Front Matter

Contributors

Foreword

1 Introduction

2 A Working Partnership Between Clinicians and Therapy Dogs in the Treatment of Mental Disorders

3 Roles of Animals With Individuals Who Have Mental Illness

4 Companion Animals in Crisis Intervention

5 Companion Animals in the Treatment of At-Risk and Adjudicated Youth

6 Companion Animals in the Treatment of ADHD

7 Companion Animals in the Treatment of Autism Spectrum Disorder

8 Companion Animals in the Treatment of Depressive Disorders

9 Companion Animals in the Treatment of Stress and Anxiety

10 Companion Animals in the Treatment of PTSD

11 Companion Animals in the Treatment of Serious Mental Illness

12 Companion Animals Assisting Patients in Hospice

13 Companion Animals in the Treatment of Dementia and Aging-Related Concerns

14 Animal-Assisted Interventions for Improving the Mental Health and Academic Performance of University Students

15 Dog Visitation Programs in Hospitals

16 Animal-Assisted Therapy in Psychotherapy

17 Take-Home Messages

Index

Research Scientist, Center for Research and Education, Benjamin Rose Institute on Aging, Cleveland, Ohio

Chancellor, University of Tennessee Health Science Center, Memphis, Tennessee

Lecturer, Department of Human Development, Washington State University, Pullman, Washington

Professor, Department of Counseling and Higher Education, University of North Texas, Denton, Texas

President, Center for Psychiatry and Behavioral Medicine, Inc., Las Vegas, Nevada

Chair, Department of Psychiatry; Director, Psychiatric Research Institute; and Marie Wilson Howells Professor, University of Arkansas for Medical Sciences, Little Rock, Arkansas

Professor and Chair, Department of Psychiatry, and C. Kenneth and Diane Wright Distinguished Chair in Clinical and Translational Research, Virginia Commonwealth University, Richmond, Virginia

Professor Emeritus, Licensed Psychologist, California Polytechnic State University, Pomona, California

Professor and Associate Dean for Research, University of Maryland School of Nursing, Baltimore, Maryland

Professor, Department of Psychiatry; Director, Center for Human-Animal Interaction; and Bill Balaban Chair in Human-Animal Interaction, Virginia Commonwealth University School of Medicine, Richmond, Virginia

Ph.D. Student, Evolution Ecology and Organismal Biology, Ohio State University, Columbus, Ohio

Assistant Professor, Department of Counseling, ISU Meridian Sam and Aline Skaggs Health Science Center, Idaho State University, Meridian, Idaho

Occupational Therapist, Dogwood Therapy Services, Albuquerque, New Mexico

Professor of Psychiatry and Executive Director, Institute for Women’s Health, Virginia Commonwealth University, Richmond, Virginia

Associate Dean for Research and Scholarship, and Professor, Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida

Rhona Arenstein Professor of Psychiatry and Chair of the Division of Consultation/Liaison Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, Virginia

Professor of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas; and Director, Texas Children’s Hospital, Child and Adolescent Psychiatry Autism and Developmental Disorders Clinic

Doctoral Student, Department of Human Development, Washington State University, Pullman, Washington

Research Assistant, Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida

Associate Professor, Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, N. Grafton, Massachusetts

Postdoctoral Research Associate, College of Veterinary Medicine, University of Arizona, Tucson, Arizona

Professor, Associate Dean for Research, College of Veterinary Medicine, University of Arizona, Tucson, Arizona

Professor, Department of Human Development, Washington State University, Pullman, Washington

Assistant Professor of Nursing, Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida

Postdoctoral Research Fellow, Human-Animal Bond in Colorado, School of Social Work, Colorado State University, Fort Collins, Colorado

Assistant Professor in Residence, Pediatrics, School of Medicine, University of California, Irvine, Irvine, California

Associate Professor, Department of Counseling, Idaho State University, Pocatello, Idaho

Associate Professor and Chair, Division of Inpatient Psychiatry; and Medical Director, Inpatient/Acute Psychiatry and Neuromodulation Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, Virginia

Assistant Professor, Clinical Rehabilitation Counseling, College of Education, Florida Atlantic University, Boca Raton, Florida

Associate Professor, Departments of Pediatrics and Psychiatry, Children’s Hospital of Richmond; and Clinical and Research Associate, Center for Human-Animal Interaction, Virginia Commonwealth University, Richmond, Virginia

Lecturer, Department of Human Development, Washington State University, Pullman, Washington

Owner, Occupational Therapist, and Professional Dog Trainer, Dogwood Therapy Services, Albuquerque, New Mexico

Yet, the phrase “Lassie! Timmy’s in the well,” inspired by a 60-year-old television show, lives on. It has become a meme, passed on through generations, signifying the ability of nonhuman animals to rescue us from danger or, perhaps more accurately, our desire that they do so.

Many of us have felt rescued by a dog. We don’t need to be trapped in a well to wonder if we would have made it through something—the pandemic, sexual abuse, profound grief—without a dog on our couch. However, enjoying the companionship of a strokable, sentient, emotionally receptive mammal does not tell us if dogs, or other animals, can be constructively involved in the therapeutic treatment of mental illness and developmental disorders.

This could be true for many reasons, perhaps best suggested, at its deepest level, by the words of John Muir: “I only went for a walk, and finally concluded to stay out till sundown, for going out, I found, was really going in.” The fact is, as special as we humans might be—with our busy brains and our elaborate communication—we do not “just happen to inhabit” the world, as David Abram reminds us in Becoming Animal: An Earthly Cosmology.¹ Other animals (and the land around them) are “as much within us as they are around us” (p. 77).

Perhaps this is another way of saying that we all need to feel connected. Humans are highly social animals, but the need to be with others is not necessarily confined to members of the same species. Biologist Edward O. Wilson popularized the concept of biophilia,² “the urge to affiliate with other forms of life,” while Richard Louv, in the Last Child in the Woods: Saving Our Children From Nature-Deficit Disorder,³ coined the phrase nature-deficit disorder to emphasize that to be truly healthy, people need to feel close to the natural world around them, including animals, plants, and the land. This is not news to the peoples of many cultures, including members of many Native American tribes, but has, until recently, been counter to the perspective of classic Western philosophy.

At a more proximal level, we know that nonhuman animals are often seen as givers of unconditional love and affection. In part, this is no doubt because they cannot use human language. I have joked in many a speech that it is a good thing that dogs can’t talk, because we wouldn’t always like what they have to say. Every animal behaviorist and dog trainer can tell you a story in which they would bet the farm that an animal’s facial expression would translate into something unprintable. However, our perception of unconditional love is based on far more than a lack of language. As is described in detail in Chapter 1, “Introduction,” and many of the chapters that follow, many adults and children have emotional attachments to companion animals on par with those of their siblings. Dogs, for one, can “get us coming and going,” as I write in For the Love of a Dog: Understanding Emotion in You and Your Best Friend.⁴ They can provide a sense of the unconditional love we all desire from our parents, while, because of their relative helplessness, eliciting feelings in us of parental love and nurturance.

These attachments are not one-directional. Social and highly emotional animals like dogs, horses, and, yes, cats clearly form strong attachments to their humans that are often equally powerful, driven by a shared mammalian physiology that shows, for example, an increase in oxytocin during relaxed gazes between dogs and their owners. Although oxytocin is a far more complicated hormone than is sometimes portrayed in the popular press, its deficits appear to be a potentially important player in many psychiatric challenges, including autism and anxiety disorders.

But is this enough to support the idea that animals can, or should, be involved in the treatment of mental illness or disability? Or to tell us which animals? For whom? In what way? Not at all, which is why the science presented in this book is so important. Decades ago, when I was starting out as an applied animal behaviorist, the head pharmacist at the University of Wisconsin School of Veterinary Medicine told me that if a drug had the power to do good, then it had the power to do harm. That is also true of animal-assisted therapy (AAT) and animal-assisted interventions (AAIs).

I remember a client I had years ago, a middle-aged devoted mother with a 12-year-old son on the autism spectrum. She had adopted a dog for him, based on the recommendation of a professional, in the belief that the dog would provide companionship and, she was promised, an increase in the child’s ability to communicate. By the time I came into the picture, the dog and the child were terrified of each other.

She wanted me to fix it. I couldn’t begin to, unless you define fixing as explaining that the situation was untenable. The dog was a highly reactive and sensitive herding breed, who barked when he became aroused at fast, erratic movements. The child was overwhelmed by the dog’s movements and barking and flapped his arms and screamed when they happened, which set off the dog, which set off the child. It was a heartbreaking cycle of dysfunction and suffering and an illustration of why it is vital that each case is carefully evaluated. After doing my best to explain that the situation was unfair to both her child and the dog, I was summarily dismissed. I never knew how it sorted out.

This is why the information contained in, for example, Chapter 7, “Companion Animals in the Treatment of Autism Spectrum Disorder,” is so valuable. As in other chapters, the authors emphasize what factors lead to successful outcomes (or failures). They summarize the results of 85 studies, which suggest that AAI can lead to increased social interactions, along with improved communication abilities, in some cases, in some environments. However, as is often the case in this field, the authors also note concerns with methodology, small sample sizes, and a lack of randomized controlled trial designs.

The Centers for Disease Control and Prevention estimates that 1 in 25 Americans lives with a serious mental illness, and the National Institute of Mental Health stated that in 2020, 1 in 5 adults in the United States had “any mental illness.” We are in desperate need of information about how to prevent and treat these debilitating conditions more effectively. Editors Gee, Townsend, and Findling have done prodigious work collecting state-of-the-art knowledge about when and how companion animals can be involved effectively in the treatment of mental illness and developmental disorders and the promotion of mental health.

The information in this book is a critical antidote to two of the biggest challenges facing the AAT and AAI fields: first, the feel-good assumption that dogs, in any context and with any patient, make everything better; and second, that you cannot take human-animal interaction seriously because it’s “just about pets” and what is scientific about that? The answer to the latter is—a lot, thanks to the work and expertise of the authors of the book’s chapters. Their chapters are rich with case examples, practical applications, and insights about what we know, as well as what we still need to know, to make progress in the field. This book will do much to advance the fields of AAT and AAI, to remind practitioners that the welfare of the animals involved must be protected, and to establish that companion animals, in the right context, can play a vital role in treating mental health illness and developmental disorders.

We are all “trapped in the well” to some degree, including mental health professionals who struggle to balance heavy patient loads with staying current about the best ways to help them. Some people are down deeper than others, and in some cases, as we learn in the pages that follow, there are indeed Lassies out there just waiting to assist in the rescue.

Certified Applied Animal Behaviorist Author, The Education of Will and
The Other End of the Leash