Pet therapy

Synonyms

AAA, AAT, animal-assisted activities, animal-assisted therapy, animals in human therapy, canine visitation therapy, companion animal therapy, CVT, pet-assisted therapy, pet-facilitated therapy.

Background

Animal companionship has been used as an informal source of comfort and relief of suffering across cultures throughout history.

For over 40 years, pet therapy has been a subject of serious study for nursing and other healthcare disciplines concerned with emotional well-being and quality of life.

Pet therapy is used with people of all ages, but particularly with children and the elderly.

Pet therapy offers psychological benefits in terms of emotional connection, stress reduction, and reduced feelings of loneliness or isolation.

Pet therapy is used in clinical programs to treat social or emotional difficulties and communication disorders.

Animal companionship has been used as an informal source of comfort and relief of suffering across cultures throughout history.

For over 40 years, pet therapy has been a subject of serious study for nursing and other healthcare disciplines concerned with emotional well-being and quality of life.

Pet therapy is used with people of all ages, but particularly with children and the elderly.

Pet therapy offers psychological benefits in terms of emotional connection, stress reduction, and reduced feelings of loneliness or isolation.

Pet therapy is used in clinical programs to treat social or emotional difficulties and communication disorders.

Theory

Chronic stress is a major risk factor in many medical and mental health conditions. Animal companionship may aid in stress reduction and promote relaxation, thereby reducing risk or symptom levels in stress-related conditions.

Chronic feelings of isolation or alienation are also risk factors for medical and mental health conditions. Animal companionship may aid in reducing these feelings.

The tactile stimulation involved in animal companionship provides a pleasurable form of neurological stimulation that encourages relaxation and well-being.

The experience of being emotionally engaged in a relationship with a companion animal may foster growth in emotional maturity and self-awareness.

Children who are victims of trauma or have communication disorders may perceive animals as less threatening than people. As a result, pets may help such children become aware of their feelings and develop a clearer sense of self.

Companion animals encourage social interaction among the people around them, promoting a more interactive social environment.

Evidence

DISCLAIMER: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Quality of life: Pet therapy may benefit both patients and caregiving staff in a hospice setting. In one study, the presence of a dog was found to encourage staff-patient interactions, ease patient-visitor relations, and improve staff and patient morale. The preferred interactions with the dog were those that had a relaxing or comforting effect on the human. Not all patients, however, may be interested in contact with an animal.
Grade: B

Alzheimer's dementia: In the institutionalized elderly, there is evidence that pet therapy may reduce depression and blood pressure, reduce irritability, reduce agitation and increase social interaction. In Alzheimer's disease there is evidence that the presence of a companion animal may increase social behaviors such as smiles, laughs, looks, leans, touches, verbalizations, name-calling, or others.
Grade: C

Hypertension: There is evidence from one well-designed trial that pet ownership may have additive value in patients with hypertension who are taking conventional blood pressure medication.
Grade: C

Invasive medical procedures: Evidence is unclear about the extent to which pet therapy may be of value in reducing anxiety and depression in invasive medical procedures. A study of institutionalized psychiatric patients being treated with electroconvulsive therapy (ECT) had inconclusive results. More studies are needed to determine the value of pet therapy in preparing people for invasive or unpleasant procedures.
Grade: C

Loneliness in the elderly: Pet therapy has been shown to reduce loneliness and depression in residents of long-term care facilities, particularly in people with a prior history of pet ownership. The presence of a pet has also been found to lead to increased verbal interactions among residents.
Grade: C

Mental illness: There is evidence that the presence of a pet dog among psychiatric inpatients promotes social interactions. In people with schizophrenia, there is evidence that pet therapy may lead to improved interest in rewarding activities as well as better use of leisure time and improved motivation. There is also evidence of improvement in socialization skills, independent living, and general well-being. In a large, well-designed study, hospitalized patients with a variety of psychiatric disorders were found to have reduced anxiety after a single session of pet therapy. For most, the benefits were superior to those of a session of regular recreation therapy.
Grade: C

Nutrition (Alzheimer's patients): There is evidence from one well-designed study that animal-assisted therapy in the form of a fish aquarium in an institutional care facility for people with Alzheimer's disease may improve nutritional intake, improve weight gain, and reduce the need for nutritional supplementation.
Grade: C

Pain (pediatric): Based on preliminary study, canine visitation therapy (CVT) may be an effective adjunct to traditional pain management for children. More high-quality studies are needed to make any firm recommendations.
Grade: C

Tradition

WARNING: DISCLAIMER: The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.
Adaptation to a stress (in a hospital environment), anxiety, autism, communicative disorders (nonverbal), depression, diabetes, emotional expression, high blood pressure, muscle strength, motivation, post-traumatic stress disorder, rehabilitation, self-esteem, sensory stimulation, spinal cord injury, stress reduction, well-being.

Safety

DISCLAIMER: Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

Routine veterinary screening of both resident and visiting companion animals is recommended for all nursing homes offering pet-assisted therapy.

There have been reports of pet therapy animals being carriers of disease organisms (bacteria, parasites) that have been transmitted to patients interacting with them. This is of special concern when the people interacting with the animals are immuno-compromised or otherwise more vulnerable to infection.

Some people have allergic reactions to some companion animals. This should be considered before the introduction of pet therapy, particularly in a setting where multiple people may be exposed.

Attribution

This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Tracee Rae Abrams, PharmD (University of Rhode Island); William Collinge, PhD, MPH (Collinge & Associates); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Dana A. Hackman, BS (Northeastern University); Jennifer Minigh, PhD (Medical Communication Consultants); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration); Shannon Welch, PharmD (Northeastern University).

Bibliography

DISCLAIMER: Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

Allen K, Shykoff BE, Izzo JL Jr. Pet ownership, but not ace inhibitor therapy, blunts home blood pressure responses to mental stress. Hypertension 2001;38(4):815-820.

Banks MR, Banks WA. The effects of animal-assisted therapy on loneliness in an elderly population in long-term care facilities. J Gerontol.A Biol Sci Med Sci 2002;57(7):M428-M432.

Barker SB, Pandurangi AK, Best AM. Effects of animal-assisted therapy on patients' anxiety, fear, and depression before ECT. J ECT 2003;19(1):38-44.

Churchill M, Safaoui J, McCabe BW, et al. Using a therapy dog to alleviate the agitation and desocialization of people with Alzheimer's disease. J Psychosoc Nurs Ment Health Serv 1999;37(4):16-22.

Edwards NE, Beck AM. Animal-assisted therapy and Nutrition in Alzheimer's disease. West J Nurs Res 2002;24(6):697-712.

Enoch DA, Karas JA, Slater JD, et al. MRSA carriage in a pet therapy dog. J Hosp Infect 2005;60(2):186-188.

Fick KM. The influence of an animal on social interactions of nursing home residents in a group setting. Am J Occup Ther 1993;47(6):529-534.

Guay DR. Pet-assisted therapy in the nursing home setting: potential for zoonosis. Am J Infect Control 2001;29(3):178-186.

Hall PL, Malpus Z. Pets as therapy: effects on social interaction in long-stay psychiatry. Br.J Nurs. 11-23-2000;9(21):2220-2225.

Jessen J, Cardiello F, Baun MM. Avian companionship in alleviation of depression, loneliness, and low morale of older adults in skilled rehabilitation units. Psychol Rep 1996;78(1):339-348.

Kovacs Z, Kis R, Rozsa S, et al. Animal-assisted therapy for middle-aged schizophrenic patients living in a social institution. A pilot study. Clin.Rehabil 2004;18(5):483-486.

Nathans-Barel I, Feldman P, Berger B, et al. Animal-assisted therapy ameliorates anhedonia in schizophrenia patients. A controlled pilot study. Psychother Psychosom 2005;74(1):31-35.

Richeson NE. Effects of animal-assisted therapy on agitated behaviors and social interactions of older adults with dementia. Am J Alzheimers Dis Other Demen 2003;18(6):353-358.

Sobo EJ, Eng B, Kassity-Krich N. Canine visitation (pet) therapy: pilot data on decreases in child pain perception. J Holist Nurs 2006 Mar;24(1):51-7.

Stasi MF, Amati D, Costa C, et al. Pet-therapy: a trial for institutionalized frail elderly patients. Arch Gerontol Geriatr Suppl 2004;(9):407-412.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.