On Tuesdays, Doc’s coat gets an extra brush and he chews an extra breath freshener before he heads off to work. When he comes into the office to sign in, everyone is happy to see him. His easy-going manner and big smile make him an ideal addition to the hospital setting and his presence has helped alleviate the pain, fear, and loneliness of a hospital stay for many people. Doc is a therapy dog.
Doc is a Labrador Retriever who is part of the Scripps Therapy dog program in San Diego. He makes the rounds, just like the human volunteers; going into pre-approved rooms and offering comfort to the patients and making their stay a little easier. Animal- assisted therapy has emerged to help people, especially patients in hospitals, relax and heal, and the benefits they experience may be physiological as well as emotional.
Humans have always interacted with animals and used them in labor-intensive tasks, and the discovery that animals could be used in the healing process occurred much earlier than one might think. Animal assisted therapy (AAT) goes as far back as the 9th century in Belgium, where disabled people could learn to care for farm animals. In 1792, the Quaker-founded York Retreat in England used caring for animals as a therapy for the insane. Even Florence Nightingale in her Notes on Nursing recommends “a small pet animal” as an “excellent companion for the sick.”
It was first medically proven that animals could be used as part of a successful therapy program and be medically beneficial at the Oakwood Forensic Center, an institution for the criminally insane. In 1975 a patient in the ward for the most depressed and non-communicative patients found a hurt sparrow in the yard and smuggled the bird into the building. The patients adopted the bird and caught insects to feed it. For the first time, the inmates began acting like a group and related well to the staff. When the staff realized animals could be effective therapy, the hospital proposed a study to evaluate the benefits. The hospital conducted a year-long comparison study between two identical wards, one with pets and one without. The patients on the ward with the pets required half the amount of medication, had reduced violence, and made no suicide attempts. The other ward had eight suicides attempted during that period. Animals have been gradually making their way into therapy programs ever since.
While the emotional benefits of AAT were clear, the physiological benefits were not. Several studies have been conducted to see if patients can actually experience physiological benefits from interacting with a therapy dog. In my research, two studies stuck out.
The first study, done by Sandra B. Barker, et al., focused simply on the stress-relieving benefits of a therapy dog. The responses of adult dog owners interacting with their own dog or an unfamiliar therapy dog under similar conditions were examined. The study attempted to answer if the physiological response is similar when people encounter their own dog as opposed to an unfamiliar therapy dog.
To measure stress reduction, the participants first relaxed for 30 minutes in a comfortable chair, then were administered a stress task in the form of the Stroop Color Word Test. They were shown a succession of names of colors that were inked in a conflicting color. For example, they might be shown the word “red” printed in green ink. They participant must then correctly name the color printed. The participants then interacted with a dog, according to what group they were in, for 30 minutes, and then watched a 60-minute neutral video.
The results showed that there was only a mild stress response to the stress test and had little consequences on the physiological signs that were being measured. However, the changes there were observed, particularly with heart rate and blood pressure, seem to indicate trend of relaxation when the participant interacted with the dog, whether their own or the unfamiliar dog. It seems that a therapy dog can be used as a stress reducer. But what about a hospital setting, where the environment is far more stressful than taking a Color Test?
Another study, conducted by Chia-Chun Tsai et al., explored the stress-reducing effect of dogs on hospitalized children. Hospitalization leads to high levels of anxiety and fear in children and this stress can lead to health problems later in life. While it is well known that AAT can bring comfort, few studies have measured the physiological effect of AAT on children. The experiment measured the heart rate and blood pressure of a sample of 15 hospitalized children, aged 7-17, during a session of AAT and a session of puzzle building with a research assistant. The Child Medical Fear Scale was used for the children to self report their levels of medical fear and the State Anxiety scale of the State Anxiety Inventory for Children was used to self report anxiety. The sessions took place at the same time of day on two consecutive days.
The researchers found that the systolic blood pressure of the children decreased from pre- to post- AAT visits and remained decreased after the session was over, indicating that the effects of AAT last beyond the session itself. Systolic blood pressure did decrease during the puzzle session, but rose back up to pre-session levels within a few minutes after the session ended. Diastolic blood pressure decreased after AAT visits but remained elevated and did not decrease after a puzzle session.
No child reported high levels of anxiety after either the AAT or the puzzle session. On the Child Medical Fear Scale, five children indicated great fear after AAT and four reported great fear after a puzzle session. There was no significant difference in anxiety levels comparing after AAT and after the puzzle session. However, the presence of fear is explainable because the fear of medical procedures is to be expected as the children still have the stressor of an unfamiliar medical procedure looming. General anxiety decreased, but actual fear of medical procedures did not as this is seen as a threat. The AAT was found able to calm general anxiety.
Both these studies demonstrate that AAT is an effective way to relieve both everyday stress and stress caused by hospitalization. Measuring physiological changes as well was an important part of the experiment beacuse self-reports do not indicate a difference between the effects of AAT and puzzle-building. Getting the physiological data reduces the observer bias and the courtesy bias, so the researchers obtain a more accurate picture of the effect AAT has on people. Both these studies indicate that, aside from emotional comfort, AAT helps reduce blood pressure and other signs of stress.
From beasts of burden and guard dogs, animals have found their way into our home and our hearts. The effect “man’s best friend” has on its owner is unmistakable and this effect can be translated to a stress relief program, even a hospital setting. As it turns out, coming into contact with a dog does not just make you feel better, it actually has a positive effect on one’s health.
Bibliography
Barker, Sandra B., Knisely, Janet S., McCain, Nancy L., Schubert, Christine M., Pandurangi, Anand K. (2010). Exploratory Study of Stress-Buffering Response Patterns from Interaction with a Therapy Dog. Anthrozoos, 23:1, 79-91
Christiansen, Jennifer. “History of Animal Assisted Therapy”. Associated Content. Accessed: 4/5/11. <http://www.associatedcontent.com >
Strinple, Earl O. (2003). A History of Prison Inmate–Nanial Interaction Programs. American Behavioral Scientist. 47:70, 70-78
Tsai, Chia-Chun. Friedmann, Erika. Thomas, Sue A. (2010) The Effect of Animal-Assisted Therapy on Stress Response in Hospitalized Children. Anthrozoos, 23:3, 245-258