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Time to move beyond the anecdotes around animal-assisted therapies | Psyche

Daniel Smith, 15, with Ru, a therapy dog, 31 March 2018. Photo by Hyoung Chang/The Denver Post/Getty

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Time to move beyond the anecdotes around animal-assisted therapies

Daniel Smith, 15, with Ru, a therapy dog, 31 March 2018. Photo by Hyoung Chang/The Denver Post/Getty

by Mirena Dimolareva + BIO

The use of ‘therapy dogs’, pet-assisted therapy and visiting classroom animals are all on the rise. So too are related news stories, usually accompanied by cute photos and excitable headlines. Consider this example – ‘“Dogs Have A Magic Effect”: How Pets Can Improve Our Mental Health’ (The Guardian, 2020), which talked about the ‘dramatic effects’ reported in pet-therapy trials.

You might be wondering how much truth there is behind the hype and hope. As a scientist working in this field, I started with an open mind. I knew the published literature relating to dog interventions showed mixed findings. But at the same time, anecdotally, I’d seen for myself the apparently powerful benefits that animals can have.

I remember a pre-verbal, Autistic nine-year-old with severe learning difficulties – I’ll call him Peter – who would often walk off on his own and engage in self-stimulatory behaviours rather than the class activities. When asked to walk down a corridor to another room, Peter usually sat down and needed encouragement to continue. Yet it was a different story when he was introduced to a therapy dog – a Golden Retriever called Harry. Yes, after first going to Harry, Peter soon moved away and engaged in self-stimulation. But then Harry walked over and nudged the little boy’s arm or placed his snout on Peter’s legs as if to say: ‘I am here’ and grabbing his attention. As the sessions went on, Peter spent less time engaging in self-stimulatory behaviours and more time interacting with Harry. When it was time for the future sessions, I saw Peter run down the corridor to the room where Harry was.

The visible improvements didn’t stop there – Peter’s teachers told me that he was producing more vocalisations in class, and his parents had noticed the same at home. These sounds were interpreted as Peter trying to communicate with the adults, which was particularly the case on the days he’d seen Harry. His parents and teachers saw this as quick progress, which had not been achieved with other interventions.

Individual stories like this suggest that therapy dogs might well be the magic pill for unlocking engagement and children’s communication, apparently justifying the positive newspaper headlines and blogs about the benefits of pet ownership and visiting therapy animals. Many teachers and parents have also expressed their excitement at the prospect of animals helping the children under their care. But what does the science say?

Any animal interaction gets construed as beneficial when the positive impact could have been due to the structure of the session

Before I tell you about the research, it’s useful to note that there are in fact various different ways that animals can be used to potentially benefit humans. Some interventions – forms of ‘animal-assisted therapy’ and ‘animal-assisted education’ – are highly structured and goal-directed, and are usually led by a trained professional. At the other end of the spectrum, there are unstructured interactions between animals and humans, which fall under the broad category of animal-assisted activities, which can be delivered by volunteers who might not have specialist training. So, there’s a lot of variation, and approaches that are part of an established therapy are more likely to be beneficial.

For example, a form of animal-assisted therapy that aimed to improve spoken-language clarity in children, led by a speech and language therapist, would probably be more effective than having a therapy dog simply visit the classroom during usual lesson activities. However, these kinds of distinctions tend to be glossed over in the media, leading to any animal interaction being construed as beneficial when in fact the positive impact could have been due to the structure of the session or to the specific therapeutic intervention involved.

Moreover, many newspaper articles exaggerate the benefits of animal interventions and draw conclusions that go beyond the evidence. For instance, that Guardian article I mentioned earlier included speculation that pets benefit their owner’s mental health because they trigger the release of the neurohormone oxytocin. In fact, there is no conclusive evidence to suggest this is true. There may well be physiological effects when we interact with our pets, but they probably involve much more than a single hormone.

Overall, what research in this area really shows is that there are benefits from various animal activities and interventions, but a lot depends on the target of the intervention and who is taking part – and there’s much that we’ve yet to find out.

In 2020, my colleague Thomas Dunn and I published a paper in which we recalculated the data so far on school-aged Autistic children and the effects of animal-assisted interventions on social skills, communication and Autism symptoms. As many of the studies had small numbers of children taking part and the comparison groups varied, our aim was to combine the data in order to get a clearer picture of the effectiveness of the interventions.

We found that animal-assisted interventions do slightly improve children’s social interaction and communication, which is promising, but they do not improve children’s core Autism symptoms. Unfortunately, there were not enough studies comparing the animal-assisted interventions with a similar intervention without animals, so we can’t say yet if the involvement of animals leads to more benefits than similar non-animal interventions.

The findings for children with some conditions such as Autism and trauma were promising when there was a specific, structured and targeted animal intervention

Likewise, in 2017 Victoria Brelsford and her colleagues reviewed the existing literature on animal-assisted interventions in mainstream and in special educational needs (SEN) schools, and concluded that most studies show beneficial effects in improving cognitive, socioemotional and physiological factors. However, they said more research is needed to establish the optimal approaches, and to conclude whether including animals within the setting is valuable. This additional knowledge would allow us to advise schools on how to incorporate animals into their teaching and which children are most likely to benefit. Such information is vital as the use of animals in school classrooms is increasing, with no clear guidance on best practice and associated outcomes.

Aside from the education-based findings, there is also promising research relating to mental health. Kimberly Hoagwood and her colleagues conducted a review of the literature between 2000 and 2015, to investigate the effectiveness of animal-assisted therapy for children and adolescents who are at risk of developing a mental health condition. They found the results are mixed, but the findings for children with some conditions such as Autism and trauma were promising when there was a specific, structured and targeted intervention.

A number of different theories can help to explain the apparent benefits of animal interventions. For instance, participants may build a secure attachment to the therapy animal, if they spend long enough with the same animal. In some contexts, animals may also act as a form of social support. This is in line with research by Andrea Beetz and colleagues that found that children were less stressed when completing a difficult task if they were in a room with a therapy dog, compared with being in a room with a toy dog or a friendly human. Most likely the benefits we’ve seen are due to a combination of biological, psychological and social factors, and further research will clarify these.

Despite the theoretical underpinning and the potential benefits I’ve described, it is vital that we move more towards evidence-based practice in this field and away from relying on positive anecdotal stories. Having conducted research in many schools, I have seen a greater incorporation of animals within education and heard the claims of beneficial effects – but without a thorough evaluation, which potentially raises the hopes of parents without justification. What is more, private organisations are selling their often expensive services to schools, again with little supporting evidence.

Gathering scientific knowledge will provide us with more confidence that a given intervention will have benefits for a particular group of people, as well as allowing others to replicate what works. This is important in justifying the working time for the therapy animals and the financial costs.

The future for animal-assisted interventions looks promising. I have seen first-hand how children regulate their behaviour during lessons and playtime (often the most challenging time, due to the lack of structure) to make sure they are allowed to spend time with the therapy dogs. If we can teach children to regulate their behaviour in the classroom and potentially transfer this to their day-to-day life, it would have a groundbreaking impact on their ability to learn as well as their overall wellbeing. This is particularly exciting as animals may have the potential to elicit these benefits for children – and adults – who do not currently respond to other interventions.

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9 August 2022