How Does Animal Assisted Therapy Affect The Duration Of Therapy

Within the concluding decade, studies supporting the health benefits of companion animals take emerged (one,2,3,4). Cardiovascular furnishings are frequently the focus, due partly to findings from a 1980 study that reported longer survival rates following myocardial infarction for pet owners compared with people with no pets (5). More recent bear witness of cardiovascular benefit was documented in an Australian study involving 5,741 participants (6). The authors plant that pet owners had significantly lower blood pressure and triglyceride levels compared with non-pet-owners, and the differences could non be explained past differences in cigarette smoking, diet, body mass index, or socioeconomic contour.

Stress and feet are considered contributory factors to cardiovascular affliction. Investigators have hypothesized that companion animals may serve to lower levels of stress and feet (4,7,viii). Several authors have reported lower blood pressure readings among adults and children when a previously unknown companion animal is present during various stressful activities (v,9,ten,xi,12,13,14).

Animals have been associated with positive effects on patients in a variety of health care settings (xv). When animals were first introduced to these settings, they were mostly brought for visits that were incidental to the treatment programme. Currently, animals are purposely included in treatment through various interventions broadly known as animal-assisted therapy.

Brute-assisted therapy involves the use of trained animals in facilitating patients' progress toward therapeutic goals (sixteen). Interventions vary widely, from long-term arrangements in which patients adopt pets to short-term interactions between patients and a trained beast in structured activities.

Although animals have typically been well received on psychiatric services, much of the data attesting to their benefits has been anecdotal (17,eighteen,19). Several decades ago, Searles (xx) and Levinson (21) addressed the therapeutic benefit of a companion domestic dog for patients with schizophrenia, contending that the caring, human-canine relationship helped ground the patient in reality. Chronic mentally ill residents in supportive intendance homes who were visited by puppies had decreased depression later the visits, compared with a matched control group (22).

More recently, Arnold (23) described the use of therapy dogs with patients with dissociative disorders. Benefits included the dog's calming influence, ability to alert the therapist early to clients' distress, and facilitation of advice and interaction. Others have proposed that an animal tin serve as a clinical span in psychotherapy, providing an entree to more sensitive bug (16,24,25).

On an inpatient psychiatric unit, animal-assisted therapy was found to attract the greatest number of patients among those who selected groups to nourish voluntarily and was found to be the most effective in attracting isolated patients (26). Other researchers establish that a group meeting for psychiatric inpatients held in a room where caged finches were located had college attendance and higher levels of patient participation, and was associated with more than improvement in scores on the Brief Psychiatric Rating Scale, compared with a matched group held in a room without birds (27). Anecdotally, psychiatric patients who are withdrawn and nonresponsive take been described as responding positively to a therapy canis familiaris with smiles, hugs, and talking (xvi). For elderly patients with dementia, lower centre rates and noise levels were associated with the presence of a therapy dog (28), and patients with Alzheimer's illness significantly increased socialization behaviors when a therapy domestic dog was nearby (29).

Based on the evidence in the literature associating companion animals with anxiety reduction and with positive responses from clinical populations, this study investigated the event of an animal-assisted therapy group session on the anxiety levels of psychiatric inpatients. Likewise of inquiry involvement was whether any anxiolytic outcome found varied by diagnostic grouping.

Methods

A pre- and posttreatment crossover design was used for this written report. Changes in anxiety ratings were compared for the same patients under ii conditions: a single animal-assisted therapy group session and a single therapeutic recreation group session that served as a comparison status. The setting for this study was the inpatient psychiatry service of an urban academic medical center. The service treats developed patients with a total range of acute psychiatric disorders. The average length of stay is 7 to eight days.

The brute-assisted therapy session consisted of approximately xxx minutes of group interaction with a therapy dog and the dog's owner. During the semistructured session, which was held one time a week, the possessor talked generally nigh the dog and encouraged discussion about patients' pets as the dog moved freely about the room interacting with patients or carrying out basic obedience commands.

The comparison condition was a therapeutic recreation group session held on the unit on the mean solar day following the animal-assisted therapy session. Therapeutic recreation sessions were held daily on the unit. They varied in content, including education about how to spend leisure time, presentations to increase sensation of leisure resources in the community, and music and art activities. Coordination of both the animal-assisted therapy sessions and the therapeutic recreation sessions was shared by three recreational therapists.

The study used the state scale of the Country-Trait Feet Inventory to measure patients' levels of anxiety earlier and later on the beast-assisted therapy session and the therapeutic recreation session (30). The State-Trait Anxiety Inventory is a brief, easy-to-administer cocky-report measure that is widely used in research and clinical practice.

The land calibration, which measures the level of feet felt at the present time, has been plant to be sensitive to changes in transitory anxiety experienced by patients in mental health treatment. The inventory consists of 20 items related to feelings of apprehension, nervousness, tension, and worry. For each item, subjects circumvolve ane of four numbers respective to ratings of not at all, somewhat, moderately then, or very much so. Instruments are scored by calculating the total of the weighted detail responses. Scores can range from 20 to lxxx, with greater scores reflecting higher levels of anxiety.

The internal consistency for the state scale of the State-Trait Anxiety Inventory is high; median blastoff coefficient is .93 (thirty). The construct validity is supported past studies showing that state calibration scores are higher under stressful conditions.

Procedures

A total of 313 adult psychiatric patients consecutively referred for therapeutic recreation over an eight-calendar month period in 1996 were eligible for the study. Patients are referred for therapeutic recreation as soon as they are stable plenty to participate in group activities, more often than not within 24 to 72 hours of admission.

When patients were initially referred for therapeutic recreation, they were asked to sign a consent grade to participate in a grouping session involving a therapy dog. Patients were not eligible to participate if they had any known canine allergies, were fearful of dogs, or did not sign a consent form. Study subjects attended both an brute-assisted therapy group session and a therapeutic recreation group session. The two types of sessions were held once a week on sequent days at the same time on each day.

The iii recreational therapists providing services to the inpatient psychiatry unit of measurement volunteered to help with the study. Because the therapists were non blind to the treatment condition, steps were taken to minimize bias by training the therapists in standard data collection procedures. At the beginning and end of each beast-assisted therapy group session and the comparing therapeutic recreation group session the following twenty-four hour period, the recreational therapist administered the State-Trait Anxiety Inventory. The therapists read the instrument verbatim to whatsoever patient who had difficulties reading. For the animal-assisted therapy group, the pretreatment instrument was completed before the dog entered the room.

2 female owners of therapy dogs volunteered to provide the fauna-assisted therapy sessions. The first volunteer provided the therapy for the initial 4 months of the written report; then she became ill and could not continue. The second volunteer agreed to continue the written report following the same format used by the first volunteer. Her participation required reversing the days that the beast-assisted therapy session and the therapeutic recreation session were offered.

The dogs and owners met hospital policy for participating in fauna-assisted therapy, including documentation of the dog's electric current vaccinations, controllability, and temperament. The volunteers were advised of the fauna-assisted therapy grouping session and given direction on how to lead the therapy grouping.

Analysis

Instruments were scored twice for accuracy by one of the authors using the scoring keys for the State-Trait Anxiety Inventory. A mixed-models repeated-measures analysis was used to compare pre- and posttreatment differences in anxiety scores between and within the brute-assisted therapy condition and the therapeutic recreation condition by diagnostic category.

Results

Considering this study was conducted in a clinical setting, pre- and posttreatment measures on all subjects nether both weather were difficult to obtain. 6 patients refused to participate because of canine allergies or fear of dogs. Of the 313 patients who were eligible for the study, 73 percent (North=230) participated in at to the lowest degree i creature-assisted therapy group session or one recreation group session and completed a pre- and a posttreatment measure for the session. L patients completed a pre- and a posttreatment measure out for both types of sessions. Failure to complete all iv measures was primarily due to time conflicts with medical treatments and patient discharges.

Patient characteristics

The mean±SD age of the 313 patients referred for therapeutic recreation was 37±12 years, and their mean length of stay was x.98±8.88 days. A full of 174 patients were women, and 139 were men. The majority were blackness (169 subjects, or 54 percent) and single (195 subjects, or 63 per centum). They had completed an average of 11.three±two.6 years of didactics.

For analysis, patients were categorized by primary discharge diagnosis. The diagnoses were collapsed into four categories: mood disorders, including all depressive, bipolar, and other mood disorders, for 154 patients (49.two percent); psychotic disorders, including schizophrenia, schizoaffective disorder, and other psychotic disorders, for eighty patients (25.6 percent); substance use disorders, for 52 patients (16.6 percent); and all other disorders, including feet, cognitive, personality, and somatization disorders, for 27 patients (viii.vi percent).

Comparison of therapy groups

Table 1 shows the mean scores of the 230 study participants on the State-Trait Anxiety Inventory earlier and afterward attending an animal-assisted therapy group session and a therapeutic recreation group session besides as the mean change scores. Change scores were calculated using data from patients with measures at both pre- and posttreatment time points. The F test and p values show the significance of the change beyond time. No statistically pregnant differences in anxiety alter scores were found between animal-assisted therapy and therapeutic recreation. Although no significant between-group differences were found, within-group differences were statistically significant for both animal-assisted therapy and therapeutic recreation (F=6.71, df= one, 194, p=.01, and F=16.81, df=1, 194, p<.001, respectively).

Among patients who participated in therapeutic recreation, only patients with mood disorders had a significant mean decrease in anxiety. Amongst patients who participated in animal-assisted therapy, patients with mood disorders, psychotic disorders, and other disorders had a significant mean decrease in anxiety. This finding suggests that animal-assisted therapy reduces feet for a wider range of patients than the comparison condition of therapeutic recreation.

Discussion and conclusions

Spielberger (30) provided normative State-Trait Anxiety Inventory scores for neuropsychiatric patients based on information from male veterans. Compared with the normative patients with depressive reaction, the patients with mood disorders in the study reported hither had somewhat lower mean pretreatment scores (47.58± 12.73, compared with 54.43±13.02). The pretreatment scores of the patients with psychotic disorders in this study were slightly higher than the scores for the normative patients with schizophrenia (48.47±fifteen.26, compared with 45.70±13.44).

In this study, no significant difference was institute between the anxiety modify scores afterward patients participated in beast-assisted therapy and after patients participated in therapeutic recreation. Nonetheless, this lack of difference could exist due to the small-scale number of patients (Northward=fifty) who completed all four study measures. A power assay of the magnitude of differences between the change scores for animal-assisted therapy and therapeutic recreation indicated that larger samples would be needed to achieve an 80 percent power level at an alpha of .05: a sample of 300 patients with psychotic disorders, 125 patients with substance use disorders, and 61 patients with other disorders. For patients with mood disorders, the difference in anxiety modify scores was too small for whatever reasonably sized report to observe a significant difference.

For within-group differences, a significant reduction in feet after therapeutic recreation was found only for patients with mood disorders, whereas a meaning reduction after creature-assisted therapy was found for patients with mood disorders, psychotic disorders, and other disorders. The size of these reductions was similar to differences reported by Wilson (13) for college students whose anxiety scores were measured under varying levels of stress.

No significant reduction was found in anxiety scores for patients with substance use disorders after either animal-assisted therapy or therapeutic recreation. This lack of departure may exist due to the pocket-size sample size or due to a relationship between state anxiety and physiological withdrawal that is less amenable to alter within one session of animal-assisted therapy or therapeutic recreation.

The reduction in anxiety scores for patients with psychotic disorders was twice equally great after animal-assisted therapy equally after therapeutic recreation. This finding suggests that creature-assisted therapy may offer patients with psychotic disorders an interaction that involves fewer demands compared with traditional therapies. Equally Arnold (23) contends, possibly the therapy dog provides some sense of safe and comfort not found in more than traditional inpatient therapies. Alternatively, the dog may provide a nonthreatening diversion from anxiety-producing situations (31). Or perhaps it is the physical touching of the dog that reduces patients' anxiety, as has been reported for other populations (12).

In this study setting, animal-assisted therapy was offered just one day each calendar week. It would exist interesting to study the effect of more frequent exposure to determine if the reduced anxiety is partly due to novelty or if increased exposure results in further anxiety reductions. Although some patients in the study remained hospitalized long enough to participate in more than 1 animal-assisted therapy session, at that place were non plenty such patients to let investigation of the upshot of repeated exposure. Therefore, data from their initial animate being-assisted therapy and therapeutic recreation sessions were used for analyses.

It is not possible to determine how much the dog or the owner contributed independently to the reductions in feet found in this study. Although the report's purpose was to examine the effect of animal-assisted therapy, further test of the issue of its components is needed.

Considering many owners of therapy dogs volunteer their hereafter to psychiatric units, animal-assisted therapy appears to be a cost-effective intervention. Nevertheless, volunteers may non participate consistently. In this study, a 2nd therapy dog and possessor, a potential confounding variable, were introduced afterward the starting time owner became ill. Use of nonvolunteers could strengthen future studies by providing more consequent treatment weather.

Finally, although the results provide evidence of the immediate effect on state anxiety of a single session of animal-assisted therapy, further study is needed to determine if patients' overall level of anxiety is afflicted. Further studies of the effect of fauna-assisted therapy on psychiatry services are needed to replicate the findings from this study and to advance our understanding of the therapeutic benefits of the human-animal interaction.

Acknowledgments

The authors thank Al Best, Ph.D., for his assistance with statistical analysis and Pat Conley, Helen Brown, and Claudette McDaniel for their assist with data drove.

Dr. Barker is associate professor of psychiatry, internal medicine, and anesthesiology and Dr. Dawson is affiliate assistant professor of biostatistics at the Medical College of Virginia, Virginia Republic University, P.O. Box 980710, Richmond, Virginia 23298. Dr. Barker's e-mail address is [email protected]

Table 1. Mean pretreatment, posttreatment, and modify scores on the Land-Trait Feet Inventory for hospitalized psychiatric patients with diverse diagnoses who participated in an animal-assisted therapy session or therapeutic recreation

Table ane. Mean pretreatment, posttreatment, and change scores on the Land-Trait Anxiety Inventory for hospitalized psychiatric patients with various diagnoses who participated in an animal-assisted therapy session or therapeutic recreation

Enlarge table

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Source: https://ps.psychiatryonline.org/doi/full/10.1176/ps.49.6.797

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