Br J Soc Work-2012-Evans-600-17

The Practice and Ethics of Animal-Assisted Therapy with Childrenand Young People: Is It Enoughthat We Don’t Eat Our Co-Workers?

Nikki Evans* and Claire Gray

Nikki Evans has been a teaching academic in Social Work and Human Services programmes at theUniversity of Canterbury, Christchurch, New Zealand, since 1998. Her research interests include

youth violence, animal-assisted intervention and therapy, narrative therapy, and sexuality andsocial work practice. Her practice involvement has predominantly been as a Senior Specialist

Clinician for the STOP Adolescent Programme, Christchurch, New Zealand, working withadolescents who have engaged in sexually abusive behaviour. Claire Gray is a postgraduatestudent with the Human Services programme at the School of Social and Political Sciences,

University of Canterbury, Christchurch, New Zealand. Her research interests include animal-assisted therapy and cross-cultural interaction and culture, power and identity within a New

Zealand context. Her MA thesis research, begun in 2010, is on the topic of ‘white privilege’.

*Correspondence to Nikki Evans, Social Work & Human Services Programmes, School ofSocial and Political Sciences, University of Canterbury, Private Bag 4800, Christchurch 8140,New Zealand. E-mail: [email protected]

Abstract

The powerful nature of relationships between human beings and animals has been

documented extensively within the human services literature. Research on the

human–animal bond has traversed diverse topics and fields of practice. Examples

include the physical and mental health benefits of companion animals, the place of com-

panion animals in the family system, the significance of cruelty against animals as a pre-

dictor of future violent behaviour and the therapeutic impact of animal-assisted therapy

(AAT) across a range of contexts. This paper examines the relevance of animal-assisted

therapy (AAT) to an ecological approach to social work practice, particularly when

working with children and young people, and considers both practice and ethical

issues for social workers employing AAT, with reference to the implications these have

for social work education providers.

Keywords: Social work education and practice, animal-assisted therapy, children and

families, human–animal bond

Accepted: May 2011

# The Author 2011. Published by Oxford University Press on behalf of

The British Association of Social Workers. All rights reserved.

British Journal of Social Work (2012) 42, 600–617doi:10.1093/bjsw/bcr091Advance Access publication June 21, 2011

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Introduction

Within Western society at least, the idea that people and animals have anatural tendency to develop a shared connection has become almost folklore. The acceptance of this connection has been so pervasive that wholeindustries have been developed to cater to the needs of companionanimals and the whims of their owners. While perhaps not matching thisfervour, interest from social work practitioners in the use of animals tofacilitate trust building and a therapeutic connection has grown. Indeed,over the last few decades, various forms of animal-assisted therapy(AAT) have become acceptable methods of therapeutic practice and anintegral component of practice for many social work practitioners.

The generic term ‘animal-assisted intervention’ (AAI) encompasses abroad range of animal-assisted activities (AAA) and animal-assistedtherapy (AAT). Despite an absence of standardisation, the Delta Society’s(1996) definitions of AAA and AAT are widely employed in the literature.While a definitional separation can be achieved between AAA and AAT,there is inconsistent and, at times, interchangeable use of these terms withinpublished research.

Animal-assisted activities (AAA) refer to activities such as visits byhandlers and animals to residential rest homes or hospitals that are ofbenefit to patients; these less formal activities are primarily social infocus (Chandler, 2005). AAA are not individually tailored therapeuticinterventions, with the associated obligations around note taking and super-vision, nor do they have a goal-oriented approach (Chandler, 2005; DeltaSociety, 1996). Without the emphasis on targeted outputs or therapeuticgain, AAA can be perceived to be a cost-effective option by service provi-ders. Unfortunately, the variable nature of these activities and the diversepool of paid and volunteer staff implementing AAA mean that researchinto the efficacy of AAA is both challenging and complex.

Animal-assisted therapy (AAT), by contrast, is goal-directed: prac-titioners work with animals to develop interventions within their area ofexpertise and the boundaries of their professional practice (Chandler,2005; Delta Society, 1996). For example, a clinical social worker may useAAT as a part of a cognitive behavioural intervention for anxiety orsocial phobia, while another may use AAT as a part of a narrativetherapy approach whereby stories about the animal’s life and resilienceprovide a platform to eliciting stories about the child’s life. Becausesocial workers use AAT as an adjunct to their existing practice model(s),there is still a reasonable variance in the way that AAT is employedwithin direct practice (Kruger et al., 2004).

Despite the growing awareness of the complexity of AAT within other dis-ciplines, and the ecological and systems frameworks that characterise theprofession, human–animal relationships have received minimal attention

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from social work researchers and educators (Risley-Curtiss et al., 2006a).There has been, however, both a clearly discernable interest by social workpractitioners in this therapy and a recognised need that social work shouldalso embrace this field (Risley-Curtiss et al., 2006a; Risley-Curtiss, 2010;Tedeschi et al., 2005). Early research studies evaluating AAT interventionswere justifiably derided by medical professionals and, along with morerecent quantitative studies, have been criticised for poor design and over-reliance on anecdotal and qualitative data. Essentially, AAT, as an empiri-cally driven practice tool, is still in its infancy (Kruger et al., 2004).

A lack of an evidence-based, professional framework for AAT can leadto practical, ethical and safety issues for social worker practitioners andclients alike. Furthermore, whilst safety concerns for clients and potentialrisks for humans (such as allergies and zoonotic diseases) are identified(Beck and Katcher, 2003), the welfare and safety of the animal‘co-therapists’ have received less attention. Not only is it possible thatanimals used in AAT within social work practice may be harmed byclients, but the work itself may be stressful for animals (Hatch, 2007) andpotentially lead to long-term health problems (Heimlich, 2001). However,careful planning by a skilled social work practitioner can minimise therisks and maximise the benefits to both human participants and animals.We contend that, in the planning and implementation of any form ofAAT within social work practice, similar consideration needs to be givento the well-being of the animals as to human participants, and these inter-ventions should, where possible, also provide benefits for the animals.

An ecological perspective, AAT and social work practice

Ecological theory, and its focus on interdependence of life forms and theenvironment they inhabit, has provided a convenient metaphor for socialwork practice (Gitterman and Germain, 2008). Social work research andpractice have, for many years, incorporated an ecological perspectivewhereby people are believed to develop and adapt through dynamic andreciprocal transactions with all components of their environment. Thisperson-in-the-environment is a central concept of ecological theory(Gitterman and Germain, 2008; Tedeschi et al., 2005; Zastrow, 2008) anda useful framework for understanding the transactions between humans,animals and the environment.

Animals make a contribution to the lives of many people, influencingtheir development and adaptation through reciprocal transactions. This isevidenced in the important role that animals play in the home and schoolenvironments that children inhabit. Children’s toys are designed to rep-resent myriad animals, such as bears, horses, rabbits and dogs. Children’sbooks and stories are full of animals, often incorporated as the central char-acter, such as The Wind in the Willows, Winnie the Pooh, Black Beauty and

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Hairy Maclary. Whether such stories are for entertainment value or serve asa vehicle for moral learning and personal growth, they are based on thepremise that there is some inextricable link between children and their non-human counterparts (Beck and Katcher, 2003).

Such associations indicate that, in Western culture at least, animals andchildren are considered to have a natural bond (Melson and Fine, 2006).Boris Levinson (1964), one of the first to explore this bond, argued that achild’s relationship with a therapy animal could help to establish a connec-tion with the worker. As transitional objects between children and theworker, animal co-workers can be particularly beneficial for children whohave difficulties in trusting and forming attachments to people. Morerecent research supports this contention, concluding that workersaccompanied by animals are seen as more approachable (Cournoyer andUttley, 2007; Schneider and Harley, 2006). As Melson and Fine (2006)argue, ‘animals slip under the radar of human defense mechanisms’(Melson and Fine, 2006, p. 211), thus smoothing the process of engagement.The potential for animals, through the use of AAT, to facilitate engagementand enhance rapport between child and social worker is possibly one of themost important aspects of AAT.

Companion animals as a conduit to social workassessment

The quality of the therapeutic relationship is now accepted as the primaryfactor in producing positive outcomes for clients (Bickman, 2005; Priebeand McCabe, 2006; Southerland et al., 2009; Swift and Callahan, 2009).Indeed, a social worker’s ability to engage and form a positive relationshipwith a client is a fundamental yet critical skill (Compton et al., 2005). Thepotential for many forms of AAT to enhance engagement, assessmentand intervention in social work practice is clearly discernable, particularlywhere companion animals are present in the client’s home or life.

Informed by an ecological framework, social workers have opportunitiesto observe and interact with clients and their companion animals when onhome visits, to ask questions about companion and other animals and tonote the significance of non-human members of the family within theirassessment process (Boat and Knight, 2000; Kurdek, 2009; Risley-Curtisset al., 2006b; Risley-Curtiss, 2010; Tedeschi et al., 2005; Walsh, 2009). Thepossibility that an animal provides significant support to the client shouldnot be overlooked. Social support, including the presence of companionanimals, has been credited with the reduction of stress in people andtheir subsequent success in a number of areas, such as recovery fromillness, resilience in the face of adversity and in enhancing academicachievement (Melson and Fine, 2006).


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Animals are often valued as family members (Walsh, 2009) and have thepotential to provide clients with support as an adjunct to other supports orthey may be the sole support when other forms of support are missing. Inseveral studies, people have listed the emotional support, attachment andcompanionship aspects of pet ownership as very important (Faver andCavazos, 2008; Kurdek, 2009; Walsh, 2009). The power of social supportin assisting clients through change and adaptation further highlights thepotential for an animal to adopt a support role in a range of ecologicallyinformed social work therapies. The social worker’s assessment, then,should consider the potential for an animal (the client’s or the worker’s)to become part of the therapeutic process (Risley-Curtiss, 2010).

On the other hand, situations of neglect or of ‘hoarding’ animals maypose physical health risks and be an indication of the potential for arange of mental health issues for the client (Nathanson, 2009; Patronek,1999, as cited in Boat and Knight, 2000). A greater awareness of the signifi-cance and implications of a history of animal cruelty and its link to violenceand abuse within interpersonal relationships, which we discuss later, willenable social workers to conduct more comprehensive assessments anddevelop individual plans for therapy accordingly (Risley-Curtiss et al.,2006b; Risley-Curtiss, 2010). It is well to remember that home visits arenot without risks for the worker, who may need to manage encounterswith dangerous or aggressive animals, conflicting understandings ofanimal ‘custody’ or welfare and a range of other difficult situations (Boatand Knight, 2000).

AAT as an adjunct social work intervention method

Research and practice-based evidence supports the notion that animalsenrich the lives of non-clinical populations and can be used therapeuticallywith clinical populations. Yet, the potential for AAT as a component ofprophylactic or early intervention approaches within social work practicehas been largely untapped.

The influence of AAT on clients’ transient and permanent psychologicalstates also warrants further investigation. For example, animals have thepotential to provide significant support for young people experiencingnegative effects of developmental issues or life stressors. Many forms ofAAT can also be used in social work practice to increase protectivefactors and boost resilience against many of the risk factors children andyoung people face (Tedeschi et al., 2005).

Several studies have provided provisional support for the idea that AATmay be effective for specific clinical populations of children, such as thosewith an autism disorder (Bass et al., 2009; Prothmann et al., 2009), PDD(Martin and Farnum, 2002) or ADHD (Katcher and Teumer, 2006).While these studies rely on small samples for each diagnostic category,


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some have good inter-rater reliability (Martin and Farnum, 2002; Proth-mann et al., 2009) and all make interesting recommendations regardingthe potential usefulness of AAT. Yet, greater clarity is needed aboutwhich populations, with which issues and under what circumstances AATshould be the treatment of choice (Beck and Katcher, 2003). The socialwork profession has a role to play in adding to the knowledge basearound the efficacy of a range of types of AAT.

In some forms of AAT, animals can also be the vehicle through whichclients project needs (Trotter et al., 2008) and discuss issues that haveimportant parallels in their lives, through, for example, identifying withexperiences or events in an animal’s life. Topics such as grooming, sexuality,birth, sickness and death are all likely to arise from observation and closecontact with animals. Furthermore, animals have negative experiencessimilar to those of humans, such as moving house, owners separating ordying, anxiety and so on. The following vignette, from our social work prac-tice, illustrates how an animal’s experience or life stressor can be used as aform of normalising for a child or young person:

Puff, a small, black toy poodle cross, recently adopted by the social worker,was successfully rehabilitated following a long history of biting that possiblydeveloped in response to uncertain boundaries and feeling afraid. Puff wasintroduced to a young girl called Jaimee, who was told how to approach Puffand why she needed to take care in her interactions with him. On hearingthe story about Puff, a reflective five-year-old Jaimee said, ‘So he has gotthe worries like me’.

Following this interaction, Jaimee shared ways in which she behaved whenaffected by anxiety, which she called ‘the worries’. Jaimee was able to ident-ify with Puff, and this enabled her to share information not previously dis-closed in interventions developed to assist her with her anxiety problem. AsFriesen (2010) explains, ‘it seems to be precisely because children feel lessanxiety when interacting with therapy dogs that they are willing to engagewith peers and adults [and social workers]’ (Friesen, 2010, p. 266).

Studies also indicate that, by helping children to relax, animals may havea positive effect on a range of interventions employed by social workers(Prothmann et al., 2006). Indeed, several large quantitative studies havelent scientific support to the calming effect of AAT (see, e.g. Lange et al.,2006). Reduction in anxiety levels not only facilitates positive outcomesin therapeutic interventions, but can also contribute to children’s learning(Faver and Bradley, 2009; Jalongo, 2005). Other research suggests thathaving animals in the school setting improves students’ attendance andmotivation to engage in activities (Hart, 2006) and that contact withanimals improves communication skills in younger children (Beck andKatcher, 2003; Filiatre et al., 1986). Unfortunately, Filiatre et al. (1986),like many others, use observation as the only data-gathering method witha small sample of young children, which again limits the utility of the


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research. Nevertheless, it seems possible that the involvement of an animalmay reduce stress and enhance children’s capacity to meet environmentaldemands.

AAT and play therapy

Although AAT can potentially have important benefits, such as enhancingengagement, motivation, relaxation and providing support, the possibilitiesand benefits can extend beyond these. For instance, there is potential forsocial work practitioners to consider developing traditional play therapyto include live animals. Children may be more inclined to react to andengage with living animals than inanimate items such as toys (Melsonand Fine, 2006). This is explained by the theory of biophilia, which proposesthat there is a basic human need for association with other creatures.

An American study of seventy hospitalised children compared one formof pet therapy with the more conventional play therapy and found positiveresults for both therapies, but children were happier following sessionsinvolving animals. Not surprisingly, AAT provided children with opportu-nities for skin-to-skin contact and touch often missing in play therapy(Kaminski et al., 2002). While this research elicited encouraging findings,the sampling criteria and method excluded younger and more unwell chil-dren, thus limiting generalisability. Furthermore, procedural issues werelikely to have increased the impact of intervening variables on the findingsand, unfortunately, the use of a three-point analogue scale on the self-report mood instrument restricted variability for analysis (Kaminski et al.,2002).

Of course, not all children’s experiences with animals will have been posi-tive. Some will have developed fears and phobias about animals whileothers may have had traumatic experiences, such as being bitten by a dogor thrown from a horse. When using AAT, social work practitioners needto be aware of such possibilities and equipped to work with children whohave such a history, choosing with care the animals to be involved.

AAT, adaptation and client skill development

Facilitating forums for clients to learn adaptive behaviours or new skills is arelatively common social work endeavour. There are many ways in whichAAT can be a part of social work interventions that are focused on adap-tation and skill acquisition, enabling clients to take advantage of opportu-nities within their environment. For instance, conversations with theanimal can be used as a way for the child to practise self-talk. Furthermore,activities that invite the child to train the animal provide a forum to developand consolidate social skills. Research has also lent tentative support to the


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presumption that benefits gleaned from AAT may be independent of pre-vious involvement with animals or pet ownership (Somervill et al., 2009).

Interestingly, some research has shown that children involved in ananimal-based education programme, designed to study human–animalrelationships, have been able to generalise their learning and demonstratehigher levels of empathy with people (Ascione et al., 2007). First establish-ing a relationship with a dog has enabled many children to begin to relate toothers (Mallon, 1994) and, ultimately, can increase the level of fit betweenthe child and their environment.

Studies of Equine-Assisted Counselling (EAC) have also shown positiveresults whereby participants modified their behaviour in order to workeffectively with the horses. As Trotter et al. (2008) concluded during a com-parative study of 164 students in EAC and classroom programmes, therapyhorses react to both verbal and non-verbal communication with people,thereby enforcing an individual’s awareness of the effect of his or her be-haviour. While the results of this study should be treated with caution,given both the novel and outdoor environment of the EAC programmeand the higher number of hours students spent within it, EAC was foundto be effective in reducing internalising and externalising problem beha-viours, improving adaptive skills and reducing maladaptive skills.

Similar outcomes for clients could potentially be achieved through anAAT that focuses on training different animals, such as alpaca, kunekunepigs or other farm animals. However, the limited research into AAT forthis purpose has focused largely on the use of dogs and, to a lesserextent, horses. Further investigation into potentially suitable animals isrecommended.

AAT and residential social work

Residential social work interventions may also be supported by the pres-ence of animal(s). In an exploratory study of the effect of having dogsliving in the dormitories of a residential treatment facility for childrenwith learning and behavioural difficulties, positive outcomes were foundthat included physical contact, affection, acceptance, companionship andhaving a confidant (Mallon, 1994). Although these findings cannot be gen-eralised to other populations, it is interesting to note that both staffmembers and the children reported these benefits. An example from a resi-dential facility, as told by the housekeeper, highlights a young boy’s connec-tion with a dog called Roxanne and the support the boy gained from hisrelationship with the dog (Mallon, 1994, p. 96):

We have a little boy who never goes on home visits; he can’t because hismother is too troubled. But on those weekends when the other childrengo home and he stays behind, usually he’s really sad, but he kind of


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adopts Roxanne. He sits with her and takes special care of her, almost likeshe is his special person. Even though he usually has to share Roxanne withall the other children during the week, during these weekends, he feels thatshe is here especially for him.

Mallon cautions, however, that, while having a dog in a residential facilitycan be a splendid idea, care needs to be taken to ensure the welfare ofthe children, staff and animal(s) through adequate staff training, flexibilityand sharp policy planning. Also noting the potential for animals to beexploited or harmed, Iannuzzi and Rowan (1991) argue that all such pro-grammes should have well-developed ethical guidelines. They provideexamples of animals that have been harmed either deliberately fromabuse or inadvertently through inadequate monitoring of their needs,such as overfeeding or overworking. With protective measures in place,the opportunity for multiple positive outcomes makes AAT a compellingoption for residential and community-based social work with children andyoung people.

AAT with clients who have harmed animals

Social work practitioners employed across a range of practice settings mayfind themselves working with clients, including children, who have com-mitted acts of violence against animals and/or people. Cruelty to animalsis recognised as a symptom of a conduct disorder diagnosis, as specifiedin the DSM IV-TR, and as a significant risk factor for future serious offend-ing including acts of interpersonal violence (Hensley and Tallichet, 2009).This link has been a focus of research for some time, yet little attentionhas been paid to the methods of cruelty children use, the type of animalthey abuse or the type of interpersonal violence they engage in later inlife (Hensley and Tallichet, 2009; Merz-Perez et al., 2001). We need toengage in further research to understand more fully the trajectory of vio-lence or cruelty towards animals and its relationship to violence towardspeople (Hensley and Tallichet, 2009).

The potential for and ethics of specific forms of AAT as components ofsocial work interventions with at-risk children and young people and therole of non-human co-workers in this work also remain largely unexplored.In one of the few academic papers addressing this topic, Hatch (2007) brieflydiscusses the potential and constraints of employing AAT using the case of ayoung person who was ten years old when he killed a dog. While recom-mending caution when using AAT with young people with a history ofcruelty or violence towards animals as well as the presence of a suitablytrained professional, Hatch does not necessarily discount this type oftherapy. He argues that the intervention goal of reducing further harm topeople and animals is admirable and potentially achievable, but vigilanceis required to ensure the safety of animals involved in this kind of work.


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If we acknowledge that cruelty to animals is a risk factor for serious inter-personal violence and that AAT enables people to develop attachment andempathy, to learn skills that enable them to treat animals respectfully and togeneralise these abilities and skills to other settings (and species), we shouldbe engaging in rigorous debate about the potential for specialised AAT pro-grammes for social work practitioners when working with this population.

The development of specific tools to assess the use of or potential forhuman violence towards animals is in its infancy. Pagani et al. (2010)suggest that abuse of animals by children or young people is often hiddenfrom and/or minimised by parents and care-givers, making child andyouth self-report measures the preferred research instrument. Yet, the sen-sitivity required to elicit accurate self-disclosure from children and youngpeople about sensitive topics, such as sexual violence towards animals,killing family pets and so on, in an ethical manner means that the creationof such tools is no small feat. However, what we can be sure of is that, inaddition to those with a known history of cruelty towards animals, anumber of other social work clients will have undisclosed histories ofcruelty towards animals. And, because of this, adequate staffing levelsand supervision must be in place for AAT, regardless of the known history.

AAT and reciprocal transactions

It is generally assumed that animals involved in AAT interventions willhave been screened and completed training to ensure that they are suitablecandidates for this work. Nevertheless, animals that are in the process of‘rehabilitation’ or those in training for animal AAT work can potentiallybe part of mutually beneficial transactions. Many AAT guidelines empha-sise the importance of animal selection and training in order to minimiserisks to humans, putting the responsibility for safety on the animals andtheir handlers (Chandler, 2005). We argue, too, that, along with the socialwork practitioner, the client is a part of a reciprocal, ecological processand that they also have a responsibility to behave in ways that promotethe safety of all involved. Consistent with an ecological understanding ofdevelopment and change, research has shown that such behavioural expec-tations can be beneficial not only to the animals, but also to the human par-ticipants, as the following vignette about a toy poodle cross, referred to inan earlier example from our social work practice, illustrates:

Puff was being rehabilitated following a long history of unpredictable inter-actions with humans that left him both anxious and fearful. These would mani-fest in aggression in the form of biting small children and adults, especiallymen. When Puff’s new owner was facilitating a therapy group for youngpeople who had committed serious crimes Puff went along. The group weretold about Puff’s history and the need for them to manage themselves appro-priately so as not to upset or scare him. At one stage in the programme, John, a


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youth attending the session, struggling to contain his emotions, got up, kicked achair aside and yelled obscenities. At this point, one of the other participantsstood up and said, ‘Shut up, John, you . . . idiot, you are scaring the little dog.’John looked at the dog, stopped his outburst and sat down.

This vignette highlights how, for the well-being of the animal, participantswere expected and able to modify their behaviour, utilise skills they hadbeen learning and remain calm. Along with John, Puff also had an oppor-tunity to be exposed to a situation that had previously elicited a negativeresponse from him, but the clear boundaries and lack of negativeoutcome mitigated his previous response pattern and provided an opportu-nity for adaptation. This, then, is an example of a positive outcome ofco-therapy with a dog that is ‘in training’.

Similarly, Fredrickson-MacNamara and Butler (2006) suggest that someanimals unsuited, for example, to participate in hospital-based training pro-grammes may in fact be successful in a mental health programme for ado-lescents who also benefit from their involvement in training the dogs. Theauthors note that ‘depending on the age and diagnosis of the youth, theexperience of teaching impulsive, hyperactive, adolescent dogs mayprovide a perfect metaphor for their own emotional challenges’ (Fredrickson-MacNamara and Butler, 2006, p. 126).

Animal rehabilitation and training programmes have been establishedin a number of American psychiatric and correctional prison facilities(Strimple, 2003). In working with and training unwanted dogs and horses,the inmates save the animals from being euthanised and train them forfuture work as companions for people with special needs. In the process,the inmates give back to the community and receive ‘vocational trainingand psychological rehabilitation’ (Strimple, 2003, p. 77).

Studies of mobility-dog-training programmes involving prison inmateshave demonstrated significant changes in inmate behaviour as a result ofparticipation in these programmes (Britton and Button, 2006; Ormerod,2008). In New Zealand, the Puppies in Prisons programme has providedsimilar benefits to the inmate trainers, who were reported as incident anddrug-free during the time they were involved with the puppies (NZHerald, 2009), again increasing the level of fit between the individual andtheir social and cultural environment.

Such programmes are compatible with an ecological perspective and,while they have the potential to be implemented in correctional facilitiesfor young people, they also require adequate funding, appropriate facilitiesand suitably qualified staff in order to succeed.

AAT practice issues and social work curricula

Social work practitioners employ a range of models in their work with people.Some are now including AAT in their repertoire (Risley-Curtiss et al.,


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2006a). Indeed, a recent study of social workers in the USA found thatapproximately one-third of the workers included questions about companionand other animals in their intake assessments and just under 25 per cent werecurrently using companion and other animals in their practice. Yet, mostpractitioners had no specific training in AAT, had not received instructionin the areas of animal cruelty or abuse nor had AAT been included withinthe coursework for their social work qualification (Risley-Curtiss, 2010).

Clearly, there is negligible focus on human–animal relationships withinprofessional social work curricula and research (Risley-Curtiss et al.,2006a). In a radical challenge to the curriculum, Wolf (2000) suggeststhat social work education providers are supporting a ‘speciesist’ approachto diversity. He acknowledges that incorporating animal welfare issues andguidelines for both AAT and AAA into social work education curricula andcodes of ethics would require a considerable effort and could evoke resist-ance. Wolf’s ideas, we contend, should give us food for thought.

Working with diversity

A key area of professional development for social work practitionersemploying AAT, and an integral part of animal welfare, is an appreciationof animal culture (Pichot and Coulter, 2007). Yet, little work has been doneon the impact of culture and ethnicity on the nature of the human–animalrelationship (Risley-Curtiss et al., 2006a, 2006b; Risley-Curtiss, 2010) or anyimplications this has for culturally relevant assessment processes, choice ofanimals and appropriateness in AAT-informed cross-cultural cross-speciessocial work practice.

The social work profession values difference and expects graduates to becompetent to work across diverse ‘human’ populations. As in any cross-cultural interaction, therefore, it is important for workers using AAT notto allow their own cultural values and beliefs (i.e. human culture) to influ-ence their interpretations of situations but to attempt to understand com-munication from the animal’s perspective. Taking the time to understandwhy an animal responds in a certain way and what motivates them to doso is paramount to ensuring the animal’s well-being and the safety ofthose around them. When discussing the responsibility of the workertowards animals involved in AAT, Hatch (2007) suggests that ‘Becausewe lack a shared language, assessing an animal’s true feelings can pose a dif-ficult, but not impossible, task’ (Hatch, 2007, p. 40).

Adherence to practice standards

While there is a growing consensus in the literature that basic standardsconcerning animal welfare should be met, there is less certainty regarding


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the standards themselves; and, of course, adherence is often voluntary.Further complicating the issue for some practitioners is the debate sur-rounding animal rights and animal welfare. At one extreme is the argumentagainst the use of any animal for human gain. For others, however, animalwelfare means a focus on ‘basic welfare considerations’ (Serpell et al., 2006).As Hatch (2007) argues, irrespective of one’s position along the continuum,‘at the very least it seems reasonable to expect that those involved in . . .

[AAT] programs should be (or would want to be) concerned aboutanimal welfare and the humane treatment of therapy animals’ (Hatch,2007, p. 39).

The Delta Society’s (1996) handbook provides advice for prac-titioners on animal selection and welfare. The handbook highlightsanimal health needs and includes information about how to determineanimal suitability for involvement in programmes. This comprehensivework does, however, have an administrative rather than animalwelfare focus and it is important for practitioners to recognise this asa starting point only and to give full consideration to the physical,mental and emotional consequences of programmes for the animalsthey engage in these activities. Unfortunately, the Delta Society’s hand-book has not been updated since 1996 and, as such, has not beeninformed by recent research and debate. For instance, there isgrowing support for the need for workers to take responsibility for pro-moting the well-being of animals participating in such programmes(Serpell et al., 2006; Zamir, 2006).

Ethical issues

From an ecological perspective, not all components of an environment haveequal power and status. Zamir (2006) argues that dogs, cats and horses gaincertain (not necessarily equal) advantages from their relationships withpeople—they often live longer and have a better quality of life—butother species, such rodents, snakes, birds, dolphins or monkeys, havemuch to lose. While it is only recently that the effect of AAT on animalshas been considered, this previous lack of focus is unlikely to representany intent to deliberately exploit or place animals at risk. Indeed, AATare often initiated by people with a genuine love for animals and a desireto share the benefits of these relationships. As Serpell et al. (2006) note,the general sentiment is ‘that these are good activities for animals to beengaged in’ (Serpell et al., 2006, p. 454).

We do not pretend that the animals and humans involved in AATshare the same privileges or power. However, the term ‘co-worker’ isused here in a deliberate attempt to acknowledge the temperament,skill and work that animals contribute to all parts of the social workprocess in AAT.


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Social worker and animal co-worker care

Social work practitioners will be aware of the negative impacts they canexperience in carrying out their professional work; some will experience‘burnout’ and, over the course of their careers, most will have developeda range of self-care strategies to mitigate these effects. Long-term exposureto stress can also have a detrimental effect on an animal ‘co-worker’in much the same way as it can on the social worker (Haubenhofer, 2009;Haubenhofer and Kirchengast, 2006; Heimlich, 2001).

While a significant component of a successful programme is the suit-ability of the animal for the role, equally vital components are the abilityof the worker to recognise the impact of the sometimes unfamiliar physicalenvironment on the animal, including stress responses, and their own will-ingness to remove the animal when necessary (Fredrickson-MacNamaraand Butler, 2006; Hatch, 2007; Haubenhofer, 2009). Recently, Gehrkeet al. (2011) took electrocardiographic recordings of horses to establishbaseline heart rate values when the animals were not engaged in AATactivities. Further research of this kind can be used to complement directobservations of animal behaviour and assist workers to care for andmonitor animals involved in AAT.

Social workers using AAT, therefore, have an ethical responsibility toaddress risks and provide animals with adequate opportunities for restand recovery. The idea that social workers can structure ecologicallyinformed AAT programmes to provide benefits to all involved is exciting,but the reality is likely to require considerable thought and perhaps achange in perspective.

Conclusion

Social work practitioners using a range of AAT programmes, as we havenoted, are producing some excellent results with clients. The purpose ofthis article is to ensure practitioners are well informed about the potentialfor AAT and to highlight issues that we believe may not have beenaddressed adequately elsewhere. It is critical for social work practitionersto fully evaluate the effects of interventions they deliver and to familiarisethemselves with the potential hazards AAT can present to all involved.

While much of the existing research into the efficacy of all forms of AAIand particularly AAT has been limited by sampling or design constraints, orconceptual confusion, studies have demonstrated notable benefits of AATfor clients. There is an urgent need for a body of knowledge, specific to thesocial work profession, to guide and inform best-practice approaches toAAT. We have argued that social work practitioners have a responsibilityto contribute to the development of the existing ethical guidelines for


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AAT, extend the AAT research base and use social work theoretical per-spectives to advance the development of this practice area in ways thatdo not ignore the needs of the animals themselves.

Acknowledgements

The authors gratefully acknowledge the valuable contributions of ElizabethRathgen, Jim Anglem and Andrew Frost.

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