Three of my favorite recent books have revolved around what used to be called Pet Therapy — i.e., using animals as part of a therapeutic effort with all sorts of people — the elderly, the dying, the disabled, the mentally ill, the incarcerated. These books are Bring Me the Ocean by Rebecca A. Reynolds, Hospice Hounds, Animals and Healing at the Borders of Death by Michelle A. Rivera, and You Have a Visitor, Observations on Pet Visitation and Therapy by Renée Lamm Esordi. All three include touching and persuasive stories about how animals made life a bit easier for people in pain and/or despair.
Pet Therapy (or Pet-Facilitated Therapy) has been renamed. Two terms are now used. Animal Assisted Activities (AAA) and Animal Assisted Therapy (AAT) are both being used widely throughout the country for those who need a kind touch, a laugh, or a lick on the face. Animal Assisted Activities consist primarily of visits by friendly, calm, healthy animals such as dogs and cats to facilities to make patients or residents smile, to bring them out of themselves. Even llamas have occasionally been used for these visits; the gentle creatures hum in a way that can soothe and delight. Horses often are used with handicapped adults and children. The animals are chosen for their good temperaments and their patience.
Mankind’s true moral test, its fundamental test (which lies deeply buried from view),
consists of its attitude towards those who are at its mercy: animals. — Milan Kundera
AAT can be defined as the set of animal-related activities directed by health or human service professionals as a normal part of their practice with patients. The professional may be a doctor, occupational therapist, teacher, nurse, social worker, or other healthcare professional. The animal may be handled by this professional or by a volunteer, as directed. The activity is goal-oriented with a specific end in mind, such as improvement of movement, verbal skills, or attention span. Each session is documented in the patient or client’s record regarding progress, length of time, etc.
All sorts of animals are used in these activities, including dogs, cats, horses, rabbits, and parrots. According to Stephanie LaFarge Ph.D., a psychologist and the senior director of counseling services for the ASPCA in New York, "My belief is that different dogs work with different populations. A very interactive dog can work well with a schizophrenic or criminal population." LaFarge continues, "Some of the toughest guys do the best with a little bunny. It’s very important to make a good match."
The idea of AAT "emerged from discussions and research on the human-animal bond" explains Nancy J. Dapper, vice-president for program operations at the Delta Society, an organization that trains animal/human teams to do this work. Centers were established in the 1970s and early‘80s to study this bond more thoroughly. The earliest focus of these studies was "to establish the value that pets have on human quality of life."
Other organizations also train and certify people and animals, including Therapy Dogs International and North American Riding for the Handicapped Association. AAA and AAT activities always work best when both members of the team are adequately trained, but the sessions are almost invariably useful for people.
Many of us already know quite well how much animals do for our bodies, minds, and spirits. They get us outside ourselves. They provide companionship and love. They make older people feel safer and teach children to take responsibility. They can alleviate human aches, pains, or depressions. They can lower blood pressure, reduce stress, and encourage better physical fitness. They are beautiful to the eye and pleasant to the touch. They make us lighter in spirit; they force us to play. Often people who have an animal to care for live longer.
But what does this work do for — or to — the animals? Our companion animals pick up on our moods and stresses, and it comes out psychologically and in their physical health. When I researched my book on cancer and animals, one of my primary contacts was Donna Raditic, D.V.M., of Great Barrington, Massachusetts. She believes that "animal companions’ jobs are to take on our grief, anger, and unresolved issues. This is meant to tell us we should be happier. And through our happiness, they will be healthier." Martin Goldstein, D.V.M., author of the popular The Nature of Animal Healing, displays a related belief about animal health. He notes, "Illness in pets really does appear to begin with the emotions — and, yes, the spirit — at least as much as it does with genes, germs, and the immune system."
Stress can hurt animals in this way: stress increases the production of adrenaline, which can then suppress and shrink the thymus gland. Because this gland produces many white blood cells, stress can lead to a deficiency of these cells and suppression of the immune system, which makes an animal more susceptible to disease. Stress has also been known to trigger autoimmune diseases such as arthritis and hemolytic anemia in dogs.
I have observed something like this in my own life with animals. Franky, my parents’ cat, was clearly depressed for weeks after my father died. He would barely budge off Dad’s afghan, and he ate poorly. And last year, when my husband’s health was poor and we were upset about our immediate future, Wanda, our mixed-breed black dog, began to display occasional urinary incontinence. She stopped when we stopped being so stressed. Even though animals may not react so strongly when dealing with people outside their own human family, they can still be deeply affected by losses or changes.
Fortunately, many trainers and participants are aware of these potential risks. The Delta Society issues these cautions for animals, adapted from M. McCulloch’s Pet Therapy — An Overview: AAT is not appropriate for animals when "injuries from rough handling or from other animals may occur [and] basic animal welfare cannot be assured. This includes veterinary care, and access to water and exercise areas; [and] the animal does not enjoy visiting."
Ira B. Perelle and Diane A. Granville, of Mercy College in Dobbs Ferry, New York, wrote an article for the Psychologists for the Ethical Treatment of Animals Journal, Society and Animals, about "Pet Facilitated Therapy" in a nursing home. They found that the animal subjects seemed to enjoy interacting with the elderly residents. "But they were all under constant observation of the volunteers for any sign of stress or fatigue. If any such signs appeared the animal was immediately retired to a quiet room where it was able to rest and quench its thirst."
The authors warn that "it is possible that some animal visitation programs do not have the benefit of trained and/or knowledgeable volunteers, and, therefore, allow animals to become extremely stressed and uncooperative. This is completely unacceptable for the animal."
Stephanie LaFarge has engaged in AAT for seven years, first with horses and now with her mixed-breed border collie and Eskimo dog. She believes that AAT is a good program, in general, if handled right for both people and non-human animals. "AAT, like all such interactive activities, is basically good. It increases the activity of the animals. Most animals in families in urban settings," she says, "suffer from boredom and lack of purpose. AAT has high social value.
"It’s a very focused activity, and the animals are appreciated. It’s good for the animal — it’s activity, and most domestic animals do not have enough to do. Visiting dogs, for example, know when they’re visiting; they know what they need to do. They like to work. And it’s good for the pride of the owner. The activity hopefully makes them treat the animals better and they’ll probably generalize in their treatment of other animals."
But LaFarge does warn against the risks to animals. As can people, the animals can get burned out: "They may still know what their job is, but no longer feel any pleasure in it. They may get frantic and no longer be tuned in." Although there is no ideal number of times per week or month animals should visit facilities, LaFarge stresses, "It’s most important to watch for the mood of the animal on any particular day. We need to respect time out and make sure the animal has her basic needs met.
"We need to watch when an animal changes from tolerating a situation to finding it aversive. That can build up negative hormones, the stress hormones."
On the other hand, it also can be stressful to a dog to be banned from visits to a favorite person. "Say a dog likes to visit Mrs. Jones, but she gets sick, and he can’t see her," says LaFarge. "That would be stressful for the dog, very frustrating."
Marilyn Putz of Lincolnshire, Illinois and Tegan, an Irish setter who has survived bone cancer and has three legs, are long-time practitioners of AAA and AAT. Putz is a staff psychotherapist at an animal hospital where she does pet-loss counseling. In addition, she runs the Lincolnshire Animal Hospital Pet Visitors group, consisting of about twenty-five people/pet teams. They visit six nursing homes, two hospitals, a residential facility for developmentally disabled or "retarded" adults, and a facility for drug-addicted and abused women and their children.
Putz works with Tegan and two other Irish setters. All her dogs have been certified by the Delta Society and/or Therapy Dogs International, for which she has been a certified evaluator. Both organizations have licensed her to screen people and their dogs for application to do this type of activity. She runs the teams through the tests and is responsible for passing or failing them. If they pass, they are then certified by either of the organizations.
About visiting a nursing home with Tegan, Putz recalls, "We worked with a physical therapist who planned the goals for the patients. My dog and I spent time helping them to achieve those goals. I remember one stroke patient who needed to re-learn to use his arm. I would hand him a tennis ball and he would throw it. Tegan would retrieve it and give it back to him so that the procedure could be repeated."
Putz waxes positively about the effects of these therapies on humans, and she believes her dogs enjoy and benefit from the experiences. "Tegan and my other dogs love visiting. And, yes, sometimes the dogs do get stressed and/or tired. When I see this happening, I hold them back. But they seem to enjoy it as much as I do. Of course, my dogs love to be petted, played with, brushed and have a fuss made over them, and this makes it a really pleasurable experience for them. Tegan is a great dog for visits because his missing a leg enables amputee patients to relate to him, "Hey, if he can get around with a leg missing, so can I," they often say.
AAT is a growing field, and one that has repeatedly been shown to have positive results on its human recipients. Most animals chosen for this work seem to enjoy most interactions. The practice is based on our assumption that we’re entitled to use animals for our own purposes, hearkening back to the Judeo-Christian concept of dominion. Yet the people who have conceived of the field, and those who benefit from it, seem to recognize a moral imperative to consider the animals’ needs. Perhaps their increasing attention to and interest in the human-animal bond will lead to further regard for animal welfare. In the meantime, more studies about the impact of AAT on animals and advice on how to best prepare and protect them for this valuable work will be forthcoming.