Animal-assisted therapy (AAT) in counseling continues to be a topic of much confusion and curiosity among professional counselors, clinical supervisors and counselor educators, mainly because the concept of animal-assisted mental health is only marginally understood. For many who have experienced the power of the human–animal connection, the rationale behind incorporating a therapy animal into counseling needs little explanation. However, this is a biased perspective that is heavily influenced by personal experiences and values.

To provide an intentional and efficacious intervention to clients, professional counselors must understand the human–animal connection from a more professionalized perspective. This article will illuminate a more purposeful and empirically based approach to AAT in counseling that is grounded in literature and tempered by the clinical experiences of experts. This brief article only scratches the surface of the topic, however, so we encourage interested readers to seek additional information from the resources provided on page 56.

Defining AAT in counseling

Many readers of this magazine may have been exposed to various forms of AAT as well as animal-assisted activities. Although it may seem a trivial matter of semantics, there is a considerable difference between these two terms. Animal-assisted activities involve qualified volunteer animal-handler teams providing a service that is intended to raise morale and improve quality of life through “meet and greet” interactions. Examples of this include reading assistance dog programs and therapy animal visits to hospitals or nursing home facilities.

AAT shares some of the benefits of animal-assisted activities, but according to the therapy animal registration organization Pet Partners, it differs in that AAT is a “goal-directed intervention which is administered by a health/human service provider with appropriate training and expertise and within the scope of practice of the provider’s profession.” AAT in counseling can be conceptualized as a specialized area of AAT. Expert Cynthia Chandler defines AAT in counseling as the incorporation of pets as therapeutic agents into the counseling process, thus utilizing the human–animal bond in goal-directed interventions as part of the treatment process. When delivered or directed by a professional counselor with appropriate skills and expertise regarding the clinical applications of human–animal interactions, AAT in counseling may be incorporated into sessions in a variety of ways and across a wide range of treatment settings.

AAT in counseling requires a specialized set of skills and competencies that allows professional counselors to incorporate specially trained animals into the counseling process. Together, the professional counselor and the therapy animal can affect the therapeutic process in ways that move beyond the scope of traditional counselor–client helping relationships. For more details regarding the training and skills necessary for AAT in counseling, see the second edition (2012) of Chandler’s book Animal Assisted Therapy in Counseling or the Pet Partners website at petpartners.org.

Counselors not only employ AAT approaches across a rich diversity of practice settings and techniques, but they also choose a variety of therapy animal partners. Pet Partners recognizes the following domestic animals as eligible for therapy animal evaluation: dogs, cats, guinea pigs, rabbits, domesticated rats, horses, donkeys, llamas, cockatoos and African grey parrots. Pet Partners does not endorse any specific breeds. Therefore, all breeds of dogs (or other animals) may be eligible for evaluation. However, the organization currently excludes wolf hybrids and exotic animals such as ferrets and reptiles from eligibility.

Practitioners of AAT in counseling can be found in a wide variety of settings, including traditional office spaces, farms and stables, correctional facilities and older adult care facilities. Although counselors wishing to use an AAT approach enjoy such a wide variety of options, it should be noted that all therapy animals, regardless of species or breed, must be specially trained and appropriately suited for therapeutic work. It is important that therapy animals be desensitized to touch, accepting of unfamiliar people and tolerant of unfamiliar environments and situations. Obtaining registration through a recognized therapy animal organization helps to ensure that the potential therapy animal’s training and temperament meet minimum standards in these areas. It is further recommended that the therapy animal also be the counselor’s personal pet because this familiarity and bond allow the counselor to predict the therapy animal’s behavior and responses across a wide variety of situations.

Empirically supported benefits 

Although the empirical benefits associated with AAT in counseling are only beginning to be explored and understood, several researchers and practitioners have found that including a therapy animal in the counseling process has a unique, positive impact on the therapeutic alliance. Experts Cynthia Chandler and Aubrey Fine assert that the relationship between the therapy animal and the client facilitates rapport between the client and the human counselor, which may help the professional counselor build positive therapeutic alliances more quickly. Others, such as Martin Wesley, Neresa Minatrea and Joshua Watson, have found that incorporating AAT into counseling sessions improved the client’s perception of the quality of the therapeutic alliance. Considering that the quality of the therapeutic alliance is an essential predictor of positive outcomes in therapy, AAT may offer professional counselors a valuable treatment option.

In addition to facilitating the alliance between professional counselors and clients, many practitioners have observed the need for language decrease in the presence of the therapy animal. In fact, the client may alternatively choose to express himself or herself through physical interactions with the animal. This option for physical interaction has been noted as another unique benefit associated with AAT in counseling, with the therapy animal offering opportunities for clients to experience safe and therapeutic touch as part of the counseling process. In this way, a therapy animal may offer opportunities that are beyond the scope of human counselors.

Model of practice 

Although AAT in counseling is surging in clinical practice popularity and existent research has affirmed the therapeutic benefits of AAT when practiced by an appropriately trained counselor, little research has been done to investigate and understand the theoretical underpinnings of this unique approach. To address this gap, two of the authors of this article, Leslie Stewart and Catherine Chang, along with Robert Rice, conducted a grounded theory study in 2012 to uncover an emergent theory of AAT in counseling. On the basis of this study, we found that counseling professionals who expertly utilize AAT in counseling develop a specific set of skills and competencies and utilize a highly developed working relationship with a therapy animal to purposefully affect the therapeutic process, while enhancing the scope of traditional counselor–client relationships.

According to this emergent theory, the specialized skill set and competencies developed by professional counselors employing AAT in counseling serve as a critical foundation for the relationship with the therapy animal. The highly developed working relationship, informed by the counselor’s skill and competency, helps the counselor to address the critical element of animal advocacy more effectively, while also allowing the counselor to interpret the animal’s responses and patterns of interaction with clients in a therapeutically meaningful way. This therapeutically meaningful interpretation of the animal’s responses allows the counselor–animal team to affect the process of therapy in ways that would not be possible without the therapy animal’s presence.

Effective AAT counseling professionals go beyond the facilitation of safe human–animal interactions. These skilled clinicians are able to purposefully facilitate and interpret client interactions with the animal in ways that enhance the therapeutic process, while simultaneously utilizing the animal’s inherently spontaneous and unpredictable behaviors to reframe situations or serve as teachable moments. It is important to note that AAT-specific skills and competency are acquired additively to general counseling competencies. Counselors must demonstrate efficacy and competency as counselors before including AAT in counseling as an intervention.

The data of this study confirmed that counselors often can use an AAT-in-counseling approach to positively affect the therapeutic relationship but also revealed that when practiced with an intentional and skilled approach, AAT allows counselors to expand and enhance their existing counseling skills in ways that would not be possible without an animal partner. In addition, this study showed that AAT in counseling approaches may directly benefit counselors by helping them recognize, prevent and address symptoms of burnout and vicarious trauma. It seems that the highly developed working relationship between counselor and therapy animal is often reciprocal and may allow the animal to recognize and respond to signs of stress in the counselor, just as the counselor responds to signs of stress in the animal. This study also suggested that the counselor’s responsibility to care for the animal during and between counseling sessions provides the counselor with a much-needed break and encourages counselor self-care.

Ethical and practical considerations

Although AAT in counseling offers a potentially flexible and efficacious treatment option, the approach requires potential practitioners to consider and address numerous practical considerations. As is the case with all specialty areas in counseling, potential practitioners need to seek and obtain appropriate training and supervised experience before including an AAT-in-counseling approach with clients. It is imperative that counselors develop and demonstrate appropriate “hard skills” (knowledge of animal physiology, training, behavior, obedience skills and so on), which are incorporated with appropriate “soft skills” (general counseling competency, efficacy facilitating human–animal interactions, ability to translate interactions in therapeutically meaningful ways and more). Additionally, potential AAT practitioners must recognize the implications of including a living creature, which has its own needs and rights, into counseling work. Practical aspects of including AAT in counseling work will vary depending on treatment setting, clinical population and individual therapy animal, but certain considerations related to counseling ethics are applicable to all counselors who include AAT in their clinical work.

One of the most important ethical considerations is the issue of competency, which serves as the essential foundation of effective AAT in counseling. To comply with a minimum standard of professionalization, counselors should seek formal evaluation and registration with a recognized therapy animal organization. Examples of these organizations include Pet Partners, Therapy Dogs Inc., Intermountain Therapy Animals and Equine Assisted Growth and Learning Association (EAGALA). Although no counseling-specific registration or certification process currently exists, registration with such organizations helps to confirm that a therapy animal and its handler meet certain minimum criteria for general skills, obedience training and temperament suitability. In addition to addressing competency considerations through formal registration, a potential practitioner of AAT in counseling must develop thorough competencies regarding positive animal training philosophies and techniques, the behavior and physiology of the species of therapy animal, and counseling-specific clinical applications of human–animal interactions.

Developing such competencies will allow a counselor to better address another important ethical aspect of AAT in counseling: increased risk of harm. Although the inclusion of a specially trained and well-groomed therapy animal and a competent counselor helps to minimize risks associated with human–animal interaction, it is important to understand that human–animal interactions carry certain unavoidable risks for the humans and animals involved. All animals, regardless of temperament or training, may behave unpredictably or even aggressively when fearful, threatened or ill. Further, risks of allergies, minor accidental scratches or bruises from playful interactions, or damage to clothing by shedding, salivation or animal nails may occur when interacting with animals. Counselors wishing to employ this approach must inform clients of any and all risks associated with including AAT in the counseling process. They must also develop an additional informed consent document that is specific to AAT in counseling and that outlines risks and benefits associated with the approach.

The informed consent documents should also serve as the first step toward another essential ethical aspect of AAT in counseling: animal advocacy. A professional counselor may begin the animal advocacy process by setting clear limits in this document about client behavior toward the animal. Further, professional counselors must recognize their increased responsibility to ensure the welfare of the therapy animal. Because therapy animals cannot verbally express their needs, it is the responsibility of the counselor to recognize, respond to and actively prevent animal stress, fatigue and accidental exploitation. Additionally, the needs of the animal should be incorporated into the daily treatment setting. For example, therapy animals should be provided with fresh water, bathroom breaks and access to a quiet retreat area.

The literature suggests that the therapy animal plays an active and critical role in the counseling process. This highlights an important gap for AAT counselors because there is no current standard in the ACA Code of Ethics related to the treatment of therapy animals. This means that the responsibility for competent animal advocacy rests squarely on the counselor’s shoulders. Another gap that counselors often find problematic is the lack of formal training and registration processes that are specific to AAT in counseling. When considered in conjunction with the importance of counselor competence and animal advocacy, these gaps highlight important areas for professional advocacy related to AAT in counseling.

 

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Professional counselors interested in learning more about animal-assisted therapy in counseling may find the following web-based resources helpful:

Additional AAT resources

• Annotated bibliography of animal-assisted therapy literature: aatmh.webs.com/annotatedbibliography.htm
• University of North Texas Center for Animal Assisted Therapy: coe.unt.edu/center-animal-assisted-therapy
• Oakland University School of Nursing Animal Assisted Therapy Certificate Program: oakland.edu/nursing
• Pet Partners (formerly called the Delta Society): petpartners.org
• Equine Assisted Growth and Learning Association: eagala.org
• North American Riding for the Handicapped Association: narha.org
• Playful Pooch: playfulpooch.org
• Therapy Dogs International: tdi-dog.org
• Colorado State University, Human-Animal Bond in Colorado: habic.cahs.colostate.edu
• R.E.A.D. (Intermountain Therapy Animals): therapyanimals.org/R.E.A.D.html