Introduction

Animal-assisted therapy (AAT) is a specialised therapeutic intervention that incorporates the unique bond between humans and animals to provide and promote physical, emotional, and social well-being. AAT utilises this connection by using trained animals in therapeutic settings to achieve specific treatment goals.¹

Animals used in a therapeutic setting can be dated back to the 1600s, with physicians using animals to improve their patient's health. In the 1800s, Florence Nightingale advocated the benefits of small animals as companions for the sick.^2,3 Dogs started being used to help visually impaired people in 1931, but it was in 1964 when the term “pet therapy” was used after a psychologist noticed one of his withdrawn young patients interacting with a pet dog.⁴ 

Through various animals such as dogs, cats, horses, and birds, a tailored plan is curated to meet the specific needs of individuals, ranging from children with developmental disorders to patients coping with mental health or physical disabilities. In AAT, animals become active participants in therapeutic processes, contributing to a supportive and non-judgmental environment that encourages clients to engage with the therapy. 

Physical benefits

A large benefit of AAT is the mental and emotional support - this therapy method has shown a range of improvements in an individual's physical health and functioning. 

Regular engagement in AAT activities can involve physical movement, such as walking or playing with dogs. This can positively impact cardiovascular health by promoting gentle exercise. A trial that used cat therapy for elderly patients demonstrated a reduction in their systolic blood pressure after having three sessions a week.⁵ Similarly, dog therapy resulted in improvements to blood pressure in patients who had heart failure compared to the control group.⁶

Activities that require physical interaction with animals can also enhance motor skills, improve coordination, and assist with weight management. According to the World Health Organisation, worldwide prevalence of obesity has tripled from 1975 to 2016 and is projected to increase further. Exercise plays a major factor in managing weight loss, but motivation, consistency, and feelings of judgement can be a major deterrent in performing the physical activity. Having animals involved in therapy can provide a fun and non-judgemental partner to increase motivation and weight loss. 

Interacting with animals through horseback riding in AAT sessions requires balance and coordination. A study involving patients with Parkinson's disease taking equine therapy demonstrated an improvement in balance, gait, and quality of life.⁷  Likewise, patients with Parkinson’s disease, multiple sclerosis, and stroke exposed to dog-assisted therapies resulted in an overall improvement in gait and balance.⁸

Emotional and psychological benefits

AAT is well-known for its emotional and psychological benefits, leveraging the unique bond between humans and animals to enhance mental well-being. Animals offer an outlet for emotional expression and individuals may feel more comfortable expressing their feelings to animals, providing a safe space for emotional release. 

Interactions with animals have been shown to reduce stress. The calming presence of animals can create a soothing environment, promote relaxation, and alleviate tension and anxiety. In acute paediatric care units, children reported having an improved mood and more energy after interacting with dogs. Furthermore, cortisol levels decreased after the interaction and positive effects (physiological and psychological) lasted for hours in paediatric patients.⁹ 

Engaging with animals triggers a release of endorphins - neurotransmitters associated with joy and happiness. AAT can uplift mood and contribute to a more positive emotional state. Moreover, regular interactions with animals can help to alleviate depression. The companionship provided by animals can serve as a powerful therapy for the emotional challenges associated with depression and has been used as a combined treatment. A study showed that AAT was helpful for chronic psychiatric patients living in psychiatric residential care homes and provided an increase in happiness and overall quality of life.¹⁰

AAT can help individuals develop healthier coping mechanisms, especially in those dealing with trauma or emotional challenges. Post-traumatic stress disorder (PTSD) develops after a particularly stressful event and requires a combination of treatments to overcome. Research has shown that AAT is effective in reducing PTSD and depression-related symptoms in both adults and children.¹¹ 

Social benefits

AAT can occur in group settings, allowing opportunities for social interactions. This is beneficial for individuals who struggle with social skills - promoting positive connections with people and animals. 

Loneliness and social isolation increase the risk of serious conditions such as dementia and heart disease, with the elderly being more at risk. More than 30% of adults aged 45 and older feel lonely, and nearly 25% of adults aged 65 and older are considered to be socially isolated. In a study, AAT was shown to reduce loneliness in residents at long-term care facilities.¹²

AAT encourages both verbal and non-verbal communication. Participants may express themselves by talking to animals, using body language, or engaging in activities that promote expression. Individuals who may have difficulty communicating verbally, such as those with autism, can benefit from the non-threatening and comforting presence of an animal to help express their feelings. Furthermore, AAT has been shown to increase the social ability and emotional involvement of patients with acquired brain injuries, leading to higher social engagement, motivation, and satisfaction during a therapeutic session.¹³

Specialised applications

AAT has specialised applications across various settings, tailoring interventions to address each individual's needs and goals. The most common areas of use are with children and the elderly population. 

• AAT is used in hospitals, clinics, and healthcare facilities in collaboration with traditional medical treatments. It can aid in the recovery process by providing emotional support, reducing stress, and enhancing the overall well-being of patients.
• AAT is particularly effective in paediatric healthcare settings. It helps children cope with stressful environments and medical procedures and alleviates anxiety during their treatment.
• It has been integrated into mental health treatment plans to address various mental health conditions such as anxiety, depression, PTSD, and schizophrenia^14,15
• AAT has been shown to benefit the elderly by providing companionship, reducing isolation, and promoting physical activity. AAT is particularly useful in dementia care and elderly homes where animals can evoke positive memories and emotions.
• AAT is used in correctional systems to support rehabilitation efforts. It can help inmates develop empathy and improve social skills and overall emotional well-being.¹⁹

Considerations and precautions

While AAT can offer numerous benefits, it's important to take precautions to ensure the safety and well-being of all participants and animals. 

Assessment for allergic reactions in patients is crucial, as the consequences can be severe. Additionally, the animal itself must be healthy, well-trained, certified, and have the right temperament for therapy work. Any fears or phobias related to animals must be identified and respected. Alternative activities should be provided for those who may not be comfortable with direct animal interaction.

Continuous supervision during AAT sessions is necessary, especially when working with vulnerable populations such as the young, elderly, or individuals with cognitive impairments. Supervision and monitoring ensure the safety of all participants and animals involved.

Summary

Animal-assisted therapy is a compassionate and effective approach to improving various health and social conditions. The therapeutic benefits extend across diverse populations, including individuals facing mental health challenges, children with additional needs, and those in rehabilitation. However, the success of AAT relies on careful considerations for participant safety, animal welfare, and cultural sensitivities. As an integrative and versatile therapeutic method, AAT continues to demonstrate its effectiveness and has further potential to contribute positively to physical, emotional, psychological, and social health.