Animal Assisted Therapy

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Other Terms You May Have Heard

Although animal-assisted activities (AAA) and animal-assisted therapy (AAT) are the preferred terms, you may also hear the terms “pet-facilitated therapy” and “animal-facilitated therapy.” 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 behavior training programs. The preferred terms (AAA and AAT) suggest that the animal is the motivating force that enhances treatment provided by a well-trained person.

Animal-Assisted Activities (AAA)


The formal definition of animal-assisted activities is:

“AAA provides opportunities for motivational, educational, recreational, and/or therapeutic benefits to enhance the quality of life. AAA are delivered in a variety of environments by specially trained professionals, paraprofessionals, and/or volunteers, in association with animals that meet specific criteria.”

What does this really mean? Animal-assisted activities are basically casual “meet and greet” activities that involve pets visiting people. The same activity can be repeated with many people, unlike a therapy program that is tailored to a particular person or medical condition.

The Key Features of AAA:

  • Specific treatment goals are not planned for each visit.
  • Volunteers and treatment providers are not required to take detailed notes.
  • Visit content is spontaneous and visits last as long or as short as needed.

Examples of AAA:

  • A group of volunteers takes their dogs and cats to a nursing home once a month to “visit.” The visit occurs as a large-group activity with some direction and assistance provided by facility staff. The volunteer group facilitator keeps an informal log about who was visited.
  • An individual brings her dog to a children’s long-term care facility to “play” with residents. Although the staff is involved in the visits, the staff has not set treatment goals for the interactions. Aside from signing in and out, no records are kept.
  • A dog obedience club gives an obedience demonstration at a residential facility for teenagers with delinquent behavior.

Animal-Assisted Therapy (AAT)


The formal definition of animal-assisted therapy is:

“AAT is a goal-directed intervention in which an animal that meets specific criteria is an integral part of the treatment process. AAT is directed and/or delivered by a health/human service professional with specialized expertise, and within the scope of practice of his/her profession.

AAT is designed to promote improvement in human physical, social, emotional, and/or cognitive functioning [cognitive functioning refers to thinking and intellectual skills]. AAT is provided in a variety of settings and may be group or individual in nature. This process is documented and evaluated.”

The Key Features of AAT:

  • There are specified goals and objectives for each individual.
  • Progress is measured.

Examples of AAT

  • A volunteer brings her cat to a rehabilitation center to work with an occupational therapist and a child who has difficulty controlling fine motor skills. To improve the client’s fine motor skills, the therapist has the child manipulate buckles, and clasps on leashes, collars, and animal carriers. The child also opens containers of treats for the cat and feeds small pieces of food to the cat.
  • In an animal-assisted therapy session designed to improve a client’s ability to sequence events, a therapist teaches a client the steps of brushing a dog. For example:
    1. Get the brush out of the bag.
    2. Tell the dog to “stay.”
    3. Brush the dog.
    4. Tell the dog, “Good boy!”
    Motivated by the opportunity to brush the dog himself, the client remembers the steps, and the therapist has the client recite the order of events aloud as he goes through the actual sequence.
  • A woman recovering from a stroke has limited standing and walking tolerance. A physical therapist uses the presence of a dog to motivate the client by placing the dog on a raised table and asking the client to stand while stroking or brushing the animal’s back and head. To increase the client’s ambulation skills, the therapist has the client walk the dog for short distances around the facility grounds. (The handler uses a double lead and walks alongside the dog and client.)

Goals of AAT Programs

Animals can be incorporated into a variety of programs. If you become involved in an AAT program, ask the treatment provider to explain the person’s goals to you. The following are some examples of AAT goals.

  • Physical.
    • Improve fine motor skills.
    • Improve wheelchair skills.
    • Improve standing balance.
  • Mental Health.
    • Increase verbal interactions between group members.
    • Increase attention skills (i.e., paying attention, staying on task).
    • Develop leisure/recreation skills.
    • Increase self-esteem.
    • Reduce anxiety.
    • Reduce loneliness.
  • Educational.
    • Increase vocabulary.
    • Aid in long- or short-term memory.
    • Improve knowledge of concepts such as size, color, etc.
  • Motivational.
    • Improve willingness to be involved in a group activity.
    • Improve interactions with others.
    • Improve interactions with staff.
    • Increase exercise.

Differences Between AAA and AAT

At first glance, it may be difficult to tell the difference between AAA and AAT. The following are some critical differences you can learn to identify. Although AAA may have one or more of these characteristics, AAT must have all three. AAT is a more formal process than AAA.

  • AAT is directed by health/human services professionals as a normal part of their practice. This person may be a physician, occupational therapist, physical therapist, certified therapeutic recreation specialist, teacher, nurse, social worker, speech therapist, mental health professional, etc. The animal may be handled by a professional or by a volunteer under the direction of a professional. To be considered AAT, a professional must use the animal as part of his/her own specialty. For example, a social worker must use the animal in the context of social work. If this same social worker were to visit a group of children on an informal basis, the activity would be considered AAA.
  • AAT is goal-directed. There is a specific end in mind, such as improvement in social skills, range of motion, verbal skills, attention span, etc. Any visit with an animal may result in the achievement of one or more of these goals. Unless the goals have been identified and defined before the session, their session would not be considered AAT.
  • AAT is documented. Each session is documented in the person’s record with the progress and activity noted.

Benefits of AAA/AAT

Human-animal interactions may provide the following benefits to adults and children in a variety of human care facilities:


(Identifying with and understanding the feelings and motives of another.)

Studies report that children who live in homes in which a pet is considered a member of the family are more empathetic than children in homes without pets.

Children see animals as peers. It is easier to teach children to be empathetic with an animal than with a human. With animals, what you see is what you get. Humans are not as direct. Children can be taught to read an animal’s body language. Understanding what an animal is feeling is easier than determining what a person is feeling because the animal is straightforward and lives in the moment. As children get older, their ability to empathize with animals will carry over into their experiences with people.

Outward Focus

(Bringing individuals out of themselves.)

Individuals who have a mental illness or low self-esteem focus on themselves; animals can help them focus on their environment. Rather than thinking and talking about themselves and their problems, they watch and talk to and about the animals.


(Promoting the growth and development of another living thing.)

Nurturing skills are learned. Many at-risk children have not learned nurturing skills through the traditional channel – their parents. By being taught to take care of an animal, the children can develop these skills. Psychologically, when a person nurtures, his/her need to be nurtured is being fulfilled.


(A relationship of mutual trust or a feeling of connection or bonding.)

Animals can open a channel of emotionally safe, non-threatening communication between client and therapist.

In therapy settings, animals help present an air of emotional safety. If a therapist has an animal in his/her office, s/he “can’t be all bad.” The animal’s presence may open a path through the person’s initial resistance. Children are especially likely to project their feelings and experiences onto an animal.


(Favorable reception or approval.)

Animals have a way of accepting without qualification. They don’t care how a person looks or what they say. An animal’s acceptance is nonjudgmental, forgiving, and uncomplicated by the psychological games people often play.


At a minimum, the presence of an animal can be entertaining. Even people who don’t like animals often enjoy watching their antics and reactions. Especially in long-term care facilities, it seems everyone is entertained by animal visits in some way.


(Seeking out or enjoying the company of others.)

Studies have shown that when dogs and cats come to visit a care facility, there is more laughter and interaction among residents than during any other “therapy” or entertainment time. In an inpatient setting, the presence of animals encourages socialization in 3 ways:

  • Between clients.
  • Between clients and staff.
  • Between clients, staff, and family or other visitors.

Staff members have reported that it is easier to talk to residents during and after animal visits. Family members often come during the animal visits and some have reported that it is an especially comfortable and pleasant time to come.

Mental Stimulation

Mental stimulation occurs because of increased communication with other people, recalled memories, and the entertainment provided by the animals. In situations that are depressing or institutional, the presence of the animals serves to brighten the atmosphere, increasing amusement, laughter, and play. These positive distractions may help to decrease people’s feelings of isolation or alienation.

Physical Contact, Touch

Much has been written about the correlation between touch and health. Infants who are not touched do not develop healthy relationships with other people and often fail to thrive and grow physically. For some people, touch from another person is not acceptable, but the warm, furry touch of a dog or cat is. In hospitals, where most touch is painful or invasive, the touch of an animal is safe, non-threatening, and pleasant. There are a number of programs for people who have been physically or sexually abused in which staff and volunteers are not allowed to touch the clients. In cases like these, having an animal to hold, hug, and touch can make a world of difference to people who would otherwise have no positive, appropriate physical contact.

Physiological Benefits

(Positive effects on the basic functioning of the body.)

Many people are able to relax when animals are present. Tests have shown that the decrease in heart rate and blood pressure can be dramatic. Even watching fish swim in an aquarium can be very calming.

Something More

When they are with animals, some people feel spiritual fulfillment or a sense of oneness with life and nature. This is hard to define or explain. Some well-known authors have described their relationships with animals and nature as part of their sustaining life energy and/or part of their communion and relationship with God. Albert Schweitzer, George W. Carver, and J. Allen Boone (author of Kinship with All Life), among others, express this “something more” in their writing and work.

When AAA/AAT Would Not Be Beneficial

As beneficial as AAA and AAT can be, it is not always appropriate for every situation. Remember, “Good intention is not an adequate substitute for common sense.” The following guidelines will help you identify those situations when AAA/AAT may not be beneficial.

For the People, You Visit

AAA/AAT may not be beneficial for the people you visit in the following situations:

  • When animals are a source of rivalry and competition in a group.
  • When someone becomes possessive and attempts to “adopt” a visiting animal for him or herself.
  • Injury may occur from inappropriate handling, animal selection, or lack of supervision.
  • People with brain injury, developmental disabilities, or senility may provoke an animal without realizing it.
  • People with unrealistic expectations may think an animal is rejecting them. This may deepen their feelings of low self-esteem.
  • Allergies may create breathing problems, such as asthma, for the person.
  • Zoonotic diseases (diseases that can be passed between people and other animals) may be transmitted, particularly if precautions are not taken.
  • People with open wounds or low resistance to disease must be carefully monitored. Participation may need to be restricted.
  • Someone may be fearful of some animals.
  • People may view animals differently due to their cultural background.

For the Caregiver

Caregivers may consider AAA/AAT to be inappropriate when:

  • Staff and other caregivers are not allowed to participate in the decision-making process about AAA/AAT and are not properly oriented.
  • Some see animals in a facility as totally inappropriate.
  • Some do not like animals or fear them.
  • Caregivers may be allergic to animals.

For the Institution

Facilities may consider AAA/AAT inappropriate when:

  • Legal liability for an accident or injury involving a resident or staff member is a concern.
  • Legal obstacles may have to be overcome.
  • Noise, sanitation, disease, and other environmental concerns exist.
  • Cost factors must be weighed.

For the Animal

AAA/AAT may be inappropriate for the animals when:

  • Injuries from rough handling or from other animals may occur.
  • Basic animal welfare cannot be assured. This includes veterinary care and access to water and exercise areas.
  • The animal does not enjoy visiting.

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Tom Perry, M.D., attended Tulane University and graduated Magna Cum Laude with a B.S. degree in Parasitology. He received his M.D. degree in 1983 from the University of Virginia School of Medicine, where he gained extensive research experience, including studies conducted through the National Institutes of Health.