Incorporating animal-assisted therapy in mental health treatments for adolescents: A systematic review of canine assisted psychotherapy

Abstract

IntroductionAs interest in Animal-Assisted Interventions (AAI) grows, there is increasing need to differentiate informal activities from formal and professionally directed therapies, including mental health focussed Canine-Assisted Psychotherapy (CAP). There have been no reviews focusing exclusively on CAP and the distinct developmental period of adolescence. The aims of this study were to identify the characteristics of CAP interventions, their impacts and their acceptability, tolerability and feasibility for adolescents with mental health disorders.MethodA systematic review identified studies incorporating canines into mental health treatments for adolescents aged 10–19 years. Studies reporting qualitative or quantitative psychological or psychosocial outcomes were included.ResultsSeven studies were scrutinised. Intervention characteristics varied, including a range of formats, settings, locations, doses, and facilitators. Information on the role of the canines in sessions was sparse. CAP had a positive impact on primary diagnoses and symptomatology, conferring additional benefits to standard treatments for internalising disorders, post-traumatic stress disorder, and equivalent effects for anxiety, anger and externalising disorders. CAP was associated with positive impacts on secondary factors including increased engagement and socialisation behaviours, and reductions in disruptive behaviours within treatment sessions. Global functioning also improved. There was insufficient evidence that CAP improved factors associated with self-esteem, subjective wellbeing, or coping. Good attendance and retention rates indicated high levels of acceptability. Moderate to high tolerability was also indicated. Feasibility may be limited by additional training and logistical requirements.RecommendationsWe recommend the development of theoretically informed, standardised (manualised) intervention protocols that may subsequently form the basis of efficacy and effectiveness testing. Such protocols should clearly describe canine-participant-facilitator interactions via a formalised nomenclature; spontaneous (animal-led), adjunctive (facilitator-led), and experiential (participant-led).ConclusionsThere is emerging evidence to suggest that CAP improves the efficacy of mental health treatments in self-selected adolescent populations via reductions in primary symptomatology, and via secondary factors that improve therapeutic processes and quality, such as engagement and retention.

Human-Animal-Environment Interactions as a Context for Child and Adolescent Growth

“…These findings were consistent with existing research that found that HAEIs had a general positive impact on participants (Bowler et al, 2010). More specifically, HAEIs were shown to have a positive impact on special-education students' social abilities (Kim et al, 2012), autismspectrum symptoms, emotional well-being, and reduced behavioral issues and developmental delays in youth who were in need of special education support (Hoagwood, Acri, Morrissey, & Peth-Pierce, 2017;Jones, Rice, & Cotton, 2019;Nimer & Lundahl, 2007;O'Haire, 2013).…”

Considering Family Dog Attachment Bonds: Do Dog-Parent Attachments Predict Dog-Child Attachment Outcomes in Animal-Assisted Interventions?

“…Animal-Assisted Interventions (AAI) have increased in prevalence in recent years ( Julius et al, 2013 ; O’Haire, 2017 ). Consequently, there has been increased research on the effectiveness and efficacy of different AAI approaches and predictors of outcomes across different populations ( O’Haire, 2017 ; Hu et al, 2018 ; Jones et al, 2019 ; Chitic et al, 2020 ). Dog-assisted interventions are among the most common AAI, likely due to a number of factors including, but not limited to, a dog’s accessibility, trainability, cost of care, and size ( Linder et al, 2018 ).…”

“…Animals, including dogs, have been known to respond in less predictable ways in the presence of these populations which can in some cases lead to increased risk ( Overall and Love, 2001 ; Yin, 2011 ). Nevertheless, dogs are commonly used in therapeutic settings and interventions with both children and individuals with disabilities ( Leonardi et al, 2017 ; Jones et al, 2019 ). Less is known about why some dog-child pairs clash (e.g., specific stimuli, strained interaction history, etc.)…”

“…In such cases, understanding the possible connection between attachment quality and AAI participation could help predict the likelihood of achieving social support and other beneficial outcomes across settings. For example, it has been shown that a human participant’s feelings of attachment toward a dog during AAI promotes participation in the intervention, including greater motivation to attend and greater pro-social engagement ( Jones et al, 2019 ). Thus, one goal of dog-assisted interventions with children might be to establish or promote secure attachments between the dog and child engaged in AAI given the associated benefits reported in cases where stronger attachment relationships are perceived or exist.…”

Improved Wellbeing for Both Caretakers and Users from A Zoo-Related Nature Based Intervention—A Study at Nordens Ark Zoo, Sweden

“…It also appears to influence people's environmental thinking and actions. The interaction between humans and animals encompasses a wide variety of physical, social, psychological, environmental, existential, and spiritual aspects, all of which have a positive impact on people's health and wellbeing and lead the individual to a functional whole [9,11,15]. This has led to increasingly extensive behavioral and neurophysiological studies on relations between humans and animals.…”