1. What is animal-assisted therapy? Animal-assisted therapy (AAT) is a goal-directed intervention in which an animal is an integral part of the treatment process. AAT is directed and/or delivered and documented by a health/human service professional with a specific clinical goal for a particular individual in mind. According to Animal-Assisted Therapy--Therapeutic Interventions, AAT is not a style of therapy, like rational-emotive therapy, cognitive therapy, behavioral therapy, etc. Instead, a therapist who utilizes AAT operates from his/her professional foundation and facilitates change in a client through the client’s interactions with an animal. Physical therapists, occupational therapists, certified therapeutic recreation specialists, recreational therapists, teachers, social workers, and others can incorporate AAT into their work and treatments in a multitude of ways. Animal-assisted activities (AAA) also provide social, motivational, educational, and/or recreational benefits for people during interactions. These activities do not have to be overseen by healthcare professionals and do not work toward particular clinical goals. AAA often occurs in meet-and-greet sessions in a variety of settings and can be administered in groups or with individuals. 2. How are the uses of therapy animals and service animals different? Therapy animals provide animal contact to numerous people who may or may not have disabilities. A therapy animal works in animal-assisted activities and animal-assisted therapy. It is usually the personal pet of its handler, and typically works with its handler in attendance during the sessions. Visiting animal-handler teams (such as those registered as Delta Society Pet Partners) are the most common source of therapy animals. The handlers of these visiting teams may be volunteers or healthcare professionals on the staff of the facility they visit. Healthcare professionals may find both benefits (e.g. not having to schedule a volunteer) and drawbacks (e.g. having to manage the client as well as the animal) when incorporating their own therapy animals into AAT sessions. Service animals and residential animals can also be integrated as therapy animals. Federal laws have no provisions for people to be accompanied by therapy animals in places of public accommodation with “no pet” policies. Service animals, as defined by the Americans with Disabilities Act (Federal Code of Regulations, 1990), are individually trained to do work or perform tasks for the benefit of a person with a disability (a physical or mental impairment that substantially limits one or more of the major life activities of the individual). Federal law permits qualified people, who have disabilities, to be accompanied by their service animals in all places of public accommodation, including places with posted “no pet” policies. Service animals are not considered “pets.” 3. What are some of the advantages and disadvantages of utilizing AAT? AAT can offer healthcare professionals a unique treatment tool that enables them to work with hard-to-reach clients. Improved clinical outcomes are achieved in a cost-effective manner and in many cases in a shorter period of time when animals are introduced to the treatment plan. Educational (e.g. increased vocabulary, improved communication), physical (e.g. improved range of motion, better balance), cognitive (e.g. better attention to task, increased ability to organize), and psychological (e.g. improved self esteem, confidence, and mood) benefits can be achieved through the use of AAT. Good references with examples of AAT goals as well as techniques/methods for achieving these goals can be found on Delta Society’s web site, (www.deltasociety.org) and in the books Standards of Practice for Animal-Assisted Activities and Animal-Assisted Therapy, Animal-Assisted Therapy Therapeutic Interventions and Handbook on Animal-Assisted Therapy. Currently, the major disadvantage is that too many healthcare providers are unaware of the tremendous healing potential of animals in a wide variety of settings and lack the proper information/training to incorporate animals into their care and treatment plans. Increases in standardized programs, analytical studies, and evidence-based clinical research will hopefully continue to impact professionals and improve the credibility of the long-standing connection between humans and animals. 4. Who benefits from AAT? Patients and clients in a limitless spectrum of institutional settings, including hospitals, nursing homes, hospice care, mental health facilities, and schools, enjoy the benefits of AAT. In addition to participating in AAT in institutional settings, people benefit from therapeutic sessions with horses, dolphins, and farm animals in sites designed for these interactions. General observations of a variety of therapy sessions indicate the presence of an animal may make sessions more pleasurable and productive and improve therapeutic outcomes. Clients of all ages with all types of medical conditions experience calming effects, brightening of mood and increased motivation when an animal is present during treatment. Participants in studies involving companion animals (pets) show improvement in self-esteem, psychological well being, and community integration. Evidence indicates that particular populations, such as children with autism and people with dementia-related diseases like Alzheimer’s, benefit tremendously from AAT. For example, a study on children with autism (Redefer & Goodman 1989) suggest that a dog when used as part of a child’s therapy can have a strong impact on behavior resulting in an increase in prosocial behavior and decrease in self-absorption. Therapy animals can indirectly help the staff of healthcare facilities. While animal visits are usually intended to help patients and clients, these visits tend to lift the spirits of staff and at least temporarily take their focus off of the emotionally difficult parts of their work. The same positive physiological and psychological effects experienced by patients and clients can also impact staff and employees. Animal-assisted therapy is also being incorporated into schools and libraries through reading programs for children who have had difficulty learning to read. According to the Reading Education Assistance Dogs (R.E.A.D®.) an Intermountain Therapy Animals program, as children read aloud to animals, they tend to be less intimidated than when reading to another person, display greater confidence, and forget about their limitations. Teachers notice improved reading scores, increased confidence, improved self-esteem, and decreased absenteeism from the children who participate in reading programs with therapy animals. Another therapeutic application of animals occurs in prisons and correctional facilities through programs in which animals are taken from animal rescue organizations, receive training from inmates, and are placed into the community as service animals to help people with disabilities. Programs like these aid in the rehabilitation of inmates as they learn pet industry vocation skills, such as training, grooming, and boarding animals, which they can to apply in employment when they resume their lives outside of prison. Inmates also benefit from the important opportunity to give back to the community, and experience the acceptance and unconditional love of animals and the healing power of the human-animal bond. 5. What suggestions would you have for healthcare clinicians and facilities that want to implement animal-assisted therapy programs for clients? Careful planning and implementation of an AAT program are essential to a successful program. Prior to designing the logistics of AAT programs (such as policies and procedures and administrative issues), healthcare professionals should become familiar with key elements of AAT like treatment methods, animal behavior and welfare, and current research validating AAT. Before instituting any AAT program, each clinician and facility should go through a site assessment and client assessments to determine what types of AAT programs will be appropriate for each environment and patient population. All contraindications should be noted and examined. Other important steps include developing AAA/AAT policies and procedures specific to each facility, understanding animal screening criteria, and conducting staff training to identify goals and responsibilities. Healthcare professionals who want to use their own animals for AAT can register as Delta Society Pet Partners or through other registries. While this sort of registering is not absolutely necessary, it will give legitimacy to the AAT program. (Please note the liability insurance information in FAQ #7, below.) Facilities can register with Delta Society and receive helpful guidelines in the Facility Registration Packet, references to Pet Partners in their areas, and support from Delta Society. A valuable resource when starting a program is Standards of Practice for Animal-Assisted Activities and Therapy, which includes practice guidelines supporting safety, quality assurance, and professional consistency. This resource was developed by an expert advisory panel and is published by Delta Society. 6. How do healthcare professionals and facilities manage the risks of bringing in therapy animals? AAT services are designed and delivered to minimize risk for all involved. To safeguard the health and welfare of all participating people and animals, each facility receiving services must establish and clearly document its own set of AAA/AAT policies and procedures in addition to risk management plans. Everyone involved must also comply with local, state, and national laws regarding the presence of animals in various settings and concerning infection control. Standards of Practice for Animal-Assisted Activities and Therapy covers every aspect of a visit including infection control issues, and the Centers for Disease Control and Prevention has published draft guidelines relating to animals in facilities as a part of a larger infection-control policy for healthcare facilities. The CDC has information on species-specific infections on “Healthy Pets, Healthy People” and an additional resource is “Guidelines for Environmental Infection Control in Healthcare Facilities,” which includes a section on AAA and AAT. Go to the main CDC web site at www.cdc.gov and search on document titles. Visiting animal programs like Delta Society’s Pet Partners program evaluate animal-handler teams in the areas of skills and aptitudes, require health screening from veterinarians, and offer training to volunteers about interacting with clients, infection control, and procedures for handling unusual occurrences and injuries. 7. Is AAT reimbursed by insurance? There is currently no reimbursement code specific to AAT interventions. Animals are usually incorporated into existing care and treatment plans, and to our knowledge, providers do not have difficulty obtaining reimbursement for AAT services provided as a part of traditional plans. Registered Pet Partners are covered by liability insurance when volunteering, but Pet Partners that are professionals using AAT during staff time are not covered by Delta Society insurance. AAT is not a separate field of practice. Instead, the animal is a modality or tool that the therapist incorporates into his/her treatment plan. AAT is a service which can be billed to third-party payers when certain criteria are met. In the first place, in order for an interaction to be considered therapy, there must be a credentialed therapist who can bill for service who sets individualized treatment goals, guides the interaction and evaluates the process. Then that therapist (OT, PT, MSW, etc.) incorporates an animal in a patient’s treatment, whether to motivate compliance with treatment or to facilitate cooperation with treatment, it is called animal-assisted therapy (AAT). If a credentialed therapist is not part of the process, then it is not a billable therapy, but is instead animal-assisted activities (AAA). Under these circumstances, the billing procedure for AAT is the same procedure that disciplines use for any reimbursable treatment session. The animal is the modality that has been utilized within the therapy discipline, but the goals have been set by the therapist. Treatment goals remain the same whether an animal is present or not. The patient is billed for Occupational Therapy, Physical Therapy, psychotherapy, etc. Treatment goals and outcomes are documented in the same manner that the insurance company requires for any session. Both JCAHO and CARF audits of facilities providing AAT support the incorporation of AAT into a patient’s treatment plan as long as it is appropriate for the patient and the criteria for therapy are met. 8. Can my animal and I still be involved with AAT even though I am not a healthcare professional? Yes. As mentioned above, visiting handler-animal teams are the most common source of therapy animals as they work with healthcare professionals and clients during therapy sessions. In these cases, the volunteer handler and the healthcare professional work as a treatment team as the handler has the responsibility of managing the animal while the therapist works toward the individualized treatment goals. This is a very effective way to utilize AAT since the therapist can focus on the treatment and the handler can utilize the use of his/her animal. 9. How can interested professionals and volunteers further their knowledge about and training in AAT? Everyone from students to credentialed practitioners can learn about AAT through reading books, networking with others, attending local seminars, national conferences, and subscribing to professional journals. (Besides Anthrozoös: A Multidisciplinary Journal of the Interactions of People and Animals published by Purdue University Press, journal articles and abstracts about AAT are found in those specific to particular fields such as nursing, psychology, etc.) Delta Society provides training opportunities to learn new skills, improve education, and network with others in the field. Other trainings exist throughout the country that offer similar opportunities and may be found by searching on-line. Delta Society also offers a hands-on course called AAT Applications for healthcare professionals that cover such areas as client assessment, AAT techniques, documentation, and evaluation. Information about this course and other trainings are available on Delta Society's web site, www.deltasociety.org. Delta Society’s web site also includes an on-line store with numerous helpful resources, bibliographies, publications, and printed references about AAT that include Standards of Practice for Animal-Assisted Activities and Therapy, Animal-Assisted Therapy Therapeutic Interventions, Animals in Institutions, Animals in Residential Facilities, and Good for your Animals, Good for You. The web site also includes an updated list of AAA/AAT Degree and Certification Programs and Educational Resources and Links for Researchers and Students. Both are found under Animal-Assisted Therapy Services. The links listed provide helpful information about a variety of programs related to the human-animal health connection at universities, organizations, hospitals, etc. and can lead to important contacts with other professionals across the Delta Society is trying to make our web site as information packed and useful as possible. We refer people to it with the hopes of reaching a greater number of people through this avenue.
|
Delta Society, 875 - 124th Ave NE #101, Bellevue, WA 98005 U.S.A.
