depressive symptoms in older adults. In addition, a sub-analysis based on dog-assisted therapy (g= -0.65; 95%CI -1.21 to -0.08; p = 0.025), a specific type of AAT, showed a modest effect on reducing depressive symptoms.

CONCLUSIONS

Our study concluded that AAT and DAT had a moderate and statistically significant effect as interventions to reduce depressive symptoms in older adults. On the other hand, PRI did not show a significant effect in reducing depressive symptoms.

Being in a meaningful context. Nature and animal-assisted activities as perceived by adults with autism

INTRODUCTION

Animal-assisted and nature-based interventions in psychosocial treatment for various groups of clients have been studied internationally. However, there is little knowledge about how young adults with autism experience participation in such types of interventions. This clinical study aimed to describe the feasibility of animal-assisted and nature-based activities on a farm as a complementary intervention for young adults with autism and social withdrawal.

METHODS

The participants were aged 18-30 years, diagnosed with autism and social withdrawal, with no organised occupation during the previous year. Eleven of 13 participants completed a 12-week intervention in small groups. They took part in interviews before and after, which focused on their current life situation and expectations about, and experiences of the intervention. The feasibility was described in terms of participants' characteristics, attendance, and their experiences of participating in the activity. Data were analysed with descriptive statistics and qualitative content analysis.

CONSUMER AND COMMUNITY INVOLVEMENT

The intervention was formed in collaboration with participating supervisors, ordinary clinical staff, and a young woman with a user perspective.

FINDINGS

The level of feasibility was found to be high. The mean participation rate during the activity days was 75% and varied from 50 to 100%. The analysis of the participants' experiences from the activity generated three categories, "Being in a meaningful context", "Creating a comfort zone" and "Developing structure in everyday life", and each of these included sub-categories.

CONCLUSION

The main categories revealed a dynamic process based in meaningfulness, comfort and structure in everyday life. The positive experiences of undemanding activities, emotional relationships and non-verbal communication with the horses were prominent and might facilitate the development of social interaction. However, the intervention's timeframe of 12 weeks was experienced as too short for long-lasting change.

The Impact of Transportation on the Cortisol Level of Dwarf Rabbits Bred to Animal-Assisted Interventions

(1) Background: the popularity of rabbits has increased during the last decade and become the third most common companion animal in the EU. Rabbits' participation in Animal-Assisted Interventions (AAIs) is growing. It is highly important to ensure the well-being of the animals in AAIs. Whereas the needs and the advantages of people involved in AAI are becoming more and more evident, the needs of animals are not clearly defined, therefore, it is a great field of inquiry. Animals who are used for AAI need to be transported regularly, which itself might be a source of stress. (2) Methods: the stress of rabbits-caused by transportation-was measured in a non-invasive way: cortisol levels were determined from feces, based on their breakdown products. Eighteen animals were involved in the study. Rabbits experienced a 30 min transportation every second day for two weeks (altogether six times) while 126 samples were collected. (3) Results: rabbits could handle the transportation procedure the first time but subsequently the stress hormone metabolites in feces samples increased regardless of the offered treatments (hay, carrot and apple) during the carriage. (4) Conclusions: those owners who use rabbits for Animal-Assisted Interventions need to take into account that transportation itself is a stressful experience for the animals.

An Exploratory Study into the Backgrounds and Perspectives of Equine-Assisted Service Practitioners

Equine-Assisted Services (EASs) are commonplace in today's society, but vary widely in both theoretical and practical applications. Until now, practitioners' experiences and perspectives in relation to these services have received little attention. To address this, a purpose-designed online questionnaire was distributed to EAS practitioners, exploring issues relating to the nature of the service provided, practice patterns, practitioner education, perceived knowledge, challenges faced and the future direction of these services. An analysis revealed a significant association between practitioners' backgrounds and the nature of the service offered, as well as perceived knowledge. Median EAS training received to first practice was 20 days of block release over a year; however, nearly half of the sample (42.4%) reported less training than this. Equine-specific training was more limited, with 41.5% of practitioners having no horse-relevant qualifications. The most important challenges reported by practitioners involved client and equine welfare, financial sustainability and raising awareness of EAS. This research highlights the diverse nature of EAS and also raises important challenges and possible opportunities for development. Findings suggest that more progress is needed to professionalise and legitimise the area to support and help practitioners provide the best service for all concerned.

The ethical perspectives of using animals in pediatric health

While there are ethical standards for human biomedical research, animals have historically not benefitted from the same levels of protection. Cultural shifts in response to studies demonstrating animal capacity to suffer have resulted in laws defining minimum ethical standards for the treatment of various animal populations. However, none of these pertain to service or therapy animals nor do they define ethical considerations regarding training, placement, environment, and duty limitations specific to this population. The potential for harm and inability to provide consent should raise ethical questions of animal assisted interventions (AAI), including how to best balance the risk: benefit ratio for both animal and human participants. While service animals have specific definitions, therapy and emotional support animals are much less clearly defined and therefore have far less standardized practices regarding their training, certification, and process for matching to handlers. This can lead to animals being inadequately trained to cope with the stresses of their jobs or being placed in incompatible environments. Meanwhile, service animals' duties are constant, and the animal has little ability to consent to or withdraw from participation, leading to overwork, without the opportunity to engage in activities that align with the animals' natural preferences. Emotional support animals are the least defined of these populations, receive no formal training, and are at increased risk of inadequate care, unstable housing, and abuse from handlers who may also be poorly prepared to properly handle their needs. To uphold our moral obligations to the animals that serve to improve our own mental wellness and physical independence, urgent actions are needed to improve the protections in place for these populations.

Developing and Planning a Protocol for Implementing Health Promoting Animal Assisted Interventions (AAI) in a Tertiary Health Setting

The Ottawa Charter identifies that multiple levels of government, non-government, community, and other organizations should work together to facilitate health promotion, including in acute settings such as hospitals. We outline a method and protocol to achieve this, namely an Action Research (AR) framework for an Animal Assisted Intervention (AAI) in a tertiary health setting. Dogs Offering Support after Stroke (DOgSS) is an AR study at a major tertiary referral hospital. AAI has been reported to improve mood and quality of life for patients in hospitals. Our project objectives included applying for funding, developing a hospital dog visiting Action Research project, and, subsequent to ethics and governance approvals and finance, undertaking and reporting on the Action Research findings. The Action Research project aimed to investigate whether AAI (dog-visiting) makes a difference to the expressed mood of stroke patients and their informal supports (visiting carers/family/friends), and also the impact these visits have on hospital staff and volunteers, as well as the dog handler and dog involved. We provide our protocol for project management and operations, setting out how the project is conducted from conception to assess human and animal wellbeing and assist subsequent decision-making about introducing dog-visiting to the Stroke Unit. The protocol can be used or adapted by other organizations to try to avoid pitfalls and support health promotion in one of the five important action areas of the Ottawa Charter, namely that of reorienting health services.

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 Interventions for Autism Spectrum Disorder: A Systematic Review of the Literature from 2016 to 2020

In the last five years, the literature on animal-assisted intervention (AAI) for Autism Spectrum Disorder (ASD) has doubled in size from 42 studies prior to 2015 to 85 studies (cumulative total assessed in 2020). Horses remain the most commonly researched animal for AAI, followed by dogs. The most commonly researched outcome was social interaction, across 21 studies. Though the quantity of studies has increased, issues with methodological rigor remain. Results highlight the need for a continued focus on methodological rigor as well as refining the structure of animal-assisted interventions, addressing the welfare needs of the animals involved, and continuing to establish an evidence base of both significant and nonsignificant findings for AAI for individuals with ASD.

Understanding the Role of Therapy Dogs in Human Health Promotion

Dogs may provide humans with a range of physical, mental and social benefits. Whilst there is growing scientific evidence of benefits to humans, there has been less focus on the impact to canine health, welfare and ethical considerations for the dogs. The importance of animal welfare is increasingly acknowledged, indicating that the Ottawa Charter should be extended to include the welfare of non-human animals supporting the promotion of human health. Therapy dog programmes are delivered across a variety of settings including hospitals, aged care facilities and mental health services, highlighting the important role they play in human health outcomes. Research has shown that that there are biomarkers for stress in humans and other animals engaged in human-animal interactions. This review aims to assess the impact of human-animal interactions on therapy dogs engaged in providing support to human health. While challenging, it is paramount to ensure that, within the framework of One Welfare, the welfare of therapy dogs is included, as it is a key factor for future sustainability. We identified a range of concerns due to the lack of guidelines and standards to protect the wellbeing of the dogs engaged in these programmes. Extension of the Ottawa Charter to include the welfare of non-human animals with leveraging through a One Welfare approach would promote animal and human health beyond current boundaries.

Reading to Dogs at Home: A Pilot Study

In summer 2021, during the coronavirus pandemic, 8 parent-child dyads were recruited to participate in a pilot project to investigate the potential benefit of an at-home adaptation of an Animal-Assisted Intervention (AAI) for literacy. After completing a demographic survey and the Perceived Stress Scale-10 (Cohen et al., 1983), children's reading level was established using the Fry method and past report card information. Parents were given access to an online levelled-reader e-book provider along with written instructions and video training. Parent-child dyads engaged in the at-home AAI literacy support for 6-weeks during which time children's reading level was tracked online. Parental stress was assessed again upon completion. Findings indicate that reading level increased in 6 out of 8 cases, although not significantly. Parental stress, however, increased significantly from the start to end of the project. This descriptive pilot project discusses the potential and pitfalls of an at-home AAI literacy intervention.

What are the effects of animals on the health and wellbeing of residents in care homes? A systematic review of the qualitative and quantitative evidence

BACKGROUND

There is some evidence to suggest that animal-assisted interventions can have beneficial impact for residents in long-term care, but the focus of the evidence has largely been on behavioural and psychosocial measured outcomes. Animals, either as companion animals or in the form of pet/animal-assisted therapy, may provide benefits in the form of social contact, as well as opportunities for sensory experiences and meaningful engagement not picked up by outcome tools. This review aimed to create a state-of-knowledge synthesis, bringing together qualitative and quantitative findings, on the impact of animal-human interaction on care home residents and care home staff.

METHODS

Fourteen databases were searched from inception to July 2020. Forward and backward citation chasing of included articles was conducted. Screening was undertaken independently by a team of reviewers. Thematic synthesis and meta-analysis were used to synthesise the qualitative and quantitative data.

RESULTS

Thirty-four studies, published in 40 articles (20 qualitative and 20 quantitative) were included. Five themes relating to resident wellbeing were identified in the qualitative evidence synthesis. These were animals as 'living beings', reminiscence and storytelling, caring (as 'doing' and 'feeling'), respite (from loneliness, institutionalisation, and illness), and sensory engagement. A sixth theme related to staff perceptions and wellbeing, and a seventh to animal health and wellbeing. Maintaining identity was identified as an overarching theme. The majority of randomised trials had small sample sizes and were rated as low quality, mostly showing no evidence of beneficial effect. There was, however, limited evidence of a positive effect of pet/animal interaction on outcomes of loneliness, anxiety and depression, supporting the themes of respite and sensory engagement.

CONCLUSIONS

The presence of animals can significantly impact the health and wellbeing of some care home residents. Residents had meaningful relationships with animals and derived pleasure and comfort from them. Interacting with animals offered residents a way to maintain a sense of self in the care homes, and with support, residents with dementia could also express their identities. Facilitating residents to interact with animals as part of person-centred care may also help residents to feel 'at home' in the care home.

TRIAL REGISTRATION

PROSPERO registration no: CRD42017058201.

The effectiveness of animal-assisted therapy for children and adolescents with autism spectrum disorder: A systematic review

BACKGROUND

and purpose Individuals with autism spectrum disorder (ASD) experience difficulty with communication, learning, behaviour, and social interactions. Animal-assisted therapy (AAT) is a growing alternative and complementary therapy for ASD. This review aims to investigate the effectiveness of AAT for children and adolescents with ASD in the domains of cognitive, social, emotional, behavioural, and physical.

METHODS

A systematic search of databases (Medline, Emcare, Embase, Cochrane Library, PsycINFO, PsycARTICLES, Scopus, ERIC and OTseeker) was conducted in March 2022. Grey literature was also explored which included searching Trove database and the first 10 pages of Google, as well as pearling reference lists of included studies. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The methodological quality of the included studies was assessed using a modified Joanna Briggs Institute Review Form for Randomised Controlled Trials. A descriptive synthesis was undertaken due to heterogeneity within the evidence base.

RESULTS

Seven randomised controlled/clinical controlled trials with moderate methodological quality were included in this review. Overall, participation in AAT identified positive trends in the cognitive, social, emotional, behavioural, and physical domains. Despite the positive outcomes, implementation of AAT should be taken with caution as there are currently no standardised frameworks due to heterogeneity within the intervention protocols and outcome measures.

CONCLUSION

AAT may have positive effects across a multitude of outcomes in the management of ASD for children and adolescents. However, the current literature has considerable methodological concerns which should be addressed by future research.

Mobile Zoos and Other Itinerant Animal Handling Events: Current Status and Recommendations for Future Policies

Mobile zoos are events in which non-domesticated (exotic) and domesticated species are transported to venues such as schools, hospitals, parties, and community centres, for the purposes of education, entertainment, or social and therapeutic assistance. We conducted literature searches and surveyed related government agencies regarding existing provisions within laws and policies, number of mobile zoos, and formal guidance issued concerning operation of such events in 74 countries or regions. We also examined governmental and non-governmental guidance standards for mobile zoos, as well as websites for mobile zoo operations, assessed promotional or educational materials for scientific accuracy, and recorded the diversity of species in use. We used the EMODE (Easy, Moderate, Difficult, or Extreme) algorithm, to evaluate identified species associated with mobile zoos for their suitability for keeping. We recorded 14 areas of concern regarding animal biology and public health and safety, and 8 areas of false and misleading content in promotional or educational materials. We identified at least 341 species used for mobile zoos. Mobile zoos are largely unregulated, unmonitored, and uncontrolled, and appear to be increasing. Issues regarding poor animal welfare, public health and safety, and education raise several serious concerns. Using the precautionary principle when empirical evidence was not available, we advise that exotic species should not be used for mobile zoos and similar itinerant events.

Fur, Fin, and Feather: Management of Animal Interactions in Australian Residential Aged Care Facilities

Animal-assisted interventions (AAI) have been occurring in Australian Residential Aged Care Facilities (RACF) for more than 40 years and may relieve loneliness and improve quality of life. The presence of animals in RACF poses an inherent risk to residents and the animals involved. Little is known about the policies and guidelines for including animals in the Australian RACF. We anticipated that most RACFs would have some policies, but they may lack the detail necessary to keep humans and animals safe. Using an adapted survey, we surveyed and interviewed a small but representative sample of Australian RACF managers. The results demonstrated that RACF did have animal policies; however, the content regarding the need for hand washing, infection prevention, and animal welfare was lacking. Including unregulated family pets in RACF was an unexpected additional risk factor identified during data analysis. There is a need for national guidelines tied to the national aged care policy, which includes training and educational resources for RACF and AAI providers.

Informing Implementation: Perspectives from the Australian University Community Regarding an Animal Assisted Intervention

Animal Assisted Interventions (AAIs) have become increasingly popular in the university setting; however, there is limited research exploring their potential on an Australian university campus and participants' views prior to implementation. Therefore, this study aimed to explore university staff members' and students' interest in participating in an AAI and their perspectives on intervention characteristics. This was a mixed methods study, using an online survey and semi-structured interviews. The survey had 344 responses, and 45 interviews were conducted. A large majority of participants (86%) were interested in participating in an AAI. In the survey, participants indicated their preferred intervention characteristics for the location of the intervention, frequency of participating, and ways of hearing about the intervention. Participants also expressed concerns regarding therapy animal welfare. In interviews, participants discussed various considerations which may impact the intervention (such as the accessibility of the location, the impact of workload on participating, the effectiveness of promotion strategies, and factors that may assist therapy animal welfare, such as the therapy animals' handlers). Gaining an insight into the university community's views prior to implementation may ensure the intervention is feasible to implement and can be beneficial to both humans and therapy animals.

Survey of international academic centers and institutes focused on human-animal bond: Scope and landscape in 2021

Routine surveying of academic centers focused on the human-animal bond is critical to understand the trajectory of the field and to create an environment where centers can learn from one another and build collaborations. The purpose of this manuscript was to report the findings of a survey of these human-animal bond centers, to summarize the status of the field, and to identify changes within the field since 2016. Survey questions concentrated on the demographic characteristics, engagement programs, educational opportunities, and research focuses of the centers. Findings suggest that the field continues to grow as one-third of human-animal bond centers are less than 10 years old. The number of centers that participated in this survey increased by 31% compared to the previous survey (O'Haire et al., 2018). Centers have developed a variety of engagement programs, including animal-assisted intervention and companion animal education programs. About half of the centers (48%) offer degree programs and about one quarter of the centers (24%) offer certificate programs. Most centers (95%) focus their research on companion animals with the most studied companion animal being dogs (95%). The most frequent data collection method was surveys (86%). Qualitative analyses, behavior measures, and physiological measures were also common. The most notable changes from the 2016 survey include overall growth of the field (indicated by the establishment of new centers) and a shift in the specialty area of directors, moving from 44% of directors being veterinarians in 2016 survey to 90% having a human-focused specialty in the 2021 survey. Most centers' research focused on animal-assisted interventions which is consistent with the previous survey. As the field of the human-animal bond continues to grow and more centers emerge, ongoing evaluation of offerings is important to track changes, identify needs, and foster success.

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.

Animal-Assisted Counseling for Young Children: Evidence Base, Best Practices, and Future Prospects

Increasing numbers of young children are experiencing mild to moderate mental health issues that require support in addition to that typically provided by family members and teachers. The services of professional counselors can be particularly useful when children need help adjusting to and coping with various stressors and situations. Many school counselors and other mental health professionals have found that carefully planned interactions between young children and animals (e.g., guinea pigs, rabbits, dogs, horses) represent an effective alternative/complementary therapeutic modality. Animals may provide an accepting, nonjudgmental presence that focuses young children's attention, motivates them to learn, and encourages participation in planned intervention activities. This article begins by describing the general purposes for counseling with young children and the role that early childhood educators can play in increasing families' awareness of and access to these services in their communities. Next, it defines animal-assisted counseling and reviews the relevant research to build a rationale for including carefully selected animals in mental health support services for children. The third section discusses caveats about involving animals in individual and small group counseling sessions, in classrooms, and in other facilities/programs that work with young children. The article then summarizes best practices in animal-assisted counseling and how they are influenced by variables within the child, animal welfare considerations, different contexts, availability of resources, and interagency collaborations. The conclusion is a statement on the future of animal-assisted counseling for young children and how it supports the goals of humane education.

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.

Molecular Biomarkers of Adult Human and Dog Stress during Canine-Assisted Interventions: A Systematic Scoping Review

Simple Summary

Interactions between people and dogs may lower participants’ stress levels. However, this is a fairly new area of research and there has not been a review of what we know across studies. We examined the existing research and found that human–dog interactions consistently improve some indications of human stress levels and don’t seem to negatively affect dogs. However, we need to do more research to gain a better understanding of the impacts on people and dogs with a wider lens that looks at more markers of stress.

Abstract

Positive relationships, including those between humans and other animals, particularly dogs, may be a way to reduce stress in humans. However, research into this area is relatively new, and a comprehensive review of the impacts of these interactions on humans and dogs has not been conducted. A scoping review of the scientific literature was conducted to explore what is known about the impacts of canine-assisted interventions on molecular biomarkers (e.g., cortisol and oxytocin) and associated measures (e.g., heart rate and blood pressure) of human and canine stress. As reported across 27 identified studies, canine-assisted interventions have consistently been demonstrated to elicit positive changes in human stress markers, and typically do not cause negative impacts on the studied canine stress markers. However, results were inconsistent across measures of stress. For example, in humans, it was common for a study to show improvements to cortisol levels but no change to self-reported stress, or vice versa. Many of the reviewed studies also had significant methodological issues, such as not aligning the timing of sample collections to when the analyzed stress biomarkers could be expected to peak. More rigorous research should be conducted on the impacts of canine-assisted interventions on a wider range of stress biomarkers.

Recommendations for Transdisciplinary Professional Competencies and Ethics for Animal-Assisted Therapies and Interventions

AAI is a transdisciplinary field that has grown exponentially in recent decades. This growth has not always been synergistic across fields, creating a need for more consistent language and standards, a call for which many professionals in the field have made. Under the umbrella of human–animal interactions (HAI) is animal-assisted interventions (AAIs), which have a more goal-directed intention with animals who have been assessed for therapeutic, educational, or vocational work. The current article offers a brief history and efficacy of HAI, describes the limitations and gaps within the field and recommends a new set of competencies and guidelines that seek to create some of the needed common language and standards for AAI work to address these limitations.

Impact of Equine-Assisted Interventions on Heart Rate Variability in Two Participants with 22q11.2 Deletion Syndrome: A Pilot Study

People with disabilities due to genetic origin often present high levels of stress: non-pharmacological interventions such as Equine-Assisted Interventions (EAI) may be a useful strategy. The objective of this pilot study was to evaluate stress levels in two participants with 22q11.2 deletion syndrome diagnosis, immediately after carrying out the EAI. A single case experimental design methodology was chosen due to the small sample size. Two participants with 22q11.2 Deletion Syndrome, a rare disease, with different comorbidities were included. The present study considered the EAI as the independent variable while the Heart Rate Variability (HRV) represented the dependent one, as HRV is considered an indicator of stress level. Measurements were performed before and after carrying out the interventions. The results showed an HRV increase in one of the participants and an increase in the arousal level evidenced by a decrease in his HRV. After having carried out the program, EAI seems to cause an impact on the activation level of the participants depending on the typology and nature of the intervention. However, these results should be treated with caution due to the small sample size. This study is a pilot to test the feasibility of the proposed interventions on the variable under study.

Therapy Dog Welfare Revisited: A Review of the Literature

During the past decade, the field of human-animal interaction(s) research has been characterized by a significant increase in scientific findings. These data have contributed to our current understanding of how humans may benefit from contact with animals. However, the animal experience of these interactions is still an under-researched area. This paper addresses the welfare of dogs who participate in animal-assisted interventions (AAIs) to improve health in human recipients. This paper builds on previous work by Glenk (2017) and provides an updated review of the literature on therapy dog welfare published from 2017-2021. New advances in scientific methodology, such as the determination of salivary oxytocin, breath rate and tympanic membrane temperature, are analyzed regarding their value and limitations for research in AAIs. Moreover, welfare-related social and environmental factors (e.g., freedom of choice, exploration of novel environments, inequity aversion, individual development, working experience, relationship with handler and handler skills) that profoundly influence dog perception and well-being are reviewed and discussed. Accounting for the globally increasing interest and the number of dogs utilized in AAIs, safeguarding therapy dog well-being, and identifying situations, circumstances and protocols that may challenge animal welfare remains an emerging and crucial area of scientific effort.

Providing Humans With Practical, Best Practice Handling Guidelines During Human-Cat Interactions Increases Cats' Affiliative Behaviour and Reduces Aggression and Signs of Conflict

The importance of animals' experiences and associated comfort during Human-Animal Interactions (HAI), and particularly Animal Assisted Interventions (AAI), are increasingly recognised. However, there remains a paucity of published research, particularly concerning less formal but frequent HAIs to which companion animals are typically exposed, such as stroking or petting. Additionally, few practical evidence-based guides to facilitate humans' optimal animal handling and interaction in these contexts exist. A simple set of Human-Cat Interaction (HCI) guidelines were therefore created, with the aim to enhance domestic cats' comfort during generic HCI contexts. Based around a “CAT” acronym, guidelines focused on providing the cat with choice and control (“C”), paying attention (“A”) to the cats' behaviour and body language and limiting touch (“T”), primarily to their temporal regions. Guidelines were presented to human participants during a brief training intervention, and guideline efficacy was subsequently assessed. Domestic cats available for rehoming at Battersea Dogs and Cats Home, UK (n = 100) were filmed during interactions with novel members of the public (n = 120). Cats were exposed to a maximum of six, 5-min interaction sessions, balanced across “control” (interactions with humans pre-training) and “intervention” conditions (interactions with humans post-training). For each observation, cat behaviour and posture were coded and humans' cat-directed behaviour rated on the degree to which it reflected best practice principles. Data were extracted from a total of 535 observations and average human interaction ratings and cat behaviour values compared between control and intervention conditions via paired Wilcoxon tests. Compared to the control, humans' interaction styles were rated as significantly more closely aligned with best practice principles in the intervention condition. Cats also displayed significantly greater frequencies and/or durations of affiliative and positively-valenced behaviours in the intervention. In contrast, cats in the control displayed significantly greater frequencies of human-directed aggression, in addition to greater frequencies and/or durations of behaviours associated with conflict and negative valence. Results demonstrate the positive impact of practical interaction guidelines on cats' social behaviour and comfort during HCI, with the potential to improve cats' general experiences during interactions, reduce human-directed aggression and ultimately improve cat-human relationships.

Assistance, Service, Emotional Support, and Therapy Dogs

This article focuses on the areas where harnessing the canine's trainability, mobility, and sociability enables their use for aiding and augmenting humans. This area, which is rapidly expanding, has provided life-changing solutions for persons affected by various impairments and disabilities (eg, visual, hearing, physical, mental).

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.

Effectiveness of a school-based programme of animal-assisted humane education in Hong Kong for the promotion of social and emotional learning: A quasi-experimental pilot study

Background

Humane education, which focuses on the cultivation of kindness and empathy towards animals, the environment, and fellow humans, helps children to be less egocentric and more sensitive to the human–animal interaction in ecology.

Aim

This study aimed to evaluate an animal-assisted, school-based humane education programme that promotes a humane attitude and enhances social–emotional competence for children in Hong Kong.

Method

A sequential mixed-methods formative evaluation was adopted in the pilot year of the programme. A controlled trial and focus groups were conducted to evaluate the preliminary outcomes and process of the programme and to identify the implementation obstacles and effective strategies. One hundred and ten primary three students from two primary schools participated in the study (55 in the intervention group and 55 in the control group with ordinary formal school extra-curricular activities). Paired sample t tests and a mixed ANOVA were conducted to explore the changes in students’ social–emotional competence in our programme and two typical extra-curricular school programmes. Thematic analysis was conducted to categorise the transcriptions from the focus groups.

Results

Quantitative findings indicated that class-based, animal-assisted humane education increased cognitive competence (t[24] = 2.42, p = .02), empathy (t[24] = 2.94, p < .01), and reduced hyperactivity (t[23] = -2.40, p = .02). Further analysis indicated that the participant recruitment strategies moderate the impact of interventions on the development of empathy (F[2,104] = 4.11, p = .02) and cognitive competence (F[2,104] = 2.96, p = .05). Qualitative analysis suggested three major themes: enhancement of self-control, promotion of humane attitude, and improvement of reading skills.

Conclusion

The preliminary results of this pilot study indicate positive effects of the programme. Vigorous systematic formative evaluation on the process and effective implementation should be included in future follow-up studies to ensure its sustainability and fidelity.

Resilience: Safety in the Aftermath of Traumatic Stressor Experiences

The relationship between adverse experiences and the emergence of pathology has often focused on characteristics of the stressor or of the individual (stressor appraisals, coping strategies). These features are thought to influence multiple biological processes that favor the development of mental and physical illnesses. Less often has attention focused on the aftermath of traumatic experiences, and the importance of safety and reassurance that is necessary for longer-term well-being. In some cases (e.g., post-traumatic stress disorder) this may be reflected by a failure of fear extinction, whereas in other instances (e.g., historical trauma), the uncertainty about the future might foster continued anxiety. In essence, the question becomes one of how individuals attain feelings of safety when it is fully understood that the world is not necessarily a safe place, uncertainties abound, and feelings of agency are often illusory. We consider how individuals acquire resilience in the aftermath of traumatic and chronic stressors. In this respect, we review characteristics of stressors that may trigger particular biological and behavioral coping responses, as well as factors that undermine their efficacy. To this end, we explore stressor dynamics and social processes that foster resilience in response to specific traumatic, chronic, and uncontrollable stressor contexts (intimate partner abuse; refugee migration; collective historical trauma). We point to resilience factors that may comprise neurobiological changes, such as those related to various stressor-provoked hormones, neurotrophins, inflammatory immune, microbial, and epigenetic processes. These behavioral and biological stress responses may influence, and be influenced by, feelings of safety that come about through relationships with others, spiritual and place-based connections.

Animal-Assisted Therapy as an Intervention for Older Adults: A Systematic Review and Meta-Analysis to Guide Evidence-Based Practice

BACKGROUND

Animal-assisted therapy (AAT) can ameliorate diverse health problems in older adults. However, applications of AAT have been limited because of the lack of intervention guidelines for older adults.

AIMS

This study aimed to explore applications of AAT to older adults, analyze its health effects, and provide evidence for future interventions.

METHODS

A systematic review and meta-analysis were conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Data were analyzed based on both a narrative synthesis and a meta-analysis specifically for depression.

RESULTS

A total of 47 studies were selected for analysis. About 45% focused on older adults with diseases such as dementia, and 57.4% selected dog(s) as an intervention animal. About 34.0% delivered interventions once a week, and the behavioral outcome domain was the most frequently investigated. The meta-analysis showed that the effect sizes of the AAT group were -1.310 (95% CI [-1.900, -.721]).

LINKING EVIDENCE TO ACTION

This review provides evidence for AAT as an intervention in the physiological, psychosocial, cognitive, and behavioral domains of older adults. When planning interventions for older adults, nurses should consider intended health outcomes, appropriate therapeutic animals, and the consequent intervention contents.

Dog Welfare, Well-Being and Behavior: Considerations for Selection, Evaluation and Suitability for Animal-Assisted Therapy

Simple Summary

Benefits for humans participating in animal-assisted therapy (AAT) have been long documented; however, welfare considerations for the animal counterparts are still quite non-specific, often relating to more general concerns associated with animal-assisted interventions (AAIs). Providers of AAT have a moral and ethical obligation to extend the “Do No Harm” tenet to the animals with whom they work. Companion animals do not ask or voluntarily sign up to be a part of a therapeutic team and their natural traits of love and sociability can easily be misinterpreted and exploited. This article reviews the current state of animal-assisted interventions; it highlights the lack of sufficient evaluation processes for dogs working with AAT professionals, as well as the risks associated with not protecting the dogs’ welfare. Finally, the authors make recommendations for determining the suitability of specific dogs in the clinical setting and ensuring that the population, environment, and context of the work is amenable to the dogs’ welfare and well-being.

Abstract

Health care and human service providers may include dogs in formal intervention settings to positively impact human physical, cognitive and psychosocial domains. Dogs working within this context are asked to cope with a multitude of variables including settings, populations, activities, and schedules. In this article, the authors highlight how both the preparation and operation of dogs within animal-assisted therapy (AAT) differs from less structured animal-assisted activities (AAA) and more exclusive assistance animal work; the authors highlight the gaps in our knowledge in this regard, and propose an ethically sound framework for pragmatic solutions. This framework also emphasizes the need for good dog welfare to safeguard all participants. If dogs are not properly matched to a job or handler, they may be subjected to unnecessary stress, anxiety, and miscommunication that can lead to disinterest in the work, overt problematic behavioral or health outcomes, or general unsuitability. Such issues can have catastrophic outcomes for the AAT. The authors propose standards for best practices for selection, humane-based preparation and training, and ongoing evaluation to ensure the health, welfare and well-being of dogs working in AAT, which will have concomitant benefits for clients and the professionalism of the field.

The Psycho-Social Impact of Human-Animal Interactions

When I was asked by the Journal to guest edit a special issue on the psychosocial impact of human-animal interactions, I was honored to accept the invitation [...].

How Equine-Assisted Activities Affect the Prosocial Behavior of Adolescents

Multiple studies have investigated the positive effects of human–animal interactions and showed that animal-assisted activities can be successfully used to better human physical and mental health. Equine-assisted activities have also raised considerable attention within the field. Our research focuses on healthy students (aged 14–18) without deviations or special educational needs. We analyze the occurrence of behavior problems and prosocial behavior among adolescents who regularly have interactions with horses, and those who have no connection to horses at all. The subjects of our investigation completed the strengths and difficulties questionnaire (SDQ), and we use a ‘quasi’ 2 × 2 before-after control-impact design to analyze the data. Students studying equine-related vocations and students of other vocations are compared, at the beginning and at the end of their studies. Our results indicate that students of equine-related vocations are more helpful and empathetic, and have fewer behavior problems, than those studying other vocations. There is a negative correlation between prosocial behavior and behavior problems. The development of the prosocial behaviors of students with regular horse–human interactions is more remarkable than of those who have no connection to horses. With these results, we are going to confirm the hypothesis that equine-assisted activities correlate with positive behavioral traits among healthy adolescents.