OCCUPATIONAL THERAPY ANDANIMAL ASSISTED THERAPY

Jamie Morris, BS, OTS

Department of Occupational Therapy

Loma Linda University

LEARNING OBJECTIVES• Understand the difference between animal assisted activity and

animal assisted therapy

• Identify how to incorporate AAT into OT practice

• Demonstrate appropriate use of AAT with case studies and visiting dogs

ANIMAL ASSISTED ACTIVITY (AAA)

• Definition: “Activities that involve animals visiting people”-Lange, Cox, Bernert, & Jenkins, 2006/20076

ANIMAL ASSISTED THERAPY (AAT)• Definition: “Involves a health or human service professional

who use an animal as part of his/her job.”-Lange, Cox, Bernert, & Jenkins, 2006/2007

CLARIFICATION POINT“The term ‘pet therapy’ should be avoided because it is inaccurate and misleading. This term was widely used several decades ago to refer to animal training programs. The currently preferred terms suggest instead that the animal is a motivating force to enhance

treatment provided by a well-trained person.”-Delta Society, 2008

EARLY RESEARCH ON AAT

• 1792: Quaker society recognizes the therapeutic use of animals for those with illness

• 1919: US military promoted use of dogs for psychiatric patients

• 1961: Recognition of human-pet bonding noted by Dr. Boris Levinson

• 1990: Creation of Eden Alternative, a long-term care facility that includes animals

EARLY RESEARCH• Improvements in:

• Blood pressure• Mental health symptoms• Heart rate• Skin temperature• Arousal levels• Medication intervention

CURRENT RESEARCH

• Improvements primarily in mental health symptoms

• Decrease in anxiety• Increase in socialization• No change in blood pressure• Increases in neuro-hormone levels

“They found that students who were in the classrooms with the dog exhibited greater information processing and greater

empathy toward animals than those in the control group. Moreover, teachers in the study reported a decrease in the

amount of aggression and an increase in societal behavior in the children exposed to the dog.”

-Lange, Cox, Bernert, & Jenkins, 2006/2007

JAZZ AND CHAMP• Instant bond

• “just seemed to get it”• Proprioceptive input and tactile input:

• Relaxation, calming, decreased anxiety

*Please also visit: www.jazzkmg.blogspot.com

FIELDWORK CASE EXAMPLE• Senor X

• 60+ year old male, brain injury patient• Primary symptoms: balance, dizziness, socially

inappropriate behaviors• Intervention Activities: brushing, fetch, keep away,

tug

POST-INTERVENTION OBSERVATIONS

• Maintained edge of chair balance• No complaints of dizziness• Socially appropriate comments and behaviors for three

consecutive days• Remained calm during sudden fire emergency

ANIMALS AND OCCUPATION

• Areas of Occupation:• Functional mobility• Care of pets• Community mobility• Health management/maintenance• Sleep preparation• Sleep participation• Education participation• Play participation• Leisure participation• Social participation

CLIENT FACTORS AND AAT

• Mental Functions• Higher-level cognitive• Perception• Emotional• Sequencing

• Sensory Functions• Vestibular functions• Proprioceptive functions• Touch functions

• Neuromusculoskeletal• Joint mobility• Joint stability• Muscle endurance• Control of movement• Gait patterns

• Cardiovascular system function• Speech functions

• Voice functions• Body structures

INCORPORATING AAT INTO OT PRACTICE

• The animal is used as any other therapeutic media/tool is used

• Used to address any client factors or areas of occupation needing to be addressed

+ =

INTERVENTION OPTION:

• Stroke patient:• Place the animal on the affected side

and complete a brushing activity• Addresses neglect, sensation changes,

and mobility

INTERVENTION OPTION:

• Autistic child:• Have the student take the animal for a

walk during recess• Addresses social participation and

community mobility

INITIATING AAT

• Option 1: Pet Partner Team• A volunteer pet partner team

• Typically do AAA

• Therapist guides the Pet Partner Team in activities to address patient’s therapy goals

• Option 2: Therapist Team• Therapist goes through pet partner

training and registration• Utilizes animal in therapy to address

goals just as any other tool

OT PERSPECTIVEPraveen Injeti, OTR/L•Loma Linda University, Behavioral Medical Center•Program:

• Group format• All ages: children, adults, and geriatric• Begin session: discussion about animals• Activity: Introduce pet partner team• End session: reflection and discussion about experience

•Practice Model:• SI, client-centered approach, psychoanalytical approach

•OT role:• Guide session• “Reignite” roles in the client• Give a reality base

• Role of the Animals:• Transference in regards to emotion• Occupations come after roles have been re-established. The

animals aid in the reconnection with roles and reality.• Reconnect with the self so that acceptance of the the self can

happen.• Case Example:

• Catatonic client• Dog came close and waited until the client reached to pet him

“YOU CAN TEACH SOMEONE TO WALK, TALK…BUT WE CAN’T TEACH SOMEONE HOW

TO FEEL.”-Praveen Injeti

HOW TO CREATE AN AAT TEAM

• Delta Society• Recognized nationally • Connect you to a team• Connect you to trainings• Resources for therapists

COMMON CONCERNS ASSOCIATED WITH AAT

• Zoonotic infections• Research: “No zoonotic infections were reported in

3,281dog visits to 1,690 hospitalized patients during a 5-year period.”

• “A children’s hospital reported no increase in the rate of zoonotic infections or any other adverse incidences in the first 2-year period.”

-Cole, Gawlinski, Steers, & Kotlerman, 2007

• Delta Society:• Zoonotic infections

• Strict rules regarding placement of animals• Use of draw sheets, towels, and gloves

• Department Policies• Aid in registration, research, and guarantees regarding liability

insurance for registered teams

“IT’S A CHEMISTRY BETWEEN AN ANIMAL AND HUMAN”

-PRAVEEN INJETI

REFERENCES• Cole, K., Gawlinski, A., Steers, N., & Kotlerman, J. (2007). Animal-assisted therapy in patients

hospitalized with heart failure. American Journal Of Critical Care, 16(6), 575-586. • Delta Society (2008), Student manual: Pet partners team training course, Delta Society: Bellevue, WA• Fournier, A., Geller, E., & Fortney, E. V. (2007). HUMAN-ANIMAL INTERACTION IN A PRISON

SETTING: IMPACT ON CRIMINAL BEHAVIOR, TREATMENT PROGRESS, AND SOCIAL SKILLS. Behavior & Social Issues, 16(1), 89-105.

• Johnson, R., Meadows, R., Haubner, J., & Sevedge, K. (2008). Animal-assisted activity among patients with cancer: effects on mood, fatigue, self-perceived health, and sense of coherence. Oncology Nursing Forum, 35(2), 225-232.

• Lange, A. M., Cox, J. A., Bernert, D. J., & Jenkins, C. D. (2006). Is Counseling Going to the Dogs? An Exploratory Study Related to the Inclusion of an Animal in Group Counseling with Adolescents. Journal Of Creativity In Mental Health, 2(2), 17-31. doi:10.1300/J456v02n0203

• Sockalingam, S., Li, M., Krishnadev, U., Hanson, K., Balaban, K., Pacione, L., & Bhalerao, S. (2008). Use of animal-assisted therapy in the rehabilitation of an assault victim with a concurrent mood disorder. Issues In Mental Health Nursing, 29(1), 73-84.

• Velde, B. P., Cipriani, J., & Fisher, G. (2005). Resident and therapist views of animal-assisted therapy: Implications for occupational therapy practice. Australian Occupational Therapy Journal, 52(1), 43-50. doi:10.1111/j.1440-1630.2004.00442.x