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

Janet Eggiman, BSN, MSN


October 12, 2006

In This Article

Research Findings

Quantitative research on AAT is sparse. Elisabeth Reichart, in a 1998 article about treatment of sexual abuse, stated that she could not find any research on the treatment of sexual abuse with AAT.[9] She proposed the use of AAT as an adjunct to play therapy for treatment of sexually abused children and described treatment with her Dachshund, Buster.

A child, while petting and holding Buster, often became comfortable enough to disclose stories of sexual abuse. She reported that often children will whisper in his ear. If Buster's presence was not enough to help the child with disclosure, she used storytelling techniques.[9] Therapeutic storytelling is a technique that uses metaphor and symbols to help children understand and express feelings that have been aroused or numbed by the abuse.[10]

Reichart told the child a story about Buster going to the woods to play and returning with an invisible bandage over his mouth. Because of the bandage, Buster could not sleep and became irritable and withdrawn. Attempts by Buster's mother to help him just caused him to withdraw more. Eventually Buster was helped by an old dog who removed the invisible bandage, and Buster was able to tell his mother about a traumatic event in the woods. Reichart reported that the child did not disclose the abuse during the storytelling session, but at the next session, Buster gave her his paw as she disclosed the abuse.

Reichart stated that, from her experience with Buster and sexually abused children, the use of AAT as an adjunct to play therapy benefited the overall therapeutic process by reducing anxiety, helping the child disclose abuse and express feelings, and by promoting projection and identification of feelings.[9]

A story that shows the use of AAA highlights a Labrador Retriever named Murphy. He helped a 4-year-old child with cerebral palsy take her first steps. As the child took slow steps forward, Murphy would respond by taking steps backward, thereby motivating the child to continue taking steps. The dog did this without any commands. Suddenly the dog sat down, and the child said that she was ready to sit, too. She was able to take 4 steps for the first time in her life.[11]

Research from Intermountain Therapy Animals (ITA) reported preliminary findings of an animal-assisted reading program. Therapy dogs visited a reading program in Salt Lake City, Utah, called Reading Educational Assistance Dogs (READ). They reported that all children in the program for 13 months increased their reading level by 2 grade levels, and some by 4 grade levels.[12]

A study of middle-aged schizophrenic patients showed that over the course of a 9-month program, patients showed improvement in adaptive functioning. At the beginning of each session, the therapy dog went around asking for affection. This served to increase social interactions and engaged the patients enough to share their thoughts and feelings. Interventions with the therapy dog were gradually increased in complexity to include grooming and training techniques. An Independent Living Skills tool was then used to rate patients' behaviors. It was found that patients' health, domestic activities, and social skills improved significantly.[13]

One survey was completed in an Australian pediatric unit. They wanted to analyze hospital staff attitudes with regard to a pet visitation program before and after implementation of the program. Prior to implementation, staff expressed the view that they expected that the pet visits would distract children from their illness, relax children, and that it was a worthwhile project. The survey after implementation showed that the staff's expectations were fully met. It was also found that the staff believed that the work environment was happier and more interesting. The nurses accepted the dogs and no longer worried about adverse affects, such as dog bites or dogs damaging equipment.[14]

In a long-term care facility for children with multiple disabilities, Hemlich[15] explained that the purpose of the study was to provide an objective format for evaluating the effectiveness of AAT. They had 1 therapy dog, a Labrador named Cody, and 14 participants. Using a Direct Observation Form and the Teacher's Report Form developed by Achenbach,[16] and The Behavior Dimensions Rating Scale by Bullock and Wilson,[17] improvement in children was found on 4 variables: attention span, physical movement, communication, and compliance.

They could not complete their study because Cody became ill. He had symptoms of Cushing's disease from an elevated cortisol level. Like human therapists, he may have been experiencing "burnout." It was believed that he was experiencing chronic stress from the intensity of the program. In this situation, staff found that the dog did notget enough breaks between sessions; children in hallways would engulf Cody, causing him to feel tentative; and some aggressive children purposely hurt him.[15]

The researchers recommended that when starting AAT, stress in the service animal should be prevented; administrative support should be in place; and all staff should be educated on AAA.


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