The development of the PET@home toolkit: An experience-based co-design method study.

Objective: The relevance of pets in long-term home care is increasingly recognised because of their effects on health outcomes in clients and the rising number of clients receiving long-term care at home (further referred to as clients receiving home care). Currently, there is a lack of supportive materials that address pet-related challenges within home care. This study aimed to develop a toolkit for clients receiving home care with pets, their family, and professional caregivers using a participatory research approach. Methods: We used the Experience-Based Co-Design method involving clients receiving home care, family caregivers, and professional caregivers to create tools that are based on both theory and practice. This approach consists of four phases: 1) Exploring topics of emotional significance requiring attention (i.e., key moments) from the perspective of clients receiving home care, family caregivers, and professional caregivers; 2) Collaboratively prioritising these topics, through prioritisation meetings; 3) Developing and refining Toolkit materials through a co-design process; and 4) Evaluating the quality and feasibility of these materials. Results: Based on the results of a previously-conducted systematic review and individual interviews, we developed a preliminary information booklet and conversation cards. Subsequently, we conducted a total of 28 semi-structured interviews and seven focus groups, including one with representatives of animal interest organisations, such as veterinarians. This process led to the PET@home Toolkit which includes various materials to support pet ownership in home care settings, such as leaflets with advice on communication and animal welfare and an infographic. Conclusion: The PET@home Toolkit can support professional caregivers and their pet-owning clients receiving home care, family caregivers, and their pets. It may be a valuable addition to providing person-centred care in long-term care at home for clients with pets. The PET@home Toolkit and future updates will be readily available and free to download from May 2024 via the University Knowledge Network for Older Adult Care Nijmegen (www.ukonnetwerk.nl). Tweetable abstract: The PET@home Toolkit: Supporting pet ownership in long-term care at home.

Psychophysiological effects of walking in forests and urban built environments with disparate road traffic noise exposure: study protocol of a randomized controlled trial.

BACKGROUND: Stress is a widespread phenomenon and reality of everyday life, entailing negative consequences for physical and psychological wellbeing. Previous studies have indicated that exposure to greenspaces and nature-based interventions are promising approaches to reducing stress and promoting restoration. However, an increasing percentage of the population lives in urban regions with limited opportunities to spend time in greenspaces. In addition, urban settings typically feature increased levels of noise, which represents a major environmental stressor. Although various studies have compared the effects of exposure to greenspaces versus urban built environments, evidence of the effects of noise in this context is very limited. Psychophysiological benefits of exposure to greenspaces compared to urban built environments reported in earlier studies might be less (or at least not only) due to features of the greenspaces than to additional stressors, such as road traffic noise in the urban built environment. Hence, differences in the effects attributed to greenness in previous studies may also be due to potentially detrimental noise effects in comparison settings. This paper reports the study protocol for a randomized, controlled intervention study comparing the effects of walking in forest versus urban built environments, taking road traffic noise exposure during walks in the respective settings into account. METHODS: The protocol envisages a field study employing a pretest-posttest design to compare the effects of 30-min walks in urban built environments and forests with different road traffic noise levels. Assessments will consist of self-reported measures, physiological data (salivary cortisol and skin conductance), an attention test, and noise, as well as greenness measurements. The outcomes will be restoration, stress, positive and negative affect, attention, rumination, and nature connectedness. DISCUSSION: The results will inform about the restorative effect of walking in general, of exposure to different types of environments, and to different noise levels in these sites. The study will provide insights into the benefits of walking and nature-based interventions, taking into account the potential detrimental effects of noise exposure. It will thus facilitate a better understanding of low-threshold interventions to prevent stress and foster wellbeing. TRIAL REGISTRATION: ISRCTN48943261 ; Registered 23.11.2023.

Effects of including a dog on treatment motivation and the therapeutic alliance in child and adolescent psychotherapy: study protocol for a randomized controlled trial.

BACKGROUND: Motivation and a therapeutic alliance are crucial for successful therapy. It is assumed that dogs can increase motivation and help support therapeutic relationships. This is one of the reasons for including dogs in psychotherapy. While the positive effects of psychotherapy with dogs have been documented over the past years, little is known about the underlying mechanisms of animal-assisted psychotherapy. This study therefore aims to investigate whether and how the presence of a dog affects motivation and the therapeutic alliance in child and adolescent psychotherapy. METHODS: The study is a randomized controlled trial assessing motivation and the therapeutic alliance during the first five sessions of psychotherapy attended by children and adolescents with different psychiatric disorders. We will recruit 150 children and adolescents and randomly assign them to one of three conditions: (a) a dog is present but not integrated in the therapeutic narrative, (b) a dog is actively integrated in the therapeutic narrative, and (c) no dog is present. The children's and adolescents' evaluations of the therapeutic alliance and of their motivation will be assessed as the primary outcomes using standardized questionnaires before and after the first five therapy sessions as well as at follow-up. Further outcomes include the therapists' evaluations of the therapeutic alliance and their motivation, treatment adherence of the children and adolescents, and treatment satisfaction of the children and adolescents, their parents, and of the therapists. Interventions are conducted by experienced therapists who regularly work with their dogs. Outcomes will be analyzed using general linear models, with the treatment group as a fixed factor and the baseline values as covariates. DISCUSSION: This study provides information on the possible motivation and alliance-enhancing effects of integrating a dog into child and adolescent psychotherapy. This is relevant for practice, as these two components are strong predictors of therapy outcome. Moreover, the study will contribute to a better understanding of how a dog should be incorporated into psychotherapeutic settings. This can lead to a more purposeful inclusion of dogs in psychotherapy for children and adolescents. TRIAL REGISTRATION: The trial was registered on ClinicalTrials.gov, NCT05384808, on 20 May 2022.

Children's bond with companion animals and associations with psychosocial health: A systematic review.

Background: Companion animals can fulfill children's attachment needs. A secure attachment to humans is positively associated with psychosocial health, therefore, the extent to which this applies to a strong child-companion animal bond is worth examining. Aims: We aimed to gain insight into the current literature regarding the bond between children and companion animals and psychosocial health. Secondary, we also synthesized evidence about the (1) characteristics of children and companion animals and the strength of their bond; (2) the correlations between attachment to humans and the child-companion animal bond; and (3) the instruments used to measure the child-companion animal bond. Method: According to PRISMA guidelines, we searched three major electronic databases (PubMed, EBSCOhost, and Web of Science) in September 2021 and included records with the following criteria: peer reviewed English articles with quantitative and qualitative data on child-companion animal bonds and children's psychosocial health. Reports with participants younger than 18 years of age with a family owned companion animal were included. Two authors performed the screening and determined eligibility according to a predefined coding protocol. Results: The search revealed 1,025 unique records, of which we included 29 studies. Some positive associations were reported between the strength of the child-companion animal bond and children's psychosocial health outcomes like empathy, social support, and quality of life, although some results were contradictory. We found differences in associations between a child's gender, companion animal species and the strength of the child-companion animal bond. A secure attachment style to parents was positively associated with a stronger child-companion animal bond. Most of the instruments currently used, measure the strength of the bond. Discussion: This review suggests that the child-companion animal bond could be beneficial for children's psychosocial health, but some results were inconclusive. Also, not every relationship develops into an attachment. Since a strong bond with animals might not be the same as a secure attachment, we advise to modify human attachment instruments, in order to effectively study children's attachment to companion animals. Lastly, research designs that are able to investigate the causality of the relationship between the child-companion animal bond and psychosocial health are required.

Animal-Assisted Psychotherapy for Pediatric Chronic Pain: Case Series of an Open Pilot Study to Test Initial Feasibility and Potential Efficacy.

Objective: Chronic pain is a common complaint in children and adolescents, placing an enormous burden on individuals, their families, and the healthcare system. New innovative approaches for the treatment of pediatric chronic pain (PCP) are clearly warranted, as drop-out rates in intervention studies are high and it can be difficult to engage patients with PCP in therapy. Here, animal-assisted interventions (AAIs) might be promising, since there is preliminary evidence for the approach in adults with chronic pain, and AAIs are generally known to foster the therapeutic motivation of patients. To date, however, AAIs have not been examined in pediatric chronic pain. Methods: The aim of this open pilot study was to examine the initial feasibility of recruitment and potential efficacy of an animal-assisted group psychotherapy (including horses, rabbits, chickens, goats, and a dog), providing case reports of three children with chronic pain. We applied a mixed-methods approach, including the conductance of semi-structured interviews and assessment of quantitative pre-post data with a focus on pain severity, avoidance behavior, pain acceptance, and ability to defocus from the pain. Results: The three participating girls (age: 9-12 years) reported chronic pain in the head and abdomen. The process of recruitment turned out to be challenging. All three children reported reduced pain-related disability and pain-related distress, as well as an increased ability to accept pain and to defocus from the pain. The qualitative data revealed that patients and their parents had a positive attitude towards AAIs. Conclusion: Our initial open pilot study is the first to investigate AAIs in the context of pediatric chronic pain. Notably, we had difficulties in the recruitment procedure, mostly due to the Covid-19 situation. Based on three case reports, we found some first indication that AAI approaches might be associated with symptom changes. Future randomized-control studies with larger sample sizes are clearly warranted. Clinicaltrialsgov Identifier: NCT04171336.

The Importance of the Treatment Rationale for Pain in Animal-Assisted Interventions: A Randomized Controlled Trial in Healthy Participants.

Animal-assisted interventions (AAIs) is a promising treatment approach for pain, but possible mechanisms still need to be elucidated. This study set out to investigate the analgesic effects of an animal provided with a treatment rationale in a randomized controlled trial employing a standardized experimental heat-pain paradigm. We randomly assigned 128 healthy participants to: dog treatment (DT), placebo treatment (PT), dog and placebo treatment (DPT), and no treatment (NT). Primary outcomes were heat-pain tolerance and the corresponding self-reported ratings of pain unpleasantness and intensity. Results revealed no differences in heat-pain tolerance between the conditions. However, participants in the DT condition experienced heat-pain as significantly less unpleasant at the limit of their tolerance compared to participants in the NT condition (estimate = -0.96, CI = -1.58 to 0.34, P = .010). Participants in the DT condition also showed lower ratings of pain intensity at the limit of their tolerance compared to participants in the NT condition (estimate = -0.44, CI = -0.89 to 0.02, P = .060). This study indicates that a dog has analgesic effects on pain perception when integrated into the treatment rationale. We assume that providing a treatment rationale regarding the animal is important in AAIs for pain. PERSPECTIVE: This study shows that the presence of an animal is not sufficient for animal-assisted interventions (AAIs) to have an analgesic effect on pain unless they are provided with a treatment rationale. This could imply that not only the animal but also contextual factors are important in AAIs. TRIAL REGISTRATION: Clinical Trials NCT04361968.

Effects of contact with a dog on prefrontal brain activity: A controlled trial.

BACKGROUND: There is a broad range of known effects of animal contact on human mental and physical health. Neurological correlates of human interaction with animals have been sparsely investigated. We investigated changes in frontal brain activity in the presence of and during contact with a dog. METHODS: Twenty-one healthy individuals each participated in six sessions. In three sessions, participants had contact with a dog, and in three control sessions they interacted with a plush animal. Each session had five two-minute phases with increasing intensity of contact to the dog or plush animal from the first to the fourth phase. We measured oxygenated, deoxygenated, and total hemoglobin and oxygen saturation of the blood in the frontal lobe/frontopolar area with functional near-infrared spectroscopy (SenSmart Model X-100) to assess brain activity. FINDINGS: In both conditions, the concentration of oxygenated hemoglobin increased significantly from the first to the fourth phase by 2.78 µmol/l (CI = 2.03-3.53, p < .001). Oxygenated hemoglobin concentration was 0.80 µmol/l higher in the dog condition compared to in the control condition (CI = 0.27-1.33, p = .004). Deoxygenated-hemoglobin concentration, total hemoglobin concentration, and oxygen saturation showed similar patterns. CONCLUSION: Prefrontal brain activation in healthy subjects increased with the rise in interaction closeness with a dog or a plush animal. Moreover, interaction with a dog stimulated more brain activity compared to the control condition, suggesting that interactions with a dog can activate stronger attentional processes and elicit more emotional arousal than interacting with a nonliving stimulus.

The Significance of Pets for Vulnerable Older Adults during the COVID-19 Pandemic: An Explorative Qualitative Study.

Older adults receiving long-term care at home (LTCH-clients) were impacted by the COVID-19 pandemic and its countermeasures. Previous research suggests that pets can mitigate some of the pandemic's impacts for older adults but results are contradictory. Our aim was to investigate experiences of LTCH-clients and the significance of their pets during the pandemic. Accounting for saturation, semi-structured interviews were conducted with five LTCH-clients and four family caregivers of LTCH-clients with dementia. Participants were asked about their experiences with COVID-19 and the significance of LTCH-clients' pets during the pandemic. Two researchers performed thematic analyses in ATLAS.ti using open coding and an iterative-inductive approach. All participants reported negative experiences as a result of COVID-19 countermeasures. Results suggested that caring for pets provided pet owners with structure, which may have contributed to a sense of stability and continuity. Our outcomes underlined an important role of pets for LTCH-clients both before and during the pandemic.

Effects of a Dog-Assisted Social- and Emotional-Competence Training for Prisoners: A Controlled Study.

BACKGROUND: Previous research has called for improving psychological interventions and developing new treatments for prisoners. Animal-assisted prison-based programmes have increasingly been used as an approach, but there is a lack of studies investigating the effectiveness of such programmes. OBJECTIVE: To investigate the effects of a dog-assisted social- and emotional-competence training on the socioemotional competences of prisoners compared to treatment as usual. METHODS: In a controlled trial, we investigated 62 prisoners that participated in either a 6-month dog-assisted psychotherapeutic programme or the standard treatment. We assessed social and emotional competences before and after the training and at a 4-month follow-up. Data were analysed with linear models. RESULTS: The prisoners' self-assessed social and emotional competences did not differ. The psychotherapists rated the prisoners' emotional competences in the intervention group higher at the follow-up but not after the training. The psychotherapists did not rate the prisoners' social competences in the intervention group differently but did find them to have higher self-regulation at follow-up and lower aggressiveness after the training than the control group. CONCLUSIONS: This study indicates that dog-assisted programmes with a therapeutic aim might be beneficial for prisoners. However, the inconsistent results indicate that more research is needed to determine the potential and limits of animal-assisted programmes in forensic settings.

The Promotion and Development of One Health at Swiss TPH and Its Greater Potential.

One Health, an integrated health concept, is now an integral part of health research and development. One Health overlaps with other integrated approaches to health such as EcoHealth or Planetary Health, which not only consider the patient or population groups but include them in the social-ecological context. One Health has gained the widest foothold politically, institutionally, and in operational implementation. Increasingly, One Health is becoming part of reporting under the International Health Legislation (IHR 2005). The Swiss Tropical and Public Health Institute (Swiss TPH) has played a part in these developments with one of the first mentions of One Health in the biomedical literature. Here, we summarise the history of ideas and processes that led to the development of One Health research and development at the Swiss TPH, clarify its theoretical and methodological foundations, and explore its larger societal potential as an integrated approach to thinking. The history of ideas and processes leading to the development of One Health research at the Swiss TPH were inspired by far-sighted and open ideas of the directors and heads of departments, without exerting too much influence. They followed the progressing work and supported it with further ideas. These in turn were taken up and further developed by a growing number of individual scientists. These ideas were related to other strands of knowledge from economics, molecular biology, anthropology, sociology, theology, and linguistics. We endeavour to relate Western biomedical forms of knowledge generation with other forms, such as Mayan medicine. One Health, in its present form, has been influenced by African mobile pastoralists' integrated thinking that have been taken up into Western epistemologies. The intercultural nature of global and regional One Health approaches will inevitably undergo further scrutiny of successful ways fostering inter-epistemic interaction. Now theoretically well grounded, the One Health approach of seeking benefits for all through better and more equitable cooperation can clearly be applied to engagement in solving major societal problems such as social inequality, animal protection and welfare, environmental protection, climate change mitigation, biodiversity conservation, and conflict transformation.

Specific and Non-specific Factors of Animal-Assisted Interventions Considered in Research: A Systematic Review.

Research on animal-assisted interventions (AAIs) has increased massively in the last few years. But it is still not clear how AAIs work and how important the animal is in such interventions. The aim of this systematic review was to compile the existing state of knowledge about the working mechanisms of AAIs. We searched 12 major electronic databases for previous AAI studies with active control groups. Of 2001 records identified, we included 172 studies in the systematic review. We extracted previously published hypotheses about working mechanisms and factors that have been implicitly considered specific or non-specific in AAI research by categorizing control conditions using content analysis. We analyzed the categories using descriptive statistics. We found that 84% of the included studies mentioned a hypothesis of working mechanisms, but 16% did not define specific hypotheses. By analyzing their control conditions, we found that in most controlled studies, the animal or the interaction with the animal was implicitly considered as a specific factor for the effects of the AAI. Non-specific factors such as therapeutic aspects, social interactions, or novelty have also been controlled for. We conclude that AAI research still cannot answer the question of how and why AAIs work. To address this important research gap, we suggest using component studies with innovative control conditions and results from placebo research to address both the specific and non-specific, contextual factors of AAIs to disentangle its mechanisms. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=158103, identifier: CRD42020158103.

Effects of animal-assisted psychotherapy incorporating mindfulness and self-compassion in neurorehabilitation: a randomized controlled feasibility trial.

Transdiagnostic psychotherapeutic approaches are increasingly used in neurorehabilitation to address psychological distress. Animal-assistance is thought to increase efficacy. The present study evaluates a psychotherapeutic mindfulness- and self-compassion-based group intervention (MSCBI) with and without animal-assistance for patients with acquired brain injury. Patients (N = 31) were randomly assigned to the 6-week intervention with (n = 14) or without animal-assistance (n = 17). Primary outcome was psychological distress at post- and follow-up treatment, secondary outcomes were changes within-session of patients' emotional states, adherence to treatment and attrition. Psychological distress significantly decreased in both groups from pre- to follow-up treatment with no difference between groups. Patients in the animal-assisted MSCBI group reported significantly higher increases in feeling secure, accepted, comforted, grateful, motivated and at ease during the sessions compared to patients in the MSCBI group without animal-assistance. Adherence to sessions was significantly higher in the animal-assisted MSCBI group. Attrition did not significantly differ between groups. Our results show that both MSCBIs with and without animal-assistance are feasible and effective in reducing psychological distress in patients with acquired brain injury. The significant changes within-sessions mainly in relationship-based emotional states and the higher treatment adherence suggest additional effects of animal-assistance. Animal-assistance might increase acceptability and patients' commitment to psychotherapy.

Animal presence modulates frontal brain activity of patients in a minimally conscious state: A pilot study.

Integrating animals into therapy is applied increasingly in patients in a minimally conscious state (MCS). This pilot study investigates the effect of animal presence on frontal brain activity in MCS patients compared to healthy subjects. O2HB, HHb and tHb of two MCS patients and two healthy adults was measured in frontal cortex using functional near-infrared spectroscopy during three sessions with a live animal and three sessions with a mechanical toy animal present. Each session had five phases: (1) baseline, (2) watching animal, (3) passive contact, (4) active contact, (5) neutral. Data were descriptively analysed. All participants showed the largest hemodynamic response during direct contact with the live or toy animal compared to "baseline" and "watching." During active contact, three of the four participants showed a stronger response when stroking the live compared to the toy animal. All participants showed an inverted signal with higher HHb than O2Hb concentrations while stroking the live or toy animal. Animal contact leads to a neurovascular reaction in both MCS patients and healthy subjects, indicating elevated neural activity in the frontal cortex. We conclude that while a toy animal can elicit attention processes, active contact to a living animal is combined with emotional processes.

Effectiveness of animal-assisted interventions for children and adults with post-traumatic stress disorder symptoms: a systematic review and meta-analysis.

Background: Animal-assisted interventions (AAI) are increasingly applied for people with post-traumatic stress disorder (PTSD) symptoms albeit its effectiveness is unclear.Objectives: To examine the effectiveness of AAI for treating PTSD symptoms.Method: We searched 11 major electronic databases for studies reporting quantitative data on effects of AAI for children and adults with PTSD symptoms. Of 22'211 records identified, we included 41 studies with 1111 participants in the systematic review comprising eight controlled studies with 469 participants in the meta-analysis. We conducted random-effects meta-analyses with all controlled studies based on standardized mean differences (SMD), and calculated standardized mean change (SMC) as effect sizes for studies with a pre-post one-group design. Two independent researchers assessed the quality of the included studies using the NIH Study Quality Assessment Tools. The primary outcome was PTSD or depression symptom severity measured via a standardized measurement at pre- and post-intervention assessments.Results: There was a small but not statistically significant superiority of AAI over standard PTSD psychotherapy (SMD = -0.26, 95% CI: -0.56 to 0.04) in reducing PTSD symptom severity while AAI was superior to waitlist (SMD = -0.82, 95% CI: -1.56 to 0.08). Getting a service dog was superior to waiting for a service dog (SMD = -0.58, 95% CI: -0.88 to -0.28). AAI led to comparable effects in reducing depression as standard PTSD psychotherapy (SMD = -0.03, CI: -0.88 to 0.83). Pre-post comparisons showed large variation for the reduction in PTSD symptom severity, with SMCs ranging from -0.38 to -1.64, and for depression symptom severity, ranging from 0.01 to -2.76. Getting a service dog lowered PTSD symptoms between -0.43 and -1.10 and depression with medium effect size of -0.74.Conclusions: The results indicate that AAI are efficacious in reducing PTSD symptomatology and depression. Future studies with robust study designs and large samples are needed for valid conclusions.

Antecedentes: Las intervenciones asistidas por animales (AAI por sus siglas en inglés) se aplican cada vez más a personas con síntomas de trastorno de estrés postraumático (TEPT) aunque su eficacia no es clara.Objetivos: Examinar la efectividad de la AAI para el tratamiento del TEPTMétodo: Se realizaron búsqueda en 11 bases de datos electrónicas importantes para estudios que reportaran información cuantitativa sobre los efectos de AAI para niños y adultos con síntomas de TEPT. De los 22.211 registros identificados, se incluyeron 41 estudios con 1111 participantes en la revisión sistemática que comprendían ocho estudios controlados con 469 participantes en el metanálisis. Se realizaron metanálisis de efectos aleatorios con todos los estudios controlados según las diferencias medias estandarizadas (SMD según siglas en ingles), y se calculó el cambio de medias estandarizado SMC (por sus siglas en inglés) como tamaños del efecto para los estudios con diseño de un grupo pre-post. Dos investigadores independientes evaluaron la calidad de los estudios incluidos usando las Herramientas de Evaluación de Calidad del Estudio del NIH. El resultado primario fue la medición de la severidad del TEPT o síntomas depresivos a través de mediciones estandarizadas en evaluaciones pre y post intervención.Resultados: Hubo una pequeña superioridad, pero no estadísticamente significativa, del AAI sobre psicoterapia estándar para TEPT (SMD= −0.26, IC 95%:-0.56 a 0.04) en la reducción de la severidad de los síntomas de TEPT, mientras que la AAI fue superior a la lista de espera (SMD= −0.82, IC 95%:-1.56 a 0.08). Tener un perro de servicio fue superior a esperar por un perro de servicio (SMD= −0.58, IC 95%:-0.88 a −0.28). La AAI produjo efectos comparables en la reducción de depresión como la psicoterapia estándar para TEPT (SMD= −0.03, IC: −0.88 a 0.83). Las comparaciones pre-post mostraron una gran variación en la reducción de la severidad de síntomas de TEPT, con rangos de SMC desde −0.38 a −1.64, y para la severidad de síntomas de depresión, rangos desde 0.01 a −2.76. Tener un perro de servicio bajo los síntomas de TEPT entre −0.43 a −1.10 y la depresión con un tamaño de efecto medio de −0.74.Conclusiones: Los resultados indican que los AAI son eficaces para reducir la sintomatología del TEPT y depresión. Se requieren estudios futuros con diseños de estudio sólidos y muestras grandes para obtener conclusiones válidas.

Lack of Effects of the Presence of a Dog on Pain Perception in Healthy Participants-A Randomized Controlled Trial.

Animal-assisted interventions (AAIs) have been shown to be effective in the treatment of pain. Studies suggest that relationships with animals can have comparable qualities to relationships with humans and that this enables animals to provide social support. Further, the presence of an animal can strengthen the therapeutic alliance between patients and treatment providers. This suggests that the analgesic effects of AAI might be mediated by social support from an animal or by strengthening the alliance between the patient and the treatment provider. To test these assumptions, we examined the effects of the presence of a dog on experimentally induced pain in a pain assessment and a pain therapy context. Hundred thirty-two healthy participants were randomly assigned to the conditions "pain," "pain + dog," "pain + placebo," or "pain + placebo + dog." We collected baseline and posttreatment measurements of heat-pain tolerance and the heat-pain threshold and of the corresponding subjective ratings of heat-pain intensity and unpleasantness as well as of participants' perceptions of the study investigator. The primary outcome was heat-pain tolerance. The presence of the dog did not influence the primary outcome ("pain" vs. "pain + dog": difference = 0.04, CI = -0.66 to 0.74, p = 0.905; "pain + placebo" vs. "pain + placebo + dog": difference = 0.43, CI = -0.02 to 0.88, p = 0.059). Participants did also not perceive the study investigator to be more trustworthy in the presence of the dog ("pain" vs. "pain + dog": difference = 0.10, CI = -0.67 to 0.87, p = 0.796; "pain + placebo" vs. "pain + placebo + dog": difference = 0.11, CI = -0.43 to 0.64, p = 0.695). The results indicate that the mere presence of a dog does not contribute to pain reduction and that the analgesic effects of AAI that previous studies have found is not replicated in our study as AAI did not increase perceived social support and had no effect on the alliance between the participant and the treatment provider. We assume that the animal most likely needs to be an integrated and plausible part of the treatment rationale so that participants are able to form a treatment-response expectation toward AAI. Clinical Trial Registration: This study was preregistered as a clinical trial on www.clinicaltrials.gov (Identifier: NCT0389814).

Influences of Animal-Assisted Therapy on Episodic Memory in Patients with Acquired Brain Injuries.

Animal-assisted therapy (AAT) is shown to be an effective method to foster neurorehabilitation. However, no studies investigate long-term effects of AAT in patients with acquired brain injuries. Therefore, the aim of this pilot study was to investigate if and how AAT affects long-term episodic memory using a mixed-method approach. Eight patients rated pictures of therapy sessions with and without animals that they attended two years ago. Wilcoxon tests calculated differences in patients' memory and experienced emotions between therapy sessions with or without animals. We also analyzed interviews of six of these patients with qualitative content analysis according to Mayring. Patients remembered therapy sessions in the presence of an animal significantly better and rated them as more positive compared to standard therapy sessions without animals (Z = -3.21, p = 0.002, g = 0.70; Z = -2.75, p = 0.006, g = 0.96). Qualitative data analysis resulted in a total of 23 categories. The most frequently addressed categories were "Positive emotions regarding animals" and "Good memory of animals". This pilot study provides first evidence that AAT might enhance episodic memory via positive emotions in patients with acquired brain injury.

Defining the PTSD Service Dog Intervention: Perceived Importance, Usage, and Symptom Specificity of Psychiatric Service Dogs for Military Veterans.

Research suggests that psychiatric service dogs may be an effective complementary treatment option for military veterans with posttraumatic stress disorder (PTSD). Although this practice continues to increase in popularity and research has reached the rigor of clinical trials, the components of the PTSD service dog intervention remain largely undefined. This research aimed to (1) quantify the importance, usage, and PTSD symptom specificity of service dog trained and untrained behaviors, (2) explore how PTSD severity, time since receiving the service dog, and the veteran-dog relationship relate to outcomes, and (3) compare expectations of veterans on the waitlist to experiences of veterans with service dogs. In a cross-sectional design, 217 post-9/11 military veterans with PTSD were recruited from a national service dog provider, including n = 134 with a service dog and n = 83 on the waitlist. Results showed that the service dog's trained tasks of calming and interrupting anxiety were perceived as the most important for veterans' PTSD, the most frequently used in a typical day, and as helping the most PTSD symptoms. Trained tasks were most helpful to the PTSD symptoms of hypervigilance and intrusion, and least helpful toward the symptoms of amnesia and risk-taking. Although all trained tasks were helpful toward PTSD symptoms, veterans rated the service dog's untrained behaviors on average as more important for their PTSD. After controlling for covariates, there was no relationship between a veteran's PTSD severity and perceived importance or frequency of task use. However, veterans who reported feeling closer to their service dogs reported using trained tasks more often, and veterans who had their service dogs for longer reported using trained tasks less often. Finally, veterans on the waitlist reported higher expectations regarding task use and importance than described by veterans with a service dog. In conclusion, findings describe the core components of the PTSD service dog intervention by quantifying the use and value of trained and untrained dog behaviors. Overall, this study helps explain the PTSD service dog's clinically relevant value while contributing to the scientific understanding of this emerging practice.

Is Animal-Assisted Therapy for Minimally Conscious State Beneficial? A Case Study.

OBJECTIVE: The goal of this single case study was to qualitatively investigate the effects of animal-assisted therapy in a patient in a minimally conscious state. METHOD: We present a 28-year-old female patient in a minimally conscious state following polytrauma after a sports accident leading to cerebral fat embolism causing multiple CNS ischemic lesions. She received eight animal-assisted therapy sessions and eight paralleled control therapy sessions over 4 weeks. We investigated the reactions of the patient during these sessions via qualitative behavior analysis. RESULTS: The patient showed a broader variability and higher quality of behavior during animal-assisted therapy compared to control therapy sessions. CONCLUSION: The observed behavioral changes showed higher arousal and increased awareness in the presence of an animal. The presented case supports the assumption that animal-assisted therapy can be a beneficial treatment approach for patients in a minimally conscious state.