Cognitive-Behavioral Therapy: A Case Report -- Animal-Assisted Therapy

Janet Eggiman, BSN, MSN


October 12, 2006

In This Article

History of AAT

York Retreat in England, an establishment that was founded by the Quakers for the treatment of mental illness, was the first to document the use of animals as an adjunct to therapy.[1] However, there are others who shared these beliefs. The first and most surprising is Sigmund Freud. He believed that dogs had a "special sense" that allowed them to judge a person's character accurately. His favorite chow chow, Jo-Fi, attended all of his therapy sessions.

It is rumored that Freud depended on Jo-Fi for an assessment of a patient's mental state. Freud believed that Jo-Fi could signal a patient's level of tension by where he would lay in the room. If he stayed close to the patient, the patient was free of tension; if he lay across the room, the patient was tense. Freud thought that the presence of a dog had a calming influence on all patients, particularly children. It was also rumored that Jo-Fi would signal the end of Freud's sessions by pawing at the door.[2] Having a dog in the session (along with his cigars, an office in his home, and his treasured pre-Columbian artifacts) is contradictory to Freud's position of seriousness of neutrality in psychoanalysis.

A second proponent of AAT was Boris Levinson. He discovered that he could reach a disturbed child during therapy sessions when his dog, Jingles, was present. He wrote about an unplanned intervention with a 9-year-old boy. The child's mother asked Levinson to see her son for treatment because the boy was extremely withdrawn, and past therapeutic experiences had not been successful. Levinson agreed to see the boy. As it happened, Levinson's dog, Jingles, was present when the boy was brought in. Jingles greeted the boy enthusiastically and the boy reacted positively.

Levinson believed that subsequent sessions with Jingles as his "co-therapist" established an atmosphere of trust and developed a solid relationship with the child. He presented his findings to the American Psychological Association (APA) convention in 1961. There were mixed reactions, but a later survey indicated that 16% of 319 psychologists actually used companion animals in their work with clients.[3]

The Blacky test for children, which was developed by Blum in 1950,[4] consists of 12 cartoon drawings of a black puppy of indeterminate sex (Blacky) engaged in ambiguous activities. The puppy lives with a sibling and both parents. Each of the drawings shows Blacky in a situation that is designed to evoke a psychoanalytically expected conflict, eg, anal sadism, sibling rivalry, Oedipal feelings, and anger. The child is asked to tell a story about what is going on in the picture and to then respond to a set of inquiry questions.[4]

The Children's Apperception Test (CAT), which was developed in 1950 by Leopold and Sonia Bellak,[5] is a projective technique that presents situations of special concern to children. It consists of 10 animal pictures in which the animals are in a number of social and family contexts involving the child in situations of conflict, identity confusion, role problems, family structure issues, and interpersonal interactions. A supplement (CAT-S) presents children with common family situations (ie, prolonged illness, physical disability, mother's pregnancy, or the separation of parents). The operative notion behind the CAT was that children would more easily respond to pictures of animals in family situations than to human figures in those same situations.[5]

Finally, Aesop's Fables, the stories of H.C. Anderson, and The Brothers Grimm all used animals as metaphoric figures, so that animals are often anthropomorphized in human situations and would have human qualities of insight, empathy, and caring.

In a recent news release, the American Kennel Club presented Noodle, a registered therapy dog, the ACE award (Award for Canine Excellence). He is a silver standard poodle owned by Dr. Stacia Bjarnson, who trained him to be a therapy dog. Dr. Bjarnson, a psychologist, uses him in group and individual sessions at a special education school that is composed of 200 students with social, emotional, behavioral, and academic challenges. Dr. Bjarnson realized that the students who were challenged with social and emotional issues could benefit from "working" with Noodle. She found that children can talk about their feelings and thoughts in the presence of Noodle. She believed that it was much less threatening to talk about emotions when Noodle was present.[6]


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.