Paws with a Purpose: Animal-Assisted Therapies (AAT) in Psychological Practice

Humans and animals have shared a special bond throughout history. Many types of animals, most often dogs and horses but certainly other species too, have a long heritage of working with humans in a myriad of ways. For example, the military has utilized horses, dogs, pigeons, and even dolphins in their missions. Animals have worked farms by pulling plows, herding sheep, and guarding property for centuries. The many ways animals and humans have learned to work together are a testament to the unique human-animal bond.

There are three different categories of animals that relate to health and wellness. Service dogs (and sometimes miniature horses) have been specifically trained to assist individuals with disabilities including but not limited to blindness, deafness, paralysis or limited mobility, seizure disorders, diabetes, autism spectrum disorders, and psychiatric conditions such as post-traumatic stress disorder. For example, a Service Dog may be trained to help someone without sight or hearing cross a busy intersection, fetch insulin during a diabetic episode, recognize and intervene in tic-like behaviors, or alert to an impending seizure, panic attack, or PTSD flash-back. Service animals are the most highly trained of the three categories and fall under the purview of Title II and Title III of the Americans with Disabilities Act (ADA). Service animals are allowed to accompany their human partners in public places where animals are typically not allowed.

The second and newer category of assistance animals are Emotional Support Animals (ESA) which are not necessarily trained to perform certain tasks (though they may be) but directly reduce symptoms of a mental health conditions such as anxiety or depression by virtue of attestation from a licensed mental health provider. Emotional Support Animals are governed under different laws than Service Dogs. While they are not covered under the ADA, they are regulated by the Aircraft Carrier Access Act (ACAA) and the Fair Housing Act (FHA) which allows them access to air travel without charge and to reside with their human partner in permanent and temporary housing, even if it would not ordinarily allow pets. The use of ESAs, though legitimate, has been controversial due to abuse of these privileges by individuals who do not truly suffer from a mental health condition and exploit the situation in conjunction with unethical and unscrupulous providers willing to dole out the appropriate documentation for a fee with minimal or no evaluation. However, for those who truly need and benefit from the support of a furry friend, their role is both a valuable and honorable one.

A related but distinct category is a Therapy Animal, which is used in Animal-Assisted Therapies (AAT) of many different types and forms. While horses and dogs tend to dominate the Therapy Animal role, other animals are often integrated into the therapeutic process and have included pigs and chickens among other furry and feathered friends. The utilization of animals in various therapy modalities is becoming more mainstream and is increasingly recognized in scientific literature in multiple areas of mental and physical healthcare. While a Therapy Animal is not required to be formally trained or certified, several registries exist that require extensive training protocols and passage of exams in order to obtain voluntary certification. At minimum, these animals should be able to be trusted to behave in public environments in a safe and appropriate manner consistent with environmental expectations of hospitals, assisted-living facilities, correctional facilities, schools, etc. For example, Therapy Animals cannot be aggressive, bark excessively, or be reactive to atypical stimuli such as wheelchairs, walkers or sounds made by monitors, equipment, or sirens. Therapy Animals, unlike Service Dogs and Emotional Support Animals, do not have legal rights to access public places or transportation. However, Therapy Animals, especially if they are trained and certified through a reputable program, are often granted access at the discretion of and by consent of the facility.

Research has repeatedly demonstrated that the presence of an animal is therapeutic. For example, multiple studies have shown that simply the act of petting a dog has been shown to lower blood pressure, to increase the “feel good hormones” of serotonin, dopamine, and oxytocin, and to decrease the “stress hormones” of cortisol, epinephrine, and norepinephrine. Essentially, the presence of an animal appears to have therapeutic properties for those who welcome them into the treatment dynamic.

This psychologist personally has a therapy dog in training who accompanies me to my private practice every day. While she is in the first year of a two-year multi-tiered training protocol leading to therapy dog certification, patients are already reporting positive experiences and benefits of her integration into their care. As society becomes more pet-friendly in general, we can expect to see more animal-assisted therapies available for those who are open to the value of their unique contribution to the healing process.


Sarah Shelton, PsyD, MPH, MSCP

Licensed Clinical Psychologist – Kentucky
Board of Directors, National Register of Health Service Psychologists
President-Elect, Kentucky Psychological Association