Going to the Dogs: Working with Animals in Treatment

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Going to the DogsWorking with Animals in
Treatment

• Ann R. Howie, LICSW, ACSW

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Going to the Dogs
Turn to a person near you. Share with that
person the two most important things you want to
learn in this presentation. Be prepared to state
those when asked.
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Learning Objectives

• Describe the philosophy behind working with
  animals in mental health treatment.
• Describe five considerations for choice of
  handler.
• Report five roles animals may take in treatment
  sessions.

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Learning Objectives (cont.)

• Identify five ways that animals can help clients
  attain goals related to symptoms of
  Post-Traumatic Stress Disorder.
• Analyze three general precautions,
  contraindications, and challenges to including
  animals in mental health treatment.

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Anns Work

• AAA/T Consultant
• AAT experience since 1986
• Human-Animal Solutions
• Author
• Private counseling practice
• Animal behavior
• Professor
• St. Martins University
• University of Denver
• Yamazaki College
• Founder, Providence AAA/T
• Former Delta Society AAT Director

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Philosophy
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Philosophy
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Philosophy (cont.)
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Philosophy (cont.)
The introduction of an animal into a therapeutic
environment changes the entire environment. It
changes the rules governing the behavior of all
the participants patients, therapists, staff,
visitors, volunteers, and professionals.
-- Dr. Aaron Katcher
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Philosophy (cont.)
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Philosophy Think Point
Turn to a person near you. Tell that person the
most important thing you learned in this section
of the presentation.
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Case Study
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Case Study

• Setting
• County in-patient psychiatric hospital, locked
• Court-committed clients (involuntary)
• Most were chronically mentally ill, few in first
  episode
• 3-month average length of stay
• 2 units acute and stabilized
• I was full-time staff therapist

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Case Study (cont.)

• Client
• 24-year-old woman, single
• Post-partum, no hx of depression
• Major depression with suicidal ideation
• Electively mute, communicated with hand gestures
• Rarely left room on acute unit
• Hospitalized for 6 weeks without progress ?
  approval for AAT

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Case Study (cont.)

• Treatment
• Parents gave hx and permission to work with dog
• 1st goal come out of room
• 2nd goal leave unit go to therapists office
• 3rd goal begin speaking
• Length of treatment 6 weeks
• Discharged to separate apartment and part-time
  job, gradually resumed full care of infant

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Settings

• In-patient and out-patient treatment
• Counseling center
• In home
• Animal shelter
• Barn, farm
• Zoo, aquarium

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Settings Think Point
Take a moment now to think about the setting in
which you practice. In your handout, draw a
symbol of whether you think your setting might
incorporate AAT. Or, if you can think of an
animal facility youd like to partner with, write
down that facilitys name.
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The Handler
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The Handler (cont.)

• Who will the handler be?
• Treating therapist
• Other therapist
• Paid staff (not a therapist)
• Trained and screened volunteer

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The Handler (cont.)

• Who will the handler be? (cont.)
• Must understand role
• Must know how to respond therapeutically to
  client
• Must know and understand therapy goals
• Must be willing to follow the therapists lead
• Must know the animal population as well as the
  individual animal

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The Handler (cont.)

• Environmental Impact
• Office, center, barn, etc.
• Goals of treatment affect choice of environment
• Privacy in an office vs. in a barn
• Handler fear/anxiety about environment vs.
  familiarity comfort

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The Handler (cont.)

• Dynamics of adding another person
• Distraction to client
• Client uncertainty about or distrust of handler
• Requires therapist preparation of both client and
  handler

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The Handler (cont.)

• Confidentiality
• Legally, how much is an outside handler allowed
  to know?
• Preparation is required before each session
• Must be confident of handlers ethics
• Sign Oath of Confidentiality (volunteer or paid
  staff)

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The Handler (cont.)

• The therapist as handler
• Is responsible to assure safety of all concerned
  client(s), animal(s), other staff, etc. while
  focusing on client needs and goals
• Are you capable of doing all those things?

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Handler Think Point
In your handout, identify three things you really
want to remember about choice of handler and mark
those items with a star.
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The Animal
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The Animal (cont.)

• Common therapy animal species
• Dogs and cats
• Horses
• Farm animals
• Other domesticated wild

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The Animal (cont.)

• Suitability to the task
• Matching animals characteristics to clients
  needs
• Ability of animal to enjoy setting
• Ability of the setting to accommodate the animal

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The Animal (cont.)

• The animals role
• Assistant or tool, not co-therapist!
• Animal gives the therapist a rich smorgasbord of
  behaviors for therapeutic work
• Accept grooming
• Participate in training
• Eat

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The Animal (cont.)

• Stress
• Therapy animals require de-stressing
• Handler/staff must know and recognize animal
  behavior
• Handler/staff must be willing to do something
  about animal stress
• The clients work must not be done at the expense
  of the animal

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Animal Think Point
Find The Animal section in your handout. Think
about the concept that stands out for you the
most in this section. Draw a doodle that
represents that concept for you.
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AAT Interventions
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Dx Post-Traumatic Stress Disorder (309.81)

• Precautions
• Dissociation
• Self-mutilating behaviors
• Angry or uncontrolled outbursts

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Dx Post-Traumatic Stress Disorder (309.81)
(cont.)

• Contraindications
• If precautions cannot be adequately supervised
• If adequate supervision cannot guarantee safety

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Dx Post-Traumatic Stress Disorder (309.81)
(cont.)

• Interventions
• Work with horses in activities that gradually
  require more skill
• Study horses in a field
• Go into the field and be with the horses
• Choose a horse to catch
• Feed the horse
• Groom the horse
• Etc.

• Symptoms
• High level of arousal
• Flashbacks
• Trauma
• Stress, anxiety

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Dx Post-Traumatic Stress Disorder (309.81)
(cont.)

• Interventions
• Work with a well-trained dog, then work with a
  dog that has less training (make the interactions
  more challenging only after the client gains more
  skill and confidence)

• Symptoms
• High level of arousal
• Flashbacks
• Trauma
• Stress, anxiety

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Dx Post-Traumatic Stress Disorder (309.81)
(cont.)

• Interventions
• Participate in an activity that is both physical
  and enjoyable to the client (agility, fly ball,
  rally, etc.) so that the client learns to
  gradually handle increasing levels of arousal
  while having fun

• Symptoms
• High level of arousal
• Flashbacks
• Trauma
• Stress, anxiety

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Dx Post-Traumatic Stress Disorder (309.81)
(cont.)

• Symptoms
• High level of arousal
• Flashbacks
• Trauma
• Stress, anxiety

• Interventions
• Go for a ride on a horse and verbally express
• Where client is in time, place, and person
• What the clients body feels like on the horse
• What it is about riding that helps the client
  feel grounded and in the present

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Dx Post-Traumatic Stress Disorder (309.81)
(cont.)

• Symptoms
• High level of arousal
• Flashbacks
• Trauma
• Stress, anxiety

• Interventions
• Work with a puppy, kitten, or other young animal
• Talk about how young animals keep our
  attention/focus
• Teach the young animal boundaries
• Teach about proper, safe animal behavior
• Teach social skills

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Dx Post-Traumatic Stress Disorder (309.81)
(cont.)

• Symptoms
• High level of arousal
• Flashbacks
• Trauma
• Stress, anxiety

• Interventions
• Work with an animal that was traumatized or part
  of a traumatic event
• Help animal heal
• Help animal become socialized
• Leads to metaphorical discussion of clients own
  trauma
• Helps client process his/her own traumatic
  situation

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Dx Post-Traumatic Stress Disorder (309.81)
(cont.)

• Symptoms
• High level of arousal
• Flashbacks
• Trauma
• Stress, anxiety

• Interventions
• Groom or pet an animal while talking with the
  therapist about his/her trauma
• Physical activity can be soothing, ? BP
• Environment is neutral
• Animal is a non-threatening link between client
  and therapist

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Dx Post-Traumatic Stress Disorder (309.81)
(cont.)

• Symptoms
• High level of arousal
• Flashbacks
• Trauma
• Stress, anxiety

• Interventions
• Observe fright/flight responses in an animal
• Journal observations about animals specific
  behavioral responses
• Make guesses about what animal was feeling
  (emotionally and physically) with the behaviors
• Journal about and/or discuss clients own trauma

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Dx Post-Traumatic Stress Disorder (309.81)
(cont.)

• Symptoms
• High level of arousal
• Flashbacks
• Trauma
• Stress, anxiety

• Interventions
• Practice being in the here and now while grooming
  an animal. Using the animal as the focal point,
  attend to
• Posture
• Body movements
• Breathing
• Response to animals movements

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Dx Post-Traumatic Stress Disorder (309.81)
(cont.)

• Symptoms
• High level of arousal
• Flashbacks
• Trauma
• Stress, anxiety

• Interventions
• Practice being in the here and now while taking
  an animal for a walk. Using the animal as the
  focal point, attend to
• Pace
• Heel-toe movements
• Arm movements
• Reaction to animals movements

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Dx Post-Traumatic Stress Disorder (309.81)
(cont.)

• Symptoms
• High level of arousal
• Flashbacks
• Trauma
• Stress, anxiety

• Interventions
• Teach the client slow breathing exercises while
  in the presence of an animal.
• Have the client match breathing to the animal
• Help the client use the animal as an anchor-point
  image to return to when away from the animal

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Dx Post-Traumatic Stress Disorder (309.81)
(cont.)

• Symptoms
• High level of arousal
• Flashbacks
• Trauma
• Stress, anxiety

• Interventions
• Teach guided imagery exercises
• Focused around an animal (could be a totem or
  guide)
• In the presence of an animal

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Dx Post-Traumatic Stress Disorder (309.81)
(cont.)

• Symptoms
• High level of arousal
• Flashbacks
• Trauma
• Stress, anxiety

• Interventions
• Teach grounding breathing exercises
• First in the presence of an animal
• Teach how to come back to being with animal in
  mind at times when client is anxious or stressed
  (outside of sessions)

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AAT Think Point
Think of a client you have worked with who might
have responded to an animal. Jot down two ideas
of ways you might have worked with that client
and an animal.
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General Precautions, Contraindications, and
Challenges
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Precautions and Contraindications (cont.)

• Client assessment
• Psychosis
• Delusions
• Hallucinations
• Assaultive
• Hx of animal abuse
• Ability to follow directions
• Judgement

• Confusion
• Impulsivity
• Self-harm or acting-out behaviors
• Physical ability
• Weight
• Sign a safety contract

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Challenges (cont.)

• Matching animal to client
• Sometimes need similar characteristics sometimes
  need different
• Medication
• Uncertainty or anxiety
• Disability

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Challenges (cont.)

• Matching animal to client (cont.)
• May prefer different animals at different points
  in treatment
• Use what screening criteria?
• Delta Pet Partners?
• Local group
• Certified Applied Animal Behaviorist
• Veterinarian

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Challenges (cont.)

• General liability insurance
• For an organization
• If working with a volunteer, work only with
  volunteers who have liability insurance coverage
  through their credential
• Most organizations carriers cover volunteers if
  they have received the organizations volunteer
  orientation
• If a staff member is the handler, the
  organizations carrier will need to be queried
  about coverage
• It is the handler who needs coverage, not the
  animal

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Challenges (cont.)

• General liability insurance
• For an individual practitioner
• Some carriers refuse to write a policy if dogs
  are included in treatment
• Too few practitioners inadequate loss history
• May need to use a carrier that writes policies
  for high-risk businesses ( high cost)

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Challenges Think Point
Think about the setting where you practice. On
your handout, identify two challenges that apply
to your setting and mark those with a check mark.
Then share those challenges with a person
nearby.
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A Few Resources
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A Few Resources

• Animal-Assisted Therapeutic Interventions, by
  Molly DePrekel, MA, and Tanya Welsch, MSW
• Animal-Assisted Therapy in Counseling, by Cynthia
  Chandler, Ed.D.
• Teaching Empathy, by Lynn Loar, PhD., and Libby
  Colman, Ph.D.
• Animal-Assisted Therapy Therapeutic
  Interventions, Delta Society

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A Few Resources (cont.)

• Equine-Facilitated Mental Health Association
  (EFMHA), http//www.narha.org/SecEFMHA/
  WhatIsEFMHA.asp
• Minnesota Linking Individuals, Nature,
  Critters, http//www.mnlinc.org
• Centaur Center for Human-Animal Relationships,
  Virginia-Maryland Regional College of Veterinary
  Medicine, http//www.vetmed.vt.edu/centaur/

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Review
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Review

• Describe the philosophy behind working with
  animals in mental health.

• The presence of the animal changes the
  interaction between therapist and client
• The therapist facilitates treatment based on
  planned and unplanned interactions with animals
• Animals are not co-therapists

61
Review (cont.)

• Report five considerations for choice of handler
  in mental health AAT.

• Who will handler be?
• Dynamics of adding another person
• Confidentiality
• Environmental impact
• The therapist as handler

62
Review (cont.)

• Report five roles animals may take in mental
  health AAT sessions.

• Assistant or tool, not co-therapist
• Provide smorgasbord of behaviors as therapeutic
  palette
• Accept grooming
• Participate in training
• Eat

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Review (cont.)

• Identify two ways that animals can help clients
  attain goals.

• Post-Traumatic Stress Disorder
• High level of arousal
• Flashbacks
• Trauma
• Stress, anxiety

64
Review (cont.)

• Analyze three general precautions,
  contraindications, and challenges to including
  animals in mental health treatment.

• Client assessment
• Matching animal to client
• General liability insurance

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Action Plan
Take a moment to become introspective. Think
about whether or not you want to explore AAT for
your clients. If you want to proceed, write down
the first thing you want to do I plan to . . .
. Then turn to a person near you and tell that
person your plan or the reason why this isnt a
good idea right now.
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(No Transcript)
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Thank You!
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