An Introduction to Animal-Assisted Psychotherapy

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When Jay and I first met, he was ten and already a veteran of several programs for severely emotionally disturbed children. None of his previous counselors had been able to agree on his diagnosis. One psychologist thought he met the criteria for oppositional defiant disorder; another, citing Jay's aggressive outbursts, opted for conduct disorder.

His psychiatrist finally settled on major depressive disorder and PTSD due to his history of abuse and neglect. But his hostility and unwillingness to participate in therapy meant that few counselors worked with him for long.

Jay's history and home life were complicated. His father was unknown, his mother struggled with addiction, and he'd done time in foster care and residential treatment. He was impulsive and socially isolated, bullied by others for his small size (at ten, he was the size of an eight-year-old), and he'd been expelled from school for fire-setting.

Of course, he had positive traits, too. Even his most pessimistic providers acknowledged his intellect, quirky sense of humor, and great affinity for animals of all kinds. It was for this last reason that Jay's aunt, his guardian caregiver, sought me out. She hoped that therapy involving animals might lure Jay into behavioral change.

A Child's First Experience with Animal-Assisted Therapy

I met them in the parking lot at the first session. Jay groaned theatrically at my approach but grudgingly left his aunt's car after she told him firmly that he'd forfeit his weekly karate class if he didn't cooperate.

"I'll go with you if I have to, but I'm not talking," he warned. He managed five seconds of silence as we walked on the path to my office, then commenced to narrate his history, a nonstop and impressive resume of delinquency for such a little boy. Did I know about the fire he'd set at his last school? Had I heard that he'd stolen a car from his foster mother and had been in juvie, a group home, and the psych unit? That he'd finally landed at his auntie's house because he was so bad that no foster home would keep him? "You're, like, my seventh counselor," he bragged, giving me a somewhat skeptical side-eye. "What do you think you can do for me?"

"I guess we'll see." I unlocked my door to reveal a nicely equipped play therapy room, complete with a comfy sofa, a small table and a couple of chairs, and open shelves displaying games, puppets, and other supplies.

Oh, and my co-therapist was there too, curled up nose-to-tail on her blanket in the footwell of my desk. Lucy was a soft-coated golden retriever, big for her breed but gentle and playful, with warm brown eyes and extravagant whiskers. Her tail thumped once in greeting as I opened the door, but she didn't move from her spot as she and Jay took stock of one another.

He was instantly smitten, his bravado replaced with unabashed delight. "There's a dog in your office! Does she live here? Can I play with her? Can we take her for a walk?"

First things first, I told him, and gave a rundown of the rules. Yes, we could take Lucy for walks in the field behind the office during our sessions. Yes, she would probably like to play and be friends with him if he was kind to her; she was an expert frisbee catcher and an enthusiastic fetcher of balls and sticks. She enjoyed being brushed and receiving fresh water and crunchy kibble, and he could take charge of her care during our sessions if he wished. She appreciated feel-good touches but was not to be hurt or harassed in any way. If she retreated to her blanket under my desk, it meant she wanted to be left alone. Her blanket was her safe place, and it had to be respected without fail.
"Lucky dog," he said. "I wish I had that."

I tilted my head quizzically. "You wish you had… a blanket?" Probing for his level of insight, I was delighted by his quick reply.

"A safe place," he clarified. "A getaway. Where, when I went there, no one was allowed to bug me."

"That would be good, wouldn't it?" I slipped to the ground with my back against the sofa. When I patted the floor next to me, he dropped down at once, and Lucy emerged from her den. She studied Jay for a long moment, then nuzzled his neck with her nose until he giggled. After stretching luxuriously, she rolled onto her back with all four legs in the air, inviting a tummy rub. She gave a little wiggle, looking at us expectantly, and Jay laughed right out loud. He used both hands to scratch and stroke her. I noted that his touch was appropriate, and his body posture and facial expression were relaxed.

I took a breath and a chance, knowing that the next few moments were critical. Having connected with Lucy, would he also connect with me? "Tell me more about this getaway place you'd like to have, where no one could bug you when you wanted to be left alone."

He didn't even hesitate. Still rubbing and scratching Lucy's long, deep chest, he said, "Well, it would be far away from everyone, like maybe on an island. Or a treehouse! Maybe a treehouse on an island. And I'd have a trapdoor with a rope ladder that I could drop down or pull up depending on who I wanted to see..."

And there, just like that: our therapeutic journey was underway.

Research Findings on the Therapeutic Power of Animals

Animal-assisted psychotherapy (AAP) is a mental health specialty in which appropriately credentialed mental health providers, working within their professional scope of practice, leverage the human-animal bond to treat their clients. Unlike what you may have seen on Showtime's "Couples Therapy," during which the therapist's dog greets each patient for a pat on the head before retreating to his bed for a nap, AAP involves the structured, intentional inclusion of an animal in the treatment process.

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The client, therapist, and animal work together in therapeutic activities that are outlined on a treatment plan, with clearly identified goals for change, specific and measurable objectives, and the expectation of identifiable progress toward the treatment goals.

Many challenges are associated with studying psychotherapy in general and AAP in particular. Factors such as the strength of the working relationship or therapeutic alliance between client and therapist are subjective and personal, rendering them difficult to measure or quantify. In AAP, the traditional dyadic relationship between client and therapist is expanded to include the animal as a therapeutic third, which adds complexity to the relationship, the work, and the study of both. Finally, AAP interventions are uniquely challenging to standardize, further tangling scientific research into their effectiveness.

Despite these complications, investigative experiments have been completed that support AAP as a beneficial intervention. One study by German psychiatrist Anke Prothmann introduced therapy dogs to psychiatrically hospitalized children in free play. She found that the presence of the animals supported an atmosphere of empathy, security, and acceptance that was especially beneficial at the start of treatment because it established favorable emotional conditions between the child and the therapist. In controlled clinical conditions, she discovered that the presence of the dogs enhanced the children's alertness and openness to social contact and helped the children become more psychologically well-balanced. She further found that the therapeutic effect was most significant in children who had felt the worst before having contact with the dogs.

Jay, Lucy, and I worked together for the better part of a year. When he turned eleven, he had a growth spurt that caught him up to most other kids his age. His aunt started the formal adoption process, which increased his sense of security and belongingness and (no big surprise here) substantially reduced his acting out. He didn't start any more fires or fights in school.

In therapy, he practiced social skills with Lucy, working cooperatively to teach her new tricks and skills. He proudly led her on walks in the neighborhood around the office, saying to passersby, "This is Lucy, and see how well she listens to me?" She did, too. The year after he graduated from therapy, we received a Christmas card from him, carefully addressed to both of us in his scrawling script. In it, he shared the joyful news that his aunt was allowing him to adopt a dog, having finally judged him responsible enough to take charge of its care.

Lucy and I couldn't have been prouder.