A New Approach for Kids Who Refuse Counseling

Donna Hindman, used with permission

Children sometimes need counseling to cope with their challenges. They may internalize and shut down due to intense emotional experiences with anxiety or depression. Conversely, they may externalize, or act out inappropriately, when their outsized feelings overwhelm their still-evolving verbal skills or impulse control. Some kids need help to develop or maintain a group of friends, or they may struggle in isolation to cope with the aftermath of a traumatic event.

Counseling can be powerfully effective in helping children cope with these and other difficulties. It offers an outlet for the safe expression of feelings and is a space for learning vital life and social skills.

As a parent, you can count on the fact that counselors specializing in child psychotherapy are particularly attuned to children’s interests and concerns. They are by and large empathetic, non-judgmental, and kind, creating counseling spaces that are age-appropriate, warm, and welcoming.

Most importantly, they are trained to tailor their interventions to each child’s needs and developmental level. Psychotherapy for younger children may include creative activities such as storytelling, music, art, or play, while teens may benefit from cognitive-behavioral interventions, role-plays, and stress-management techniques.

Once you’ve noticed that your child might benefit from professional help, you’re likely to feel hopeful about collaborating with a therapist to help your child feel better and cope more successfully with their troubles. However, at least at first, children rarely understand or express their need for counseling and may feel embarrassed, uncomfortable, or worried about spending time alone with an unknown adult. This may lead to resistance or lack of engagement in the treatment process and premature termination before any therapeutic effect has been gained.

Animal-Assisted Psychotherapy

Animal-assisted psychotherapy (AAP) is an increasingly popular therapeutic approach that includes animals in treatment to help children work through their emotional or behavioral issues. Pet Partners, one of the largest therapy-animal organizations in the world, registers nine species, including dogs, horses, cats, birds, and rabbits. However, dogs are by far the most popular choice in psychotherapeutic work.

AAP’s first use with children was documented in the 1950s by child psychologist Boris Levinson. While working with patients in his home office, Levinson discovered that a withdrawn child responded positively to Jingles, Levinson’s pet dog. He encouraged Jingles to join the boy’s sessions, gradually theorizing that Jingles helped facilitate the child’s participation in psychotherapy. Since then, hundreds of treatment studies have examined the efficacy of AAP in children with wide-ranging diagnoses, including autism, eating disorders, substance use disorders, and posttraumatic stress.

Many benefits are associated with AAP in children’s treatment, including the emotional connection and trust between the child and the dog. The presence of animals establishes a soothing atmosphere where children may more readily discuss their thoughts and feelings. Children may be more willing to talk to the dog, with the therapist listening, than to the therapist directly, especially with sensitive or painful material. They can participate in activities such as grooming and walking the dog, which encourages leadership and responsibility. They may also work with the therapist to teach the dog a multi-step trick or skill, thereby practicing their organizational skills, sequential thinking, and concentration.

Animal-assisted play therapy, which includes the animal in treatment to help the child explore emotions and behavior through play, is a popular intervention for younger children. Animal-assisted relaxation is another technique involving guided imagery involving the animal to help children learn how to successfully manage their anxiety. Several studies have demonstrated that petting a friendly dog can reduce cortisol, a hormone associated with stress.

Research Support

Research has shown that AAP benefits children who resist participation in more traditional forms of mental health treatment. For example, one researcher evaluated the effectiveness of AAP in improving interpersonal trust and the therapeutic alliance in children (Parish-Plass, 2018). She measured the children’s level of trust in the therapist and their social-emotional avoidance at week three of treatment and again at week eight. She found a large effect size in the strength of the therapeutic alliance and interpersonal trust at week three among the children receiving animal-assisted play therapy compared to the children receiving play therapy alone. However, by week eight, there was no significant difference in the therapeutic alliance between the treatment and control groups.

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Similarly, she found lower levels of social-emotional avoidance in the treatment group at week three compared to the control group. Again, the differences were no longer significant by the eighth week of treatment. The researcher’s important finding was that engagement with animals in the earliest weeks of treatment helped the children persist in therapy until their relationship with the therapist was securely established.

Similarly, another study examined the benefit of animal-assisted therapy for children who demonstrate posttraumatic symptoms after experiencing sexual abuse (Signal et al., 2017). Noting that one of the significant challenges in this population is early termination, they found that 90 percent of the children in their study adhered to the entire treatment protocol, suggesting that AAP may be an appropriate interventional choice for children who otherwise might refuse to continue their therapy.

Conclusion

Animal-assisted psychotherapy offers many benefits for children, especially in treatment engagement from their first sessions. It can help children (and adults) develop the tools to build happy and healthy lives. As research support grows, it will likely become an increasingly popular and effective treatment option.

On the other hand, AAP is not a magic bullet. It isn’t suitable for every person or every situation. For example, it should not be considered for children who are aggressive, fearful of, or allergic to dogs. Cultural considerations are also important. People from some Asian or Middle Eastern cultures may view dogs as a food source or unclean, making them potentially inappropriate therapy adjuncts for people with those customs and beliefs.

The presence of a therapy animal in the counselor’s office may encourage your child to engage actively in treatment from their earliest appointments. As your child’s most important advocate, you are best situated to decide if this intervention might be right for your child. If so, you can search for a conveniently located animal-assisted psychotherapist on any therapist search finder or your insurer’s database.