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What Happens to the Animals Who Are Used to Treat People in Therapy?

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Massive amounts of time, money, and energy have gone into understanding the effects of animal-assisted therapy people. In general, the results are positive. Animals can help rehabilitate prison inmates, they help sick children and adults feel better, and they can help folks with social or emotional disorders learn to better cope and engage with the world.

Rarely do we ask how the animals in these relationships are faring.

Modern animal-assisted therapy (AAT) programs refer to programs with specific goals for patients. Stroke patients help to groom dogs, or a child with cerebral palsy rides horses — both activities improve motor coordination. Animal-assisted activities (AAA), on the other hand, are less goal-oriented. The animals simply "visit" a population, such as ill children or the elderly. The main role for these animals is to act as companion. In either case, how does participation in such programs impact animal welfare?


A Haphazard History

In general, the main welfare-driven focus on the animal "volunteers" in AAT and AAA programs has been on how to treat the animals such that they may be maximally effective at doing their jobs. Guidelines have been established for how often animals should be bathed and housed. They should be spayed or neutered, and they need to be current on vaccinations. They ought to be housebroken, well trained, willing to interact with strangers, and so on. In addition, some research has focused on potential negative health outcomes, mainly involving zoonoses, diseases that can be transferred from humans to animals, or vice versa.


But despite hundreds of years of incorporating non-human animals into both AAT and AAA programs – the practice goes back at least to the 9th century – the predominant question has always been "how can animals benefit us?" Little attention has been devoted to the question of how participating in such programs affects the animals themselves. It is perhaps telling that there is still no standardized manual for optimizing the psychological welfare of therapy and service dogs.

Taking A Dog's-Eye View

In the most ideal of cases, AAT/AAA programs should benefit the animals as well as the humans. At minimum, they should not be detrimental.


Sociologist Alison Hatch interviewed ten human volunteers who facilitated animal visits for elderly clients. Most worked with dogs but several handled cats and rabbits, all of which were taken from shelter animal populations. The assumption guiding her research was that given the impossibility of asking an animal to express its feelings at participating in such programs, the next best option would be to talk to the human handlers.


Many of the human volunteers argued, Hatch reports, that shelter animals benefit from participating in such programs because it allows them increased exposure to humans. In the shelter, animals receive little human attention at all, and many arrived at the shelter having come from environments with negative interaction. Thus, participation in this AAA program, or similar ones, may serve, at least in part, to rehabilitate the animals themselves and to teach them to interact positively with humans.

How well does reality align with that idealized scenario? The results are mixed.

For one thing, animals can only benefit if the humans interact appropriately with them. That's a challenging proposition, given the high proportion of AAT/AAA clients who may suffer from psychiatric disorders, who may be themselves fearful of or aggressive towards animals, and so on. Hatch provides an illustrative example: "One of the respondents worked with a 'troubled' teenager who, at age ten, had killed a dog after the dog bit him. The goal of AAA for him was to learn to like and trust animals. The program's objective for this teen is obviously a worthy one, but situations like these call for extraordinary vigilance on the part of the handler and perhaps the presence of a mental health professional." Routine human volunteers are probably not equipped to handle these sorts of situations. She also describes an elderly man who, for no apparent reason, smacked a dog on his nose.


Still, Hatch's research indicated that there is at least a theoretical possibility that therapy and service programs can actually benefit animals, in the right circumstances. For shelter dogs, positive human socialization can even increase their chances of adoption. But the humans – both handlers and clients – need to be carefully vetted and highly trained.

Secrets in Saliva

Better than interviewing non-expert volunteer handlers would be to find a way to assess stress in the animals themselves. In the last few years, scientists have begun to understand the ways in which measurements of hormones in dog saliva can reflect their psychological well-being. Earlier this year, Lisa Maria Glenk of the Department of Comparative Medicine at the University of Vienna used salivary cortisol to assess the stress levels of therapy dogs.


With her colleagues, Glenk focused on five dogs that participated in a standardized "multiprofessional animal-assisted intervention," as a part of a mental health care program for adults with substance abuse disorders. The program had significant success at improving prosocial behavior among the humans, but this was the first study to ask specifically about the animals' well-being.

Salivary cortisol in dogs is influenced by human interaction. Positive behaviors and play can decrease cortisol, while punishments, threats, and aggression increases cortisol. Glenk's data showed that that the dogs' cortisol did not increase over the course of the therapy sessions, and it occasionally decreased, suggesting that the dogs did not find their work stressful, and sometimes even found it pleasant or rewarding. And there were no overall differences in cortisol levels between working days and "days off."


But the program that Glenk assessed perhaps reflected the most optimal sort of animal therapy program. Handlers were health care professionals. Dogs were highly trained. Each therapy session included one dog and two therapists, one of whom was the dog's owner. The two therapists kept tight control over how the human patients interacted with the dogs. Human-animal contact was initiated by the dog, who was kept off a leash. The dogs had unlimited access to water and could leave the room at any time.

Glenk's findings are roughly in agreement with Hatch's. AAT and AAA programs can be organized in such a way that they can be positive for both animals and clients. However, it may be that such outcomes are only possible when the handlers have extensive training, when the clients are kept under strict supervision, and when the animals have the proper temperament for this sort of work. Like any other form of therapy, it is not as simple as putting a human and an animal in a room together.


Images: Pleple2000/Wikimedia Commons; US Air Force/Public domain