Handbook on Animal– Assisted Therapy Theoretical Foundations and Guidelines for Practice Third edition Edited by Aubrey H. Fine Department of Education College of Education and Integrative Studies California State Polytechnic University Pomona, California, USA AMSTERDAMdBOSTONdHEIDELBERGdLONDONdNEWYORK OXFORDdPARISdSANDIEGOdSANFRANCISCOdSINGAPORE SYDNEYdTOKYO AcademicPressisanimprintofElsevier AcademicPressisanimprintofElsevier 32JamestownRoad,LondonNW17BY,UK 30CorporateDrive,Suite400,Burlington,MA01803,USA 525BStreet,Suite1800,SanDiego,CA92101-4495,USA Firstedition2001 SecondEdition2006 ThirdEdition2010 Copyright(cid:1)2010,2006,2001ElsevierInc.Allrightsreserved Nopartofthispublicationmaybereproduced,storedinaretrievalsystemortransmittedin anyformorbyanymeanselectronic,mechanical,photocopying,recordingorotherwise withoutthepriorwrittenpermissionofthepublisher PermissionsmaybesoughtdirectlyfromElsevier’sScience&TechnologyRights DepartmentinOxford,UK:phone(+44)(0)1865843830;fax(+44)(0)1865853333;email: [email protected],visittheScienceandTechnologyBookswebsite atwww.elsevierdirect.com/rightsforfurtherinformation Notice Noresponsibilityisassumedbythepublisherforanyinjuryand/ordamagetopersonsor propertyasamatterofproductsliability,negligenceorotherwise,orfromanyuseoroperation ofanymethods,products,instructionsorideascontainedinthematerialherein.Becauseof rapidadvancesinthemedicalsciences,inparticular,independentverificationofdiagnoses anddrugdosagesshouldbemade BritishLibraryCataloguing-in-PublicationData AcataloguerecordforthisbookisavailablefromtheBritishLibrary LibraryofCongressCataloging-in-PublicationData AcatalogrecordforthisbookisavailablefromtheLibraryofCongress ISBN:978-0-12-381453-1 ForinformationonallAcademicPresspublicationsvisit ourwebsiteatwww.elsevierdirect.com TypesetbyTNQBooksandJournals PrintedandboundinUnitedStatesofAmerica 10111213 10987654321 About the Editor Dr.FinehasbeenafacultymemberatCaliforniaStatePolytechnicUniversitysince 1981. Recipient of many awards, he earned the prestigious Wang Award in 2001, given to a distinguished professor within the California State University system, in this instance for exceptional commitment, dedication, and exemplary contributions withintheareasofeducationandappliedsciences.HewasalsoawardedtheEducator ofthe Year in1990 by the Learning DisabilityAssociation ofCalifornia. AnimalshavebeenanintegralpartofDr.Fine’sclinicalpracticeoverthepastthree decades. His clinical practice primarily focuses on the treatment of children with attention,behavioral,adjustmentanddevelopmentaldisorders.Hispracticeincludes twotherapydogs,birdsandabeardeddragon.Inadditiontohisexpertiseinthearea ofAAT,Dr.Finehaspublishedseveralacademicbooksandvideodocumentarieson related subjects such as parent/child relationships, learning/attention disorders, and sportspsychology.HisnewestbookAfternoonswithPuppyisaheartwarmingaccount abouttheevolvingrelationshipsandoutcomesamongatherapist,histherapyanimals and his patients overthe course ofover two decades. Contributors Phil Arkow The Latham Foundation, California and The American Humane Association, Englewood Arnold Arluke Northeastern University, Boston, Massachusetts, 02115, USA Frank R. Ascione University of Denver Graduate School of Social Work, Denver, Colorado 80208, USA Mara M. Baun University of Texas Health Science Center at Houston, Houston, Texas 77030, USA Alan M. Beck School of Veterinary Medicine, Purdue University, West Lafayette, Indiana, 47907, USA Ann Berger, MSN National Institutes of Health, Bethesda, Maryland, 20892, USA Barbara W. Boat University of Cincinnati College of Medicine; Cincinnati Children’s Hospital Medical Center, Ohio, 45267, USA Christine Bowers California State Polytechnic University, Pomona, California, 91010, USA Andrea Brooks Pets Are Wonderful Support (PAWS), San Francisco, California, 94107, USA Kris Butler American Dog Obedience Center, LLC, Oklahoma, 73069, USA Cynthia Chandler University of North Texas, Denton, Texas, 76209, USA xii Contributors Susan Phillips Cohen The Animal Medical Center, New York, 10065, USA Raymond Coppinger Hampshire College, Amherst, Massachusetts, 01002, USA Aubrey H. Fine California State Polytechnic University, Pomona, California, 91768, USA Erika Friedmann University of Maryland School of Nursing, Baltimore, Maryland, 21201, USA Julia Gimeno California State Polytechnic University, Pomona, California, 91768, USA Ken Gorczyca Pets Are Wonderful Support (PAWS), San Francisco, California, 94107, USA Temple Grandin Colorado State University, Fort Collins, California, 80523, USA Lynette A. Hart School of Veterinary Medicine, University of California, Davis, California, 95616, USA Jana I. Helgeson California State Polytechnic University, Pomona, California, 91768, USA Rebecca A. Johnson SinclairSchoolofNursing,UniversityofMissouri,Columbia,Missouri,65211,USA Aaron H. Katcher Psychiatrist—Independent Practice, Arlington, Texas, 76017, USA Alan E. Kazdin Department of Psychology, Yale University, New Haven, Connecticut, 06520, USA Jane Irene Kelly Editorial Consultant Steven Klee Green Chimneys Children’s Services, New York, 10509, USA Katherine A. Kruger Center for the Interaction of Animals and Society, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA Contributors xiii John Lipp Pets Are Wonderful Support (PAWS), San Francisco, California, 94107, USA Maureen A. Frederickson-MacNamara Animal Systems Ltd, Asheville, North Carolina, 28805, USA Gerald P. Mallon Hunter College School of Social Work, New York, 10021, USA Marie S. McCabe AmericanHumaneAssociation,Human-AnimalInteractions,Englewood,Colorado, 80112, USA Patricia McConnell University of Wisconsin, Madison, Wisconsin, 53515, USA Richard Meadows CollegeofVeterinaryMedicine,UniversityofMissouri,Columbia,Missouri,65211, USA Gail F. Melson Purdue University, West Lafayette, Indiana, 47907, USA Jeffrey Mio California State Polytechnic University, Pomona, California, 91768, USA Laura Nelson Pets Are Wonderful Support (PAWS), San Francisco, California, 94107, USA Dana O’Callaghan National University and Palomar College, California, 91730, USA Jose M. Peralta College of Veterinary Medicine, Western University, Pomona, California, 91766, USA Teri Pichot Private Practice, Denver, Colorado, USA Allie Phillips AmericanHumaneAssociation,Human-AnimalInteractions,Englewood,Colorado, 80112, USA Lori Popejoy School of Nursing, University of Missouri, Columbia, Missouri, 65212, USA xiv Contributors Lisa Ross Touro University, California, 94592, USA Samuel B. Ross, Jr. Green Chimneys Children’s Services, New York, 10509, USA Karen Schaffer New Mexico State University, Las Cruces, New Mexico, 88001, USA James A. Serpell School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA Perry Skeath National Institutes of Health, Bethesda, Maryland, 20892, USA Heesook Son University of Maryland School of Nursing, Baltimore, Maryland, 21201, USA C. Victor Spain Merck & Co., Inc, Philadelphia, Pennsylvania, 19146, USA Ilana Strubel Vet SOS Philip Tedeschi Institute for Human/Animal Connection, University of Denver Graduate School of Social Work, Denver, Colorado, 80208, USA Richard Timmins AssociationforVeterinaryFamilyPractice,CamanoIsland,Washington,98282,USA Chia-Chun Tsai Yuanpei University Department of Nursing, Taiwan, R.O.C. Dennis C. Turner Institute for Applied Ethology and Animal Psychology, Switzerland Stephanie Venn-Watson National Marine Mammal Foundation Cindy Wilson Uniformed Services University of the Health Sciences, Bethesda, Maryland, 20895, USA Belinda Wong University of California, San Francisco, California, 94720, USA Foreword Thebookthatyouareholdingisacompendium,containingdata,theoryandguidelines forthepracticeofwhathascometobeknownasanimal-assistedtherapy(abbreviated as AAT). This is defined as a form of therapy that involves using an animal as afundamentalpartofaperson’streatment.Althoughthemostcommonformofanimal used is the dog, followed by cats, many kinds of animals have been used in therapy, mostlysmall animals (rabbits, birds,fish, gerbils), butsome large animals have been employed(mostlyhorses),andsomeexoticspecies(e.g.elephants,dolphins,lizards). The range ofproblemsthat animal-assisted therapy has addressedisquite broad. Whilemostpeopleareawareofassistanceanimals,suchasguidedogsfortheblind, hearing assistance dogs, handicap assistance dogs and, more recently, seizure alert and seizure assistance dogs, thegeneral public isonly slowly coming tounderstand that animals can be used to deal with a broad variety of psychological as well as physical problems. Most often animals are used to assist in problems involving emotionaldistressand/orgeneralstress-relatedsymptoms.Whenusedinthiscontext the animals are often referred to as comfort animals. However, some animal inter- ventionsinvolvetreatmentofcognitivefunctioning,socialinteractionproblems,and evenextremeconditions,suchasautism.Morerecently,thetherapeuticuseofanimals has been extended to educational settings, where the animal is used to improve motivation and focus the attention of children, as demonstrated by several successful programs that utilize reading assistance dogs. WhenIseeabooklikethis,withallofitsdata,theoryandpracticeinformation,I mustadmitthatIhaveafeelingofdisbelief.Thisisnotadisbeliefinthevalidityof the data, or the success of animal-assisted therapeutic interventions, but rather a disbelief that this area has come to be accepted by mainstream psychological, educational and medical researchers and practitioners. This was not always so. My own first contact with this type of therapy actually led me to predict that such endeavorswould nevercome topass. Before we get to my experience, it is important to know that therapeutic use of animals has a long history. In ancient Egypt, the city of Hardai became known as Cynopolis(CityofDogs)becauseinitsmanytemplesdedicatedtoAnubis,thedog- headedguideofthedead,dogswereusedasofferings.However,dogswerealsoused inhealingpractices there. Itwasbelievedbeinglicked byadog,especiallyinthose areasofthebodycontainingsoresorlesions,couldhelptohealtheinjuryorcurethe diseasecausingit.ThispracticewaspickedupbytheGreeks,andtemplesdedicated toAsclepius,theirgodofmedicineandhealing,oftencontaineddogstrainedtolick wounds.IntheMiddleAges,SaintRochwassaidtohavebeencuredofaplagueof sores through being licked by his dog. The value of being licked by a dog is still believed by many cultures to have curative powers. There is even a contemporary French saying, “Langue de chien, langue de me´decin” which translates to “A dog’s tongue is a doctor’s tongue.” Perhaps there is some validity to this since recent xvi Foreword research has shown that the dog’s saliva actually contains a number of antibacterial andantiviralcompounds, aswellassomegrowthfactorsthatmay promotehealing. However, animal-assisted therapy today involves using animals to assist in the healingofpsychologicalandemotionalproblems,ratherthanusingthemassources of antibiotics which are better obtained from pharmacological sources. Here, again, wehavehistoricalantecedents.Inthelate1600s,JohnLocke(whowouldintroduce psychology to the concept of association in learning), suggested that small pet animals aided in the social development of children, including the development of empathy.Inthe19thcentury,FlorenceNightingalesuggestedthatsmallpetsrelieved depression inpatients, especiallyfor thosewith chronic conditions. Stilltherewerelittledata,norwastherewidespreadacceptanceofthefactthatthe presenceofanimalscanassistandimprovepsychologicalfunctioning.Instead,there weremanyanecdotesthatsuggestedthatthismightbethecase.Forexample,during World War II, a Corporal William Wynne was recovering from wounds in an army hospital in the Philippines. To cheer him up members of his company brought his Yorkshireterrier,Smoky,tothehospital.Theeffectwasremarkable,andnotonlydid CorporalWynne’smoodimprove,butithadapositiveeffectontheotherinjuredsoldiers in the ward. The degree of psychological improvement impressed the commanding officerofthehospitalunit,Dr.CharlesMayo,whowouldlatergoontoheadthenow famousMayoClinicinRochester,Minnesota.Asaresult,hedecidedtoregularlytake Smokyon his roundsin themilitary hospital to actas a living antidepressantfor his patients.Ineffect,Smokybecameatherapydog,andassuchhecontinuedtobepartof avisitationprogramfor12years,wellbeyondtheendofWorldWarII. Thisbringsustomyinitialcontactwiththeideaofanimal-assistedtherapy.Itwas quite early in my career, in the 1960s, and I was attending the American Psycho- logicalAssociationmeetingsinNewYork.Becauseofmyinterestindogsandtheir relationship to humans, I was caught by the title of a talk to be given by a child psychologist,BorisLevinson,whowasatYeshivaUniversity.Thiswouldturnoutto be the first formal presentation of animal-assisted therapy given before a national audience. Levinson was working with a very disturbed child and found, by chance, that when he had his dog Jingles with him the therapy sessions were much more productive. Furthermore, other children who had difficulty communicating seemed more at ease and actually made real attempts at conversation when the dog was present.Levinsongathereddatafromseveralsuchcasesandthisformedthebasisof the paper that he presented at this APA meeting. The reception of his talk was not positive,and the tone in the room did not do credit to the psychological profession. Levinson was distressed to find that many of his colleagues treated his work as alaughingmatter.Oneevenaskedhimwhatpercentageofthetherapyfeeshepaidto the dog. This did not bode well for the future of such research and therapy, and I thought that it was likely that I would never hear about such use of animals in therapeutic interactions again. Imighthavebeencorrect,exceptthatasaviorofthisconcept,whosevoicecould not be ignored by the psychological community, essentially spoke from beyond his grave.Atthispointintime,itwasonlysome15yearsafterSigmundFreud’sdeath. Justbychance,severalnewbiographiesofFreud’slifehadrecentlybeenreleased.In addition,translationsofmanyofhislettersandjournalswerejustbeingpublishedin