We just released a DVD of the seminar I did in Naples, Florida on Animal Assisted Therapy and Activities, “Lending a Helping Paw.” I’m excited about it, because it gives me the opportunity to help individuals and organizations who want to help others. It is an example of an activity we can do with our dogs that is a triple win (for us, our dogs, and people who need some oxytocin and/or physical therapy). Because of that, old social worker that I am, it’s near and dear to my heart.
Speaking of hearts, and what fills ours with happiness, the question arises about how effective AAT (Animal Assisted Therapy) and AAA (Animal Assisted Activities) really are. I remember a conference put on by the Delta Society many, many years ago that included a controversial study. It showed that, in this study anyway, the greatest benefit was to the owners of the dogs, not the patients in the facility. Whoops. While the audience greeted the news with a disapproving silence, I was cheering in the wings, because it’s good to examine the issue objectively, rather than just following our hearts in this case.
Indeed, the study was very useful and no doubt had an impact on “best practices” as currently defined. It found that the teams in this case had just walked into people’s rooms without asking permission. No surprise then that the residents weren’t all in favor of the project; they’d already lost so much control in their lives that the last thing they needed was to lose more. That’s why good programs like The Delta Society and TDI emphasize the importance of putting the patient first, and letting them drive the system.
But the question remains: Is AAT and AAA really effective? First, we need to distinguish between AAT and AAA. Much of what people call AAT isn’t truly therapy in the medical sense of the word. To be labeled as therapy the interactions need to be directed or delivered by health and human service professionals, with goals set, treatment plans written and progress carefully recorded. Animal Assisted Activities, on the other hand, include visits, petting, games and tricks.
Here’s the good news for those of us who want to believe that AAA and AAT are beneficial to the recipients: There is indeed research that shows it’s efficacy in several modalities: Two studies that I can think of off the top of my head found that visits from dogs decreased the perception of pain after surgery. One study asked children to rate their pain (Robbins et al, J of Holistic Nursing, Vol 24, No 1, 206) and another looked at the amount of pain medication used after joint surgery, which is a good, objective and quantifiable measure (Kaplan, AAT Conference Abstract 2004). A third study found that walking with a dog significantly increased compliance with physical therapy programs and increased ambulation exercise: 28% refused to walk without a dog, only 7.2% with a dog. In addition, steps walked more than doubled once patients did walk (Abate et al J. of Cardio. Nursing 2011).
This is not surprising to those of us who are aware of the impact of dogs on our oxytocin levels, and the impact of oxytocin on pain perception (it decreases), immune responses (it increases) and affect (it tends to make us feel safer and more secure). But we do have to be careful here: Not everyone benefits from visitations or therapy from a companion animals. You have to like dogs to get an oxytocin rush from them. (Most “therapy” animals are dogs, but some programs have cats or rabbits for selected patients. No reports of sheep yet….) Awhile ago I visited a senior center with a good friend and her dog. I’d guess about half the people we saw were interested in interacting. The rest appeared to be either neutral or clearly avoiding an interaction. My friend knows what she is doing, and was careful to not impose her dog onto anyone who wasn’t a dog lover.
This all gets back to one thing I emphasize in the DVD: The patient is the star of the program. Not your dog, not you. As much as we love our dogs, if we do this right we’re doing it for people who aren’t as fortunate as we are, and don’t have the opportunity to interact with dogs as we do. It’s all about them, and keeping that in mind is critical to a program’s success.
Other aspects of AAT and AAA are essential too: The Lending a Helping Paw DVD has an extensive section on what dogs are suited for therapy work, and how to ensure that your dog is really enjoying the process (these are the 2 most common problems that professionals in the field encounter). It discusses organizations that certify teams, what is required to obtain certification and how to work with facilities in a professional and pro-active way.
MEANWHILE, back on the farm: Instead of playing with the lambs or gardening, last night I went to a senior facility outside of Madison and delivered copies of the DVD to one of the stars of the show: Ruth Trameri. She’s the lovely lady on the right of the cover, with my good friend Beth Viney’s (on the left) and her certified therapy dog, Czar. (Czar was an early admirer of my Gr Pyr, Tulip… that’s actually how Beth and I met.) Here they are, gracing the cover of the new DVD:
And here’s a video from the DVD of Tootsie’s first visit to a facility. We used her (and Willie and 3 other dogs) to evaluations of potential therapy dogs. (Tootsie passed, Willie… no surprise here, does not: too enthusiastic). This video segment is testing for one of the most important qualities of a good therapy dog — sociability. Dogs need to be interested in everyone, true social butterflies, but calm and respectful at the same time. Watch how Tootsie tells us where she’d most like to be…. (and feel your oxytocin levels rise?). Thanks to Beth Viney, the Director of Pet Pals in Madison WI, Dr. Linda Sullivan, and Pet Pals volunteer Diane Peltin and Ruth Trameri for helping with the evaluation section of the video, we all had a great time and it resulted in some very instructive (and, I might add, amusing) videos.
Nancy's Point says
Wonderful. Just wonderful. Animal assisted therapy or animal assisted activities are both worthy endeavors.
And you’re absolutely right, the patient is the “star” of the program. Benefiting the patient is the whole point. Still as you said, everyone benefits when things are done properly.
Thanks for the great DVD/resource.
Kat says
Ranger and I do this work. We’re registered with TDI. It wasn’t my plan when we adopted him but it’s clearly what he was born to do. The group we visit with has an escort from the facility who knows who is most in need of a visit. Still residents are always asked if they’d like a visit.
It’s always the same when we visit. We wait in the main reception area until everyone that’s coming arrives and Ranger, whines and paces and sings and barks and generally is a pain. He doesn’t want to wait, he wants to go to work NOW thank you very much. Watching him while we wait you’d think he’s the last dog that should be there but the instant we start down the hall he’s calm, gentle, quiet and an absolute delight. My role is to drive him there, hold his leash and to speak for him–after all as brilliant as he is at communicating he can’t ask if the person wants a visit. I’ve often wondered what would happen if he was just released to wander the halls and visit at will. Not that we’ll ever try it but I suspect he’d know exactly who needs his attention and how long he needed to stay with each person.
I’m always amused at Ranger as he seems to know just what the person he’s visiting needs. Last time we were visiting the activities director and I were moderately horrified when he jumped onto the resident’s nicely made up bed and curled up as if for a nap. Typically he never puts paws up on anything when we’re visiting unless cued. The resident was delighted by this behavior as it was 1) clear proof that he really liked her and 2) reminded her of a special dog from her past. The resident talked about it for weeks so the benefit of his visit extended beyond the brief time he was actually with her.
Ranger is the biggest dog in the group we visit with and he’s often asked to paws up on a particularly high bed. As you say, we’re there for the residents and we don’t want to startle them with this large dog suddenly looming up so I ask him to paws up just above where their knees are and then walk up to within petting reach. Once in awhile we get someone what decides they don’t want to meet him after all when they see how big he is (he’s probably five feet tall on his back legs) in which case I ask him to get off and we ask the small dogs–the ones that can be picked up to visit that person. I can’t imagine trying to argue or cajole the resident into meeting him if they say they don’t want to this whole exercise is supposed to be about them having a positive experience.
Dena Norton ("Izzee's Mom") says
Trish, I can feel the oxytocin rush just looking at Tootsie’s waving tail while she’s looking up at the lady in the wheelchair. And she seems to cuddle in so nice and close.
EmilyS says
I’m fully in favor of science. But the notion of needing some kind of objective test to “prove” the benefits of animals visiting people in institutions… not so much.
I didn’t need any “proof” that my dog’s visits to my mom at her nursing home meant the world to her… as it did to the other residents who eagerly greeted, petted and received kisses from my dog (though yes, of course, I always asked if they wanted to meet him and avoided anyone who seemed indifferent or the slightest bit fearful.. that is very important advice. BTW, I observed certified therapy dogs from a national organization who themselves didn’t seem incredibly thrilled with making the visits….)
So what if oxytocin levels didn’t rise, or if their pain didn’t have a measurable decrease? You’d have to be some kind of stone (and here I am obviously not referring to Dr McConnell!) NOT to see the difference the visits made in their lives, if only for a few minutes.
Beth with the Corgis says
Tootsie looks like a natural. I’ve said it before and I’ll say it again: Corgis are exactly the wrong size for nursing homes. They are too heavy for laps and too short to be reached from a chair. I’ve taught “paws up” but the place we visit has lino floors and Jack is very reluctant to cooperate on that surface, and I can’t blame him.
Maddie is sweet and tractable and could take it or leave it; it neither stresses her nor thrills her to visit. Jack loves to go and eagerly goes from room to room, and loves the day room, but again his size is an issue. He likes to sit on feet and so tends to gravitate towards the staff and visiting relatives. Not that that’s a bad thing, but not quite what the goal is.
He’d be great with kids (handles unpredictable outbursts well) but my work schedule makes that difficult. And having had two very bad experiences with developmentally challenged adults, I am reluctant to put my dog in that situation again; when someone has your dog by the neck and won’t let go it makes for an alarming few minutes. Thankfully for everyone, Jack’s reaction was to make wild eyes in my direction, but still the thoughts of what could have happened have scared me off that front. Perhaps with a larger dog…
Beth with the Corgis says
One thing I wanted to add is that when deciding if your dog would be a good therapy dog, it’s important to watch how he or she acts with OTHER people, not just yourself.
Maddie is the sweetest cuddler at home, loves nothing more than to crawl in your lap, but she is frequently indifferent to strangers. If people actively call her she will come for attention, and she has a few people she likes, but otherwise more or less ignores people unless they have treats. You would not guess that by her home behavior.
Jack is the opposite; he rarely likes to be petted or cuddled, always wants to play, and can be a bit grumbly and argumentative at home. With people outside the house, he is gracious and loves nothing more than to meet-and-greet. He never argues, and if he is harassed his response is to turn and walk away. What made me want to do therapy work was watching how he draws people out and makes people smile and feel special. I call him “The Mayor;” he’s such the politician. The people who know him best know he can be stubborn and pushy but everyone who knows him casually thinks he is the sweetest, most laid-back dog on the earth. The bigger the crowd, the more relaxed he is.
Nicola says
Go Tootsie! How amazing she is, given her terrible start in life.
001mum says
It’s sort of a balance isn’t it? Pup has to learn appropriate behaviour in various sitations.
No way would I want my dog always eagerly greeting everyone he meets. As a foster parent for future service dogs ignoring distractions is a huge part of training.
However, that said, when pup and I go to see my mum at a long term care facility there is the thrill of several residents excitingly announcing that “the dog is back”, “look how good he is”, “my how he’s grown”, “can I pet him?”, “Once I had a dog like that !”
and then those that can, chatter amongst themselves about their long ago family pets.
Periodically I stop and he gets a good “chin-chuck” that comes from a resident’s
memory bank on how to pet a dog.
The grins from the residents and pups eagerness to greet people with assistive devices and not fear anyone is pure magic. His head and shoulders are relaxed and his tails swishes up and side to side,some people get more of a ‘wiggly-bum” than others. Watching him learn appropriate behaviour is joy for me as well.
I’ll say it is a triple combo -patient/client must be thrilled to see pup, dog happy to receive affection and handler to be sensitive to both of the above.
Personally I believe in the tremendous value that our pets have in improving mental health.
glauber says
That’s a big dog! 🙂
Nicole says
Great post. I’ve recently made the incredibly difficult decision to pull my dog from therapy work (she’s registered with Delta Society). While I’m certain that she’s provided a benefit to our patients, I don’t think she is enjoying the work. Passing the Delta exam was a HUGE accomplishment for us, given that she’s a (recovering) reactive dog. I’m looking forward to reading the book, in hopes that someday I will have a dog that really wants to do this.
Rose says
I originally had hopes for Daisy to be a therapy dog, she certified with TDI, however, as it turns out, she can be a little shy and is somewhat indifferent to people unless they have something for her – TREATS – which are not allowed during therapy visits – with good reason of course.
It looks like Tootsie is a natural at this – I’m a believer that dogs either have this or they don’t. Sure you can train them to past the test most of the time, but if they don’t truly enjoy people – it doesn’t work.
Liz says
Great DVD cover- looks like time well spent in good company! Lovely smiles.
The clip of Ruth and Tootsie made my gratitude list, too.
Not sure if it’s common knowledge… In my experience, if your loved one is in a care facility, you often only have to show proof of vaccines in order to bring a dog in for a visit. If you have considered AAA or AAT and want to do a test run before going all in with a dog who may not make a good fit: check with your loved one’s facility, round up your dog, a Kong and your vaccination records, and go in for a visit!
Annie R says
Awww, how sweet! Trisha, when you first met Tootsie and were looking at her and other dogs for adoption, did any particular characteristics lead you to choosing her? Any that you were looking for in terms of having a therapy dog? She sure does seem like a natural!
Susan says
There’s one story I will never forget, from my time working for a therapeutic riding school. One of the physical therapists took a teenaged girl for a “trail ride,” really just walking through a field instead of the usual ride in the arena. Something caused the girl to slip sideways, and she was too heavy for the PT to lift back into the saddle. The PT eased the girl’s weight onto the ground and had to leave her while going to get help (this was before cell phones). This is one of those nightmare scenarios that no one would deliberately set up, and it could have had devastating effects. Instead, though, the girl was fine and fortunately help was just 10 minutes away. When people got to the girl, she was delighted to have had 10 minutes all by herself. She had never been alone before in her life. This was with good reason as she was quadriplegic and needed all kinds of help just to maintain life. But it was such a gift to this girl to experience 10 minutes alone in a grass field, and almost as much a gift to the instructors to gain this perspective. The other, more common, benefit to these kids of being on a horse was that people had to look up to talk to them. From their wheelchairs even much younger siblings were taller than them, and they loved it that even adults had to look up to interact with them. Such stuff that is so taken for granted. None of this was on the lists of benefits to be gained from horseback therapy, but you never know what collateral benefits can be part of the program. Probably true in some way of AAT with dogs too?
Shalea says
I’ve stated explicitly that if I’m ever confined to a medical facility, my husband is to either smuggle my own dog in to see me or to make arrangements with one of the local groups to bring their dogs. I *NEED* my minimum daily therapeutic level of dog petting. 🙂