Introduction

In recent times, animal-assisted therapy (AAT) has emerged as a remarkable therapeutic approach that harnesses the uniqueness of the bond between humans and animals. In AAT, trained animals, such as dogs are incorporated into therapeutic interventions to assist individuals in achieving specific treatment goals and improving their overall quality of life. This holistic approach to healing can be traced in historical times, in various cultures and civilisations. However, AAT became a structured therapeutic intervention and gained recognition in healthcare settings worldwide in the late 20th century. The therapeutic benefits of AAT are diverse and wide-ranging, encompassing improvements in physical health, mental well-being, and social interaction. Although various animals are used in AAT, dogs have the innate ability to form deep bonds with humans, adapt easily to different environments, and are trainable, this is why they easily serve roles such as assistance dogs, and search and rescue services. The presence of dogs can create a sense of comfort and security, making them ideal companions for individuals undergoing challenging medical treatments or facing emotional distress.^1,2

Characteristics of dogs that make them suitable for AAT

1. Dogs are friendly, sociable, non-judgmental, approachable and comforting companions for individuals in need of emotional support
2. Dogs have an innate ability to sense and respond to human emotions and understand those they interact with during therapy sessions
3. Dogs easily adapt to different environments and interact with diverse populations, making them versatile partners in AAT settings
4. Through the right training and socialisation, dogs can learn to follow commands and exhibit appropriate behaviour during therapy sessions
5. Dogs are affectionate and form deep bonds with their human counterparts, fostering a sense of trust and connection³

Types of dogs commonly used in AAT

AAT dogs are employed to meet the specific needs of different individuals and therapeutic settings. Golden Retrievers, Labrador Retrievers, and Poodles are used for therapy mostly because they are gentle, well-behaved breeds with calm temperaments. They are trained to provide companionship to individuals in hospitals, nursing homes, schools, and other healthcare or educational settings assistance dogs for example are trained to perform specific tasks to assist individuals with disabilities or medical conditions. Their specific roles include guiding individuals who are blind or visually impaired, alerting individuals with hearing impairments to sounds or assisting individuals with mobility limitations. While certain dog breeds are commonly used in AAT due to their temperament and characteristics, there is no one-size-fits-all answer to this question. The suitability of a dog for AAT depends on individual temperament, training, and experience, rather than breed alone. However, some breeds are often favoured for therapy work due to their gentle, friendly, and predictable nature.^{3, 4} 

Training and certification process for therapy dogs

The training and certification process for therapy dogs varies depending on the organisation and the specific requirements of the therapy program. Therapy dogs must be able to demonstrate basic obedience skills, such as sitting, staying, walking on a leash, and responding to their names when called. After exposure to various environments, people, and situations therapy dogs are expected to be well-behaved in different settings. Temperament evaluation assessment is also done as dogs with calm, gentle, and predictable temperaments are preferred for AAT. Therapy dog handlers also receive training on how to recognise and respond to the needs and cues of both the dog and the client, and also how to effectively manage and facilitate interactions between their dogs and individuals receiving therapy.⁵

Benefits of using dogs in AAT

Studies have demonstrated that the calming effect of petting or stroking a dog can promote relaxation, decrease physiological markers of stress, and may help in managing conditions such as hypertension and heart disease. The presence of therapy dogs in healthcare settings, that is engaging with dogs during therapy sessions can distract individuals from their pain, provide comfort, and release endorphins, the body's natural painkillers.                                                                                                                   

Interactions with therapy dogs have been shown to trigger the release of oxytocin, while simultaneously reducing levels of cortisol, a stress hormone, resulting in a sense of calmness and emotional well-being.  Research has shown that interactions with therapy dogs can elevate mood, increase feelings of happiness and contentment, and reduce symptoms of depression. The unconditional love and non-judgmental acceptance offered by dogs create a supportive environment where individuals feel valued and understood, fostering a sense of emotional connection and fulfilment. Therapy dogs facilitate social interactions by serving as conversation starters, icebreakers, and sources of common interest in AAT settings. Their presence encourages individuals to engage in verbal and non-verbal communication, express emotions, and initiate social interactions with others, leading to improved social skills and relationships.

Children and individuals with special needs

Yes, therapy dogs can work with children and individuals with special needs in a variety of therapeutic settings, including schools, hospitals, rehabilitation centres, and counselling programs. Dogs have been shown to have a positive impact on children's emotional, social, and cognitive development, as well as their physical health and well-being. Interactions with therapy dogs can help children build self-esteem, improve communication skills, reduce stress and anxiety, and enhance overall quality of life. Similarly, therapy dogs can provide valuable support and companionship to individuals with special needs, including those with autism spectrum disorder (ASD), developmental disabilities, and behavioural challenges.

Benefits of AAT for older adults and individuals with dementia?

AAT has been shown to have numerous benefits for older adults and individuals living with dementia in long-term care facilities, nursing homes, and memory care units. Interactions with therapy dogs can reduce feelings of loneliness, depression, and agitation while promoting relaxation, comfort, and emotional well-being. AAT has also been shown to improve cognitive function, communication skills, and quality of life in individuals with dementia, enhancing their mood, behaviour, and overall functioning.

Healthcare professionals’ interactions with therapy dogs can help alleviate the emotional toll of caring for patients with complex medical conditions or experiencing pain and suffering. Dogs provide a source of joy, humour, and companionship for healthcare professionals, fostering a positive work environment and promoting staff well-being.

Safety precautions, limitations and constraints of using dogs in AAT

One of the primary safety concerns in AAT is the risk of transmission of zoonotic diseases. Therapy dogs may pass pathogens such as bacteria, viruses, or parasites that can pass illness on to vulnerable individuals. Thorough health screenings, vaccinations, and regular veterinary check-ups should therefore be conducted for therapy dogs. Handlers and therapy team members should also practice appropriate hygiene and infection control, such as handwashing and disinfection of equipment, to prevent the spread of pathogens.                                                                                           

Some individuals may have allergies to pet dander, saliva, or urine, which can trigger respiratory symptoms, skin rashes, or other allergic reactions therefore, potential clients should be assessed before initiating AAT sessions. Therapists and handlers should be sensitive to diverse cultural beliefs and individual preferences when incorporating dogs into therapy programs and should offer alternative interventions or accommodations as needed to ensure inclusivity and accessibility for all patients. This will help remove the potential accessibility barriers that may prevent certain individuals from fully participating in therapy sessions.⁶

Summary

Dogs have played a pivotal role in the lives of humans as loyal companions, helpers, and healers. The benefits of using dogs in AAT are multifaceted and profound, encompassing physical health improvements, psychological well-being, and social interaction enhancements. Interactions with therapy dogs have been shown to reduce stress and anxiety, alleviate pain, improve mood and emotional resilience, enhance communication and social skills, and increase motivation and engagement in therapy sessions. The therapeutic bond forged between individuals and therapy dogs transcends language, culture, and ability, offering solace, comfort, and hope to those facing adversity. AAT should be implemented as part of a multidisciplinary approach to care, with clear goals, protocols, and outcome measures to ensure the effectiveness and safety of therapy interventions.