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Going to the Dogs: Working with Animals in Treatment

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Title: Going to the Dogs: Working with Animals in Treatment


1
Going to the DogsWorking with Animals in
Treatment
  • Ann R. Howie, LICSW, ACSW

2
Going to the Dogs
Turn to a person near you. Share with that
person the two most important things you want to
learn in this presentation. Be prepared to state
those when asked.
3
Learning Objectives
  • Describe the philosophy behind working with
    animals in mental health treatment.
  • Describe five considerations for choice of
    handler.
  • Report five roles animals may take in treatment
    sessions.

4
Learning Objectives (cont.)
  • Identify five ways that animals can help clients
    attain goals related to symptoms of
    Post-Traumatic Stress Disorder.
  • Analyze three general precautions,
    contraindications, and challenges to including
    animals in mental health treatment.

5
Anns Work
  • AAA/T Consultant
  • AAT experience since 1986
  • Human-Animal Solutions
  • Author
  • Private counseling practice
  • Animal behavior
  • Professor
  • St. Martins University
  • University of Denver
  • Yamazaki College
  • Founder, Providence AAA/T
  • Former Delta Society AAT Director

6
Philosophy
7
Philosophy
8
Philosophy (cont.)
9
Philosophy (cont.)
The introduction of an animal into a therapeutic
environment changes the entire environment. It
changes the rules governing the behavior of all
the participants patients, therapists, staff,
visitors, volunteers, and professionals.
-- Dr. Aaron Katcher
10
Philosophy (cont.)
11
Philosophy Think Point
Turn to a person near you. Tell that person the
most important thing you learned in this section
of the presentation.
12
Case Study
13
Case Study
  • Setting
  • County in-patient psychiatric hospital, locked
  • Court-committed clients (involuntary)
  • Most were chronically mentally ill, few in first
    episode
  • 3-month average length of stay
  • 2 units acute and stabilized
  • I was full-time staff therapist

14
Case Study (cont.)
  • Client
  • 24-year-old woman, single
  • Post-partum, no hx of depression
  • Major depression with suicidal ideation
  • Electively mute, communicated with hand gestures
  • Rarely left room on acute unit
  • Hospitalized for 6 weeks without progress ?
    approval for AAT

15
Case Study (cont.)
  • Treatment
  • Parents gave hx and permission to work with dog
  • 1st goal come out of room
  • 2nd goal leave unit go to therapists office
  • 3rd goal begin speaking
  • Length of treatment 6 weeks
  • Discharged to separate apartment and part-time
    job, gradually resumed full care of infant

16
Settings
  • In-patient and out-patient treatment
  • Counseling center
  • In home
  • Animal shelter
  • Barn, farm
  • Zoo, aquarium

17
Settings Think Point
Take a moment now to think about the setting in
which you practice. In your handout, draw a
symbol of whether you think your setting might
incorporate AAT. Or, if you can think of an
animal facility youd like to partner with, write
down that facilitys name.
18
The Handler
19
The Handler (cont.)
  • Who will the handler be?
  • Treating therapist
  • Other therapist
  • Paid staff (not a therapist)
  • Trained and screened volunteer

20
The Handler (cont.)
  • Who will the handler be? (cont.)
  • Must understand role
  • Must know how to respond therapeutically to
    client
  • Must know and understand therapy goals
  • Must be willing to follow the therapists lead
  • Must know the animal population as well as the
    individual animal

21
The Handler (cont.)
  • Environmental Impact
  • Office, center, barn, etc.
  • Goals of treatment affect choice of environment
  • Privacy in an office vs. in a barn
  • Handler fear/anxiety about environment vs.
    familiarity comfort

22
The Handler (cont.)
  • Dynamics of adding another person
  • Distraction to client
  • Client uncertainty about or distrust of handler
  • Requires therapist preparation of both client and
    handler

23
The Handler (cont.)
  • Confidentiality
  • Legally, how much is an outside handler allowed
    to know?
  • Preparation is required before each session
  • Must be confident of handlers ethics
  • Sign Oath of Confidentiality (volunteer or paid
    staff)

24
The Handler (cont.)
  • The therapist as handler
  • Is responsible to assure safety of all concerned
    client(s), animal(s), other staff, etc. while
    focusing on client needs and goals
  • Are you capable of doing all those things?

25
Handler Think Point
In your handout, identify three things you really
want to remember about choice of handler and mark
those items with a star.
26
The Animal
27
The Animal (cont.)
  • Common therapy animal species
  • Dogs and cats
  • Horses
  • Farm animals
  • Other domesticated wild

28
The Animal (cont.)
  • Suitability to the task
  • Matching animals characteristics to clients
    needs
  • Ability of animal to enjoy setting
  • Ability of the setting to accommodate the animal

29
The Animal (cont.)
  • The animals role
  • Assistant or tool, not co-therapist!
  • Animal gives the therapist a rich smorgasbord of
    behaviors for therapeutic work
  • Accept grooming
  • Participate in training
  • Eat

30
The Animal (cont.)
  • Stress
  • Therapy animals require de-stressing
  • Handler/staff must know and recognize animal
    behavior
  • Handler/staff must be willing to do something
    about animal stress
  • The clients work must not be done at the expense
    of the animal

31
Animal Think Point
Find The Animal section in your handout. Think
about the concept that stands out for you the
most in this section. Draw a doodle that
represents that concept for you.
32
AAT Interventions
33
Dx Post-Traumatic Stress Disorder (309.81)
  • Precautions
  • Dissociation
  • Self-mutilating behaviors
  • Angry or uncontrolled outbursts

34
Dx Post-Traumatic Stress Disorder (309.81)
(cont.)
  • Contraindications
  • If precautions cannot be adequately supervised
  • If adequate supervision cannot guarantee safety

35
Dx Post-Traumatic Stress Disorder (309.81)
(cont.)
  • Interventions
  • Work with horses in activities that gradually
    require more skill
  • Study horses in a field
  • Go into the field and be with the horses
  • Choose a horse to catch
  • Feed the horse
  • Groom the horse
  • Etc.
  • Symptoms
  • High level of arousal
  • Flashbacks
  • Trauma
  • Stress, anxiety

36
Dx Post-Traumatic Stress Disorder (309.81)
(cont.)
  • Interventions
  • Work with a well-trained dog, then work with a
    dog that has less training (make the interactions
    more challenging only after the client gains more
    skill and confidence)
  • Symptoms
  • High level of arousal
  • Flashbacks
  • Trauma
  • Stress, anxiety

37
Dx Post-Traumatic Stress Disorder (309.81)
(cont.)
  • Interventions
  • Participate in an activity that is both physical
    and enjoyable to the client (agility, fly ball,
    rally, etc.) so that the client learns to
    gradually handle increasing levels of arousal
    while having fun
  • Symptoms
  • High level of arousal
  • Flashbacks
  • Trauma
  • Stress, anxiety

38
Dx Post-Traumatic Stress Disorder (309.81)
(cont.)
  • Symptoms
  • High level of arousal
  • Flashbacks
  • Trauma
  • Stress, anxiety
  • Interventions
  • Go for a ride on a horse and verbally express
  • Where client is in time, place, and person
  • What the clients body feels like on the horse
  • What it is about riding that helps the client
    feel grounded and in the present

39
Dx Post-Traumatic Stress Disorder (309.81)
(cont.)
  • Symptoms
  • High level of arousal
  • Flashbacks
  • Trauma
  • Stress, anxiety
  • Interventions
  • Work with a puppy, kitten, or other young animal
  • Talk about how young animals keep our
    attention/focus
  • Teach the young animal boundaries
  • Teach about proper, safe animal behavior
  • Teach social skills

40
Dx Post-Traumatic Stress Disorder (309.81)
(cont.)
  • Symptoms
  • High level of arousal
  • Flashbacks
  • Trauma
  • Stress, anxiety
  • Interventions
  • Work with an animal that was traumatized or part
    of a traumatic event
  • Help animal heal
  • Help animal become socialized
  • Leads to metaphorical discussion of clients own
    trauma
  • Helps client process his/her own traumatic
    situation

41
Dx Post-Traumatic Stress Disorder (309.81)
(cont.)
  • Symptoms
  • High level of arousal
  • Flashbacks
  • Trauma
  • Stress, anxiety
  • Interventions
  • Groom or pet an animal while talking with the
    therapist about his/her trauma
  • Physical activity can be soothing, ? BP
  • Environment is neutral
  • Animal is a non-threatening link between client
    and therapist

42
Dx Post-Traumatic Stress Disorder (309.81)
(cont.)
  • Symptoms
  • High level of arousal
  • Flashbacks
  • Trauma
  • Stress, anxiety
  • Interventions
  • Observe fright/flight responses in an animal
  • Journal observations about animals specific
    behavioral responses
  • Make guesses about what animal was feeling
    (emotionally and physically) with the behaviors
  • Journal about and/or discuss clients own trauma

43
Dx Post-Traumatic Stress Disorder (309.81)
(cont.)
  • Symptoms
  • High level of arousal
  • Flashbacks
  • Trauma
  • Stress, anxiety
  • Interventions
  • Practice being in the here and now while grooming
    an animal. Using the animal as the focal point,
    attend to
  • Posture
  • Body movements
  • Breathing
  • Response to animals movements

44
Dx Post-Traumatic Stress Disorder (309.81)
(cont.)
  • Symptoms
  • High level of arousal
  • Flashbacks
  • Trauma
  • Stress, anxiety
  • Interventions
  • Practice being in the here and now while taking
    an animal for a walk. Using the animal as the
    focal point, attend to
  • Pace
  • Heel-toe movements
  • Arm movements
  • Reaction to animals movements

45
Dx Post-Traumatic Stress Disorder (309.81)
(cont.)
  • Symptoms
  • High level of arousal
  • Flashbacks
  • Trauma
  • Stress, anxiety
  • Interventions
  • Teach the client slow breathing exercises while
    in the presence of an animal.
  • Have the client match breathing to the animal
  • Help the client use the animal as an anchor-point
    image to return to when away from the animal

46
Dx Post-Traumatic Stress Disorder (309.81)
(cont.)
  • Symptoms
  • High level of arousal
  • Flashbacks
  • Trauma
  • Stress, anxiety
  • Interventions
  • Teach guided imagery exercises
  • Focused around an animal (could be a totem or
    guide)
  • In the presence of an animal

47
Dx Post-Traumatic Stress Disorder (309.81)
(cont.)
  • Symptoms
  • High level of arousal
  • Flashbacks
  • Trauma
  • Stress, anxiety
  • Interventions
  • Teach grounding breathing exercises
  • First in the presence of an animal
  • Teach how to come back to being with animal in
    mind at times when client is anxious or stressed
    (outside of sessions)

48
AAT Think Point
Think of a client you have worked with who might
have responded to an animal. Jot down two ideas
of ways you might have worked with that client
and an animal.
49
General Precautions, Contraindications, and
Challenges
50
Precautions and Contraindications (cont.)
  • Client assessment
  • Psychosis
  • Delusions
  • Hallucinations
  • Assaultive
  • Hx of animal abuse
  • Ability to follow directions
  • Judgement
  • Confusion
  • Impulsivity
  • Self-harm or acting-out behaviors
  • Physical ability
  • Weight
  • Sign a safety contract

51
Challenges (cont.)
  • Matching animal to client
  • Sometimes need similar characteristics sometimes
    need different
  • Medication
  • Uncertainty or anxiety
  • Disability

52
Challenges (cont.)
  • Matching animal to client (cont.)
  • May prefer different animals at different points
    in treatment
  • Use what screening criteria?
  • Delta Pet Partners?
  • Local group
  • Certified Applied Animal Behaviorist
  • Veterinarian

53
Challenges (cont.)
  • General liability insurance
  • For an organization
  • If working with a volunteer, work only with
    volunteers who have liability insurance coverage
    through their credential
  • Most organizations carriers cover volunteers if
    they have received the organizations volunteer
    orientation
  • If a staff member is the handler, the
    organizations carrier will need to be queried
    about coverage
  • It is the handler who needs coverage, not the
    animal

54
Challenges (cont.)
  • General liability insurance
  • For an individual practitioner
  • Some carriers refuse to write a policy if dogs
    are included in treatment
  • Too few practitioners inadequate loss history
  • May need to use a carrier that writes policies
    for high-risk businesses ( high cost)

55
Challenges Think Point
Think about the setting where you practice. On
your handout, identify two challenges that apply
to your setting and mark those with a check mark.
Then share those challenges with a person
nearby.
56
A Few Resources
57
A Few Resources
  • Animal-Assisted Therapeutic Interventions, by
    Molly DePrekel, MA, and Tanya Welsch, MSW
  • Animal-Assisted Therapy in Counseling, by Cynthia
    Chandler, Ed.D.
  • Teaching Empathy, by Lynn Loar, PhD., and Libby
    Colman, Ph.D.
  • Animal-Assisted Therapy Therapeutic
    Interventions, Delta Society

58
A Few Resources (cont.)
  • Equine-Facilitated Mental Health Association
    (EFMHA), http//www.narha.org/SecEFMHA/
    WhatIsEFMHA.asp
  • Minnesota Linking Individuals, Nature,
    Critters, http//www.mnlinc.org
  • Centaur Center for Human-Animal Relationships,
    Virginia-Maryland Regional College of Veterinary
    Medicine, http//www.vetmed.vt.edu/centaur/

59
Review
60
Review
  • Describe the philosophy behind working with
    animals in mental health.
  • The presence of the animal changes the
    interaction between therapist and client
  • The therapist facilitates treatment based on
    planned and unplanned interactions with animals
  • Animals are not co-therapists

61
Review (cont.)
  • Report five considerations for choice of handler
    in mental health AAT.
  • Who will handler be?
  • Dynamics of adding another person
  • Confidentiality
  • Environmental impact
  • The therapist as handler

62
Review (cont.)
  • Report five roles animals may take in mental
    health AAT sessions.
  • Assistant or tool, not co-therapist
  • Provide smorgasbord of behaviors as therapeutic
    palette
  • Accept grooming
  • Participate in training
  • Eat

63
Review (cont.)
  • Identify two ways that animals can help clients
    attain goals.
  • Post-Traumatic Stress Disorder
  • High level of arousal
  • Flashbacks
  • Trauma
  • Stress, anxiety

64
Review (cont.)
  • Analyze three general precautions,
    contraindications, and challenges to including
    animals in mental health treatment.
  • Client assessment
  • Matching animal to client
  • General liability insurance

65
Action Plan
Take a moment to become introspective. Think
about whether or not you want to explore AAT for
your clients. If you want to proceed, write down
the first thing you want to do I plan to . . .
. Then turn to a person near you and tell that
person your plan or the reason why this isnt a
good idea right now.
66
(No Transcript)
67
Thank You!
www.HumanAnimalSolutions.com
  • HumanAnimalSolutions_at_comcast.net

360-493-2586
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