What is an Emotional Support Animal?
How’s your ESA doing? It’s a good bet you didn’t know your family’s pet(s) could also be “Emotional Support Animals.”
Here’s another related acronym, “animal assisted therapy (AAT).” This is a growing field of research and practice in the use of animals for psychological therapy.
It’s not difficult to understand the underlying beliefs about how animals can have a healthy effect on the human psyche – just hold a warm, fuzzy and purring kitten for a while.
However, when it comes to psychology, medicine, and the benefits for people with mental illness, animal assisted therapy can be more fuzzy than warm.
The Benefits of Animal Assisted Therapy
While human beings have known for centuries that relationships with animals could be beneficial, there’s a really big step from the benefits of a pet and the use of an animal to treat a serious mental condition such as PTSD, depression or autism.
For one thing, as a practice of medicine, animal assisted therapy usually involves animals trained for the task. Most of these animals are dogs, although dolphins, horses, chinchillas and many other animals are also used.
There’s a significant difference between a pet, an animal ‘just around the house’ for a long time (usually years), and an ESA/AAT animal such as a dog trained to recognize symptoms of certain mental distress and to help individuals with recovery and treatment for a specific time (usually months, but sometimes for very short visits), similar to the difference between you trying to repair your roof with duct tape or getting professionals from this Website to do it.
For another thing, AAT animals are not a panacea. They aren’t effective for every kind of mental condition nor for every patient. Psychiatrists recognize that animals are best for conditions where stress and emotional upset are mild enough to tolerate the animals.
People with violent or highly aggressive mental problems are (for obvious reasons) least likely to respond properly to animals – and they may represent a risk for the animal.
Evaluating Effectiveness of Animal Assisted Therapy
Another problem for the psychiatrist and other medical professionals is the lack of clinical trial evidence for the positive effect of animal therapy. Common experience and decades of observational data connect animals to good benefits, but without controlled conditions, it’s very difficult to accurately evaluate how much benefit is due to the animals and how much to other factors.
The relative lack of clinical trials in AAT reflects, in part, the traditional subjectivity of evaluating the value of animal companionship. It’s also difficult to conduct the trials in conditions that can identify and monitor other factors such as the living environment, type of mental problem, the training of the animal (or not), the attitude of the person toward animals, and the length of time for contact with the animals.
New Trials Researching Animal Assisted Therapy
A good example of new attempts to evaluate AAT in a clinical trial is the joint project of the American Humane Association, Zoetis, Inc. (a large animal medicine firm) and the pharmaceutical giant, Pfizer, Inc. After a pilot study using dogs with children suffering from cancer, the clinical trial, which opened in October of 2013 and scheduled to run 14 months, is a major test of animal assisted therapy for pediatric oncology.
The trial will involve approximately 100 children at three sites, beginning with St. Josephs Children’s Hospital in Tampa, Florida. The project, called Canines and Childhood Cancer (CCC), seeks to provide evidence for two hypotheses:
1. Pediatric patients with various forms of cancer and undergoing chemotherapy, children aged 3-12 years, and their parents/guardians who receive animal assisted therapy will experience less distress throughout the course of their treatment than patients who do not receive AAT.
2. Participating therapy dogs will exhibit minimal distress over the course of the CCC study.
Methods for Testing Animal Assisted Therapy
The methods for testing need to be well defined. In this case, children are first assessed for their base level of distress (essentially from the course of cancer treatment). A psycho-social survey testing physiological benchmarks (heart rate, blood pressure, etc.) provides this information for each participant, whether they receive AAT or not (in the control group).
During the period of the trial, the children in the treatment group visit with their therapy dog for about 20 minutes once a week during their visits to an outpatient clinic. Each visit is videotaped and their stress level, psychosocial attitudes and physiological condition are recorded.
In this trial, the dogs are also evaluated. Samples of the dog’s saliva are collected from each session to measure the cortisol level (related to stress levels). The dogs’ handlers complete a self-report about the dog’s behavior, and what activities occurred during the session.
This study is one of very few taking place in clinical and hospital settings, which is important because of the intensity of treatment involved for cancer patients. The use of dogs for therapy is ameliorative; it makes the patients feel better but is not a primary treatment.
The clinical trial hopes to put some quantitative measurements to this outcome. Doctors will also be looking to evaluate the therapy in the context of the overall treatment for cancer. It’s part of a growing recognition of the importance of stress reduction and positive mental outlook for cancer patients.
In the broad context for animal assisted therapy, clinical trials such as this one are important to establish the specific circumstances for benefit – the types of mental and physical diseases, the attitudes of the patients, the type and training of the animals and the level of possible therapeutic benefit. The more specific the information, the more likely it will be that AAT can become a routine part of treatment – perhaps leading to standards of treatment and certification of AAT trained animals.
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