Animal Therapy: An In-Depth Look at Animal-Assisted Interventions

Though many refer to it as ‘animal therapy,’ animal-assisted interventions (AAI) have emerged as a transformative approach to therapy, education, and recreational activities that leverage the deep bonds between humans and animals. By incorporating live, robotic, plush, and/or virtual animals into various interventions, AAI aims to enhance physical, emotional, and social well-being. This blog post explores the multifaceted nature of animal-assisted interventions its different approaches, competencies, standards of practice and the profound impact it has on individuals with dementia and other neurocognitive disorders.

Animal therapy, more formally referred to as “animal-assisted therapy,” is often confused with AAI. Although both involve human-animal interactions aimed at enhancing emotional, physical, or psychological well-being, animal-assisted therapy usually follows a more structured framework and is facilitated by a licensed professional. On the other hand, AAI covers a wider array of activities, including educational and recreational programs that involve animal interaction but may not have distinct therapeutic objectives. While all interventions involving animals fall under the umbrella of AAI, not every animal-assisted intervention meets the criteria for animal-assisted therapy.

This blog post explores the multifaceted nature of animal-assisted interventions, its different approaches, competencies, standards of practice and the profound impact it has on individuals with dementia and other neurocognitive disorders. It will also provide you with a FREE Occupation-Focused Manual for Dementia Care Using Animal-Assisted Interventions to utilize in your own occupational therapy practice, a discount code for joining the Association of Animal-Assisted Intervention Professionals (AAAIP) and how to get certified.

Understanding AAI 

Animal-assisted interventions serves as an umbrella term that encompasses several distinct practices, including Animal-Assisted Therapy (AAT), Animal-Assisted Education (AAE), Animal-Assisted Activities (AAA), and the emerging concept of Animal-Related Engagement (ARE). Each of these approaches and types of animal therapy integrates in unique ways to achieve therapeutic benefits (Association of Animal-Assisted Intervention Professionals [AAAIP], n.d.). 

• Animal-assisted therapy (AAT)

Animal-assisted therapy, is a structured and goal-oriented approach that includes animals in therapeutic settings. It is conducted by healthcare or human service professionals—such as occupational therapists, psychologists, or social workers—who work with clients to achieve specific, measurable therapeutic goals. AAT allows a trained therapy animal to accompany an owner or handler to an  appointment. The animal participates during the session, provides a needed distraction, and helps reduce stress for the client.   

• Animal-assisted education (AAE)

Animal-assisted education integrates animals into educational settings, supporting and enhancing students’ learning experiences. AAE can take many forms, from reading programs where children read to therapy dogs to hands-on animal care lessons that teach responsibility and empathy. The primary aim of AAE is to improve academic performance, social skills, and emotional well-being.

• Animal-assisted activities (AAA)

Unlike animal-assisted therapy and animal-assisted education, animal-assisted activities are more informal and do not have specific treatment goals. AAA focuses on enhancing quality of life through positive interactions with animals. This can occur in various settings, such as hospitals, nursing homes, and schools, where trained volunteers or handlers facilitate interactions. The aim of animal-assisted activities is to provide comfort, companionship, and relaxation, making it an excellent option for individuals in stressful or isolating environments.

• Animal-related engagement (ARE)

Animal-related engagement is an emerging practice within animal-assisted intervention, allowing participants to engage with the benefits of the human-animal bond through various activities. This could include virtual reality experiences involving animals, educational videos, or creative activities like coloring sheets and calligraphy that feature animal themes. The goal of animal-related engagement is to promote general well-being and stress relief, broadening the scope of how we can engage with animals therapeutically.

The Importance of Competencies and Standards in Animal-Assisted Interventions

 

Handler Competencies 

Handlers play a crucial role in animal-assisted interventions, requiring a deep understanding of their animals’ behavior, needs, and health indicators. 

They must demonstrate:

• Knowledge of Animal Behavior: Handlers should understand the body language of their animals and respond appropriately to changes in behavior.
• Safety Awareness: Knowledge of infection prevention and specific safety policies for the populations they serve is vital.
• Professional Training: Handlers must be trained in the interventions they provide and know how to select and pair an appropriate animal with each client.

Therapy Animal Standards 

Therapy animals themselves must meet specific standards, which include:

• Temperament and Training: Animals must have a suitable temperament, be well-trained, and enjoy interacting with various clients. Additionally, they must be updated with all current vaccinations. 
• Adaptability: Therapy animals should be able to adapt to changing environments and situations, which is essential for creating a positive therapeutic environment.

Regular assessments are crucial for therapy animal teams to demonstrate their competencies and ensure ongoing safety and effectiveness.

Certifications 

An Animal Assisted Intervention Specialist Certification (C-AAIS) is recommended for practitioners who wish to incorporate AAI into their practice. Becoming AAIS Certified may validate a practitioner’s knowledge of best practices when working with therapy animals (AAAIP, 2024). Certification can be completed through the AAAIP website. Applicants must take and pass a computer-based exam comprising 125 multiple-choice questions.

The exam covers content from the five domains:

1. animal welfare and well-being
2. zoonosis and infection prevention
3. animal behavior awareness
4. animal-assisted intervention foundations
5. professional best practices

Interested persons may prepare for the exam by reading field texts, taking university courses, or completing Association of Animal-Assisted Intervention Professionals’s self-paced online education. More information about the exam process and examination fees can be found on the AAAIP website.

Screening Clients

Effective screening and assessment of clients prior to utilizing animal-assisted therapy and animal-assisted activities is crucial.

This includes, but are not limited to:

• Individuals with underlying asthma, respiratory allergies, immunosuppressive disorders or allergies to animal food, dander, fur or saliva face significant risks when engaging in AAT (Centers for Disease Control and Prevention, 2024). 

 

• Clients with specific fears or phobias to certain animals or the general concept of animal interaction may experience heightened anxiety during AAT or AAA and must be considered (Centers for Disease Control and Prevention, 2024).  

 

• Identifying potential risks such as allergies, phobias, and emotional discomfort, is essential. 

Evidence Supporting AAI and Benefits of Animal Assisted Therapy for Individuals with Dementia and Other Neurocognitive Disorders 

Dementia, including Alzheimer’s disease, significantly impacts various cognitive functions like memory and thinking. However, recent studies highlight the positive effects of engaging patients in personalized activities, especially those involving pets. Simple interactions, such as calling a pet by its name or remembering its favorite toys, can help boost short-term memory by stimulating cognitive processes (Alarcón-Braga et al., 2023).

Incorporating therapy dogs into animal-assisted therapies has shown remarkable benefits as well. Patients participating in animal therapy programs with therapy dogs experienced significant improvements in their range of motion, fine motor skills, and overall motivation.

One innovative approach involved dressing therapy dogs in modified jackets with zippers and buttons, allowing patients to practice important daily living skills. This hands-on activity resulted in a notable 68.1% enhancement in fine motor skills among participants (Fralinger et al., 2023). These findings suggest that personalized, pet-focused activities can create a more engaging and supportive environment for individuals living with neurocognitive disorders.

Non-pharmacological therapies have been shown to effectively address challenging behaviors and mental stability issues in patients with dementia. One particularly valuable approach is art therapy, which helps individuals manage their symptoms and enhances their overall well-being and quality of life. According to Emblad and Mukaetova-Ladinska (2021), art-based interventions improve communication opportunities and facilitate therapeutic activities, creating a more engaging and supportive environment for patients.

Additionally, incorporating animals into art therapy may enhance these benefits by providing additional topics for social interaction. Participants in art therapy sessions have demonstrated significant improvements in memory domains (Emblad & Mukaetova-Ladinska, 2021). Overall, the activation of cognitive skills through visual therapeutic art positively impacts the quality of life for individuals with dementia, paving the way for future benefits.

Virtual reality (VR) has emerged as a safe, realistic, and cost-effective interactive environment that enhances client engagement. Interventions utilizing VR include sessions with robotic pets or virtual reality treatments, allowing individuals to interact with virtual animals using hand gestures, creating an immersive experience akin to being part of a real therapy group (Abdessalem et al., 2022). These activities promote upper extremity reach, postural control, and hand-eye coordination, fostering positive physical engagement while clients participate from the comfort of their own homes (Abdessalem et al., 2022).

An Occupation-Focused Manual for Dementia Care 

We’ve created a free manual focused on evidence-based activities for occupational therapy practitioners working with dementia patients and other neurocognitive disorders using animal-assisted interventions in community-based settings.

This evidenced-based AAI manual intends to provide practical guidance for therapists, advocate for further research and training in this area, and highlight potential barriers that are inhibiting OTPs from utilizing animal-assisted interventions in their treatment planning. This compilation of evidence-based activities can offer therapists a structured framework for incorporating AAI into their practice, ensuring that interventions are effective and focus on a patient’s needs. 

2 Examples of What Happens in an AAI Session? 

1. Animal-Assisted Therapy

Individual or Group Activity: Shuffling Hats 
Materials Needed:

•  Therapy animal (i.e., dog, cat, bunny, etc.) 
• Dog treats
• Multicolor party hats

Instructions:

1. Have the client interact with the animal; begin by petting them so they become comfortable with engagement 
2. Have the client align the party hats on a flat surface, in a row, following one of the color sequences from the worksheet attached
3. Instruct the client to place a treat under a particular color hat(s)
4. Therapist shuffles the party hats out of order
5. The therapist instructs the client to remove the hat(s) that contain the treat(s) for the animal. If the pet is trained to find treats, the pet can search for the treat(s). 

Modifications:

Upgrades:

• Have the client use a reacher to grasp the party hats and treats from a high surface and place them on the ground 
• Increase the number of party hats to increase scanning in a busier environment 
• Have the client place the hats on a lower surface to address postural control 

Downgrades:

• Position the party hats in front of client at comfortable distance 
• Limit the number of cones
• Incorporate rest breaks by allowing client to pet animal between each set

Safety Precautions: To ensure the patient’s safety, please supervise them while working with animals. If your patient has food allergies or dander, fur, or saliva allergies, this intervention strategy is unsuitable for them. Additionally, if they have a fear of specific animals or heightened anxiety during live interaction with animals, this activity is not recommended. Be cautious of potential paper cuts. Ensure that the animal does not display resource guarding. It is recommended that animals pass a behavioral evaluation prior to performing activity.

Purpose: The goal of the activity is to engage participants in a fun and stimulating experience, encouraging them to learn and develop skills important for everyday life. The activity not only focuses on motor skills such as reaching, but it encourages clients to problem-solve, important for activities such as dressing or grooming. 

Performance Skill: This activity addresses several process skills, including attending (maintaining attention to the task), choosing (the appropriate party hat), handling (supporting and stabilizing the party hats to ensure that they do not rip), sequencing (aligning the hats in a particular order), searching (finding the indicated hat), and organizing (arranging the hats in an orderly fashion) (AOTA, 2020b). The activity also addresses range of motion and reaching in different planes, including crossing midline.

Area of Occupations: Social participation, leisure, ADLs (AOTA, 2020b). 

2. Animal-Related Engagement 

Group Activity: Pet-themed Collage Making 

Materials Needed:

• Animal magazines 
• Glue
• Scissors
• Stickers
• Markers, crayons, and/or colored pencils
• Poster Boards or cardstock

Instructions:

1. While introducing the activity, provide each participant with a poster board or piece of cardstock and various animal magazines. Ask participants to cut out images of animals they like or words that would describe their dream pet.
2. Participants can create a collage of their own “dream pet” by cutting and gluing pictures onto the provided canvas.
3. While creating the collages, encourage participants to share stories about why they chose specific animals or words. 
4. Potential discussion questions: 
   • “Why did you choose that dog?” 
   • “What do you think this animal would like to do?” 
   • “What are some characteristics this animal might have?”
5. Allow participants to share their collages with the group. The facilitator should observe all colleges and make connections between group members to encourage social interactions. 

Modifications:

Upgrades:

• Allow participants to work together on one large collage, encouraging increased interaction to agree on the single animal
• Add details writing prompts regarding chosen animals

Downgrades:

• Provide pre-cut images or allow participants to tear out images rather than using scissors 
• Allow caregivers or additional staff to assist in more complex tasks such as gluing or writing 

Safety Precautions: Use safety scissors if needed to ensure decreased chance of harm. Ensure all provided materials are non-toxic (e.g. glue, markers, etc…). Monitor participants to ensure they are safe while using sharp tools such as scissors. Remain observant and mindful of potential overstimulation or maladaptive behaviors from participants. 

Purpose: The purpose of the activity is so clients can collaborate, share ideas, and discuss creations, fostering a sense of community. Additionally, participants can work on motor skills that are engaging and meaningful to them. 

Performance Skill: This activity enhances producing speech by encouraging participants to share their thoughts while making their collages. It also addresses taking turns, gesticulating (through crafting), expressing emotions, and encouraging others as participants share and complement each other’s work.

Area of Occupations: Social participation, leisure (AOTA, 2020b)

References

About Our Guest Bloggers:

Vanessa Brito OTS, Kaila Phaychanpheng OTS, Brooke Shackelford OTS, and Gabriela Villasenor OTS are master of occupational therapy students from Stanbridge University, completing their thesis project on Animal-Assisted Interventions under their thesis advisor, Dr. Macy Burr, OTD, OTR/L, ATP, C-AAIS, CAS.