Animal Assisted Therapy: The Perspective Of An Activist/ Therapist
Animal Assisted Therapy (AAT) is defined as “the presentation of an animal to one or more persons for the purpose of providing a beneficial impact on human health or well-being”.  When trying to determine whether AAT is an acceptable form of treatment from the perspective of the nonhuman animals, one must consider two questions. First, is the intervention providing more benefit to the patients therapeutically than other interventions could achieve? Second, from the perspective of an animal advocate, is it morally or ethically justifiable to use nonhuman animals for human ends in this manner? I embody two different roles: one as a Marriage and Family Therapist Intern building my private practice and one as an animal advocate who is equally concerned with the rights and well being of human and nonhuman animals; thus, the role of AAT in therapy is particularly concerning to me. In this post, I introduce the history of AAT, the debate surrounding the use of AAT, and explain why I have come to the conclusion that research testing the efficacy of AAT is lacking at best and that my ethical concerns as an animal advocate lead me to decide that AAT will not play a role in my work.
By Rima Danielle Jomaa (guest blogger)
Animal assisted therapy has a long and rich history dating back to prehistoric times, with animals playing a part in a human’s daily life in roles such as companions and healers. There are cave drawings of people with wolves, Egyptians buried with cats or other pets in hopes of being together for eternity, and a 12,000-year-old tomb in Israel of a man embracing the remains of a puppy.  In Gheel, Belgium, in the 9th century, people with disabilities could learn to care for farm animals in exchange for compensation. Founded by Quakers in 1792, a program for the mentally ill incorporated birds and rabbits into their therapy programs. Florence Nightingale was known to recommend small animals for companions for the ill, saying they provided pleasure. In Germany, animals including birds, cats, dogs, and horses were used for interaction with epileptic patients in 1867. Dogs and other animals continued to be instated into therapy programs throughout the 1900’s including one that encouraged veterans to work with animals at the center’s farm, and then eventually created a program for the veterans to work with dogs.
Boris Levinson is credited with being the father of animal-assisted therapy; he coined the term pet therapy in 1964. Levinson was working with a nonverbal child who showed up early for session one day and encountered Levinson’s dog. Levinson then noticed that the boy would speak and focus more on communication when the dog was in the session. He found the dog contributed to rapport building and softening of children’s defenses. Levinson researched the topic for many years and published many studies in the field.
Other researchers expanded upon Levinson’s work, especially Sam and Elizabeth Corson, who used pets with adolescents and adults. Their interest in using dogs in therapy happened purely by chance, since there was a kennel close by the Ohio State University Psychiatric Hospital where the patients were being held and the children whom had self-imposed streaks of silence broke their silence to request to play with the dogs. The researchers found that patients improved in socialization with the staff members, increases in confidence, and increases in self-respect.
The term “animal assisted therapy”, or AAT, has come to encompass a wide range of definitions in different fields of study. When talking about AAT in terms of mental health treatment, researchers have defined AAT as “the presentation of an animal to one or more persons for the purpose of providing a beneficial impact on human health or well-being”. Animals used in these therapies include dogs, cats, rabbits, rodents, birds, reptiles, amphibians, farm animals, horses, monkeys, dolphins, and so on.  There are six general categories that AAT programs can be divided into; each presenting their individual animal welfare concerns. The categories are “1) pet program for elderly and other clients; 2) service animal programs; 3) institutionally based residential programs; 4) visitation programs; 5) equine programs; and 6) wild animal programs”. 
There has been a longstanding debate about the effectiveness and ethical concerns surrounding AAT. Service dogs and working dogs for individuals with handicaps provide companionship and practical assistance for their humans. It has been shown that these dogs stimulate a sense of calmness and relaxation while increasing social interaction, ease the sense of isolation for their humans, and foster nurturing behavior.  The research has typically shown that dog and animals can help patients exhibit improvement in happiness, alertness, responsiveness, and optimism. Interaction with animals has also been shown to promote self-reliance, increased responsibility among patients, and an increase in motivation.  Researchers and advocates for animals often ask questions, though, such as, “What is the validity of using animals in therapy… and how important is the animal in animal-assisted therapy? 
The arguments against AAT span from issues like ethical concerns for the animals’ wellbeing, to concerns for human welfare on many different levels, to the validity of the research on success of AAT with patients. The most commonly raised concerns by practitioners of AAT on questionnaire responses in one survey were animal fatigue and burnout.  The Delta Society’s website warns that it is inappropriate to use any animal in AAT when 1) injuries can occur from rough handling from patients, handlers or other animals; 2) basic animal welfare cannot be assured (this includes veterinary care and access to water and exercise areas; and 3) the animal does not enjoy visiting. Some researchers have found that a live dog is not necessary to produce the positive effects produced by a dog in therapy, as a robotic dog was just as effective as a live dog in decreasing loneliness scores. 
Such considerations from the perspective of academics and professionals working with AAT in some form or another barely scratch the surface of the moral issues AAT raises from the perspective of a liberationist. A liberationist acknowledges that animals are not resources to be exploited by humans, while a practitioner of AAT argues that they do not “use” animals, but rather that they work with them. 
Liberationists give six distinct ways that using animals in AAT is immoral. 1) Limitations of Freedom: the loss of freedom that occurs when an animal serves as a modified pet (like a guide dog), for example. 2) Life Determination: employing an animal therapeutically requires making a life-determining decision for that particular animal. 3) Training: requiring animals to undergo long periods of training invariably violates the animal’s wellbeing, including “breaking” horses to create therapy horses and forcing animals to be exposed to human presence to the point that the animals are terrified. 4) Social Disconnection: depriving animals from their kin—especially animals like Simians, rabbits or rodents, dolphins, or dogs—is cruel and causes distress and a sense of loss by the animal. 5) Injury: a small percentage of animals are injured during therapeutic work through mishandling by strangers or handlers and anxiety can be triggered when encountering strangers. 6) Instrumentalization: it is inconceivable to retain a subgroup of human beings as therapeutic aids of another group of human beings even if proved as facilitating extremely effective therapy; doing this to animals is analogously wrong. 
As an animal rights advocate, I find it difficult to justify the “use” of animals in any setting when the end goal is to benefit human animals. Though the topics of concern detailed above are the most common concerns of AAT, they are not the only issues that come to my mind. When society as a whole justifies using animals for the benefit of humans, even if the animal is reasonably cared for and might have otherwise been a shelter animal (as some argue), society begins to accept the negative impacts of such employment of animals as an unavoidable sacrifice. For example, I can imagine breeders and trainers who find that producing animals for AAT to be lucrative, thus contributing to the overpopulation of animals already being faced by the companion animal population. One must also face the realization that many animals used in AAT are “discarded” once they are no longer useful to the trainer or organization, a fact that further makes it difficult for me to justify the use of animals in AAT. Through researching AAT, it became evident to me that the effectiveness of using animals in AAT is not so substantial or obvious and that similar results are difficult to replicate in most studies. There is much variability within results as well as issues of whether certain research is adequately measuring what is intended to be measured or not; for example, the novelty of using an animal in an experiment can produce positive effects in and of itself instead of the actual interaction with the animal. As a therapist, it is important to take all of this variability into consideration when determining if patients can experience similar results by using other therapeutic interventions not including animals.
As a Marriage and Family Therapist Intern, I have successfully worked with clients experiencing depression, anxiety, and loneliness and was able to use hands-on or cognitive approaches to achieve many of the positive effects achieved by using animals and AAT. Common interventions I have used include meditation, breathing exercises, increasing coping skills and replacing old behaviors with new, positive behaviors, and tracking thoughts and feelings and processing them to find alternative thought processes. Some of the positive effects experienced from these interventions are similar to effects found from AAT and include increased sense of calmness, decreased loneliness scores, increased motivation to heal, and increased sense of independence. Reflecting on these details, I would not be able to justify using animals in treatment as AAT when other equally effective and less ethically and morally charged therapeutic techniques exist and are easily applicable, even more so than AAT. When our use or “employment” of animals supersedes their rights and freedoms to a natural life, it cannot be justified.
When Rima Danielle Jomaa isn’t spending her time as a grassroots activist in Los Angeles, she is counseling individuals, families, couples, children, and groups as Marriage and Family Therapist Intern. Her purpose in life is to help people find happiness by leading them to understand that compassion is happiness, and that living a compassionate lifestyle includes loving yourself and all sentient creatures. Rima is from Southern California and moved to Los Angeles 4 years ago to attend Pepperdine University, before finally settling in Venice Beach. She lives with her black cat, Zuko (as in Danny Zuko). Rima enjoys surfing, hiking, skating, yoga, spending all day at the beach, studying spirituality and meditation, or anything involving the outdoors.
Sources: Christiansen, Jennifer. “History of Animal-Assisted Therapy”. Yahoo Voices. http://voices.yahoo.com/history-animal-assisted-therapy-557454.html. July 31, 2012.  Iannuzzi, D. & Rowan, A. N. Ethical Issues in Animal-Assisted Therapy Progrms. Anthrozoos, Vol 4(3), pp. 154-163.  Marino, L. (2012). Construct Validity of Animal-Assisted Therapy and Activities: How
Important Is the Animal in AAT? Anthrozoos, volume 25, pps139-s151. http://www.humanespot.org/node/4748  Palley, L. S., O’Rourke, P. P., & Niemi, S. M. (2010). Mainstreaming Animal-Assisted
Therapy. ILAR Journal, vol 51(3), pp. 199-207.  Zamir, T. (2006). The Moral Basis of Animal-Assisted Therapy. Society & Animals, vol 14(2), pp. 179-199.