Embed Size (px)
Citation preview
Turning Point Training Institute and Dublin
City UniversitySchool of Nursing and Human Sciences.
UNDERSTANDING THE VALUE OF DOG FACILITATED PSYCHOTHERAPY, WHAT THEORY EMERGES?
Annemarie Una Harmon O’Brien
Ms. Felicity KennedyDr. Carol Barron
2016
Dissertation submitted in partial fulfilment for the degree of MSc Integrative Counselling and Psychotherapy.
DISCLAIMER
I hereby certify that this material, which I submit for assessment on the programme of study
leading to the award of MSc in Integrative Counselling and Psychotherapy, is entirely my
own work and has not been taken from the work of others save and to the extent that such
work has been cited and acknowledged within the text of my work.
Signature:_______________________________
Student number: 11120444
Date: 29 th August 2016
ABSTRACT.
Title: Understanding the value of dog facilitated psychotherapy, what theory emerges?
Submitted by: Annemarie Una Harmon O’Brien
Animal Assisted Therapy is a field that is growing substantially with animals purported to
be a panacea from everything from autism to prisoner reform. In many countries they are
incorporated into psychotherapy process. The researcher wanted to explore if this is a valid
form of practice, the mechanisms behind it and ultimately to seek if it could be empirically
validated from each aspect of the therapy triangle of therapist, client and dog.
The preliminary process of conducting interviews with eight experienced psychotherapists
who practice with their dog, analysing the data via Grounded Theory and triangulating with
the literature as data inferred, that from the point of view of the therapists it was
efficacious. A detailed look at critiques and interdisciplinary literature contradicted
participants, showing that it could not/possibly never can be, empirically validated. Thus,
any emergent theory is merely conjecture and it raises more ethical questions than
therapeutic benefit.
Contrary to expectation and the results of other studies, this study presents the argument
that animal assisted therapy in psychotherapy presents more challenges than therapeutic
agency. This is significant in that it contradicts the status quo and challenges the practice
on grounds of lack of efficacy and ethical questionability.
LIST OF ACCRONYMS AND TERMS.
PFP Pet facilitated psychotherapy.
PFT Pet facilitated therapy.
AAT Animal assisted therapy.
AAI Animal assisted interventions.
AAA Animal assisted activities.
DFP Dog facilitated psychotherapy.
DAT Dolphin assisted therapy
GT/GTM Grounded Theory/Grounded Theory Method
IACP Irish Association for Counselling and Psychotherapy.
IAHIP Irish Association of Humanistic and Integrative
Psychotherapy.
ESAAT European Society of Animal Assisted Therapy
ISAAT International Society of Animal Assisted Therapy
Object Relations The development of self and psyche in relation to others
Self Psychology A persons view and beliefs about the world and objects in
it, in relation to the self
Projective Identification
The psychic forcing of unconscious feelings and fantasies
into another.
Role Suction An unconscious process in groups whereby one individual
is selected to have a role assigned to them in order to meet
the needs of the group.
Transference The unconscious displacement of feelings and memories
that belong to past experiences onto a present situation or
person.
Transference displacement
The unconscious transference of feelings and memories
that are felt towards one being are displaced and expressed
towards another being.
Projection Denial of traits in self and instead projecting them onto
another.
Attachment A bond and emotional connection to another being.
Transitional object An object of comfort that soothes and reassures.
ACKNOWLEDGEMENTS
I would firstly like to thank my supervisor Felicity Kennedy, Dr. Anne O’Connor, Frances
Walsh, Arlene, Geraldine, Kay, Mary Paula, Sandy, Olive, Elisabeth, Mary, Gearoid and all
of the faculty/peers who I have worked with along my Turning Point journey.
Thank you to Dr. Carol Barron of DCU.
Thank you to all the participants and their canine companions who shared their stories and
time generously.
Thank you to my family and friends.
I thank my beloved companions who inspired this research project- Ally, Black Beauty,
Claudia, Freddy, Grace, Neo, Charlie, Jasper, Mia, Milo, Isabella, Kasper, Juliet, Una,
Stella and Buffy. Goldie, Dannan, Benson, Mike, Noah, Scooby, Cedar, Seymour, George,
Polly and Topsy you are always present in spirit.
“When a human being dies, there is a bridge they must cross to enter into Heaven. At the
head of the bridge waits every animal that human encountered during their lifetime. The
animals, based on how that person treated them, decide which humans may cross the
bridge… and which are turned away." - An Indian legend
TABLE OF CONTENTS
DISCLAIMER.....................................................................................iiABSTRACT........................................................................................iiiLIST OF ACCRONYMS AND TERMS..........................................ivACKNOWLEDGEMENTS...............................................................viQUOTATION.....................................................................................xi
1. INTRODUCTION..................................................................1
1.1 Introduction. ...................................................................................1
1.2 Background to research problem....................................................2
1.3 Importance of the study...................................................................2
1.4 Purpose statement & research questions.........................................3
1.5 Design & context. ...........................................................................3
1.6 Significance. ...................................................................................4
1.7 Conceptual framework. ..................................................................4
1.8 Thesis overview. ............................................................................4
1.9 Conclusion. .....................................................................................5
2. LITERATURE REVIEW......................................................6
2.1 Introduction. ...................................................................................6
2.2 Literature in GT...............................................................................6
2.2.1 Researcher’s stance on literature..........................................6
2.2.2 Justification..........................................................................7
2.3 Introduction to AAT literature........................................................9
2.3.1 Historical context of AAT..................................................10
2.3.2 Major texts in AAT............................................................10
2.3.3 Theory in literature.............................................................11
2.3.4 Critical literature.................................................................11
2.4 Psychotherapy theory & AAT.......................................................12
2.4.1 Psychotherapy theory & esoteric phenomena....................13
2.5 AAT studies relating to psychotherapy practice...........................14
2.6 Ethical issues in the literature.......................................................15
2.7 Canine intelligence & theory of mind...........................................16
2.8 Conclusion ....................................................................................18
3. METHODOLOGY...............................................................19
3.1 Introduction...................................................................................20
3.2 State of the field............................................................................20
3.3 Justification of research & methodology used..............................20
3.3.1 Gaps in the knowledge & criticisms of field......................18
3.3.2 Justification of choice of GT method.................................24
3.3.2 Justification of triangulation & falsification......................25
3.3.2 Justification of abduction...................................................26
3.4 Research procedures......................................................................27
3.4.1 Recruitment of participants & sampling............................28
3.4.2 Confidentiality....................................................................29
3.4.3 Data collection....................................................................30
3.4.4 Interview information.........................................................30
3.4.5 Secondary data collection...................................................31
3.5 Analysis ...................................................................................31
3.5.1 Transcription......................................................................31
3.5.2 Coding................................................................................31
3.5.3 Initial coding......................................................................32
3.5.4 Focused coding...................................................................32
3.5.5 Theoretical coding..............................................................32
3.5.6 Constant comparison..........................................................32
3.5.7 Memoing............................................................................33
3.6 Limitations of the method.............................................................33
3.7 Reflexivity ...................................................................................34
3.8 Conclusion....................................................................................34
4. RESULTS.............................................................................35
4.1 Introduction...................................................................................35
4.2 Participant profile..........................................................................35
4.3 Theoretical codes..........................................................................36
4.4 Theoretical code 1 – Enhances therapeutic relationship...............36
4.5 Core conditions.............................................................................38
4.6 Theoretical code 2 – Facilitates therapeutic insight......................41
4.7 Theoretical code 3 – Generates relaxation & calm.......................45
4.8 Conclusion ....................................................................................47
5. DISCUSSION.......................................................................48
5.1 Introduction...................................................................................48
5.1.1 AAP Therapy triangle – Group & systems theory.............49
5.1.2 Clinical cases in literature..................................................52
5.1.3 Transference phenomena....................................................53
5.1.4 Psychotherapy studies........................................................55
5.1.5 Esoteric phenomena...........................................................58
5.1.6 Critics of AAT....................................................................59
5.1.7 Question of empirically validated efficacy........................63
5.2 Clients perspective........................................................................64
5.2.1 Introduction........................................................................64
5.2.2 What kind of client could benefit from AAP?...................64
5.2.3 Contraindications & consent..............................................65
5.2.4 Studies relating to clients...................................................66
5.2.5 Freud – How not to practice DFP.......................................69
5.2.6 Background........................................................................69
5.2.7 Freud’s analysands perspectives........................................71
5.2.8 Conclusion..........................................................................75
5.3 Dog’s perspective..........................................................................75
5.3.1 Introduction........................................................................75
5.3.2 Sentience, cognition & theory of mind..............................77
5.3.3 Canine cognition – “Dognition” (Hare 2013)....................80
5.3.4 Emotional contagion & affect disturbance in dogs............83
5.3.5 Dogs & the relaxation response..........................................85
5.3.6 Questioning ethics & disturbing literature.........................86
5.3.7 Summation.........................................................................92
5.3.8 Conclusion..........................................................................95
6. CONCLUSION.....................................................................99
6.1 Introduction...................................................................................99
6.1.1 Reflexive statement............................................................99
6.2 Achievement of studies aims & objectives.................................100
6.3 Evaluation of the GT...................................................................101
6.3.1 Credibility.........................................................................102
6.3.2 Originality........................................................................102
6.3.3 Resonance.........................................................................102
6.3.4 Usefulness........................................................................103
6.4 Implications for psychotherapy practice.....................................103
6.5 Limitations of this study..............................................................104
6.6 Recommendations for further research.......................................104
6.7 Conclusion ..................................................................................105
BIBLIOGRAPHY ............................................................107
APPENDIXES ..................................................................134
LIST OF APPENDIXES
APPENDIX A - Ethics Approval..........................................1
APPENDIX B - Psychotherapists Grounded Theory.........2
APPENDIX C - Schedule of interview questions................3
APPENDIX D - Plain Language Statement.........................4
APPENDIX E - Informed Consent Form............................7
APPENDIX F - Information sheet on Interview Structure10
APPENDIX G - Closing the interview and debriefing.....11
APPENDIX H - Concluding Information Sheet ...............12
APPENDIX I - Sample of transcription and coding.......13
i
“Because the soul of the dog is love, the dog can love other animals, itself, and us, with
a completeness, a purity and an intensity, that we can admire, and perhaps even learn to
emulate. Dogs as gurus? As purveyors of wisdom, the wisdom of love? We have done
worse. And, after all, no dog will ever lie to us about love.” (Masson 1997 p1920)
ii
Chapter One – Introduction
1.1 Introduction
This is a thesis that explores the subject of Animal Assisted Therapy/Psychotherapy
(here to after referred to as AAT and AAP) in the context of psychotherapy. It explores
the literature, the experience of a specific group of Psychotherapists and their canine co-
therapists.
This thesis has one over arching aim, which is to understand if AAT is valuable in the
context of private psychotherapy practice to all concerned and to attempt to answer the
question posed by Marino (2012) – “how important is the animal in AAT?”
It aims to generate theory regarding the question is AAT of value in the context of
psychotherapy. How is it perceived / experienced by psychotherapists’ who practice
within this framework with their dogs and to seriously question if the theory applies to
the whole of the AAT system of three – the triangle – the psychotherapist, the client and
the dog.
The purpose of therapy is to serve the client as they are assisted in research of the “self”,
consequentially this implies that any perceived/experienced value has a need to be
challenged and questioned.
Adding an animal into the psychotherapy environment is controversial.
This thesis aims to explore the subject of AAP from the perspective of the research
questions and generate theory regarding value and efficacy.
1
1.2 Background to research problem
The researcher acknowledges that there is an abundance of general literature pertaining
to the human-animal bond and the common field of AAT/Animal Assisted Activity
(here to after referred to as AAA), relating to multiple fields of human health. However,
according to critics, the majority of this literature is not based upon empirically sound
evidence. Some critics go so far as to question if it is possible that it can be empirically
validated.
The amount of literature and studies relating specifically to psychotherapy is limited and
there is little that actually describes and accounts for the underlying mechanisms at
work. It lacks theory.
AAT is approximately thirty years young, therefore still in its infancy. At present, the
field lacks empirical validation.
1.3 Importance of the study
This research area is significant because there is a lack of theory and a deficiency of
evidence to support efficacy. The growing interest in AAT and the modality of working
therapeutically with animals leads the researcher to believe that it is imperative to
explore all facets of evidence and make a small contribution to psychotherapists,
offering profession specific research. The study aims to allow psychotherapists to make
more conversant assessments regarding the mechanisms and efficacy of AAT in
psychotherapy.
2
1.4 Purpose statement and research questions
This research study will first explore the value of AAP, from the perspective of
psychotherapists to see if there is an emergent theory that can be justified as being
efficacious and of value to all.
It is guided by the research questions –
Is AAT of value in the context of psychotherapy?
Does the incorporation of a psychotherapist’s dog change the dynamics and
mechanisms of the therapy, if so, how and is it of value?
What is experienced & perceived as happening – Is this of value to the
therapeutic process?
Are these values efficacious and of benefit to all concerned in the therapeutic
triangle of Psychotherapist, Client and Dog i.e. is it ethical?
1.5 Design and context
The research was conducted with experienced psychotherapists who had long term
experience working in private practice with their pet dogs. These therapists lived and
worked in the UK. The research method used was that of constructivist Grounded
Theory Method (here to after referred to as GT/GTM) and used semi structured, in-
depth interviews that were then analysed and coded for concepts.
These interviews took place via Skype, whereby the researcher and the participant
spoke via this computer programme from their respective offices. The researcher then
explored a wide range of relevant literature in relation to the concepts, gaps in the
literature and questions that arose from all the data generated.
3
1.6 Significance
This research proposes to address some of the gaps identified in the literature, namely
lack of theory. The question of whether or not addition of an animal is an important
component for therapeutic change to occur, the absence of the client’s perspective/voice
and little consideration of the animal’s perspective are considered, in order to present
balanced information from all perspectives.
1.7 Conceptual framework
As there is no unified theoretical framework that exists to validate AAT/AAP, merely a
collection of unproven hypotheses, consequentially, the purpose of the researcher’s
study zeros in on the how, why, where, when and what of value/efficacy in the context
of AAT in Psychotherapy from multiple perspectives essentially asking – “is it a good
idea to add a dog to the psychotherapy dynamic?” and presents an emergent theory.
1.8 Thesis overview
This chapter has introduced and defined the research and in chapter two the use of
literature in GT is discussed and the literature relevant to this study is outlined. In
chapter three the methodology used in this study is explored and in chapter four the
results of the study are presented. Chapter five discusses key findings from the literature
and interviews from all perspectives i.e. therapist, client and dog and presents the
emergent GT. Finally, in chapter six the thesis concludes with evaluation of the theory,
reflexive statement from the researcher, limitations and recommendations.
4
1.9 Conclusion
This concludes chapter one and in the next chapter the relevant literature that related to
this study with be reviewed.
5
Chapter Two – Literature Review
2.1 Introduction
In this chapter the relevant literature used will be outlined and presented. The researcher
takes what Dunne (2008) describes as a respectful yet critical approach to literature1.
She has also used the literature to compensate for lack of theory, as a guide to
investigate the research subject via the lens, of what critics in the field, state is missing
from the evidence base, as a tool for constant comparison, triangulation, abduction and
to compliment theory generation. The researcher has heeded observations and
arguments made by under cited critics. A comprehensive rationale for this is presented.
2.2 Literature in GT
Pure inductive GT argues that one must assume the position of tabula rasa, approach the
research subject with no preconceived ideas. One must proceed and accumulate data
free of previous theoretical ideas and assumptions. One must avoid the literature to
escape contamination and to guard against forcing concepts2.
More recently a pragmatic argument supporting an informed approach to GT has
emerged, which also proposes what Thornberg (2012) terms the “abductive turn”.
2.2.1 The researcher’s stance on literature - “Results part one”
The researcher’s perspective on literature comes from a position of pragmatism.
Therefore the researcher has used literature both liberally and eclectically, as a tool of
1 Dunne (2008) states “in grounded theory the theoretical literature review is fundamentally informed by the data analysis and research findings” (p 72). 2 The constructivist approach is more liberal and Charmaz (2006) accepts that it is pragmatically necessary, also acknowledging that analysis with existing literature refines the consequences of analysis.
6
construction, abduction and information. If the results from the psychotherapists were
taken at face value there would be no empirical evidence to support their theory3.
Factors to consider were the number of gaps in the knowledge base, claims of
illegitimacy in previous findings and the number of methodological weaknesses
purported to be inherent in many existing studies. Owing to time constraints and lack of
ethical permission, the researcher did not have the luxury of returning to the field as
Charmaz (2006) would advise4.
She turned to the literature and used it to inform and guide the GT construction in
conjunction to using the interview data, constantly comparing, confirming,
disconfirming and triangulating.
2.2.2 Justification
The researcher’s use of literature is heavily influenced by the arguments and concepts
presented by Thornberg (2014) and Timmermans & Tavory (2007, 2012).
Agreeing with their argument for use of abductive reasoning, Thornberg (2012) uses
Kelle’s (1995) proposition stating that the use of abductive inference is related to the
researchers “previous knowledge, rejection of dogmatic beliefs and development of
open mindedness”(Ibid, p248). 3 The researcher has read extensive subject matter in the past twenty years plus, on psychotherapy and animal biology/psychology/ethology etc. As a result she was theoretically sensitive to some of the data. The literature had to be reviewed prior to conducting a research proposal and submission to the ethical review committee, therefore the researcher began to read generally on the therapeutic properties appropriated to animals and AAT in the literature.4 “Grounded theory begins with inductive analysis of data but moves beyond induction to create an imaginative interpretation of studied life. We adopt abductive logic when we engage in imaginative thinking about intriguing findings and then return to the field to check our conjectures” (Charmaz 2006, p137-138).
7
Thornberg (2012) presents a collection of Grounded Theorist’s arguments via six
reasons not to delay literature review which were duly noted by the researcher5.
The researcher further acknowledges the position of Timmermans & Tavory (2012)
whereby they state that “abduction should be understood as a continuous process of
conjecturing about the world that is shaped by the solutions the researcher has “ready-
to-hand” (Heidegger [1927] 1996)” (Ibid, p 172) and they continue proposing what they
suggest as the substitution of a “truth instinct” (Ibid, p172) whereby abduction can be
used to simultaneously deepen knowledge and construct theory6.
The researcher argues that due to the substantial lack of empirical evidence to support
the efficacy of AAT/AAP and the numerous gaps in the knowledge base, that it would
be negligent not to incorporate the extant literature and use it to inform theory
generation in conjunction with the primary interview data. This is advocated by
Timmermans & Tavory (2007, 2012).7
5 1)Admission of theoretical understandings is both responsible and transparent (Bruce 2007), you cannot unlearn what you already know (Schreiber 2001) and Clarke’s (2005) concept of pretending to be a “theoretical virgin” could be construed as forcing. 2) Delaying literature review could be taken as lazy ignorance (Silverman 2000, Suddaby 2006). 3)The avoidance of backing the researcher into a corner via reduction (Thornberg 2012). 4) Pragmatics of proposals and review committee requirements (Dunne 2011, Bruce 2007). 5) Ignoring theory or previous research findings will result in a loss of knowledge and prevent one from repeating previous mistakes. Dunne (2011) points to how it will cultivate awareness of methodological weakness and stimulate theoretical sensitivity. The use of literature will enrich analysis (Thornberg 2012). 6) It underestimates the researcher’s ability to both reflect upon (Dunne 2011) and be informed about theory and concepts without imposing on data (Urquhart 2007). 6 They state that this will “allow us to gain insights from the literature on positionality, wherein much is made of the fact that the researcher is part of the world of the people studied. This being-in-the-world, however, is far from being a guarantor for truth but is a core issue to be grappled with, inevitably leading to partial, historically situated insights, and provoking questions of scientific authority and representation (Harper & Atkinson 1991; Marcus & Fischer 1986)” (Ibid, p 172). 7 “The corroboration of the theory, as well as a process of “internal falsification”, in which new data points refine an emerging argument (Timmermans & Tavory 2007), occurs through narrowing the class of empirical phenomena to which the new theory applies and reshaping the theoretical scope to make it better suited for the cluster of empirical phenomena we theoretically “lump” together (Katz 2001). The result will be a new theory, emerging in abductive analysis through the iterative dialogue (both metaphorical and literal) between data and an amalgam of existing and new conceptualisations” (Timmermans & Tavory 2012, p180).
8
The researcher replicated the process of “weeding out” (Ibid p180) during inductive
code generation is replicated via constant comparison with the literature in order to
provide the external validity/credibility critics of AAT state is missing. It is also an
attempt to unify all perspectives as they state that -“often more than one casing is in
mind at a given time” (Ibid, p180) as it was from the researcher’s perspective in relation
to this study.
The theory from the perspective of psychotherapists interviewed was informed by the
available empirical literature from the perspective of clients and dogs. They are
amalgamated to form the final GT.
2.3 Introduction to AAT Literature
At first glance it appears that there is a wealth of literature relating to the field of AAT.
What is sorely lacking is material grounded in empiricism. The researcher found it
difficult to find literature that specifically related to this study owing to the fact that
there is a scarcity of psychotherapeutic AAT studies from which to correlate8, therefore
the researcher read widely9.
8 This presented a problem and created a lot of frustration for the researcher, as on close examination no literature could corroborate the perspective of the psychotherapist and the grounded theory that would emerge from their data alone, although many texts were presented as such. 9 Rather than thread the beaten path of regurgitating all of the studies ill regarded by critics of AAT, the researcher sought new lines of inquiry (Gall, Borg & Gall 1996). This entailed reading literature pertaining to psychotherapeutic theory alongside the limited amounts of studies relative to AAT and Psychotherapy and then casting the net further into disciplines of ethology, neuroscience and ethics. This was guided by the major gaps and discrepancies in knowledge discussed in detail in the next Chapter.
9
2.3.1 Historical context of AAT
Levinson was the first psychotherapist documented that worked with his pet dog Jingles
(Levinson 1962, 1997). He identified that the presence of his dog allowed previously
reticent children to communicate more freely and that Jingles offered an opportunity for
identification and projection.
The popular belief that Freud was a proponent of AAT is not true (mentioned in Beck &
Katcher 1996). Via scrutiny of the many biographies and historical accounts of family,
friends and analysands it seems Freud’s dogs were neither therapeutic nor well behaved
for anyone other than himself, despite the fact that proponents of AAT state the contrary
(Genosko 1998; Freud A 1981; Freud M 1958; Freud Museum 1998; Gay 1988;
Dufrense 2006; Roazen 1976; Dolittle 1974, 2012; Grinker 1940, 1979; Jones 1990;
Blanton 1971; Coren 2003; Morley 2007; Molnar 1992; Edmundson 2010). After close
reading of many of these texts the researcher was left with many ethical questions in the
context of evidence based ethical good practice.
2.3.2 Major texts in AAT.
The major texts on AAT are textbooks rather that articles (Borrego 2014). Books cited
extensively are those of Levinson (1997), Wilson & Turner (1997), Fine (2010),
Chandler (2012) and Parish-Plass (2013). The researcher found many of these texts
lacking theory and depth. Chandler (2012) devotes an entire chapter on breed
specificity/traits, another on behavioural training and presents opinion as fact.
The exception to psychotherapy specific literature is Parish-Plass (2013). This text
presents extensive detail on underlying psychodynamic processes at work within the
10
AAP system and was very useful when examining and analysing phenomenon that
arose from the interviews conducted. This superior text is not well cited10 and far
exceeds those of Fine (2010), Chandler (2005, 2012) and Wilson & Turner (1997).
However, none of these textbooks handle the issue of ethics satisfactorily. Parish-Plass
(2013) attempts to address ethical issues citing Singer (1975) and Maslow (1954)
however the arguments made fail miserably.
2.3.3 Theory in literature.
While searching for and exploring the literature in the quest for a theory the researcher
found that there was none, besides Wilson’s (1984) hypothesis which essentially states
that humans are biologically attracted to nature, life and living creatures. There is no
theory as to how AAT operates in the psychotherapy context, nor any other explanation
extant in other fields. There is however an abundance of empirical evidence asserting
that it cannot ever be theoretically defined as there is no evidence to support its use
(Stern & Chur-Hansen 2013). After conducting a search for relevant literature the
researcher concluded that Stern & Chur-Hansen’s (Ibid) considerations around rigor in
this field must be heeded.
2.3.4 Critical literature.
One of the most notable papers presenting a critique of AAT and what passes for
evidence was the paper by Marino (2012)11 who had previously conducted a critique of
Dolphin Assisted Therapy (here to after referred to as DAT) (Lilienfield & Marino
1998, 2007)12.
10 On Google Scholar Chandler (2012) is cited 233 times in contrast to a paltry 9 citations for Parish-Plass (2013). Fine (2010) has 589 citations listed. 11 Cited by a mere 44 other authors. 12 These papers are essential reading as they detail numerous issues relating to construct validity, risks to clients and ethics. In relation to psychotherapy the most prevalent issue to note is that of construct
11
Chur-Hansen et al (2014, 2010) and Stern & Chur-Hansen (2013) have similar
criticisms in their work outlining issues stating many studies do not include a control
group and are limited in size. Borrego (2014) also outlined deficiencies in the field and
anomalies and confusion surrounding terminology also echoed by Parish-Plass (2014).
Essentially Herzog’s (2011) assertion that anecdotal evidence is predominantly
presented as fact is entirely founded.
Meta analysis conducted by Souter & Miller (2007) and Nimer & Lundahl (2007) was
explored in detail revealing deficiencies in sample size and poor quality of research
studies. They echoed Marino’s (2012) findings that methodological weaknesses were
prevalent, thus leading the researcher to perceive this as an empirically impoverished
field.
2.4 Psychotherapy theory and AAT.
The writing of Parish-Plass (2008, 2013, 2015), Sacks (2008) and Glucksman (2005)
provided the researcher with a depth of resources with which to relate her results. They
guided her towards psychoanalytic papers and group/systemic theories that helped her
understand and process the underlying mechanisms at work in the data of the therapists
studied. Their literature was pivotal in grasping the depth and complexity of concepts to
be grappled with. Particular attention was paid to Parish-Plass (2013) presentation of the
concept of AAP triangle and objects relation concepts outlined by both Sacks (2008)
and Glucksman (2005).
confounding.
12
The main theory that could be empirically validated that arose from this study and is
relevant to AAT is that of group & systems theories in psychotherapeutic literature as
presented by Bion (1952), Yalom (2008), Kernberg (1998), Lichtenberg (1988), Wolf &
Schwartz (1962) and Redl (1942). Jourard (1958) and Gelso’s (2011) theories on
relationship were also explored and related as was Cozolino & Santos (2014) work on
psychotherapy and the mirror neuron system.
The self psychology of Kohut (1977) and objects relations concepts of Klein (1946,
1991), Winnicott (1958), Ogden (1993) and Bollas (1987, 1989, 1995, 2012) were
consulted. Redl’s (1942) concept of role suction also related strongly. These related
strongly to the subject matter.
2.4.1 Psychotherapy theory and esoteric phenomena.
The mysterious “third” (Bion 1962) (Bollas 1987) (Ogden 1984, 2004) (Lipgar & Pines
2003) (Grotsein 1996) and the collective unconscious (Jung 1966) (Carminati et al
2013) are concepts that merit frequent discussion within the field of psychotherapy.
Therefore the researcher explored the work of Mindell (1982, 1995, 2000, 2010) and the
“dreamland”.
These concepts can be viewed from the position of both constellations theory (Hellinger
2003) and the theory of morphic resonance as presented by Sheldrake (2009).
2.5 AAT studies relating to psychotherapy practice.
Three psychotherapy studies were found that could correlate to this study – that of
Stewart et al (2013), Wilkes (2009) and Mason & Hagan (1999). These were all
subjective qualitative studies completed with relatively few participants. These were the
only studies that could be found within the field of AAT in psychotherapy. 13
The biggest gap in evidence related to client literature and despite a laborious search
only two studies were read as the researcher could not find any others. Schneider &
Pilchak Harley (2006) and White et al (2015) contributed to literature on the clients’
perspective (albeit from the perspective of dog loving clients). These are both skewed
studies due to the animal loving bias and neither allow for a random assignment of
clients or a control group.
Evidence from wider client populations show lack of efficacy and Katcher et al (1989)
come to the conclusion that AAT in prisons does not change the behaviour of prisoners.
Which begs the question – why is an empirically invalidated practice in operation? The
researcher searched and read more widely discovering that many prisons receive
financial aid to incorporate AAT (Furst 2006).
The study of Banks, Willoughby & Banks (2008) has been perceived by critics (Marino
2012) to be the most rigorous and it concluded that the incorporation of an animal was
not necessary.
Studies generally pertaining to the animal human bond by Odendaal (2000) and
Odendaal & Meintjes (2003) found that it does benefit client’s relaxation response,
however as noted by Odendaal (2000) it is not significant and can be achieved my other
means.
14
There is new research that is beginning to establish the possibility that oxytocin plays a
pivotal role in the bonding process between humans and animals (Nagasawa et al 2015,
MacLean & Hare 2015, Stoeckel et al 2014).
2.6 Ethical issues in the literature.
The work of Joy (2003, 2005, 2014) and Wise (2014, 2012, 2003) questions the
speciesist attitude of humans towards animals. This was a crucial questioning lens in
light of Ianuzzi & Rowan’s (1991) honest account of ethical issues and deaths of
animals used in private practice, nursing homes and prisons used in AAT. The
researcher took a closer look and extended her search for ethical material.
The majority of papers neglected to include a section on ethics. Braun et al (2009)
outlined the serious risk of vicarious trauma and this was supported by Ianuzzi &Rowan
(1991) and Figely (2002). Hatch (2007) presents arguments of hazard and risk to clients
and animals physically via injury and zoonotic disease to both. This is further
corroborated by Lilienfield & Marino (1998, 2007). Zamir (2006) while very critical of
the ethics at work as is Friesen (2010) also concedes that for a shelter dog it may be a
better life than euthanisation. Herzog (2011) goes further, arguing that there is no
ethical or empirical justification for this field to exist. Francione (2010), Bekoff (2007)
and Steiner (2012) would agree.
When one reads the work of Ascione (2008), Meloy (1988) and Ascione & Fine (2010)
documenting detailed analysis of animal abuse and various case studies one cannot
ignore such masses of disturbing literature.
15
Furthermore, the work of veterinary surgeon Dodman (1994) and Braitman (2013,
2014) point to how animals are subject to the same psychological distress as humans
and both authors correlate their distress to human psychiatric disorders.
Emotional contagion between humans and animals poses many more ethical questions
than one could answer at present however long term studies such as that of Hunt et al
(2012) point to a need to be aware of psychological mirroring of emotion between
human and canine counterparts. Joly-Masheroni et al (2008) and Bessa & de Sousa
(2012) report yawning as a contagious activity between humans and dogs. Braun et al
(2009) question psychological contagion.
The researcher found the ethical arguments made by Francione (2010), Francione &
Garner (2010) and Steiner (2012) around “happy exploitation” to be valid and true.
2.7 Canine intelligence and theory of mind.
At a conference in Cambridge in 2012 a group of highly respected academics in a cross
section of fields came together to acknowledge animal sentience and according to
esteemed ethologist Mark Bekoff this is not before time (2013a, 2013b, 2009, 2007,
2006a, 2006b). The most convincing evidence regarding the intelligence of dogs comes
from the field of neuroscience. The work of Panksepp (2004, 2005) on our shared
emotional brains is relevant to this study. This is echoed and supported by Proctor et al
(2013) and Bekoff & Pierce (2016), Allen & Bekoff (2008), Bekoff (2013a, 2013b,
2009, 2007, 2006a, 2006b).
16
On the search for solid evidence of theory of mind many other disciplines were
consulted. The material sourced from ethologists and neuroscience was overwhelmingly
well researched, fascinating to read and made a very strong case for theory of mind.
Grandin (2006) is also supportive of the case.
Studies by Cook, Spivak & Berns (2016), Cook et al (2015) and Cuaya et al (2016) are
so new and groundbreaking, alluding to the fact that the canine brain works in much the
same way ours does and just because they don’t have spoken language their capacity to
respond to visual cues and to humans is extraordinary.
Hare & Woods (2013), Hare & Tomasello (1999) and Miklosi et al (1998) have
conducted excellent research on dogs’ exceptional capacity to perceive visual cues and
respond to them accurately. Muller et al (2015) report capacity to read human facial
expressions visually and Albuquerque et al (2016) capacity to read auditory and vocal
cues.
However, they are on a par with young children regarding their language acquisition
(Coren 2004, 2006) and this is outlined in the studies of Kaminski et al (2004), Pilley
(2013a, 2013b) and Pilley & Reid (2011). While older papers by Markman & Abelev
(2004) and Bloom (2004) refute the fact they are on a par with children, many newer
papers and academic commentators are beginning to weigh up the substantial evidence
and agree that studies such a Pilley’s (2013a&b) are a notable achievement such as
Farina et al (2016) and Frank (2016).
17
2.8 Conclusion
This concludes the overview of literature sourced for this study. A thorough overview
of the methodology used will now be presented in Chapter Three.
18
Chapter Three - Methodology
3.1 Introduction
This chapter will address the methodology used in the research study which explores the
psychotherapist’s interpretation and perception of how the presence of the therapist’s
domesticated dog influences the therapeutic process.
The aim of this research is to understand if and how AAT is valuable in the context of
private psychotherapy practice.
The research questions that inform the study are –
Is AAT of value in the context of psychotherapy?
Does the incorporation of the psychotherapists dog change the dynamics and
mechanisms of the therapy, if so, how and is it of value?
What do they experience/perceive as happening and how is this of value to the
therapeutic process?
Are these values efficacious and of benefit to all concerned in the therapeutic
triangle of Psychotherapist, Client and Dog i.e. is it ethical?
This chapter will first present the context and problems of the field in which this study
was developed and is situated. It will outline the justification for this research relating to
gaps in the knowledge base of this field. It will then proceed to outline justification of
the need for this research and present a justification and defence of the method chosen –
that of Constructivist GTM.
The research procedures that were undertaken will then be outlined in detail. 19
3.2 State of the field – the problems
Parish-Plass (2014), states that the field of AAT is in need of order as currently she
describes it as being in a state of chaos. Had the researcher known just how much chaos
was existent in this field she might never have sought approval for this study, such is the
state of actual disarray. There are problems regarding terminology (Parish-Plass2014),
(Borrego et al 2014), problems regarding theory - Kruger and Serpell (2010) assert a
specific lack of theoretical framework that can unify the varied field and problems
relating to empiricism in conjunction to research methodology (Stern & Chur-Hansen
2013).
3.3 Justification of research and methodology used.
There is an abundance of research regarding the benefits of AAT across a multitude of
health professions, however there is a deficiency of empirically validated research
regarding its efficacy (Chur-Hansen et al 2010, 2014), (Stern & Chur-Hansen 2013),
(Marino 2012), (Herzog 2011), (Borrego et al 2014), (Kamioka et al 2014) . Poor
quality is questioned extensively by Stern & Chur-Hansen (2013) to the extent that they
query if in fact AAT can be verified scientifically. Raupp (2002) states “all the
questions we have been asking since the 1970’s remain to be answered” (p357).
3.3.1 Gaps in the knowledge and criticisms of the field
Here is a list of information that appears missing from literature in the field of
AAT/AAP/AAI/AAA that the researcher identified -
There is discussion rather than investigation and a tendency to publish texts
focused on theoretical content rather than studies (Borrego 2014)
20
Anecdotal reports across a multitude of research designs (Chur-Hansen et al
2010, Chur-Hansen & Stern 2013)
Limited replication (O’Haire 2013)
Failure to control for extraneous influences/compounding effect (the competence
of the therapist, other health habits, animal attachment, client motivation and
other social supports) (Chur-Hansen et al 2010, Chur-Hansen & Stern 2013)
Claims made founded on anecdotal/descriptive evidence (Kamioka et al 2014;
Chur- Hansen et al 2014,2010; Chur-Hansen & Stern 2013, Marino 2012;
Herzog 2011)
AAT / AAI / AAA studies being published even though they do not meet
minimal standards of research design (Borrego et al 2014; Marino 2012; Nimer
& Lundahl 2007; Souter & Miller 2007)
An under-reporting of adverse affects/only reporting favourable results (for
example the damage creation of a strong attachment to an animal and subsequent
break in that attachment could have when therapy ends) (Kamioka et al 2014;
Chur-Hansen et al 2014; Herzog 2011)
A preponderance of debate/confusion regarding terminology – “a dozen possible
terms”(Borrego et al 2014, p. 86; Parish-Plass 2014)
Lack of studies outlining the client’s experience (both positive and negative).
The researcher could only find one study that specifically presented the voice of
the clients and this was presented from clients who liked dogs. She could not
locate any study that presented negative experiences.
Lack of consideration is given to the position of the animal, impact on its health
and issue of consent (Chur-Hansen et al 2014; Parish-Plass 2014;Marino 2012;
Bekoff 2008; Hatch 2007; Zamir 2006)
21
Lack of differentiation between various interventions (Parish-Plass 2014;
Chandler 2010)
Issues relating to allocation concealment in studies (Stern & Chur-Hansen 2013)
If the quantity of studies relating to AAT/AAI/AAA are increasing (Borrego et al 2014)
(Stern & Chur-Hansen 2013) why are there so many gaps in knowledge remaining?
What appears to be happening in this field is that hypotheses are being presented as fact,
when in fact the accurate representation of AAT in various helping professions should
be precisely defined as “inconclusive” (Herzog 2011) and according to Culliton (1987)
in her facetiously entitled paper “Take two pets and call me in the morning”, the
problem is one of uncontrolled sentiment. Marino (2012) indicates that published
empirical studies also possess design faults.
Borrego et al (2014) reviewed the current status of this field covering five common
forms of publication - articles, book chapters, theses/dissertations, reports and books,
between the years 1991-2011 searching a total of 228 texts. They report that in the
general field they found –
14 qualitative studies of which 5 were conducted using interviews
The subject heading “psychotherapeutic techniques” appeared 11 times with the
keyword psychotherapy appearing 8 times
“Dogs” appeared as both a subject heading and a keyword 13 times
Consequentially, the researcher presents the first justification for a qualitative interview
based research study pertaining to AAP –
22
Insufficient quantities of qualitative interview based studies13.
Stern & Chur-Hansen (2013) state that literature in the field “has only emerged in the
last thirty years” (p.129) and point to a need to prove causality, avoid anecdotal
evidence, eliminate bias and compare groups. Thus in choosing a methodology the
researcher first considered what method would adhere to their principles14.
The researcher then considered the weight of criticism pertaining to validity. Marino’s
(2012) meta-analysis of qualitative studies concluded that qualitative research has a
proliferation of poor internal validity constructs, recommends separation of the
“potentially effective components”(p.149) and states that the literature can be
strengthened if researchers utilise “more rigorous controls that dismantle potential
components of the AAT and AAA treatments” (p149).
A very thorough research method was needed. The method needed to serve two
purposes. Firstly it needed to generate an emergent theory in a field where there
was none.
Secondly it needed to have very strong protocols to ensure internal and external
validity and credibility to protect from bias of the participants, the researcher
and withstand/prevent repetition of current criticisms previously mentioned.
At the outset there are two pragmatic issues that stare the researcher in the face.
Ethically, one cannot include a dog without the consent of clients (unless you were
13 “If a concept or phenomenon needs to be understood because little research has been done on it, then is merits a qualitative approach” (Creswell 2003, p.22).
14 Adherence to twelve points on Stern & Chur-Hansen’s (2013) checklist (p.138), of thirteen core methodological considerations was achieved. The only point not adhered to was – number eight – collecting interviews at multiple points of time.
23
Anna or Sigmund Freud (Molnar 1992)); therefore the clients have a favourable
predisposition towards dogs, so the population being studied is biased in and of itself. It
is unlikely that a non dog/animal loving therapist/handler is going to incorporate one
into their work, so the practitioner group is skewed. Therefore we have are two
homogenous animal appreciating populations dominating the studies, which presents an
empirical conundrum/double bind.
As little research has been conducted into the phenomenon of AAP and as there is no
existent unified theory to explain its mechanisms the researcher decided to choose GTM
as it would allow her to conduct the most rigorous inquiry within the ethical confines of
her expertise and informed by the framework of what is missing from the data.
3.3.2 Justification of choice of GT method
According to Coyne & Cowley (2006) – “Grounded theory is a method that is not easily
understood” (p514) and they also state that it can be a difficult method for a novice
researcher (Ibid).
Therefore the version of GT chosen by the researcher was that of Charmaz (2006) as it
provided clear, simple guidelines and was easy to understand. Both Glaser’s (2007) and
Strauss & Corbin’s (1994) approach was rejected for pragmatic and ideological
24
reasons15. Charmaz’s (2006) constructivist approach to GTM allows flexibility and
adaptation to the needs of the researcher and the subject matter being researched16.
Constructivist GTM is fluid, open ended and pragmatic. It takes a reflexive stance and
encourages the researcher to scrutinise their assumptions so that they don’t elevate
anything to the level of “objectivity”. It allows the researcher to explore multiple
realities and “aim to show the complexities of particular worlds, views and actions”
(Ibid, p132).
3.3.3 Justification of triangulation and falsification
GT accepts the maxim that -“All is data” (Glaser 2004, p45), so the researcher is not
limited to the interviews and is free to turn to the literature, incorporate it flexibly, as
needed and triangulate with it in order to explore many facets of the AAP
triangle/dynamic and multiple perspectives17.
Timmermans & Tavory (2010) (in Bryant & Charmaz 2010) propose the principle of
falsification stating that “falsification works as a continual and internal method aiding
discovery and theory building” (p501). This serves as a protection from the most
common criticism of GT and of inductive methods - which is that of naive empiricism.
15 Glasserian Grounded Theory (rooted in critical realism) would have required the researcher to assume that there is an existing objective world, remain independent from the research and require no engagement with literature prior to conducting the study(Annells 1996). This was not feasible, nor a pragmatic choice as the researcher had already conducted two literature reviews, the first for a research proposal and the second for the Research Ethics Committee. Strauss & Corbin’s version, was a technical minefield of jargon and procedures and has been accused of forcing data (Charmaz 2006). 16 “Grounded theory methods consist of systematic, yet flexible guidelines for collecting and analyzing qualitative data to construct theories “grounded” in the data themselves. The guidelines offer a set of general principles and heuristic devices rather than formulaic rules” (Ibid, p2).17 The researcher acknowledges this necessity due to the subjective starting point for generating theory in the homogenous sample of this study and the deficiency of opposing perspectives in this emergent field consequently demand scrutiny.
25
Bendassolli (2013) cites Popper’s (1959) analogy – “The fact that we observe
innumerable white swans does not allow us to assume that there will never be a black
one”. Therefore the researcher argues that as a result of the biased population and biased
results from the inductive process, challenge via abduction is necessary and permitted.
The researcher placed much value on the capacity to triangulate with literature as
necessary, felt it was important due to the amount of criticism’s studies faced in this
field regarding credibility and owing to gaps in the knowledge base of the field.
According to Cho & Lee (2014) triangulation is helpful when there is no existent
theory. The role of triangulation is also one of checking confirmability and protects
against any investigator bias and therefore it can facilitate trustworthiness (Shenton
2004). This also meant that the researcher could shift perspectives after the analysis and
check, question and confirm/disconfirm the theory from the perspective of clients and
dogs.
If there was a paucity of debate regarding lack of efficacy from within the field of AAT,
it would be necessary to explore other relevant interdisciplinary contexts. GT would
allow for this.
3.3.4 Justification of abduction/abductive inference as a tool to test internal
validity in GT
This serves the interests of objectivity. The process of abduction is necessary in order to
validate the claims of the GT, in order to see if other interdisciplinary resources could
challenge the outcome, essentially asking the question – if challenge to the efficacy
26
cannot be found from inside the AAT field itself, where could it be located and what
kind of questions would the challenge pose?
Thornberg (2012) states – “the grounded theorist has to accept the impossibility of pure
induction and at the same time recognise the analytical interplay between induction (in
which he or she is never tabula rasa) and abduction” (p.247-248). Abduction is essential
in the process of justification of qualitative studies, scrutinising all explanations and is
tool to affirm and disconfirm (Charmaz 2006). The researcher decided to see how far
empirical facts and opposing philosophical viewpoints from other disciplines would
possibly agree or disagree with the premise of the generated theory. This also served as
a tool to impose rigour and to test internal validity18.
The researcher concludes that GTM was therefore deemed the most suitable method of
research as its flexibility allowed the researcher to address many of the complexities and
criticisms within the field and contribute something of value to what has been identified
as missing from the knowledge base of this field.
3.4 Research procedures
The following is an outline of procedures used in this research project.
18 The researcher could explore the experience of the psychotherapist’s who practised AAT and develop a picture of their lived experience of its benefits and value from their subjective vantage point. Then the researcher could incorporate literature and data to represent the perspectives of clients and dogs to confirm/disconfirm the theory and as a consequence present the most balanced information possible to the psychotherapy community do that they could make the most conversant assessments on what appears to be a somewhat controversial method of practice.
27
3.4.1 Recruitment of participants & sampling procedure
The researcher initially attempted to locate therapists by contacting Irish pet therapy
organisation - Peata, the European and International AAT associations - ESAAT &
ISAAT. This did not yield any suitable participants19. She then focussed her search on
the UK as she knew language would not be a barrier and began to search via Google for
Psychotherapists.
All participants in the UK that were solicited as potential candidates for the study were
contacted directly after the researcher did a Google search of psychotherapists who
publicly stated on their websites that they worked with their dogs using AAI in
psychotherapy, by conducting specific searches using the following search terms
“psychotherapist+dog”, “psychotherapy+canine” and
“psychotherapy+animal+assisted+therapy”. The researcher then phoned and emailed
those who were in the public domain20.
Participants were interviewed on a “first to consent” basis and the interviews were
scheduled via mutual agreement.
19 The researcher initially attempted to locate therapists in Ireland by contacting Peata – the Irish organisation for pets and people. It is a voluntary organisation that provides pet therapy to caring institutions. They informed me that they had no psychotherapists registered with them. The researcher then contacted ESAAT and ISAAT – the European & International Society of Animal Assisted Therapy and was forwarded contact information for some therapists, whom she emailed. Some did not respond, some elected not to take part due to either not practising for the minimum amount of practice hours with a dog or personal feeling that they were not fluent enough in English, as it was not their primary language. 20 After contacting twenty four possible candidates, eight individual psychotherapists met the criteria for participation. Some potential participants removed themselves from the selection process due to three main impediments – they did not have time in their present schedule to take part, they had practised with their dog for less than three years and some only occasionally incorporated their canine companion in the psychotherapeutic process. Two therapists were contacted as a result of referral by the first consenting psychotherapist that participated. One of these therapists fulfilled the requirements and consented to take part, the other responded once to an email saying she was busy and did not get back in touch.
28
All eight psychotherapists volunteered to take part resided and worked in the United
Kingdom. Seven of the eight participants were Supervisors. All individuals interviewed
met the criteria for the study which was as follows –
They had a minimum of three years fully accredited practice.
Three years full membership of a UK professional psychotherapy body.
They spoke fluent English.
Had a minimum of three years psychotherapy practice with their pet dog.
They incorporated their dog in sessions with consenting clients only.
Their practice included their dog for a minimum of one third of their practice
hours.
The sampling procedure was purposive21 and the sample homogenous. The mean or
average number of years experience practising psychotherapy with a dog was just
under ten years.
3.4.2 Confidentiality
The researcher also allocated numbers to all of the participants in order to protect
participant confidentiality within the findings of the research.
No identifying information was disclosed in the research thesis. The researcher took all
the steps outlined by the ethics committee22.
3.4.3 Data collection 21 The selection of “groups or categories to study on the basis of their relevance to your research questions”(Mason 1996 p94)22 The real names and any personal details of the participants were kept in a separate document to the transcripts and analysis. The content of the interviews conducted and all identifying information was kept securely and confidentially. Throughout the research process data obtained and documents formulated from the data was stored securely at the researcher’s home. Documents were kept in a locked file, digital, computer and audio files were password protected. The participants were also informed that as a very small group their anonymity cannot be absolutely guaranteed.
29
All interviews were conducted via Skype, scheduled at convenient times for the
participant and took place in the offices of both researcher and participant. There were
positives and negatives to the Skype experience. Skype offered a greater level of control
to participants and cultivated a more equal relationship between researcher and
participants whilst still offering benefits of the face to face experience23.
Six interviews took place with video and two with audio only due to technical issues24.
3.4.4 Interview information, duration and recording
The interviews lasted between 50 minutes to 1+1/2 hours, depending on how many
stories and how long it took participants to relay and communicate the information they
wished to the researcher. All interviews were recorded via Dictaphone. A series of open
ended questions were used as prompts, forwarded in the information pack prior to the
interview process via email to the research participants25.
23 It reduced the feeling of intrusiveness and offers greater safety (Hanna 2012, Hewson 2003, Hewson & Laurent 2012). Hanna (2012) also points out that “both the researcher and the researched are able to remain in a ‘safe location’ without imposing on each other’s personal space…the researched can remain in the comfortable location of their own home…thus a neutral yet personal location is maintained for both parties throughout the process”(p.241). This limited vulnerability for the participant and the researcher and gave greater control, all of these factors offered by the medium of Skype further diminished power dynamics.24 On two other occasions Skype froze and disconnected interrupting and delaying the interview and necessitating call backs. This is most certainly due to the rural location of the researcher and in the case of one participant her rural location affected her internet coverage also. 25 The process was largely open with minimal structure allowing the participants to discuss what was most relevant to them about their experience giving as much autonomy to the participant as was possible. In most interviews all of the questions were answered organically and the researcher simply sought elaboration.
30
3.4.5 Secondary data collection
Detailed online searches were conducted for secondary data26. Journal articles27,
books/textbooks and websites on qualitative research methodology and GTM were
explored and studied. References and bibliographies were examined at length for other
literature that may not have been excavated using keywords used in the initial keyword
search terms. The researcher also attended lectures given by Professor Kathy Charmaz
on GT at the DCU Qualitative Research Summer School in May of 2015.
3.5. Analysis
The analysis was conducted using the following procedures outlined below.
3.5.1 Transcription
The researcher transcribed all the interviews herself and this took extensive periods of
time28. Despite being tedious this was very helpful as she became very familiar with the
data as a result.
3.5.2 Coding
There are four stages of coding in GTM.
26 A search of Google Scholar, DCU Summons, Google Books, Amazon, Google web search, Google video search, Youtube, Vimeo and Ted.com was conducted between December 2013 and May 2015 using the search terms “Pet Facilitated Psychotherapy”, “Pet Facilitated Counselling”, “Pet Assisted Therapy”, “Animal Assisted Therapy”, “Animal Assisted Psychotherapy”, “Animal Assisted Counselling”, “Animal Assisted Interventions”, “Animal Assisted Activities”, “pets in the workplace”, “service dogs in therapy”, “therapy animals” and “human animal bond”. 27 The multidisciplinary journal – Anthrozoos, was searched manually on a regular basis as it is a peer reviewed academic journal focusing on human animal interactions and relations across a wide range of academic perspectives – “The key premise of Anthrozoos is to address the characteristics and consequences of interactions and relationships between people and non-human animals across areas as varied as anthropology, ethology, medicine, psychology, veterinary medicine and zoology. Articles therefore cover the full range of human animal relations, from their treatment in the arts and humanities, through to behavioral, biological, social and health sciences”(source-www.ingentaconnect.com).28 On average it took the researcher three days to one week to transcribe each interview.
31
3.5.3 Initial coding
The first is the initial line by line coding. The researcher formatted the interviews with
numbered lines and moved the text to the left hand side, printed the interviews and
coded them line by line with hand written pen.
3.5.4 Focused coding
Focused coding consists of capturing a theme with a word or few words to grasp its
essence and meaning. When the researcher re-read the transcripts and the line by line
codes she picked out the core concepts in the data and wrote them on a sheet, numbered.
She then wrote these codes on cards. She laid them out and compared them after each
subsequent interview.
3.5.5 Theoretical coding
Theoretical coding was the most difficult stage for the researcher and was most time
consuming during the procedure of analysis. This was the process whereby the
researcher had to reduce the concepts down to categories that could encapsulate the
essence of all the focussed codes that remained after elimination via constant
comparison.
3.5.6 Constant comparison
The researcher constantly compared her focussed codes after each subsequent interview
by laying cards with written coded on a large table. Constant comparison can generate
new codes and eliminate old codes29. Constant comparison also serves as a fact
29 For example after one interview when the researcher compared all of the codes “enhances self care” & “nurturing” codes were eliminated as the subsequent participant felt the dog did not enhance self-care but rather demanded she give extra care and attention and exercise dual awareness. Therefore the researcher had to return to the previous three transcripts and check to make sure she did not miss out the new codes “extra care and attention” and “dual awareness”.
32
checking mechanism, ensures that the theory comes from the data and serves the
function of creating an inbuilt mechanism for internal validity of codes. Constant
comparison with secondary data – the literature was also of the utmost importance,
triangulating and checking continuously, to confirm and disconfirm (Charmaz 2006).
3.5.7 Memoing
The researcher wrote memos30 from the moment after the first interview and found it to
be the most insightful and important part of the analysis. They were helpful to keep
track of thoughts and ideas, authors, concepts, articles that came to mind in relation to
words the participants had spoken. She stuck the memos on the wall and used them as a
map of ideas31.
3.6 Limitations of method
The level of multi tasking required as a novice researcher was demanding and
overwhelming at times for the researcher, also the fact that very quickly the GTM
created masses of data for which the researcher was initially unprepared and in the
beginning the researcher would state that it felt like she’d been hit by an avalanche. It
took arduous effort to sift through the data generated and process it.
3.7 Reflexivity
Reay (1996) defined reflexivity as the ability to critically reflect on the effect you as a
researcher has on the entire research process. It serves as a tool for transparency and
30 Writing up theoretical memos is at the core of grounded theory (Glaser 1998). 31 The memos allowed a flow of ideas to connect between codes and to flow during writing up especially for the discussion. They were signposts pointing the way to theory and writings she had read as she began to draft the discussion. They held everything together.
33
rigor. The researcher kept a reflexive journal throughout the process and includes a
paragraph in the conclusion regarding her reflexive position in relation to the research.
3.8 Conclusion
The coding process followed throughout was that of Charmaz (2006). Through the
application of the method outlined above the theoretical codes emerged from the data-
Enhances the relationship/alliance
Enhances therapeutic insight and
Generates calm and relaxation
In Chapter Six an evaluation of the GT will be made of this study using Charmaz (2006)
four criteria of credibility, originality, resonance and usefulness.
In the next chapter the results obtained from the use of this methodology will be
presented.
34
Chapter Four – Results.
4.1 Introduction
This chapter provides a brief participant/dog profile and the three theoretical codes that
emerged from the data and the focussed codes that led to their discovery.
4.2 Participant profile
The participant profile for this study was specific32; the therapists who participated
practice psychotherapy with their dogs33 for a minimum of one third of their practice
hours34. All eight psychotherapists who volunteered to take part were female, resided
and worked in the United Kingdom. Seven of the eight participants were Supervisors.
They met the qualification criteria as outlined in Chapter 2.
The common factor that these therapists shared was not only their dogs but the depth of
their experience. Cumulatively, participants had approximately 10 years experience of
practicing psychotherapy with a dog facilitating the process.
32 All but one therapist had a mixed client base (they worked with adults, teenagers and children). One worked in a highly specialised area of psychotherapy which will not be disclosed as it would identify the participant. Six participants had more than one dog. 33 Multiple breeds of dogs (which will not be revealed as that would identify participants) were facilitating therapy with their human companion and half of the participants dogs were rescues. Some dogs had spent their whole lives assisting their psychotherapist carers and others had begun later in life. Many were rescue and shelter dogs who had their own unique life stories.34 On some occasions the dog would not be included in sessions, if they were in season, perceived as being off colour and needing rest, when clients did not request, consent or the therapist themselves felt it imprudent to include the dog. However the dog was integrated into therapy for the minimum of one third of their practice hours as stipulated by the conditions of qualification to take part in the study again outlined in more detail in Chapter 2.
35
4.3 Theoretical codes
The theoretical codes that emerged were enhancement of the therapeutic
relationship/alliance, facilitation of therapeutic insight and generation of relaxation and
calm.
4.4 Theoretical code 1 – Enhances the Therapeutic Relationship/Alliance.
The theoretical code – “Therapeutic Relationship” emerged from the focussed codes:
triad, enhancement of trust and rapport, relational consistency and Core Conditions
(Empathy, Unconditional Positive Regard and Congruence).
The participants in this study all referred to the dog at some point in their interview as
being a bridge/clinical bridge, connector, conduit, ice-breaker, making the client feel
safe and secure, making the rapport happen quicker. Many remarked that the dog’s
warmth in terms of charm and charisma stating that they seemed to have the effect of
making the person feel special with one participant stating –
“He really makes client’s feel like they have been chosen that he really likes them”.
They all felt that the dog facilitated the therapeutic alliance/relationship and helped it
develop and grow at a faster rate than it did in dyadic psychotherapy.
One participant stated –
“There is that kind of ice-breaking effect and there is usually a bit of laughter too and
stuff when they meet her that just seems to set a more relaxed tone for things to
follow, whereas the (Clients) that don’t have her in em it might just be my
imagination but to me it seems to me like it takes a little bit longer to to you know
build that connection with them”.
36
The relational consistency was remarked upon by participants throughout, beginning
with the warmth of the greeting extended by their dog. Many told of their dogs alerting
the therapist to the client’s arrival with one noting “we don’t need a doorbell”, and
several dogs led the way to the therapy room after the welcome had been extended. This
was remarked upon by participants as setting a relaxed cosy atmosphere as a starting
point from where therapy could begin. The environment is described as non- threatening
and having the effect of minimising initial anxiety, defensiveness and initial
ambivalence towards therapy that the participants could contrast with their experiences
with clients who did not have a dog present during sessions.
One participant described it this way –
“They soften the room they make it a kinder place to be and a safer place to be”.
The level of trust that was generated as a result of the rapport created, again all
attributed to the dog’s presence. All participants stated that it rubbed off on them or that
they could “piggyback” upon it and they all articulated in some way during their
interviews that they believed it was as a result of the dog being perceived as an
extension of them.
One individual expressed it as –
“The trust in the immediate in the therapy session is allowed to grow much more
quickly cause they can see the dog makes no judgement, so there is something in
there for me which is really a kernel, this idea of really being accepted for who you
are that it’s absolutely okay ad it doesn’t matter what you say during a session”.
37
One therapist did not have to watch the clock in order to determine the time as the dog
had a talent for knowing and alerting both therapist and client, and would get up and
shuffle around at the end of the therapeutic hour.
Throughout the data the dogs ability to be completely present was mentioned also and
while this was observed by the participants as being beneficial for clients on therapist
remarked on the value it gave to her personally–
“It is really in the present and that helps me sometimes, if I am just going off
somewhere else, it really helps to remind me to bring myself back into the session
and to be with the present”.
4.5 Core Conditions (Unconditional positive regard, empathy and congruence).
All of the participants noted the dog’s ability to impart the core conditions and the first
to emerge from the data was unconditional positive regard. Many, though not all,
pointed to a commonality between themselves and the client as a result of the dog’s
presence. Others articulated it as an equaliser or balancer. Others found it to diminish
power relations and status, with several remarking explicitly that the dog doesn’t
recognise class or status. This fact can certainly not be denied and may be considered an
implicit fact to recognise.
All participants spoke in varying degrees of the unconditional positive regard and
acceptance their dog imparted to clients. One participant described it thus-
“One of the key things I have observed is firstly something about really positive
acceptance, the fact that either of my dogs, they’re different, show any sign of
38
minding who my client is, what they work at, they could be the queen or they could
be the dustbin man, it absolutely doesn’t matter to them, so what the client gets is a
real sense of – we all talk about unconditional positive regard, well I wonder how
many of us can actually deliver that, but I think dogs can. You know they say we are
all equal in the sight of god – well I think we are all equal in the sight of dogs and I
think that is hugely powerful for clients”35.
One therapist relayed a very emotional exchange between her dog and a client that was
commonplace for these therapists –
“He’d started off putting his head on her knee and then he’d put a paw there and then
she was reaching down to snuggle him and she wanted to talk about something and
she couldn’t get it out and he was looking at me and I said “I think he wants to sit on
your knee” she said “would you let him” I said “would you be okay?” she said “oh
yes” so the moment I went yes he’d jumped on her knee, she snuggled into him and
you can see all the fur he has and she just hid her face in his fur and told me through
his fur all the things that were troubling her how awful things were how desperate
she felt but because she couldn’t hug me cause that wouldn’t have been right she
could hold him there was this breathing creature that just snuggled into her that
listened, bless your heart, that she just opened up everything and that was such a
cathartic experience cause she said “he is listening and he doesn’t reject me””.
Congruence and the dog’s ability to be “genuine” links back to the theme of relational
consistency and the ability to be authentic and real. All of the therapists told stories and
35 All participants reported that their dogs would extend themselves and or their body if clients became emotional. They reported that the dog would lean into the client, place their head in the clients lap, some with permission will go onto the clients lap and allow themselves to be held.
39
mentioned their dog’s genuity. One therapist laughed as she spoke about how her dog
made her feel a sense of realness in therapy sessions stating –
“Yeah yeah, it’s all in the moment and the funniest thing that brings it all down to
earth was that once he arrived into the therapy room with my gardening shoes – the
smelliest dirtiest scruffiest ones too!”
She continued saying –
“They are so genuine – literally what you see is what you get you, they’ll say hello
and wag their tail, when they are pleased to see you, they show it”.
Another spoke of how her client perceived it –
“One of my clients had great difficulty expressing herself she had a very deep
depression and a really severe relationship break up low self worth everything was in
her boots and she’d come in, I’d open the door (the dog) would run out run rings
around her barking as he’d be happy to see her she’d walk in and I’d go “sorry about
that” she’d go “NOOOO that welcome is like the most genuine thing ever you have
to say hello and welcome – he doesn’t”.
One of the key themes that emerged from the data was empathy. This was attributed to
the dogs and what was particularly noted was their responding actions - going to,
touching, nuzzling the clients etc.
One individual stated that she had interest in how they alerted her almost helping her to
pre-empt emotional discharge.
“I don’t have any hard and fast evidence but it seemed like this often used to happen
just before a meltdown or made a bit of disclosure in a sense when I look back at my
40
work I wonder if it isn’t about an electromagnetic field or something actually
physiological happening to that client that I can’t pick up on but somehow the dog
can pick up on”
The therapist went on to ponder the work of “alert” dogs and “detection” dogs stating
simply –
“We don’t know the extent of their abilities”.
4.6 Theoretical code 2 - Facilitates Therapeutic Insight.
The theoretical code- “Facilitates Therapeutic Insight” emerged from the focussed
codes: working in the immediate here and now, observation of defences: projections,
transference/ transference displacements, dog as transitional object and attachment.
The therapist’s stories and examples from their practice experiences were interspersed
with anecdotes of how they perceived their canine companions as facilitating
therapeutic insight. What I subjectively heard as I listened to the therapists speak was
that the dog seemed to act as a mirror that reflected various processes.
What I heard as a researcher was that the dog appeared to act as a catalyst for insights as
it opened the door, via being projected onto and then that projection can be related back
to the client and be explored via enquiry in order to explore the emotion behind the
projection.
Participants proffered that –
“You can draw parallels it just makes it easier”.
41
Many stating that-
“It gives you a way in” or “it opens a doorway”.
One concluding that-
“You have got that kind of projected situation to relate to; somehow it just makes the
conversation easier”.
Another therapist surmised -
“Things instantly come up and it means that you can work with them straight away,
the projections and reflections, it’s an immediacy, the Gestalt, you have a window”.
Some therapists felt that the dog –
“Melted resistance”.
And that this led to the therapist being able to see the clients’ real feelings sooner–
“I suppose it brings out more (client’s) real feelings in a quicker way and as I say
hopefully I would pick those up anyway but I think it just brings them out quicker
projection is sped up kids will say “oh she doesn’t like me today” then I know
perfectly well that that is not about (my dog) not liking them I pick up that they may
be very uncertain about how people will respond to them and perhaps something’s
happened that has made them even more uncertain on that particular day”.
42
All concluded that the presence of the dog led to clients projecting all kinds of emotions
onto them that gave interesting clues as to what to explore for the client, thus facilitating
insight.
Transference & transference displacement or as some refer to it – lateral transference,
was very prevalent in the interviews. What came up in every interview were stories
depicting how the transference towards the therapist was displaced upon the dog, clients
would use the dog to triangulate, expressing positive and negative thoughts/feelings,
safely, via the dog.
Sometimes it manifest as a criticism of how the therapist cared for the dog, other times
it manifest early on in a positive lateral transference as an idealisation of the dog. The
most common manifestation was criticism of the therapist’s care of the dogs-
“You haven’t paid proper attention to your dogs – you know – they shouldn’t be in
this session, so there are some kind of challenging dynamics”.
Essentially the client is using the dogs to take a “pop” at the therapist, the lines get
blurred and it is only the therapist who can discern in conversation with the client what
it is that is coming up for them.
One therapist reported that a client would drive right up to the house parking near the
door in the knowledge that it would goad them and in order to get a reaction from them.
This is of course a passive aggressive action and while this is revelatory it needs to be
watched with great care and attention if the expression from the client could also be
actively aggressive in less healthy clients.
43
Participants spoke often of how the dog was often treated as a transitional object –
mainly via cuddling, however a much more explicit example of a client using the dog as
a transitional object is relayed as follows –
“(The dog) worked with two elective mutes – they wouldn’t talk to me but they
would talk to the dog...I was a non-entity but talking to him was fine, he did all the
work – I just let him get on with it – (identifying breed omitted) don’t really sit but
he would go on and sit next to her and she would talk to him through her hair and tell
him what was going on”.
In the majority of case examples the dog takes the role of comforter when it serves as a
transitional object however this example shows that the role of secure confident can be
assigned to it, primarily when it comes to work with children such as the little girl in the
example above.
While attachment is a vast subject participants spoke generally of insights it gave them
in relation to attachment. How an individual relates to a dog gives many clues to them
about how someone bonds or doesn’t bond. Initially speaking of how the client’s way of
relating to the dog could aid conjectural insights into how empathetic and also how
narcissistic they might be one participant eloquently stated –
“It helps me to see where their damage may be, whether it could be something to do
with attachment, I mean actually that works both ways cause with some clients with
attachment problems will be super loving towards her and very attached towards her
and others will not quite be rejecting of her but indifferent of her. So attachment is a
very complex subject but it will highlight to me that the client at the end of the scale
44
that is sensitive to the dog, it just highlights to me where we can explore that
together”.
While the dog may not in and of itself facilitate attachment style observations any more
than clients relating to the therapist herself, it seemed to provide a second relationship to
view, one which the therapist could observe from a distance, and that distance can make
certain elements easier to distinguish.
4.7 Theoretical code 3 – The dog generates relaxation and calm.
The theoretical code three – Generates relaxation and calm, emerged from focussed
codes: reduces anxiety and tension, therapeutic touch, calming/soothing and relaxation
in the client as a result of the dogs’ presence.
Participants all reported in detail and in various levels of depth, anecdotes and stories
that relayed how the dog put clients at ease and relaxed them during therapy. Some felt
it was the principal factor, one individual stated –
“There are so many things that the dog does but the biggest thing is reducing anxiety
in the client”.
This was noted throughout from the beginning and can be deduced from previous
examples given within the other categories also as they overlap. Some believed the
relaxing effect of the dog began immediately –
“He’s a sort of tension breaker, he has a very calming influence he takes the fear of
the new experience out of it and he makes it far more natural and easy to engage in
45
therapy ha ha ha he’ll also let us know when the session time is up he starts getting
up and shuffling around you know ha ha ha”.
Another therapist felt it was due to similarities in mammalian brain structure –
“We have the same emotional brain, it’s Panksepp” (referring to an author).
Another felt the dog’s ability to calm her client’s facilitated disclosure and dialogue
saying-
“It was very much about just calming them down so that we could talk in general and
look at some of the issues that were going on for them but it was a calming presence
and I am thinking quite particularly of two clients who had severe learning
difficulties and who really needed that sort of calm relaxation and the dog was really
good at that cause she would sit with them and they would stroke her and obviously
it increases the oxytocin and it would chill them out”.
Another participant felt that the sensory act of touching and stroking the dog facilitated
the relaxation and expressed it as follows –
“When a client does get very upset and is dealing with really painful things in a
session the dog is there as a comforter as it provides a relaxing stimulus but also
when someone is upset they can be very comforting very soothing kind of that
stroking we do, we have research evidence about how that kind of lowers peoples
stress levels if they are getting quite stressed by disclosing”.
46
4.8 Conclusion
While many elements of the codes overlap with some examples depicting all codes
simultaneously, the data contributed by the participants conveys opinions depicting the
benefits that they perceive the presence of their dogs’ contributing to the therapeutic
process. In the following chapter the researcher will discuss the findings of the research
project.
47
Chapter Five - Discussion
5.1. Introduction
The previous chapter has presented how AAT is perceived and experienced by
psychotherapists who practice within this framework and the discussion that ensues will
firstly intersect those experiences with psychotherapeutic theory.
Secondly it will question if the theory applies to the whole of the AAP system of three –
the triangle – the psychotherapist, the client and the dog36.
This chapter will draw on the primary and secondary data sources in chapters three and
four to elaborate on the concepts in relation to the context of psychotherapy and wider
AAT/AAI/AAA field37.
This chapter will explore their perspective and examine if the presence of a dog is in
fact a necessary factor for the core processes to unfold.
Critiques point out that there is not enough empirical evidence in this field and an
abundance of generalisations. The discussion will explore these criticisms and examine
them in relation to this study and the general field of AAA/AAT/AAP.
36 In response to the research question – how is AAP valuable in the context of private psychotherapeutic practice, the primary data from interviews has presented the psychotherapists’ perspective of efficaciousness – Psychotherapists who practice AAP experience that its worth exists in three core processes 1) enhances the therapeutic relationship/alliance, 2) facilitates therapeutic insight and 3) generates calm and relaxation. These theoretical codes emerged from focussed codes: triad, relational consistency, trust and rapport, core conditions, here and now, observation of defences, transitional object, attachment, therapeutic touch, reduction in anxiety and tension and calming/soothing relaxation.37 Appropriate literature is utilised to facilitate examination of perspectives of all three elements of the therapeutic system: the therapist, client and dog. The results are discussed and correlated to the psychotherapeutic theory, studies in the wider field of AAT and other relevant interdisciplinary literature.
48
Assessment of efficacy and value begins with the perspective of psychotherapists and
psychotherapy, continues via exploration of client experience and ends with the
perspective of the dog.
The purpose of this discussion is to explore AAP from meta perspectives, due to the fact
that it specifically generates a triadic dynamic rather than the traditional dyadic
psychotherapeutic phenomena.
5.1.2. AAP Therapy Triangle – Group and Systems Theory
The AAP dynamic transfers therapy from traditional client–therapist dyadic relationship
to one of a systemic triad38. Parish-Plass (2013) calls it the “AAP therapy triangle”
(p.56) and states that within the discussion of the interpersonal field the “intersubjective
reality of the analytic third comes to life” (p. 61), alluding to what Bollas (1987) calls
the psychic genera. Thus we could hypothesise that the presence of the dog as an
evocative object would enable the formation of new psychic genera (Ibid). In this
relational constellation – that of dog, client and therapist we have a dynamic which
Parish-Plass (2013) equates to the social microcosm within group therapy. The dog is
facilitating as both transitional and transformational object, and the stage is set for
psycho-creativity.
38 Triadic relating can be explored in relation to both systems and object relations theory. Triangles are a common concept in Family Psychotherapy and Walsh (2009) explores this in relation to pets in her paper “The role of pets in family systems and family therapy”, it is also mentioned briefly by Melson & Fine (2010) noting that humanocentric perspectives means that the pet is often overlooked in the family system and it too can be subject to the transference of intense interpersonal feeling. Triangulation is a very common way humans avoid conflict, it is a prevalent defensive manouvere in malfunctioning family dynamics and it is used to avoid stress (Bowen 1978).
49
Some clients (such as the selectively mute children spoken of by one participant) have a
need to avoid what may be a stressful dyadic relationship (i.e. to hide behind the dog);
the triad facilitates necessary displacements, and facilitates triangulation39.
Sacks (2008) and Glucksman (2005) have also written about the animal’s incorporation
into defensive manoeuvres (commonly referred to as triangulation in family systems
theory). These manoeuvres can be observed/mined for relational and attachment
insights without dismantling defence mechanisms.
The presence of the dog facilitates this group dynamic and a motivational system within
the therapeutic process. The animal’s presence, fulfils Lichtenberg’s (1988) five
motivational forces within systems – fulfilment of physiological requirements,
attachment/affiliation, aid’s in the capacity to react adversely (via withdrawal of
attention and displacement of focus on the animal, hiding behind etc.) and sensual
stimulation40.
The presence of the dog could be perceived as offering many of Yalom’s (2008)
therapeutic group factors also – instillation of hope (via the dog’s consistent relating,
warmth and welcome), guidance (the dog’s nurturing and empathic responses to
clients), universality (the bridge described by the therapist of equalisation and balancing
39 In psychotherapy this defensive action, normally construed, interpreted and discouraged as being pathological, can be facilitated in a healthy constructive way and used to elicit resources for the therapist and client, using the “utilisation principle”(Erickson & Gilligan 2002, p.18) of (Milton) Erickson which is a common technique in Ericksonian psychotherapy. 40 "Psychoanalytic theory is not at its core so much a theory of structure as it is a theory of structural motivation. To utilize findings of infant observation and research, psychoanalysts must be open to new conceptions of psychic organization. I propose five motivational-functional systems: the need to fulfil physiological requirements, the need for attachment and affiliation, the need for assertion and exploration, the need to react aversively through antagonism and/or withdrawal, the need for sensual and sexual pleasure. Each is built around a fundamental need; each is based on behaviour observable in the neonatal period; each may be the dominant motive expressed by an analysand's wishes during an analytic hour. For each motivational-functional system, affects are central” (Lichtenberg 1988, p57-72)
50
effect noticed thus diminishing the power dynamic between therapist and client),
altruism (the dog’s offering their body as a source of comfort as they respond to
clients), catharsis (it’s presence is noted as stimulating feeling and emotional affect),
development of new socialising techniques (the dog’s icebreaking effect coaxes clients
into a more real and spontaneous way of being), imitative behaviour (a mirroring of
behaviour is noticed by therapists), interpersonal learning (the responses of the dog in
the here and now reflect aspects of the clients self in the present moment), cohesion (the
dog makes the person feel loved and thus gifts a sense of belonging), imparting
information (the dog imparts uncensored immediate non-verbal information to the client
and the therapist in the here and now present moment therapeutically) and finally
corrective recapitulation (the dog is sometimes placed in roles (role-suction) via the
unconscious projections of the client thus allowing a gateway to open, as a catalytic
mirror, from which the therapist can observe, interpret and gift back an intervention to
help processing and working through in the therapeutic environment)41.
Finally in some cases the dog’s death (in the case of Sacks 2008) creates an opening
whereby existential factors can be explored.
When the dog is placed in a role position, Redl (1942) called this unconscious
compelling force within groups- “role-suction”. The researcher therefore perceives the
dog as being placed in the role of nurturer, pacifier, good mother, defensive shield,
container etc. This is a process whereby the client recreates their ideal object world.
This is illusory, as although the dog is a sentient, conscious, responsive being, one
41 Group theorists propose that the systems dynamic explicates conditions whereby we have fertile ground for regressive, transferential and resistant phenomena (Kernberg 1988, Wolf & Schwartz 1962, Yalom 2008).
51
cannot determine that its life’s purpose is to be sucked into an anthropomorphised role
as that of a human caretaker.
5.1.3 Clinical Cases in Literature
Accounts of clinical cases provided by Sacks (2008) and Glucksman (2005), published
in the psychoanalytic journals are congenial, agreeing with all themes discovered in the
data, as well as presenting additional themes. The cases they discuss are possibly most
relevant due to the complexity of detail, narrative corollary, with depth exploration and
attention to observed therapeutic dynamics in the context of private practice. This is
lacking in the literature (with the exception of Parish-Plass 2013). These articles are
similar, confer numerous identifications with participants which are explicated
throughout their texts, confirming relational/alliance enhancements, facilitation of
insight and the generation of relaxation and calm.
Sacks (2008), describes in detail the level of attunement that her dog Sara created within
the therapeutic alliance, offering the researcher added insight to the participants in the
study. She states her dog possessed a sense of time (similar to a dog in this study) and
rather than use the Rogerian concept of unconditional positive regard, she chooses to
use Winnicott’s term: devotion, and related object relations terminology.
She characterises Sara as having the capacity to respond to clients, which she felt led to
a “corrective object experience” (p.510). This responsiveness was what she felt
generated attachment in the alliance and in particular the dogs’ ability to go to and touch
the client at times when they were experiencing emotional pain. She felt that the dogs’
capacity to serve as a gateway to “indentifications” and “here and now” interpretations
52
in the present moment was a valuable role and an adjunct to her presence as therapist.
She feels this work allowed them to access more of (what Winnicott called) the True
Self. Theoretically she states that she viewed Sara as the “Good Mother”, her presence
holding and containing via her empathetic responding and “devotion”42.
Glucksman’s (2005) article echo’s that of Sacks (2008). She feels her dogs most
important role “is that of a non judgemental, supportive, loyal co-therapist” (p.611),
facilitating a holding environment. She states patients feel less threatened when he is
present, points to his even-temper, empathetic nature and outstanding confidentiality.
She feels he functions as a client and therapists “best friend in the consulting room”
(p618).
The researcher agrees with Sacks (2008) and Glucksman’s (2005) accounts, as they fit
cohesively with those of the participants studied, in fact, from reading their articles, they
could easily have been participants.
5.1.4. Transference Phenomena
The researcher would like to add discourse regarding polarised transference and
Kernberg’s (1995) concepts of the “idealised transference”. In contrast to Kohut (1984),
Kernberg (Ibid) thought the idealised transference got in the way of the real working
42 Sacks (Ibid) also found Sara to be a social lubricant and helpful with clients who found it difficult to relate directly to the therapist, noting transference displacements (both positive and negative). Her interpretation is also in agreement with the subtheme - relational consistency (albeit interpreted via Kohut’s concept of self-object) and may explain the generation of trust and rapport that the therapists in the study outlined. She states that this “repetitive experiencing”(p.519) is developed via the human animal bond in clinical practice and facilitates the “corrective self-object experience” leading to trust. She also agrees with sub-themes of “defence observation”.
53
through. Kohut (Ibid) believed it was a natural part of the clients healing and had to be
facilitated. Here the addition of an animal serves to take the path of the golden mean.
In the eyes of the researcher it appears the data presented in the study (and that of the
psychotherapeutic literature) that the dog takes on the idealised transference, becoming
the all-good object, the “good mother”. The dog’s presence and extension of self could
be viewed as gifting to clients what Bion (1962) termed reverie - the mother’s capacity
to alleviate anxiety and tension “reverie is a factor of the mother’s alpha function”
(p36).
This opens the doorway to secure attachment and trust. The dog as the good object
became a symbol of “generative innocence” (Bollas 1995, p200) within the therapeutic
dynamic “this generative innocence creates a continuously renewed “blank screen”
upon which one can project one’s desire” (Ibid p200).
The transference displacement indicated by the therapists point to the expedited
development of a real relationship between client and therapist. The therapist does not
become the object of idealisation - the dog does and rather than being illusionary the
dogs’ idealisation is that of evocation. This does not seem to hinder the client; leading to
what Kernberg feels would be disappointment, as the dogs’ relational consistency and
congruence does not cause undoing and negative regression within the therapeutic
process, as the idealisation does not seem to fade43.
43 The researcher hypothesises that this would allow the clients conflicts emerge free from the normal constraints of resistance, due to the sense of containment and safety created via the presence of the dog. It could also be suggested that the dogs’ role within the systemic alliance contains the idealised transference via displacement and consequentially the development of a real relationship ensues at a more expedient rate.
54
The issue of self disclosure (a term originating from Jourard 1958) is presented via the
presence of the therapist’s dogs is an explicit disclosure in the immediacy. The
symbiotic merging of therapist and dog within the psyche of the client could also aid
facilitation of - the real relationship, Gelso (2011).
The researcher would posit that if dog facilitated psychotherapy were to be observed
and studied, the use of mirror observation techniques as used in family systems therapy
would be beneficial44.
While many justified critiques exist arguing that there are no present empirically
validated study to be found in literature the researcher nonetheless includes discussion
of a quantity of studies that relate to specific points that present possibly influential
concepts worthy of further study.
5.1.5. Psychotherapy Studies
Psychotherapists in Mason and Hagan’s study (1999) report that the “use of animals
was helpful as an “icebreaker” in the beginning of therapy” (p.1240). They reported that
it facilitated the building of the relationship and that it occurred faster. The calming
affects reported by participants along with the themes’ of projection, sensory touch –
44 Mirror observation was first used by Fulweiler in the 1950s (Haley 1996, p.133) and led to Batesons theory of circular causality, (which he exposits in “Mind and Nature: A necessary unity”, 1979) where he proposes reciprocal, rather than linear cause and effect. It might be a helpful tool here as the addition of a dog to psychotherapeutic process seems to induce a circular causality within the dynamic that is evident in the theme transference displacement. It would be interesting to examine processes in detail. The researcher proposes the hypothesis that it may offer elaboration of the theory in much the same way as it led to the confirmation of the theory of circular causality in family systems theory. This could possibly aid in ratification of hypothesis presented in this discourse especially at this stage of its development as a treatment modality. This would clarify the mechanisms presented and allow a more explicated development of phenomena.
55
giving “contact comfort” (p.1241) and reduction in anxiety as a result of the dogs
presence are all in accord.
This study included mention of a client mistreating the animal and a participant stated,
“it resulted in his being kind of cruel to the dog”. No elaboration is given other than a
statement that the dog was removed. It raises valid issues of risk along with serious
ethical questions. (These will be discussed later in this chapter in more detail, as
unfortunately the researcher discovered there are multiple accounts of varying degrees
of abuse detailed in the literature that are not commonly presented in studies).
Some psychotherapists in Mason and Hagan’s (1999) study also stated that having the
dog in the therapeutic dynamic was for selfish reasons45.
Correlations can be made to the work of Wilkes (2009) who found similar results in
counselling psychologists, specifically – enhanced therapeutic alliance/relationship.
Conforming results include: empathetic responses from the dog, trust and rapport,
relaxing and calming. One participant stated, “a child was hurting and the dog took it
upon himself to comfort her. The dog went to her on his own, seeming to know the
child needed the warmth and love he could provide” (p.63).
Another participant allowed clients to bring their own dogs to therapy. Speaking about a
young female client he states – “this big German Shepherd sat right on her lap and the
questions that I asked she would look out around behind the German Shepherd and
45 They felt it made them happier by increasing their job satisfaction and they felt it increased business and lowered cancellation rates. Some clients reported jealousy in therapy and felt the dog was in fact a barrier between them and the therapist.
56
answer the questions. And what a sense of how unsafe she felt and how much that dog
was needed by her” (p.59).
Experiences described by participants were, similar to Sacks (2008), related to object
relations theory and the conclusion of Wilkes (2009) was that “animals in the
therapeutic environment act as catalysts in the holding environment assisting clients to
feel connected to spirit” (p.89).
Stewart et al (2013) pursued discovery of “theoretical underpinnings” (p332) of AAT in
counselling. Their aim was to gain understanding of the impact of various techniques of
AAT within the counselling context and the counsellors attitudes to AAT in their
practice. The theme “Impacting the therapeutic process” can be related to this study46.
This could logically lead to the proposition that the dogs mirror neuron system is
activated. According to Cozolino & Santos (2014) the mirror neuron system can
“activate emotional states supportive of emotional resonance and empathy” (p. 164).
(This can be linked to the studies on yawning contagion (Joly-Masheroni et al 2008,
Bessa & de Sousa 2012). This proposition is inextricably linked to theory of mind. The
hypothesis of the empathic response of the dog in the therapeutic environment will be
discussed further on in the context of relaxation and the perspective of the dog.
46 They mention relationship enhancement, development of trust and rapport, lowers defensiveness, AAP triangle, present moment, touch and a very interesting example illustrating empathetic resonance was given outlining how during breathing exercises with clients “the dog’s breathing changes. His breath becomes very deep and very slow and very meditative. You can hear it very easily”(p.341).
57
5.1.6. Esoteric Phenomena
The dog also seems to aid analytic intuition. In some examples, even “knows” before
the therapist does. Is it a channel for Bion’s (1962) mysterious third, or perhaps
Mindell’s (1982, 1995, 2000, 2010) concepts of roles, role-switching and ghost
representatives in clients “dreamland” subjective states?
Agency in groups became as “mysterious, potentiating, synergistic summation and
transformation of the combined agencies of the individuals” (Lipgar & Pines 2003, p
14) and in these cases it could be postulated that the dogs perform a function within the
system.
Bion’s concept of “O” could also lead one to hypothesise that the dog could be
perceived as a symbolic representation of “O” within the therapeutic environment and
process.”O” being Bion’s symbol for the archetypal unconscious and unknowable
otherness. O “designates an ineffable, inscrutable and constantly evolving domain that
intimates an aesthetic completeness” (Grotstein 1996).
This poses the possibility to relate AAP to Hellinger’s (2003) constellations theory and
Sheldrake’s (2009) theory of morphic resonance. Carminati et al (2013) present the
hypothesis that AAT relates to Jung’s theory of the collective unconscious, exploring
the idea that the therapy experience with the animal “can be related to a rewinding of
the patient’s unconscious to very primitive phases of his development” (Ibid, p451)47.
47 The researcher postulates that this could be related to neuroscientific research by Stoeckel et al (2014) that found that activity in the human brain viewing images of dogs and children showed striking similarities in areas of human-child and human-animal responsive neuroanatomy. The mirroring effect of perceiving a dog as a child could therefore trigger unconscious identifications with the child like aspects of self and offer a possible explanation of why the rewinding effect is possibly triggered.
58
MacLean & Hare’s (2015) position on the possibility of a bonding pathway and the
oxytocin loop proposed by Nagasawa et al (2015) add to Stoeckel et al’s (2014) theory
and will be discussed later.
Rather than a virtual object that inhabits the space the dog is real and alive and appears
by all accounts to be very much moved by the energy and responsive to it. Ogden’s
(2004) subjugating third subject in this instance is alive and moves less virtually. How
the dog is influenced by the unconscious energy floating in the space one cannot
definitely say but can merely speculate that it does appear to be influenced by it48.
5.1.7. Critics of AAT
Marino (2012) presents a very compelling argument regarding the validity of the
construct of AAT and suggests five basic threats inherent in qualitative studies on
AAA/AAT/AAP that the researcher finds to be clear and compelling arguments-
Placebo
Novelty
Construct confounding
Demand characteristics
Experimenter expectancy effects (p143)
48 While these concepts of the collective unconscious, morphic resonance, dreamland states and constellations theory are rather esoteric- abstract, complex and not easy to verify/substantiate scientifically, they are sometimes ignored and dismissed. Despite this, the researcher simply feels the requirement to acknowledge them and present them as worthy points of information/phenomenon that have been observed and noticed. After all, within psychotherapeutic processes, these phenomenon have been distinguished by Jung (1966), Bion (1962), Ogden (1984) and Bollas (1987).
59
Marino’s (Ibid) view is that the most provocative and strongest study she examined was
an AAT study on loneliness in nursing homes by Banks, Willoughby & Banks (2008),
which generated the question - “how important is the animal in AAT?”(Ibid, p139).
Souter & Miller‘s (2007) meta analysis of AAA/AAT as an effective treatment for
depression focussed on studies that used both random assignment and control groups.
They reviewed 165 articles of which 60 studies met the criteria for inclusion and
approximately half were then eliminated as they did not include a measure of
depression. Only five met the criteria i.e. used random assignment and control groups.
However, sample sizes were small and ranged from 5-25 participants. The conclusion
they reach is that “five empirical studies show that AAA/AAT has positive effects on
depression that are both statistically significant and large enough to be of practical
significance” (Ibid, p178).
The fine print states that “our meta analyses support the effectiveness of AAA, and in
one case, AAT” (Ibid, p176)49.
Nimer & Lundahl’s (2007) meta-analysis only incorporated 49 out of 250 studies
(incidentally only 23 of the 49 studies incorporated a control group). They state that
AAT is used to frequently target mental health concerns and dogs are the most common 49 While the researcher accepts that they have found one case that concludes that AAT is an effective treatment for depression, this one case does not control for Marino’s (2012) criticism of “construct confounding”. Therefore, out of an examination of 165 articles stating that one case constitutes a conclusion that AAT as an effective treatment of depressive affect constitutes the stretching of truthful boundaries. This is precisely the problem that is so prevalent in the reporting of results within this field. If one accepts that construct confounding is an issue, as is novelty, the researcher also proposes acceptance of Marino’s (Ibid) methodological controls. One would need to include the exposure to another novel stimulus and a long-term follow up assessments within studies (which as of the present moment, no study has managed to achieve).
60
choice of animal. They state the data does not support the use of AAT with adolescents
and that “none of the correlations reached statistical significance”(Ibid, p233) and “the
correlation for medical outcomes suggest that more AAT is associated with fewer
desirable outcomes”(Ibid, p233). They also state that “the idea that AAT is particularly
effective with disabled populations may be a function of hope that AAT will reach this
difficult to help population rather than a reality” (Ibid, p234).
Chur-Hansen (2010, 2014) and Stern & Chur-Hansen (2013) also repeatedly question
methodological weakness and the persistence of this weakness in studies.
Banks, Willoughby & Banks (2008) used control groups, random assignment and
deconstructed the AAT activity for study by designating a live dog, a robotic dog and a
group given neither. They state- “we found no difference between the effectiveness of a
living or robotic dog in reducing loneliness” (p175-176) and they conclude that “robotic
dogs may be an option for those desiring pets or needing AAT in circumstances where
the needs of living animals cannot be met” (p176).
The amount of qualitative studies relative to contrast to this study are sparse, it seems
that the value of dogs in psychotherapy is verifiable only from the perspective of
individual published psychotherapeutic cases and other qualitative studies conducted in
a similar philosophical vein. In relation to AAP the primary threat to validity is the
inextricable link between therapist skill and incorporation of the dog. This component
cannot be dismantled as they are symbiotic and interdependent.
61
All, but one of the benefits cited by the therapists could theoretically be achieved within
psychotherapy without incorporating a dog50.
Odendaal (2000) concludes by alluding to the question of novelty also stating that “the
profile for neurochemicals during positive human-dog interaction can be too
generalised, it is possible that the “success” of other complimentary therapies such as
reflexology, music therapy, some types of physiotherapy, and play therapy could also be
based on the same physiological changes because attentionis egens needs are fulfilled. It
may also fit with the “skin hungry” theory.” (p280).
The researcher would state that one must consider that participant’s vast experience as
construct confounding as their knowledge and years of training and practice could be
the active component/element that is possibly a larger factor than that of a dog
influencing the generation of the theoretical concepts. Therefore the theoretical concepts
could merely represent the ideal of good therapeutic processes.
The researcher accepts that the inclusion of a dog for psychotherapeutic purposes from
the perspective of the therapist would possibly lead one to achieving greater insight and
clarity at a faster rate. The hypothesis that this might be due to the fact that it meets both
Yalom (2008) and Lichtenberg’s (1988) positive therapeutic group dynamic processes,
is possibly the most likely factor that contributes to the therapists perceiving this
stimulating effect within therapeutic relating.
50 Therapeutic touch being the only one – although body psychotherapists could theoretically provide this. The novelty effect of the dog and the demand characteristics are also major factors influencing AAP’s perceived efficacy anecdotally due to the fact that therapists and clients who like dogs have inherently biased responses regarding the research hypothesis.
62
5.1.8. The question of empirically validated efficacy
Stern & Chur-Hansen (2013) asked a very important question regarding the evaluation
of AAI’s – “If the quality of literature has continued to increase, why is it that the
quality of this research has not continued to progress with it? Is this due to the field of
inquiry being one that cannot be verified through scientific research?” (p129).
To put it succinctly and factually, the only conclusion results surrounding the efficacy
of AAT can deduce is that it is inconclusive and at present lacks sufficient evidence for
empirical support.
What must be also be taken into account is that while this study focuses on values and
efficacy within the framework of psychotherapeutic benefits, it would be essential to
repeat this study to investigate negative mechanisms that detract, contra-indications,
risks to client and dog and as Ogden (1993) states that “different psychoanalytic
perspectives are much like languages” (p.1), all psychotherapists ever do is offer
interpretation, we can never know for certain, anything.
The duality of instinct and analysis presented by the work of the therapists and the dogs
is intrinsically meta-sensual and meta-theoretical. It is intriguing and worthy of further
exploration. The researcher simply presents the various perspectives in order to allow
the reader to make their own independent assessment with as many viewpoints as
possible. The researcher will now explore AAP from the perspective of the client.
63
5.2 Clients perspective
Discussion will now progress by viewing the complex from the perspective of the
client.
5.2.1 Introduction
While deficiency of empirical validation of AAP has been previously discussed the
biggest gap in literature relates to the experience of clients. The client’s perspective will
be explored first from the perspective of what type of client might benefit. Then the
researcher will look at the only two studies she could find that relate to investigation of
client experience via Schneider & Pilchak Harley’s (2006) study evaluating people’s
perceptions of therapists with and without a dog, White et al’s (2015) study exploring
the experience of women undergoing AAT counselling in the context of breast cancer
diagnosis. Finally she presents the only negative representation found in literature found
in historical evidence pertaining to patients of Sigmund Freud.
5.2.2 What kind of client profile could benefit from AAP?
Sacks (2008) and Parish-Plass (2008) present an outline of the kind of client AAP can
assist.
Sacks (2008) states that she believes AAP is beneficial for clients who are ambivalent,
have intimacy issues, have experienced deprivation and are ego impaired. She feels the
animal serves as a mediator especially for inhibited patients and “for patients who are
constricted, feel exposed and do not find talking about themselves a pleasant
experience, use of the animal in therapy positively defuses this”(p511).
64
Parish-Plass (2008) feels it can be beneficial in the treatment of children presenting with
insecure attachments, who have suffered trauma, neglect and abuse. She feels it can
assist in therapeutic goals, presents a rationale supported by objects relations theory
(p13-17) of how it assists her in gaining trust, enables connection, the animal as
attachment object facilitates working through in here and now, creates a sense of
normalcy, safety and friendliness, acceptance, presents reality at a safe distance
psychologically, facilitates change, raises self-esteem, develops adaptive
representations and strategies, creates a feeling of being in control, offers the
opportunity for touch, facilitates ego serving regressive states, allows working through
of separation, loss and bereavement, develops capacity to empathise and assists in
working through of issues the abuse has imposed upon the life of the child.
These two authors are notable in that they both concur that the conditions created are in
alignment of group conditions.
5.2.3 Contraindications and consent
Not every client is amenable to canine company when they visit their therapist and
while the participants of this study always checked with clients before including or
introducing their dog in sessions, clients with allergies and phobias generally don’t
consent, according to participants and literature. Clients who simply state a preference
due to indifference, dislike of dogs or narcissistic pathology also have their request
respected. These elements may possibly be explored further in therapy, but without the
dog. Therapists respect ethical guidelines of their professional bodies and act in
deference to their clients’ choice. Parish Plass (2013), Fine (2010) and Chandler (2005)
cover the client’s informed consent, screening, allergies and phobias in their respective
handbooks.
65
5.2.4 Studies relating to clients
Practical issues may explain how obtaining the clients perspective on dogs they have/or
are experiencing as “co-therapist” in psychotherapy, is that it is pragmatically difficult.
Ethical constraints and the boundaries of therapy are a possible reason that only one
study could be found exploring the client’s perspective. A second study used videotapes
of psychotherapists with and without dogs in order to determine how dogs influenced
people’s perceptions and evaluations of a psychotherapist.
In both studies the samples only included individuals who actually liked dogs –
“potential participants who were the most negative toward dogs were screened out of
the study because they did not want to be in a room with an actual animal” (Schnieder
& Pilchak Harley 2006, p.138)51.
In order to determine “What is actually changing when the therapist is accompanied by
a companion animal?” from the potential client’s perspective, Schneider & Pilchak
Harley (2006, p.138) asked a group of participants to watch videos featuring a male and
female therapist, with and without a dog. They wanted to see how participants’
perceptions of therapists changed as a result of the dog’s presence. Afterwards they
completed a background information form, a therapist rating form, a disclosure to
therapist inventory and a pet attitude scale.
Their first hypothesis – that “the presence of a dog exerted a positive influence of the
psychotherapists compared with the condition where there was no dog present” (p135)
51 They state that the issue requires more research and I would pragmatically postulate that getting a study through an ethics committee whereby participants who dislike, are phobic of or allergic to dogs would take a great feat of research design, thereby presenting another double bind.
66
was proven correct. The largest factor that impacted on the positive influence was the
perception of trustworthiness.
The second hypothesis – “psychotherapists accompanied by a dog would elicit a greater
willingness to self-disclose” (p.134) was also confirmed, and they state that analysis
revealed higher levels of disclosure with a dog present. They also state that this was
significantly higher in relation to the female therapist.
They state that their third hypothesis – that positive attitudes towards pets and positive
attitudes towards therapists in ratings would influence the outcome, was not supported.
Although trustworthiness and ability to self-disclose are essential for a successful
therapeutic relationship/alliance the researcher is not convinced it can be measured via
analysis of peoples’ responses to videotapes. Results in this study state that it appeared
dog’s presence influenced peoples’ perceptions of psychotherapists favourably in this
regard, however this can by no means be equated with actual live therapy and clients’
lived experience. Nevertheless, in the absence of other data it does offer a little insight
as to dynamics that may be at work.
This outcome would lead the researcher to conclude that the perceptions of the therapist
are linked to the perception of the dog in the eyes of potential clients who are amenable
to DFP. The theme it correlates to in this study, is of “trust and rapport”, a subtheme of
“enhancing the therapeutic relationship/alliance”. However we cannot conclude that
other themes are eliminated as trust and disclosure are the only themes in the study
tested that relate.
67
In the next study direct responses were elicited from actual counselling clients who had
experienced AAT counselling.
In this study of the experience of women undergoing counselling with a therapy dog, as
support for breast cancer diagnosis is presented by White et al (2015). They conducted a
thematic analysis of eight women using semi-structured interviews which they state
“aimed to explore the acceptability of and experience of AAT”(p.460) unfortunately this
also has an inbuilt bias as “all participants identified as dog lovers” (p. 462).
The results of their study are in consonance to this study. They state that their results
suggest that “AAT served as an icebreaker and catalyst for sharing” (p.465), that “being
able to pet a dog during counselling provided a sense of familiarity combined with
feelings of greater comfort and calmness” (p.465). Participants stated that “I looked
forward to her very much” (p. 463) (positive anticipation), “dogs are very not
judgemental” (positive regard), “I found it really relaxing to just have the dog
there”(p.464) (generation of relaxation), “I just needed a break from talking; that was
nice to focus my attention on something else...you know I can pet her” (p. 464)
(transitional object), “to have another warm body there was, was comforting” (p.463)
(touch and transitional object), “when I started getting a little bit anxious, Tallulah just
came over” (p.464) (empathetic response), “when you are patting Tallulah and talking –
the feelings can actually go to Tallulah, not to the counsellor. Tallulah can endure all the
feelings, she doesn’t care, right” (p. 464) (transference, projection, objectification).
We can see that many themes are in parallel from the perspective of these participants,
however two new ones emerge – “a greater positive anticipation of counselling” and
68
objectification of the dog. White el al (2015) also state that benefits include “factors
such as novelty, safety, joy, excitement, and feelings of ease during the experience of
counselling” and “from a clinical perspective AAT promoted increased communication”
(p.465) possibly correlating to the theme of willingness to self-disclose in Schneider &
Pilchak Harley’s (2006) study.
It would seem that the data is consistent to that of the emergent GT in this study as they
seem to concur with some of the themes of enhanced therapeutic relationship/alliance
and generation of rapport, however there is an absence of any reference to the
facilitation of insight.
5.2.5. Freud – how not to practice DFP?
It is difficult to find evidence of alternative accounts to balance the advocacy of DFP in
the literature. The apparent absence of counterarguments from clients depicting an
ambivalent or negative experience with dog facilitated psychotherapy would lead one to
believe that there is an impasse. However the researcher posits that the answer might lie
in historical accounts given by the analysands of Freud. Upon closer scrutiny of texts
pertaining to Freud’s dogs in the therapy room, the researcher uncovered a very
different story to that of the usual “father of animal assisted therapy” propaganda that is
to be found in the opening paragraphs of vast amounts of papers relating to why AAT is
effective. So the method of abduction in this case comes from history.
5.2.6 Background
The Freud’s were the first known therapists documented as having their dogs present in
private psychotherapy practice. What Genosko (1998) terms the “Freudian Canophilia”
69
(p.48) late in Freud’s life as a result of Anna’s acquisition of a German Shepherd –
Wolf52, who functioned as a protector while she went for walks.
Analysands frequently encountered the Freud’s dogs. In Volume 8 of Anna Freud’s
writings she states: “Jofi patiently participated in all analytic hours” (Freud 1981, p360),
(Freud Museum 1999, p.38-40), (Genosko 1998, p.50-57), and Gay (1988) states, “the
dog would sit quietly at the foot of the couch during the analytic hour” (p.540).
Accounts like these, by what Dufrense (2006) terms Freudian “apologists” with Freud
going so far as telling people his dogs were “psychoanalytic dogs” (p.141), in his
chapter aptly entitled “Psychoanalysis, Doggie Style”, serve to perpetuate of the myth
that Freud was a ground-breaking proponent of AAP. However, in light of what will
follow I will argue that this is not exactly truthful. It seems from the accounts in the
literature that Jofi was there because Freud loved her and wanted her there.
When one takes a closer look, Martha, Freud’s wife was not the only one who did not
appreciate the dog’s presence nor how her husband fed them from the table (Roazen
1976), his patients also took issue with Jofi and Wolf also and clearly this cannot be
pathologised as a narcissistic objection or interpreted as negative transference
displacements as the accounts given of the dog’s behaviour are similar.
52 Anna’s dog Wolf, was referred to as - “the old gentleman”, (Genosko 1998, p 50) and he was treated as a member of the family. He was their longest living canine member, spending ten years with the Freuds. One of Freud’s patients, Princess Maria Bonaparte, a devout dog lover, gifted Freud two chows. The first, Lun Yug, died tragically and after a sufficient period of mourning Freud acquired Jofi.
70
5.2.7. Freud’s analysands’ perspectives.
Accounts from his patients – Hilda Dolittle (1971, 2012) and Roy Grinker (1940),
Ernest Jones (1990) (Blanton 1971) proffer that Jofi’s participation may not have been
entirely optional nor consensual.
“It’s abundantly clear that by indulging his love for dogs Freud disregarded his
precious council concerning proper analytic technique, namely, the idea that
analysts should strive for neutrality while freely attending to the patients
unconscious”(Dufrense 2006, p.141).
It is said that Freud relied upon Jofi to vet suitable candidates for treatment and she is
also credited for facilitating the closure of the therapy hour (Freud Museum 1999, p.40)
(Freud M. 1958).
Conversely, according to Ernest Jones (1990) upon meeting Wolf, the dog bit him and
Freud still accepted him as a patient. He states – “he flew at me and tore a piece of my
thigh” (p.31). One has to postulate that today’s litigious culture - that would be a
psychotherapist’s nightmare.
Grinker (1979) states that he frequently bribed Freud’s dogs with treats in order to
occupy them and prevent his analytic hour from being cut short, so it seems Jofi’s time
telling capacity was not altogether accurate and one could hypothesise that it was
simply the dogs wish to be relieved from the situation. Martin Freud (1958) confirms
that his father may have cut sessions short on the whim of the dogs.
71
While the therapists in this study interpreted projections and statements made by clients
about the dog – in Freud’s case – this appears to be contrary.
“Freud frequently offered comments and interpretations through his dog. When
Jofi would get up and scratch at the door to be let out Freud would say, “Jofi
doesn’t approve of what you’re saying”. When the dog scratched at the door to
get back in, Freud would playfully say, “Jofi wants to give you a second
chance””, (Grinker 1979, p.9).
Grinker (1979) also wrote that Freud’s dogs frequently sat beside him on the couch,
rather than quietly at clients feet, he states “as a child I had been deathly afraid of dogs.
Now Freud’s dogs got the full force of my fears and hatreds” (p.9). He also goes on to
elaborate on a very emotional moment he had whilst lying on the couch, whereby Jofi,
interrupted him, jumped upon him and Freud apparently declared that the dog was
happy that he had discovered the source of his anxiety!
While Freud thought that “this resistance was much less vigorous when the dog was in
the room” (Coren 2002, p.140), one has to question was it his own or that of the client?
The presence of the dogs appears to have stimulated resistance in Smiley Blanton, a
patient and supervisee of Freud’s, to the extent that he requested the removal of the
dogs. He is the only individual on record as having made the request (Blanton 1971).
After a session with Freud, Hilda Doolittle’s entry in her diary reads –
72
“I feel limp and frustrated. I was annoyed at the end of my session as Jofi would
wander about and I felt that the Professor was more interested in Jofi than he
was in my story” (p.162)53.
So, while Freud felt the calming presence of the dog in the therapy room reduced the
clients anxiety – stating that, “since the dog seems to be unmoved by anything the
patient says, Freud concluded that this gives the patient a sense of safety and
acceptance. Even when the patient describes very painful or embarrassing moments, the
dog doesn’t react”, (Coren 2002, p140). We know that Jofi reacted once by jumping on
Grinker (1979) so his opinion does not entirely match those given in his patients
accounts.
Morley (2007) includes a longwinded, dramatic vignette whereby Anna’s dog came into
one of Hilda Doolittle’s sessions attacking Jofi stating that it - “invaded Freud’s
consulting room during the analysis. A dog fight ensued”, (p.102).
This cannot, in anyway, have led to the generation of relaxation and calm in the client.
In support of this hypothesis, Grinker (1979) went so far as to remark that he entered
therapy with a strong element of castration anxiety owing to Wolf’s propensity to greet
him by sniffing his genital area.
What in fact seems true, is that Freud’s conviction, that pets enhanced the psychological
well-being of the individual was pondered until his death (Molnar 1992, p. 269-280),
53 What is even more interesting is the next entry where she writes of “a familiar nightmare” and states “I am annoyed but in my dream too frightened to be other than polite”(p.162). Was she too polite to request that the dog be removed from her sessions? Perhaps this proposes the question of power.
73
however judging by a more detailed examination of the evidence, this has to be taken in
the context that they seem to have enhanced his own well-being and he derived great
joy from their companionship.
The historical context and acknowledgement that these individuals continued to attend
their sessions with Freud despite whatever displeasure they voiced in private or in
hindsight, must also be considered. The researcher accepts that it is not known if or
what they may have expressed to Freud himself as they were not there and did not bear
witness. Thus a judgement cannot be made in favour of or against Freud per se,
however one can simply ask – in the absence of client perspective on AAP, do the
perspectives of Freud’s patients point us in the direction of mechanisms to explore and
debate ethically?
As has been previously stated in this thesis, the literature is skewed and the majority of
what little literature there is pertaining to psychotherapeutic contexts is extorted from
the perspective of the psychotherapist.
One has to link the accounts of Freud’s patients back to Mason & Hagan (1999),
whereby they state that some psychotherapists included a dog in therapy for selfish
reasons i.e. to make themselves feel happy and increase their job satisfaction54.
54 What the researcher can deduce, is, what appears to arise is the issue of power, and the need to question the client’s compliance and/or ability to express their viewpoint in the context of AAP/DFP. This is an issue that is debated as infinitum by psychotherapy and its critics. So while the participants of this study only work with consenting clients, those who like dogs and have and affiliative association with dogs, they are also working with dogs who have a very suitable temperament.
74
5.2.8 Conclusion
The accounts of Freud’s patients point to many risks involved in having a dog present
(or in their case several dogs). The perspective of the client points to a perspective
indicating distraction (both to the client and the therapist), violation of personal
boundaries, physical risk, causing injury and creating psychological disturbance.
The researcher, based on historic evidence presented depicting the perspective of the
client leads to the following hypothesis: While the theme “generation of relaxation and
calm” remains valid from the perspective of participants in this study, it is syllogised
that this does not explicitly translate to the perspective of the client and possibly not that
of the dog, which she will now progress to and explore.
5.3 Dog’s Perspective
The discussion will now view the phenomenon of AAT from the perspective of the dog.
5.3.1 Introduction
The position of the dog has been largely ignored in the literature, as has been stated
previously by authors in this field55 and in that of broader fields of ethology,
neurobiology and ethics. Chur-Hansen et al (2014); Parish- Plass (2014); Marino
(2012); Bekoff (2008); Hatch (2007); Zamir (2006) have all issued a call for the
perspective to the animal to be taken into consideration. Therefore the researcher felt it
was necessary to address some issues pertaining to the dog in relation to the results of
this study and that of the more generalised AAT field.
55 Parish-Plass(2013) recommends that a multidisciplinary approach is taken with AAP including animal sciences and ethics and Turner, in (Fine 2010) advocates for the necessity to include ethology, therefore this discussion draws on multidisciplinary fields.
75
The codes that can be questioned in relation to the dog are those of imparting the core
conditions (a sub-theme of enhances the therapeutic relationship/alliance) and generates
calm and relaxation. So the researcher proposes to take this section of discussion in
three parts.
The first part of the discussion will discuss the relevant results in correlation to the
literature, and essentially ask the question are the psychotherapists accurate in their
perceptions and are their dogs capable of the core conditions and in particular empathy
– can they feel and emote? And, if so are they subject to the same emotional contagion
and disturbance of affect that humans are?
The second part will inquire as to the truth of the claim that they facilitate the relaxation
response in humans that is observed by the psychotherapist participants?
The third part will explore ethical questions – examining what is written in AAP/AAT
literature; why critics are saying the ethical issues have not been satisfactorily
addressed, looking at what debates are occurring in wider interdisciplinary fields and
finally returning to this study, the question of consent and the implications of omitted
arguments for the field of AAP/AAT.
The researcher would like to reiterate the importance of challenging what are noted
inductive biases in this study and literature biases noted by critics (Chur-Hansen et al
2014; Marino 2012; Herzog 2011) Inclusion of many alternate views in the interests of
closer scrutiny via analysis as a tool to question validity and strive for rigour.
76
While the participants’ dogs in this study appear to facilitate psychotherapy willingly,
and participants state their dogs are never over worked, with several participants stating
that the door is always open in order to allow them the choice to take leave of their own
volition or access a quiet corner with a bed/crate and water which they can retreat to for
a snooze or respite.
The researcher acknowledges the high standard of ethics to which they adhere, however
when one approaches the more general AAT literature this appears to be the ideal –
rather than the verified norm and she will substantiate this claim with evidence from the
literature.
While dog owners and canophiles can claim that dogs are proficient in imparting the
core conditions, capable of empathetic responding and may go so far as stating that they
are able to create what Edmundson (2010) describes as Freud’s idealised pure love
relationship, what can science offer to the discourse to refute or support these claims
made by participants?
5.3.2 Sentience, cognition and theory of mind.
First one must address the issue sentience, then of canine theory of mind, as logically
evidence must be provided for both and they are inextricably linked to the capacity to
empathetically respond, i.e. necessary for the participants’ attributions of core
conditions and empathy, to stand ground.
77
The Cambridge Declaration on Consciousness (relating to animals) published in 2012,
accepts the sentience of a wide range of non-human animals (relative to this study – all
mammals)56.
In a systematic review of scientific literature, Proctor et al (2013) state that there is an
abundance of data attesting to animal sentience and that the subjective emotional states
of animals are “regularly measured and studied with scientific rigour” (p.882). They
state that knowledge of animal sentience is fundamental to many disciplines and
fundamental to issues of welfare. They also point out the irony that much of the
research that confirms animal sentience comes from literature on development of drugs
and treatment for humans, i.e. it includes vivisection. Their position is in acquiescence
to that of Bekoff & Pierce (2016), Allen & Bekoff (2008), Bekoff (2013a, 2013b, 2009,
2007, 2006a, 2006b)57.
One of the world’s leading ethologists and Professor Emeritus of ecology and
evolutionary biology at Colorado University – Mark Bekoff58, publicly stated that after
2,500 studies “it is time to declare animal sentience proven” (Bekoff 2013).
56 We declare the following: “The absence of a neocortex does not appear to preclude an organism from experiencing affective states. Convergent evidence indicates that non-human animals have the neuroanatomical, neurochemical, and neurophysiological substrates of conscious states along with the capacity to exhibit intentional behaviors. Consequently, the weight of evidence indicates that humans are not unique in possessing the neurological substrates that generate consciousness. Nonhuman animals, including all mammals and birds, and many other creatures, including octopuses, also possess these neurological substrates.” * The Cambridge Declaration on Consciousness was written by Philip Low and edited by Jaak Panksepp, Diana Reiss, David Edelman, Bruno Van Swinderen, Philip Low and Christof Koch. The Declaration was publicly proclaimed in Cambridge, UK, on July 7, 2012, at the Francis Crick Memorial Conference on Consciousness in Human and non-Human Animals, at Churchill College, University of Cambridge, by Low, Edelman and Koch. The Declaration was signed by the conference participants that very evening, in the presence of Stephen Hawking, in the Balfour Room at the Hotel du Vin in Cambridge, UK. The signing ceremony was memorialized by CBS 60 Minutes.57 Bekoff (2013b) notes the surge in published articles in this field, in 1990 there were 30 odd and that has consistently climbed to approximately 250 articles in 2011. 58 Bekoff has published over 1000 articles and 30 books on the subjects of animal behaviour, emotion, ethology, ecology etc. The list is very long.
78
While there is much debate regarding theory of mind in dogs with Penn & Povinelli
(2007) aggressively arguing against theory of mind in animals generally, stating that
there is no evidence whatsoever. Horowitz (2011) concedes rudimentary theory of
mind, Coren (2011) asserts that they do, Bekoff (2001) has demonstrated self-awareness
of dogs of self and other via scent and Berns (2013) states- “we found evidence for
canine theory of mind in our experiments” (p.209).
More recently the field of neuroscience has conducted cutting edge studies examining
the canine brain. The work of Cook, Spivak & Berns (2016), Berns et al (2015), Cook et
al (2015) and Berns (2013) scanned the brains of awake dogs in non-invasive, ethical
research.59 The first of its kind, their pioneering study was ground-breaking and
conducted at Emory University. In one study (Berns et al 2015) they examined the
responsiveness of the dog in relation to their familiar human, strange human, familiar
dog, strange dog and self.
They identified that the caudate was maximally activated to the scent of the dog’s
familiar human caretaker. In another, they identified the canine centre for impulse
control and state that is helps create equivalence between dog and human mechanisms
for self-control (Cook, Spivak & Berns 2016) and leads the way to establishing further
parallels between the canine and human brain.
This has led to further neuro-scientific studies, such as that of Cuaya et al (2016) that
examined the dogs capacity to discern the human face from that of other everyday
59 Gregory Berns is in favour of “personhood” for dogs (see his New York Times article “Dogs are people too”, Berns 2013 - http://www.nytimes.com/2013/10/06/opinion/sunday/dogs-are-people-too.html?_r=0).Personhood referred to in law as habeas corpus, is a hot topic in the field of animal right law at present. Echoing the sentiments of Goodall, Wise, Marino and many more.
79
objects and they concluded that they are capable of face recognition and that their
research has identified several brain regions responsible and that this is one of the
reasons for social recognition of humans in dogs.
This possibly explains the ability of dogs to recognise clients (despite only seeing them
for one hour per week) via scent and face recognition.
Stanley Coren (2004) correctly points out that the question of language comprehension
precedes that of production and he outlines how regular dogs have language receptivity
capability for what he conservatively estimates at about 60 words. He outlines basic
words and vocabulary examples that most human caretakers of a dog will recognise and
agree that dog’s do in fact comprehend on pages 100-104 of his book “The intelligence
of dogs”. How many dog owners frequently spell the word W-A-L-K?
5.3.3. Canine cognition – “Dognition” (Hare 2013)
Consequently the researcher presents literature pertaining to two border collies, Rico
and Chaser. Kaminski et al (2004) present evidence of Rico’s understanding of 200
words and to “fast map” (p.1682) i.e. learn via inference. Professor John Pilley
replicated and extended their study with his border collie - Chaser. Findings are
presented in Pilley (2013a, 2013b) and Pilley & Reid (2011). According to Pilley
(2013), Rico’s study was not accepted by academics Markman and Abelev (2004), yet
Bloom (2004) did accept that possibly it was similar to the language acquisition of
children, yet criticised the length of time it took the dog to acquire them.
80
Chaser has acquired a vocabulary of 1,033 words and has demonstrated the ability to
comprehend sentences and (Pilley & Reid 2011), (Pilley 2013a, 2013b). Farina et al
(2016) while accepting the capacity of Chaser’s memory and language comprehension,
question repetition. Frank (2016) recognises the contribution of Pilley’s work and
acknowledges his achievement. He states that “I personally don’t see any reason to
doubt the evidence”, (p.100).
Frank (2016) is “not quite sure how useful such quantitative comparisons are” (p. 100).
He continues, with reference to Chaser stating “how different is 1000 words a milestone
that many children reach in their third year” (P.100). Grandin (2006) states- “I think
animals are smarter than we know. I also think they have a different kind of intelligence
than G (factor)”60.
Dogs can not only be receptive to the spoken word, but also sign language61.
Hare & Woods (2013), Hare & Tomasello (1999), Miklosi et al (1998) have shown how
dogs are adept at accurately responding to the visual cues of humans. Muller et al
(2015) report that their study showed that dogs could discern human emotional (facial)
expressions of happiness and disgust, supporting the assertion of Nagasawa et al (2011)
60 The researcher would ponder that this capacity for learning in dogs might possibly equate with learning a foreign language acoustically, while being unable to vocalise our language as we cannot state that we can understand their tonal vocalisations comprehensibly and with certainty, leading to the same paradox present in primate studies (Roian, Egnor & Hauser 2004 ). 61 Masson (1997) refers to the call for euthanisation of deaf Dalmatians by the Board of Governers of the American Dalmatian Club of America in 1996. Curiously they stated it was the humane thing to do. He then describes how “Stephen Doleac” (p.189) advocates teaching American Sign Language as an alternative to euthanizing them. Many deaf dogs have been taught sign language. While the researcher could not find any studies there are numerous resources online that teach people how to do this. Although this is as yet seemingly uncovered in peer reviewed journals – it is apparently common and documented elsewhere.
81
study. Albuquerque et al (2016) demonstrate that dogs can combine vocal and visual
cues to interpret human emotion.
Dogs also show what ethologists call “consolation behaviour”. Dogs don’t seem to hold
grudges and appear to forgive easily. Reconciliation after fights in social groups
happens swiftly. What is interesting is that third party dogs will console the loser rather
than the winner of an argument (Hare & Woods 2013).
The evidence presented above is valid and supportive of claims for sentience and theory
of mind. This could provide part explanation as to how the participants’ dogs appeared
to understand when clients were upset and displayed regular capacity to respond
empathetically to emotion.
Many participants stated that dog would go to the client moments prior to the
empathetic response, and the researcher hypothesises that these could be explained as
the capacity to read unconscious ideomotor muscle indicators in our body language that
the highly perceptive dogs can detect, and possibly the reason why some dogs can
detect that a human will soon have a seizure and warn them. The researcher must state
that this is only her hypothesis62 and she cannot as yet find evidence to substantiate it63.
The researcher has shown how a significant population of highly respected scientists
agree that dogs are self-conscious, sentient beings, who probably possess theory of
62 It could be investigated further verified if one were to find a population of individuals who have seizure alert dog companions, ask them to agree to a study and gave them portable biofeedback equipment, monitoring the results of the equipment in conjunction with the responses of the dogs. 63 This relates to the response set theory of hypnosis (Kirsch 2000) which originated from the work of Milton Erickson.
82
mind and share the same emotional brain as we do (Panksepp 2004,2005) ; Cook,
Spivak & Berns (2016), Berns et al (2015), Cook et al (2015) and Berns (2013).
While science has not definitively concluded that they operate with the same mirror
neuron system to that of humans, Berns (2013) Berns et al (2015) studies leave open the
suggestion that it may be possible that the activation of the reward centre, the caudate
nucleus and motor activation in the dogs brain, may signify mirror neuron activity, but
more research is needed before such a claim could be made.
This evidence might only partially verify the participants’ accounts of their dogs
empathetic responding and attunement to clients within the therapeutic alliance, it is
nonetheless compelling and worthy of consideration.
5.3.4. Emotional contagion and affect disturbance in dogs.
Joly-Masheroni et al (2008) documented that dogs find yawns as contagious as humans
do and Bessa & de Sousa (2012) found that when dogs heard yawns of strangers via
audio they found those contagious also. This appears indicative of an emotional
contagion response and further supports their capacity for empathy.
Braitman (2013, 2014) outlines how many animals suffer psychologically and describes
several examples of canine neurosis including that of her own dog Oliver and his
extreme debilitating separation anxiety, which led to him jumping through a glass
window, falling several stories to the ground miraculously surviving.
83
Veterinary surgeon Nicholas Dodman (1994) outlines many similarities in behavioural
animal disorders and correlates them to human psychiatric disorders. In his book “The
dog who loved too much” he presents specific cases relating to dogs in relation to
aggression, fear and anxieties he has encountered.
Issues of emotional contagion and psychological disturbances that can be experienced
by dogs would lead one to ask the question, what effect would the experience of
experiencing the affects of psychotherapy clients have upon the dog in the long term? In
a longitudinal study on the effects of the canine search and rescue teams that worked at
the World Trade Centre 9/11 disaster, researchers found that psychological distress such
as PTSD and depression in the dogs was directly linked to their “handler”, if the handler
was psychologically resilient and had no psychological symptoms this also was
mirrored in the results of the canine search team (Hunt et al 2012).
Chur-Hansen et al (2014) raise the issue of the welfare of the therapy animal as one that
needs more attention and research as does Marino (2012) and Friesen (2010). Braun et
al’s (2009) paper on AAT interventions in hospitals with children experiencing pain
state –
“The trained dog was present on the paediatric unit three hours per
week...Unfortunately the dog died prior to the completion of the study, so the
desired sample size was not achieved. The strain of therapeutic interventions on
animal therapists must certainly be considered. In many cases “the dog”
appeared to take on the pain of the child” (p. 108).
84
This leads to the question – would exposure to psychological trauma in clients, result in
the experience of secondary trauma in dogs facilitating therapy, such as that of the
compassion fatigue experienced by psychotherapists (Figley 2002)? In the light of the
evidence outlined so far, regarding sentience, cognition, susceptibility to psychological
issues similar to those of humans, susceptibility to possible emotional contagion and
their complete “childlike” vulnerability i.e. total dependence on their human carers
means this question, morally and ethically cannot be ignored by the AAP/AAT field any
longer, it must be added to the discourse and will be examined further in the final part of
this discussion.
5.3.5. Dogs and the relaxation response
The code – generates calm and relaxation, emerged strongly from the data of this study,
and via sub themes reduces anxiety and tension, calming/soothing and therapeutic
touch. How do dogs elicit such a strong relaxation response in humans? One of the
answers may lie in the neuro-peptide oxytocin.
Oxytocin has been referred to as the bonding hormone and also the trust hormone.
Odendaal (2000) wanted to examine the physiological benefits of AAT in both dogs and
humans and he found six chemical changes as a result of the human animal interaction
but states that only one was statistically significant, that of oxytocin. Odendaal
&Meintjes (2003) found that touch between humans and dogs also increased the
oxytocin levels. In a study by Nagasawa et al (2015) oxytocin was found to increase via
dog human gazing. When they administered oxytocin nasally to the dogs, their gaze
time increased.
85
They state -
“These results support the existence of a self-perpetuating oxytocin-mediated
positive loop in human-dog relationships that is similar to that of human mother-
infant relations. Human-dog interaction by dogs’ human-like gazing behaviour
brought on social rewarding effects due to oxytocin release in both humans and
dogs and followed the deepening of mutual relationships, which led to
interspecies bonding”(para.10).
The data presented by psychotherapists and data from therapists in the literature,
relating to the generation of calm and relaxation, is supported by the studies presented.
Therefore the evidence elucidates part of the GT that dogs generate calm and relaxation.
5.3.6. Questioning ethics due to disturbing elements of literature
The question of ethics is another gap in the literature and noted by Chur-Hansen et al
(2014); Parish-Plass (2014); Marino (2012); Bekoff (2008); Hatch (2007) and Zamir
(2006). Many papers do not question the ethics of using an animal with some writing
completely devoid of any consideration of rights and welfare of animals.
The Handbook of AAT (2010) makes recommendations on best practice, advocating the
five freedoms64 and including a chapter on welfare considerations, however the freedom
to behave normally is implicitly removed from an animal required by a human to take
on the role of “therapist”. Risks are mentioned in statements such as “animals rarely
enter therapeutic settings of their own volition” (p.488), so they acknowledge the
animal’s lack of consent, and “unfortunately, many handlers appear oblivious to the
64Freedom from hunger and thirst, Freedom from discomfort, Freedom from pain, injury and disease, Freedom to behave normally, Freedom from fear and distress.
86
stress signals emitted by their animals” (p.488); they acknowledge the fallibility of
human judgement.
“The potential for stress-related fatigue or “burnout” in therapy animals is
probably greatest among residential programs- prisons, nursing homes, inpatient
psychiatric hospitals, long term care facilities etc.- where the animals are
potentially “on duty” all day, every day of the year” (Ianuzzi and Rowan, 1991:
Fine 2010, p.488).
They acknowledge that risks to the animals are immense.
Ianuzzi & Rowan (1991) also report the deaths of AAT dogs and a bird in institutions,
also reporting health issues in dogs due to over feeding. Deaths occurred due to the
following:
Hit by car when left to roam unattended
Strangled by a leash
Death by hypothermia (left outside in freezing temperatures)
A bird was killed and eaten by a prisoner.
Their paper also outlines the use of electric shocks in training capuchin monkeys to be
assistance animals. These facts are disturbing and point to serious risks for animals.
Braun et al (2009) point to vicarious trauma suffered by the dog.
Hatch (2007) points out the obvious – that crutches, wheelchairs and walking sticks
pose a hazard to animals, also point out that there are risks to clients from zoonotic
disease.
87
Katcher et al (1989) report no change in the behaviour of prisoners given pets and state
“it is necessary to document the frequency of animal death, injury and other direct
evidence of cruelty” (p. 179). Prompting the researcher to ask the question – do
proponents of AAT feel the animal is expendable in the context of prison use?
According to Furst (2006) over 52% of prisons receive funding for animal programmes
and that the positive reports she received in her review cannot be empirically validated
as they were based on the prison’s self-assessment.
Dolphin assisted therapy (here to after referred to as DAT) novel treatment de rigueur of
the 70s,80s and 90s for autism and a whole host of other issues is now refuted by the
researcher who proposed it – Dr. Betsy Smith stated in 2003 –
“A rather cynical and deceptive practice by dolphinarium and swim-with-
programs owners. Some certified therapists with no dolphin knowledge will
charge exorbitant fees for treatment that can be done without dolphins… At the
heart of all these therapy programs is the exploitation of vulnerable people and
vulnerable dolphins”65.
Marino & Lilienfield (2007) raise valid concerns over the ethical welfare of captive
dolphins used in DAT. They state that there is more evidence of injuries sustained by
participants with regard to DAT than there is evidence of efficacy and they recommend
that “at the very least, we believe that DAT practitioners should be required to inform
65 Accessed 28/06/2016 Read more: http://www.digitaljournal.com/article/353952#ixzz4CstShht288
parents, and when relevant, participants of the absence of evidence for DATs enduring
effects on psychological symptoms”(p.248).
Ben David (in Parish Plass 2013) asserts that animal use in AAP has what she calls the
“exclusive ethical state of this disciple” (p.317) is completely unfounded. The claim of
exclusivity proffers an elitist view of what is clearly an unregulated discipline that thus
far is lacking empirical justification for its existence (Herzog 2011), (Chur-Hansen
2010, 2014), (Marino 2012). The researcher asks – does this author imply that the use of
animals within the profession of psychotherapy is somehow beyond reproach?
This author goes on to argue that “use” of animals can be related to Maslow’s hierarchy
of needs, relating use in medical research, use as food, hunting, fur, cosmetics, zoos,
rodeos, circuses and pet ownership to “needs” rather than the fact that all of these are in
fact choices.
She places the human “need” for animal use in cosmetic experiments, use of skin and
fur at the sixth stage of Maslow’s hierarchy66?
She continues - stating that human entertainment via hunting of animals, circuses and
zoos relates to self-actualisation and the “seventh stage”.
She also attributes “need” to pet ownership, which is obviously elective, especially
taking into account the figures of abandonment of animals67.
66 The author’s citation is incorrect. Her citation refers to Maslow’s original hierarchy (1943, 1954), which she does not seem to have read, as the version cited only consists of five stages.67 According to Dogs Trust UK, 47,596 people abandoned their dog in council pounds, 102,363 dogs were handled by British local authorities and 5,142 were euthanized by the same authorities, for the year - 2014-2015. There were no corresponding figures available for this period relating to Ireland.
89
The practice of hunting can be attributed to human pathologies such as narcissism,
linked to abuse, provoking outrage among many groups of people68. There is much
controversy also surrounding circuses and zoos.
Joy (2003, 2005, 2014) would possibly describe this authors stance as speciesist and
lacking a humanistic perspective, and the author admits the former, however judgement
on the later will not be forthcoming – “AAP is a type of speciesism in the sense that it
involves the right to limit animals’ freedom”.
Ben-David (in Parish-Plass 2013) states that the most common AAP animals are dogs
and rabbits. Rabbits are most certainly unsuitable animals to incorporate ethically in
AAP/AAT/AAI/AAA as they are highly sensitive69. Her attribution of rabbits to the
animal classification – “rodent” is also incorrect (they are lagomorphs). Based upon the
facts, the ethical suitability of incorporating rabbits as therapy animals is highly
questionable.
Ben David (Ibid) proceeds to argue the utilitarian view, citing Singer (1975) asking –
“what if instead of animals we were to use human babies...or severely brain damaged
persons” but she thinks that would be considered improper and inhumane (neglecting to
note Singer’s (Ibid) notoriously provocative argument would have no issue with that if
it served the greater good of all). 68 The outpouring of human rage towards hunter and killer of Cecil the lion - Walter Palmer, on 1st of July 2015, could constitute as one an example where the general global population would disagree with her claims. An article by Plucinska (2015) in Time magazine article was entitled “Walter Palmer is Satan”. 69 Owing to the fact that they as highly sensitive creatures (Kotpal 2010), they generally only like to become active at dawn and dusk (Parker 2009) (Lumpin & Seidensticker 2011), have eyes that are approximately eight times more sensitive to light than humans (Parker 2009) and are highly sensitive to touch (Harkness et al 2013) (they do not like to be touched near the nose and have highly sensitive nostrils that twitch at a rate of 2-120 per minute (Buseth & Saunders 2014) and touching them near the nose can cause them to jump and kick causing injury (Oglesbee 2011)).
90
The author states that sometimes animals used in AAP could suffer injury, be exposed
to too much heat or cold and then states that therapists have the same duty of
responsibility to them as they would a child, she continues stating “animals participating
in AAP are often exposed to emotional stress during therapeutic sessions”(p.323) and
“many children play a slightly violent game with a dog”, she continues – “some
children make the animals go through very difficult challenges in order to observe the
animals behaviour”(p.323).
She states a client “repeatedly placed a hamster in a small closed box and insisted on
leaving him there blocking any possible way out” (p.323). She further states that “fatal
accidents and injuries do happen in AAP” (p.324) while continuing to make another
argumentative u-turn and state the “awareness of the emotional states of the animals is
integral to AAP” (p.326).
The researcher takes considerable issue with many of Ben David’s statements (In
Parish-Plass 2013) – in the chapter titled “The unique ethical stance of animal assisted
therapy”, the biggest one being that she doesn’t actually address any ethical issues and
the arrogance the researcher perceives in her declaration that it is unique, essentially
justifies the abuse of animals, advocates exploitation and the removal of their
sovereignty for financial gain. There are many ethical questions that must be addressed.
Rather than an article on what she calls “unique ethics”, what we have is a biased basic
exposition outlining her justification of AAP. The researcher posits that the utilitarian
view that she first argues and then rejects is her own undoing.
91
The most glaringly obvious point the researcher notes is that all of the benefits
perceived by the psychotherapists can be theoretically achieved without a dog. The
researcher does not believe there is such a thing as “happy exploitation” (Francione &
Garner 2010) and would go so far as to follow Francione’s (2010) arguments to
question the moral aspects of pet “ownership” as a result of this research study and the
reading conducted during the process.
5.3.7 Summation
The researcher concedes that the warmth and genuity of the dog’s greeting from the first
therapeutic encounter reflects to the client that they are lovable. The seeds of a sense of
worth and value are sown in the client’s psyche and “self object” transference ensues
(Kohut 1977).
Winnicott’s (1958) “period of hesitation” (p.53) is thus shortened by the whole hearted
nature of the dog “gradually he becomes brave enough to let his feelings develop”
(p.53), thus facilitating growth of trust and rapport. This may be as a result of the dog’s
genuity and trusting nature, as the dog models trust, possibly the client responds by
trusting sooner.
Elements of the dogs way of relating may be introjected (Glucksman 2005). The dog is
also a direct connection to the therapist, and an element of explicit self-disclosure
(Jourard 1958).
A “holding environment” is facilitated. The “True Self”, then begins to emerge and the
“False Self” begins to fade, as the dog models spontaneity and authenticity on a
92
consistent basis in the relationship/alliance, freeing the client to reveal the “True Self”,
and self disclose sooner in therapy.
As a result of the self-object transference, the dog receives the idealising transference, is
perhaps perceived as “the good mother” and the therapist is seen as a real person sooner,
within the alliance. The dog as transitional object, being held and petted creates a sense
of security for the client. As a result, the client’s conflict emerges sooner and the
positive and negative transference and enactments ensue to be worked through with the
therapist.
The dog’s capacity to respond empathetically and facilitate touch, soothes, calms and
relaxes the client. In this context the dog can provide the holding containment and touch
that the therapist cannot. Thus in an ideal world, working with clients who have
sufficient healthy ego functions, a context for creative exploration is facilitated by the
dog in the therapeutic alliance.
From the perspective of the wider AAT/AAI literature the researcher also presents the
practical, realistic counter-argument.
The researcher would also argue that – we do not live in an ideal world, and a large
percentage of clients do not have sufficient ego function to receive treatment with the
adjunct of an animal.
The AAI intention for behavioural intervention is stated as offering -“experiential
lessons for clients on impulse control, behavioural learning, behavioural modification”
93
(Fine 2010, p. 199) and for CBT -“challenge client’s irrational beliefs, enhance
frustration tolerance and increase self-confidence” (Ibid, p. 199). That is a lot of
expectation to place on a creature that has four paws, a tail and a smiley face.
Theoretically and ethically, the researcher voices concern is that it leads to an
encouragement of projective identification; she would take the point of view of Klein, a
manifestation of an aggressive object-relation. According to Klein –
“In psychotic disorders this identification of an object with the hated parts of the self
contributes to the intensity of the hatred directed against other people” (1946, 1991
p.183) and in this case, animals.
So rather than working deeply on internal mechanisms within the Self, dominion and
control over a more vulnerable “other” is paradoxically encouraged, in order to facilitate
major shifts in ego function, which from the theoretical perspective of the researcher is
like skipping over major therapeutic working through.
Ironically, this form of AAT is prevalent in detention facilities. Ascione’s (2008) work
has shown that animal abuse is common in people with deficits in functioning, issues of
reality testing, issues of conscience, sociopathic, psychopathic and in the extreme,
sadistic tendencies.
The researcher would argue that by definition this would include the majority of
incarcerated individuals, identification with the aggressor being the common
denominator in the majority of abuse cases, and the predilection to torture and abuse.
94
In a case example presented in the AAT Handbook of a fifteen year old boy who
tortured a cat by beating it, before strangling it and hanging it from a tree (Ascione &
Fine 2010, p. 383-395), is evaluated and paradoxically they then present a model of
treatment incorporating AAT.
The absurdity of such an intervention, whereby an individual who has demonstrated
such deficits in ego functioning and conscience, who has engaged in projective
annihilation of a vulnerable “other”, is preposterous.
Essentially, from the perspective of Meloy (1988) we could say that this boy (and any
abuser of animals) has identified with a predatory fantasy/imago in order to rid
themselves of the intolerable vulnerable feelings that exist within their unconscious,
splitting them off projecting them onto “other” and torturing. Or in the words of Bollas
(1995) “a form of unconscious transference occurs in which the killers child-self lives
through the victim, and the force of killing, renders the self mute and empty” (p.197-
198).
5.3.8 Conclusion
To conclude, there is something very wrong when therapists/handlers include an animal
in interventions to treat such populations.
The researcher would argue that is actually tragic for the animal and the client to begin
treating such individuals with AAT rather than with intensive individual
psychotherapeutic treatment to correct deficits in ego functioning, as animal abuse in
95
particular is indicative of psychopathic and sadistic pathologies, not to mention that this
modality of psychotherapy is yet to be empirically validated.
The researcher agrees wholeheartedly with Marino (2012) regarding lack of construct
validity to support its efficacy. The researcher proposes that one may view AAT as a
construct built on a house of sand until such time as sufficient evidence is presented to
suggest otherwise.
While these deficits in ego function should be treated the researcher would propose that
it would be ethically and morally reprehensible to expose a vulnerable creature to this
population of individuals.
To conclude, the researcher would state that this is not ethical practice and should be
questioned.
The GT this study would propose is that Animal assisted psychotherapy cannot be
empirically validated (Marino 2012) 70 and is of minimal value to the therapist,
minimal value to some clients and of no value to the dog.
The researcher understands that this is a strong assertion to make and that this thesis
studies canines as foci, however in the case of psychotherapy animal and therapist are
inextricably linked. It is impossible to create conditions of construct validity.
70 The validity threat of “construct confounding” inherent within psychotherapy presents a double bind. In order to overcome this issue the procedure must be separated and this is not possible as dogs cannot talk and do therapy alone with clients. There is no way of knowing how much the psychotherapist and how much the dog contributes to change, it can be minimised such as in the study of Banks, Willoughby and Banks (2008) but it can never be eliminated within the context of psychotherapy. Therefore it cannot be empirically validated in the context of psychotherapy.
96
The researcher would go so far as to take the moral and ethical abolitionist stance and
would request that animal use in therapy be prohibited on ethical grounds. Clients
cannot be exposed to techniques that are empirically unfounded and which have no
prospect or possibility of that empirical evidence can ever being forthcoming.
The researcher would go even further and request that dogs be granted the ethical status
of “personhood” in the psychotherapeutic context and go so far as providing protection
to them and recognising their intrinsic rights as thinking, feeling beings, with a will of
their own which must be acknowledged and respected.
She acknowledges that taking such an iconoclastic action in the face of the proliferation
of the amount of unsubstantiated AAT studies (essentially propaganda71 disguised as
research) might appear extreme to those of a humanocentric persuasion. However she
argues that this is fundamentally necessary in light of scientific evidence, both morally
and ethically and would elevate them above the status of “property of the therapist” with
no more rights than that of an inanimate object in the therapy environment, while
simultaneously acknowledging their cognizance, sentience, vulnerability, need for
protection and their lack of consent to be exploited for any perceived therapeutic or
financial gain in the therapeutic process.
This view is in line with those of Wise (2014, 2012, 2003), Francione (2010), Steiner
(2012) and Bekoff (2007).
71 The Oxford English Dictionary defines propaganda as: Information, especially of a biased or misleading nature, used to promote a political cause or point of view.
97
They may not possess the Rubicon (Frank 2016) of spoken language however the
evidence outlined extensively in this thesis shows that they possess sentience,
cognizance, capacity to empathetically respond thus exposing them to the risk of
secondary trauma (to which they are ill equipped to process), receptive language
capacity that can approximately be equated with that of a child between 17 months and
three years of age (Coren 2006, p122). Therefore the researcher states that the moral and
ethically conscionable position to take is that of prohibition of AAT within the context
of psychotherapy.
The researcher would argue that there is a substantive case and sufficient evidence for
Irish Psychotherapy bodies to prohibit this practice on the grounds that it is unethical.
Essentially if one would object to the inclusion of a toddler as a therapeutic
intervention, one must also object to the inclusion of a dog (or any other sentient being).
98
Chapter Six - Conclusion
6.1 Introduction
Chapter five provided a discussion of the theory of the value of dogs in psychotherapy
practice in the private one to one setting. The literature was reflected upon and
interwoven with the theory in order to situate the study in as broad an expanse as
possible.
This chapter concludes by assessing the achievement of the studies aims and objectives
by evaluating the study utilising the criteria provided by Charmaz (2007). The study is
then viewed in the context of the constructivist approach that was used and the value
that the methodology provided the study is reflected upon.
A brief outline of the researcher’s reflexive journey is presented and conclusions are
then summarised contextualising the study and identifying its implications for
psychotherapy practice (possibly transferable to other mental health professions). The
various limitations of this study are then outlined. I end by making some
recommendations for further research and conclude with a quote and brief reflection
upon the journey of the study and its findings.
6.1.1 Reflexive statement
I began this research journey thoroughly convinced of the inherent therapeutic value of
animals; in fact I would have gone so far as to state that I viewed them as having a
superior therapeutic effect than human animals. Along the trajectory of this research
journey I can state that this belief no longer holds true. I now believe that they are no
more or no less therapeutic than human animals.
99
While my belief system and life paradigm always viewed non-human animals as equal
(from a very young age I could not bring myself to eat them), the scientific evidence
that dogs are far more intelligent than was previously accepted, is so new and still
forthcoming, it was a revelation. The ethical debate around personhood for non-human
animals taken through the courts of the United States and Argentina with new cases
pending was also a new discovery. This provoked thought and examination of the
concept from a whole new perspective.
At the beginning of this project owing to lack of knowledge and exposure to
misinformation I did not view having a willing dog present in psychotherapy sessions as
unethical or exploitative, I was open to it and very persuaded and moved by emotional
accounts in some literature (now known to be biased and contrived). At the end of this
journey due to the information sourced, reading and attempting to question the
phenomenon from all perspectives my view is that the evidence explicitly indicates that
this is not a good way to practice and that the dynamics achieved can essentially be
attained within group therapy and discussing client interactions and feelings about their
beloved animal companion without actually including the animal in a therapy session.
6.2 Achievement of the study’s aims and objectives.
In Chapter One of this study I presented the concept of this research project outlining
that it sought to identify the underlying mechanisms at work and value and efficacy of
incorporating the therapists’ dog into the private psychotherapy practice. The literature
relating to this study was then examined the subjective experience of the therapists and
their accounts of their therapy work with their dogs, in order to develop an emergent
100
theory that could begin to explain the value of what the addition of a dog to the therapy
space did to effect therapy. In Chapter Four the therapists own words are used as a
starting point to extrapolate theory from the themes that emerged. The therapeutic
insights, relational enhancement and physiological values of having a dog present were
presented. These were discussed, expanded upon and challenged from the empirical
standpoint of the literature in Chapter Five offering an emergent theory that was
developed from the data that is the literature and the therapist’s data combined.
While the researcher accepts the participants experience and viewpoint as being valid it
is not confirmed by any empirically valid literature, therefore their emergent theory is
unsubstantiated and when amalgamated with the secondary data a revised emergent
theory is presented.
So I conclude that the aims and objectives of this study have been achieved by the
discovery and presentation of the three core values (and their associated processes) of
incorporating dogs into psychotherapeutic work and the possible theoretical
mechanisms at work within the processes and also presenting the challenge to their
efficacy supported by the available evidence from the literature.
6.3 An evaluation of the GT
An evaluation of the GT can be made of this study using Charmaz (2007) four criteria
of credibility, originality, resonance and usefulness to assess the achievement of this.
101
6.3.1 Credibility
This research achieved complete familiarity with the collected data and was analysed in
depth. Firstly this research explored the experiences of knowledgeable specialist experts
in the field of practising psychotherapy with a dog included in the therapeutic alliance.
Seven of the therapists were supervisors and they had an average of a decade’s
experience practising therapy with a dog. The researcher achieved complete familiarity
with the data collected. She triangulated constantly with the secondary data in order to
check and re-check her findings. Therefore the research presented is well researched
and credible.
6.3.2 Originality
This is the first known Irish/British study of its kind. In so far as was possible (in the
word count allotted) the researcher addressed as many gaps in the knowledge base as
was possible. In attempting to search for client accounts the only option available was
historical. The presentation and inclusion of the latest research into canine behaviour
and neuroscience in order to represent the voice of the dog via the work of notable
scientists in those fields is unique also. Using triangulation with both data from the
perspective of the therapeutic triad of therapist, client and dog was especially important
for the researcher in an attempt to strive for rigor and honesty, owing to the criticisms of
extant studies in this field. Therefore the researcher would state that this is an original
piece of research that has broached the subject matter in a unique way.
6.3.3 Resonance
The therapist’s emergent theory as it is presented to the reader allows the participants
lived experience to be portrayed the richness of their own words. This highlights their
102
passion for their chosen speciality within their profession and this comes forth strongly
from the data.
However after thorough searching of literature the researcher can unequivocally state
that AAT is not supported by a shred of empirical evidence.
Therefore the data presented from all three perspectives, when amalgamated, presents a
truthful and highly resonant emergent theory i.e. that pet facilitated psychotherapy is
only of value to the therapist’s that choose to practice it and a limited number of dog
loving clients.
6.3.4 Usefulness
The analysis presented offers assessment of all perspectives of the AAP therapy triangle
(not just the subjective perspective of dog loving therapists), therefore it is useful and
necessary as at present it is a lone voice in a sea of propaganda and data that is not
presenting all sides of the argument. This study may also cause therapists who do
practice this way to question what they are doing and why. The researcher would
therefore conclude that this is a very useful study.
6.4 Implications for psychotherapy practice
The aim of this research was to explore the practice of experienced psychotherapists
who conducted therapy with their pet dog for therapeutic purposes in order to examine
its perceived value. This study achieves that objective and offers profession specific
research to psychotherapists, so they can make more conversant assessments around the
efficacy of incorporating pet facilitated psychotherapy in their practice in the future.
103
The study also highlights the lack of evidence, gaps in knowledge and vast amount of
ethical questions that this way of practising presents to the profession. The researcher
perceives that these are so numerous that in the discussion section she recommends
prohibition on grounds of lack of efficacy and ethical questions.
6.5 Limitations of this study
The main limitation of this study is the lack of experience the researcher had as this is
the first research project she had ever conducted. The second limitation was the amount
of data that was generated however this is a limitation of the methodology that is GT.
The final limitation was that owing to the fact that this was a Master’s thesis the
researcher could not go back to the field and re-interview the participants in light of the
lack of empirical evidence. The researcher views this as the biggest limitation and as a
result had to make do with turning to the literature to search for possible answers to
gaps in the knowledge due to the fact that no empirical research could support the
psychotherapist’s theory.
6.6 Recommendations for further research
The researcher has yet to come across a detailed study on the ethics of practising this
type of therapy and feels it is a very necessary research question that could be explored
in another study.
There is an essential need for the client’s experience of AAT to be studied and
examined in detail. This is the biggest gap in the knowledge base and the most
important in view of the psychotherapeutic profession.
104
There is a need to study the motivation of therapists who practice this way owing to the
fact that there is no empirical validation for the method. Are they ill informed? And, if
so – how did that come about? Power dynamics in the therapeutic environment and
questions relating to power and exploitation also need to be studied and explored
further.
To conclude it needs to be stated that this area of psychotherapy research is
underdeveloped and unrefined, the element of construct confounding is hard to
overcome therefore the inclusion of control groups and the incorporation of larger group
numbers within studies would be essential in order to get a more balanced perspective.
6.7 Conclusion
We are all earthlings – human animals and non human animals, co-existing. Ethics and
good practice must be adhered to at all times for all concerned.
"Only ignorance! only ignorance! how can you talk about only ignorance? Don't you
know that it is the worst thing in the world, next to wickedness? - and which does the
most mischief heaven only knows. If people can say, `Oh! I did not know, I did not
mean any harm,' they think it is all right. “(Sewell 2015 [1877], p65).
105
Bibliography
Albuquerque, N., Guo, K., Wilkinson, A., Savalli, C., Otta, E. and Mills, D. 2016. Dogs
recognize dog and human emotions. Biology Letters, 12(1), pp.20150883.
Allen, C. and BEKOFF, M. 2008. Animal Consciousness1. The Blackwell Companion
to Consciousness, pp.58.
Amsteus, M.N. 2014. The validity of divergent grounded theory method. International
Journal of Qualitative Methods, 13(1), pp.71-87.
Annells, M. 1996. Grounded theory method: Philosophical perspectives, paradigm of
inquiry, and postmodernism. Qualitative Health Research, 6(3), pp.379-393.
Ascione, F.R. 2008. The international handbook of animal abuse and cruelty: Theory,
research, and application. Purdue University Press.
Ascione, F.R. and Arkow, P. 1999. Child abuse, domestic violence, and animal abuse:
Linking the circles of compassion for prevention and intervention. Purdue University
Press.
Ascione, F.R., Kaufmann, M.E. and Brooks, S. 2000. Animal abuse and developmental
psychopathology: Recent research, programmatic, and therapeutic issues and challenges
for the future. Handbook on Animal-Assisted Therapy: Theoretical Foundations and
Guidelines for Practice, pp.325-354.
Banks, M.R., Willoughby, L.M. and Banks, W.A. 2008. Animal-assisted therapy and
loneliness in nursing homes: Use of robotic versus living dogs. Journal of the American
Medical Directors Association, 9(3), pp.173-177.
106
Barker, R.T., Knisely, J.S., Barker, S.B., Cobb, R.K. and Schubert, C.M. 2012.
Preliminary investigation of employee's dog presence on stress and organizational
perceptions. International Journal of Workplace Health Management, 5(1), pp.15-30.
Bateson, G. 1979. Mind and nature: A necessary unity. Dutton New York.
Bekoff, M. 2013. 1 who lives, who dies, and why? The Politics of Species: Reshaping
our Relationships with Other Animals, pp.15.
Bekoff, M. 2013. A universal declaration of animal sentience: No pretending.
Psychology Today,
Bekoff, M. 2009. Encyclopedia of Animal Rights and Animal Welfare, [2 volumes].
ABC-CLIO.
Bekoff, M. 2008. Why “good welfare” isn’t “good enough”: Minding animals and
increasing our compassionate footprint. Annual Review of Biomedical Sciences,
10pp.T1-T14.
Bekoff, M. 2007. Animals matter: A biologist explains why we should treat animals
with compassion and respect. Shambhala Publications.
Bekoff, M. 2006. Animal emotions and animal sentience and why they matter: Blending
“science sense” with common sense, compassion and heart. Earthscan Publishing:
London, UK.
Bekoff, M. 2006. Animal passions and beastly virtues: Cognitive ethology as the
unifying science for understanding the subjective, emotional, empathic, and moral lives
of animals. Zygon®, 41(1), pp.71-104.
107
Bekoff, M. 2001. Observations of scent-marking and discriminating self from others by
a domestic dog (canis familiaris): Tales of displaced yellow snow. Behavioural
Processes, 55(2), pp.75-79.
Bekoff, M. and Goodall, J. 2007. The emotional lives of animals: A leading scientist
explores animal joy, sorrow, and empathy--and why they matter. New world library.
Bekoff, M. and Pierce, J. 2016. Animal welfare cannot adequately protect nonhuman
animals: The need for a science of animal well-being. Animal Sentience: An
Interdisciplinary Journal on Animal Feeling, 1(7), pp.2.
Bekoff, M. and Pierce, J. 2016. Animal welfare cannot adequately protect nonhuman
animals: The need for a science of animal well-being. Animal Sentience: An
Interdisciplinary Journal on Animal Feeling, 1(7), pp.2.
Bendassolli, P.F. 2013. Theory building in qualitative research: Reconsidering the
problem of induction. IN: Theory building in qualitative research: Reconsidering the
problem of induction. Forum Qualitative Sozialforschung/Forum: Qualitative Social
Research.
Berns, G. 2013. How dogs love us: A neuroscientist and his adopted dog decode the
canine brain. Houghton Mifflin Harcourt.
Berns, G.S., Brooks, A.M. and Spivak, M. 2015. Scent of the familiar: An fMRI study
of canine brain responses to familiar and unfamiliar human and dog odors. Behavioural
Processes, 110pp.37-46.
Bion, W.R. 1984. Attention and interpretation. Karnac Books.
108
Bion, W.R. 1952. Group dynamics: A re-view. The International Journal of Psycho-
Analysis, 33pp.235.
Bion, W. 1962. A theory of thinking. London: Routledge.
Blanton, S. 1971. Diary of my analysis with Sigmund Freud. Hawthorn Books.
Bloom, P. 2004. Behavior. can a dog learn a word? Science (New York, N.Y.),
304(5677), pp.1605-1606.
Bollas, C. 2012. The christopher bollas reader. Routledge.
Bollas, C. 1995. Cracking up: The work of unconscious experience. Psychology Press.
Bollas, C. 1989. The shadow of the object: Psychoanalysis of the unthought known.
Columbia University Press.
Bonaparte, M. 1994. Topsy: The Story of a Golden-Haired Chow. Transaction
Publishers.
Borrego, J., Franco, L.R., Mediavilla, M., Piñero, N.B., Roldán, A.T. and Picabia, A.B.
2014. Animalassisted interventions: Review of current status and future challenges.
International Journal of Psychology and Psychological Therapy, 14(1), pp.85-101.
Bowen, M. 1978. Family treatment in clinical practice. New York: Jason Aronson,
Braitman, L. 2014. Animal madness: How anxious dogs, compulsive parrots, and
elephants in recovery help us understand ourselves. Simon and Schuster.
Braitman, L. 2013. Animal Madness: A Natural History of Disorder,
109
Braun, C., Stangler, T., Narveson, J. and Pettingell, S. 2009. Animal-assisted therapy as
a pain relief intervention for children. Complementary Therapies in Clinical Practice,
15(2), pp.105-109.
Bruce, C. 2007. Questions arising about emergence, data collection, and its interaction
with analysis in a grounded theory study. International Journal of Qualitative Methods,
6(1), pp.51-68.
Buseth & Saunders 2014. Rabbit Behaviour Health and Care. Boston, MA: CABI.
Carminati, G.G., Lehotkay, R., Martin, F. and Carminati, F. 2013. An hypothesis about
jung's collective unconscious and animal-assisted therapy. Neuroquantology, 11(3),
Chandler, C.K. 2012. Animal assisted therapy in counseling. Routledge.
Chandler, C.K., Portrie-Bethke, T.L., Minton, C.A.B., Fernando, D.M. and
O'Callaghan, D.M. 2010. Matching animal-assisted therapy techniques and intentions
with counseling guiding theories. Journal of Mental Health Counseling, 32(4), pp.354.
Charmaz, K. 2014. Constructing grounded theory. Sage.
Charmaz, K. 2006. Constructing grounded theory: A practical guide through qualitative
research. SagePublications Ltd, London,
Cho, J.Y. and Lee, E. 2014. Reducing confusion about grounded theory and qualitative
content analysis: Similarities and differences. The Qualitative Report, 19(32), pp.1.
Chur-Hansen, A., McArthur, M., Winefield, H., Hanieh, E. and Hazel, S. 2014. Animal-
assisted interventions in children's hospitals: A critical review of the literature.
Anthrozoös, 27(1), pp.5-18. 110
Chur‐Hansen, A., Stern, C. and Winefield, H. 2010. Commentary: Gaps in the evidence
about companion animals and human health: Some suggestions for progress.
International Journal of Evidence‐Based Healthcare, 8(3), pp.140-146.
Clarke, A. 2005. Situational analysis: Grounded theory after the postmodern turn.
Sage.
Cook, P.F., Brooks, A., Spivak, M. and Berns, G.S. 2015. Regional brain activations in
awake unrestrained dogs. Journal of Veterinary Behavior: Clinical Applications and
Research,
Cook, P.F., Spivak, M. and Berns, G. 2016. Neurobehavioral evidence for individual
differences in canine cognitive control: An awake fMRI study. Animal Cognition, pp.1-
12.
Coren, S. 1994. The intelligence of dogs: Canine consciousness and capabilities.
Coren, S. 2011. Dogs and people: The history and psychology of a relationship
[videorecording].
Coren, S. 2006. The intelligence of dogs: A guide to the thoughts, emotions, and inner
lives of our canine companions. Simon and Schuster.
Coren, S. 2005. How dogs think: understanding the canine mind. Simon and Schuster.
Coren, S. 2002. The Pawprints of History: Dogs in the Course of Human Events. Simon
and Schuster.
111
Coyne, I. and Cowley, S. 2006. Using grounded theory to research parent participation.
Journal of Research in Nursing, 11(6), pp.501-515.
Cozolino, L.J. and Santos, E.N. 2014. Why we need Therapy—and why it works: A
neuroscientific perspective. Smith College Studies in Social Work, 84(2-3), pp.157-177.
Creswell, J.W. 2003. Research design.
Cuaya, L.V., Hernández-Pérez, R. and Concha, L. 2016. Our faces in the dog's brain:
Functional imaging reveals temporal cortex activation during perception of human
faces. PloS One, 11(3), pp.e0149431.
Culliton, B.J. 1987. Take two pets and call me in the morning. Science (New York,
N.Y.), 237(4822), pp.1560-1561.
Custance, D. and Mayer, J. 2012. Empathic-like responding by domestic dogs (canis
familiaris) to distress in humans: An exploratory study. Animal Cognition, 15(5),
pp.851-859.
Dodman, N.H. 1997. The dog who loved too much: Tales, treatments and the
psychology of dogs. Bantam.
Doolittle, H. 1971. Tribute to Freud. British Medical Association.
Doolittle, H., Pearson, N.H. and Philips, A. 2012. Tribute to Freud. New Directions
Publishing.
Dufresne, T. 2005. Killing Freud: 20th Century Culture and the Death of
Psychoanalysis. A&C Black.
112
Dunne, C. 2008. 'we Know them, but we Don't Know them': A Grounded Theory
Approach to Exploring Host Students' Perspectives on Intercultural Contact in an Irish
University,
Dunne, C. 2011. The place of the literature review in grounded theory research.
International Journal of Social Research Methodology, 14(2), pp.111-124.
Edmundson, M. 2010. The Death of Sigmund Freud: The Legacy of His Last Days.
Bloomsbury Publishing USA.
Edwards, N.E. and Beck, A.M. 2013. The influence of aquariums on weight in
individuals with dementia. Alzheimer Disease and Associated Disorders, 27(4), pp.379-
383.
Egnor, S.R. and Hauser, M.D. 2004. A paradox in the evolution of primate vocal
learning. Trends in Neurosciences, 27(11), pp.649-654.
Elizabeth Batt Dolphin assisted therapy — quackery at its finest?
[Online]. Available from: http://www.digitaljournal.com/article/353952 [Accessed June
28 2016].
Erickson, M.H. and Gilligan, S.G. 2002. The legacy of Milton H. Erickson: selected
papers of Stephen Gilligan. Zeig Tucker & Theisen Publishers.
Farina, A., Brentari, C., Dow, K., Drenthen, M., Dufourcq, A., Gaitsch, P., Kaplan, G.,
Meijer, E., Rustick, S.M. and Szerszynski, B. 2016. Thinking about Animals in the Age
of the Anthropocene. Rowman & Littlefield.
Figley, C.R. 2002. Treating compassion fatigue. Routledge.
113
Fine, A.H. 2010. Handbook on animal-assisted therapy: Theoretical foundations and
guidelines for practice. Academic Press.
Fischer, M.M. and Marcus, G.E. 1986. Anthropology as cultural critique. An
Experimental Moment in the Human Sciences, Chicago,
Francione, G. 2010. Rain without thunder: The ideology of the animal rights movement.
Temple University Press.
Francione, G.L. 2010. Animal welfare and the moral value of nonhuman animals. Law,
Culture and the Humanities, 6(1), pp.24-36.
Francione, G.L. and Garner, R. 2010. The animal rights debate: Abolition or
regulation? Columbia University Press.
Frank, M.C. 2016. Review. The American Journal of Psychology, 129(1), pp.99-104.
Freud, A. 1981. The writings of anna freud: Vol. 8. Psychoanalytic Psychology of
Normal Development 1970-1980,
Freud, M. 1958. Sigmund freud: Man and father.
Friesen, L. 2010. Exploring animal-assisted programs with children in school and
therapeutic contexts. Early Childhood Education Journal, 37(4), pp.261-267.
Furst, G. 2006. Prison-based animal programs a national survey. The Prison Journal,
86(4), pp.407-430.
Gall, M.D., Borg, W.R. and Gall, J.P. 1996. Educational research: An introduction .
Longman Publishing.
114
Gay, P. 1988. Sigmund freud: A life for our time.
Gelso, C.J. 2011. The real relationship in psychotherapy: The hidden foundation of
change. American Psychological Association.
Genosko, G. 1998. Undisciplined theory. Sage.
Glaser, B.G. 2007. Doing formal grounded theory: A proposal. Sociology Press.
Glaser, B.G. 2007. Doing formal theory. The Sage Handbook of Grounded Theory,
(Part II), pp.97-113.
Glaser, B.G. 2004. With the assistance of judith holton (2004). Remodelling Grounded
Theory, pp.2-04.
Glaser, B.G. 1998. Doing grounded theory: Issues and discussions. Sociology Press.
Glaser, B.G. 1992. Emergence vs forcing: Basics of grounded theory analysis.
Sociology Press.
Glaser, B.G. 1978. Theoretical sensitivity: Advances in the methodology of grounded
theory. Sociology Pr.
Glucksman, M.L. 2005. The dog's role in the analyst's consulting room. Psychodynamic
Psychiatry, 33(4), pp.611.
Grandin, T. and Johnson, C. 2006. Animals in translation: The woman who thinks like a
cow. Bloomsbury.
GRINKER JR, R. 2013. My fathers analysis with sigmund freud. The Annual of
Psychoanalysis, V.29: Sigmund Freud and His Impact on the Modern World, 29pp.35. 115
Grinker, R.R. 1940. Reminiscences of a personal contact with freud. American Journal
of Orthopsychiatry, 10(4), pp.850-854.
Grinker, R.R. 1979. Fifty years in psychiatry: A living history. Charles C Thomas Pub
Limited.
Grotstein, J.S. 1996. Bion's" transformation in" O"', the" thing-in-itself", and the" real":
Toward the concept of the" transcendent position". Melanie Klein & Object Relations,
Haley, J. 1996. Learning and teaching therapy. Guilford Press.
Hanna, P. 2012. Using internet technologies (such as skype) as a research medium: A
research note. Qualitative Research, 12(2), pp.239-242.
Hare, B. and Tomasello, M. 2005. Human-like social skills in dogs? Trends in
Cognitive Sciences, 9(9), pp.439-444.
Hare, B. and Tomasello, M. 1999. Domestic dogs (canis familiaris) use human and
conspecific social cues to locate hidden food. Journal of Comparative Psychology,
113(2), pp.173.
Hare, B. and Woods, V. 2013. The genius of dogs: how dogs are smarter than you
think. Penguin.
Harkness, Turner, VandeWoude & Wheler 2013. Harkness and Wagner's Biology and
Medicine of Rabbits and Rodents. 5th ed. Ames, IA: John Wiley & Sons.
Harper, R. and Atkinson, P. 1991. The Ethnographic Imagination: Textual
Constructions of Reality,
116
Hatch, A. 2007. The view from all fours: A look at an animal-assisted activity program
from the animals' perspective. Anthrozoös, 20(1), pp.37-50.
Heidegger, M. 1927. 1996. Being and Time,
Hellinger, B. 2003. Farewell: Family constellations with descendants of victims and
perpetrators. Carl-Auer-Systeme Verlag.
Hellinger, B. 2003. Peace Begins in the Soul: Family Constellations in the Service of
Reconciliations. Carl-Auer-Systeme-Verlag.
Hellinger, B., Weber, G. and Beaumont, H. 1998. Love's hidden symmetry: What makes
love work in relationships. Zeig Tucker & Theisen Publishers.
Herzog, H. 2011. The impact of pets on human health and psychological well-being
fact, fiction, or hypothesis? Current Directions in Psychological Science, 20(4), pp.236-
239.
Hewson, C. 2003. Internet research methods: A practical guide for the social and
behavioural sciences. Sage.
Hewson, C. and Laurent, D. 2012. Research design and tools for internet research.
SAGE Internet Research Methods, 1
Horowitz, A. 2011. Theory of mind in dogs? examining method and concept. Learning
& Behavior, 39(4), pp.314-317.
Horowitz, A.C. and Bekoff, M. 2007. Naturalizing anthropomorphism: Behavioral
prompts to our humanizing of animals. Anthrozoös, 20(1), pp.23-35.
117
Hunt, M., Otto, C.M., Serpell, J.A. and Alvarez, J. 2012. Interactions between handler
well-being and canine health and behavior in search and rescue teams. Anthrozoös,
25(3), pp.323-335.
Huss, R.J. 2010. Why context matters: Defining service animals under federal law.
Pepperdine Law Review, 37pp.1163.
Iannuzzi, D. and Rowan, A.N. 1991. Ethical issues in animal-assisted therapy programs.
Anthrozooes, 4(3), pp.154-163.
Joanna Plucinska Walter palmer is satan [Online]. Available from:
http://time.com/3978108/walter-palmer-cecil-the-lion-celebrities/ [Accessed 30/01/2016
2016].
Joly-Mascheroni, R.M., Senju, A. and Shepherd, A.J. 2008. Dogs catch human yawns.
Biology Letters, 4(5), pp.446-448.
Jones, E. 1990. Free associations: Memories of a psychoanalyst. Transaction
Publishers.
Jourard, S.M. 1958. A study of self-disclosure. Scientific American,
Joy, M. 2005. Humanistic psychology and animal rights: Reconsidering the boundaries
of the humanistic ethic. Journal of Humanistic Psychology, 45(1), pp.106-130.
Joy, M. 2003. Toward a non-speciesist psychoethic. Society and Animals, 11(1),
pp.103-104.
Jung, C. 1966. The personal and the collective unconscious. Two Essays in Analytical
Psychology.Collected Works, 118
Kaminski, J., Schulz, L. and Tomasello, M. 2012. How dogs know when
communication is intended for them. Developmental Science, 15(2), pp.222-232.
Kaminski, J., Call, J. and Fischer, J. 2004. Word learning in a domestic dog: Evidence
for "fast mapping". Science (New York, N.Y.), 304(5677), pp.1682-1683.
Kamioka, H., Okada, S., Tsutani, K., Park, H., Okuizumi, H., Handa, S., Oshio, T.,
Park, S., Kitayuguchi, J. and Abe, T. 2014. Effectiveness of animal-assisted therapy: A
systematic review of randomized controlled trials. Complementary Therapies in
Medicine, 22(2), pp.371-390.
Kanamori, M., Suzuki, M., Yamamoto, K., Kanda, M., Matsui, Y., Kojima, E., Fukawa,
H., Sugita, T. and Oshiro, H. 2001. A day care program and evaluation of animal-
assisted therapy (AAT) for the elderly with senile dementia. American Journal of
Alzheimer's Disease and Other Dementias, 16(4), pp.234-239.
Karen Parker 2009. The Rabbit Handbook. New York: Barron's Educational Series,
2009.
Katcher, A., Beck, A.M. and Levine, D.M. 1989. Evaluation of a pet program in prison
—the PAL project at lorton. Anthrozoös, 2(3), pp.175-180.
Katz, J. 2001. From how to why on luminous description and causal inference in
ethnography (part I). Ethnography, 2(4), pp.443-473.
Kelle, U. 1995. Theories as heuristic tools in qualitative research. Openness in
Research: The Tension between Self and Other, pp.33-50.
119
Kernberg, O.F. 1995. Object relations theory and clinical psychoanalysis. Jason
Aronson.
Kernberg, O., F. 1988. Psychic structure and structural change: An ego psychology-
object relations theory viewpoint. Journal of the American Psychoanalytic Association,
36pp.315-337.
Kirsch, I. 2000. The response set theory of hypnosis. American Journal of Clinical
Hypnosis, 42(3-4), pp.274-292.
Klein, M. 1946. On adult world and its roots in infancy. M.Klein.Envy and Gratitude
and Other Works, 1963pp.176-235.
Kohut, H. 2009. The restoration of the self. University of Chicago Press.
Kohut, H. 1977. The restoration of the self.
Kohut, H. and Goldberg, A. 1984. How does analysis cure?
Kotpal, R. 2010. Modern Text Book of Zoology: Vertebrates. Rastogi Publications.
Kruger, K.A. and Serpell, J.A. 2010. 3 animal-assisted interventions in. Handbook on
Animal-Assisted Therapy: Theoretical Foundations and Guidelines for Practice, pp.33.
Kruger, K.A., Serpell, J.A. and Fine, A. 2006. Animal-assisted interventions in mental
health: Definitions and theoretical foundations. Handbook on Animal-Assisted Therapy:
Theoretical Foundations and Guidelines for Practice, 2pp.21-38.
Kruger, K.A., Trachtenberg, S.W. and Serpell, J.A. 2004. Can animals help humans
heal? animal-assisted interventions in adolescent mental health. Center for the
120
Interaction of Animals and Society, University of Pennsylvania School of Veterinary
Medicine.Retrieved April, 28pp.2007.
Levinson, B.M. 1962. The dog as a" co-therapist.". Mental Hygiene.New York,
Levinson, B.M. and Mallon, G.P. 1997. Pet-oriented child psychotherapy. Charles C.
Thomas Publisher.
LEVINSON, B.M. 1964. Pets: A special technique in child psychotherapy. Mental
Hygiene, 48pp.243-248.
Lichtenberg, J., D. 1988. A theory of motivational-functional systems as psychic
structures. Journal of the American Psychoanalytic Association, 36pp.57-72.
Lipgar, R.M. and Pines, M. 2003. Building on Bion--Roots: Origins and Context of
Bion's Contributions to Theory and Practice. Jessica Kingsley Publishers.
Lockwood, R. and Ascione, F.R. 1998. Cruelty to animals and interpersonal violence:
Readings in research and application. Purdue University Press.
Low, P., Panksepp, J., Reiss, D., Edelman, D. and Van Swinderen, B. 2012. The
cambridge declaration on consciousness. URL
Http://fcmconference.org/img/CambridgeDeclarationOnConsciousness.Pdf,
Lumpin, S & Seidensticker, J 2011. Rabbits: The Animal Answer Guide. Balitmore,
MD: The John's Hopkins University Press.
MacLean, E.L. and Hare, B. 2015. Evolution. dogs hijack the human bonding pathway.
Science (New York, N.Y.), 348(6232), pp.280-281.
121
Marcus, D.A. 2013. The science behind animal-assisted therapy. Current Pain and
Headache Reports, 17(4), pp.1-7.
Marcus, G.E. and Fischer, M.M. 1986. Anthropology as cultural critique: An
experimental moment in the human sciences.
Marino, L. and Lilienfeld, S. 2007. Dolphin-assisted therapy for autism and other
developmental disorders: A dangerous fad. American Psychological Association,
33pp.2-3.
Marino, L. 2013. 7 humans, dolphins, and moral inclusivity. The Politics of Species:
Reshaping our Relationships with Other Animals, pp.95.
Marino, L. 2012. Construct validity of animal-assisted therapy and activities: How
important is the animal in AAT? Anthrozoös, 25(sup1), pp.s139-s151.
Marino, L. and Lilienfeld, S.O. 1998. Dolphin-assisted therapy: Flawed data, flawed
conclusions. Anthrozoös, 11(4), pp.194-200.
Markman, E.M. and Abelev, M. 2004. Word learning in dogs? Trends in Cognitive
Sciences, 8(11), pp.479-481.
Maslow, A. H.(1954). motivation and personality. Hoper & Row, EUA, pp.80-106.
Maslow, A.H. 1943. A theory of human motivation. Psychological Review, 50(4),
pp.370.
Mason, J. 1996. Qualitative reasoning.
122
Mason, M.S. and Hagan, C.B. 1999. Pet-assisted psychotherapy. Psychological Reports,
84(3 Pt 2), pp.1235-1245.
Masson, J.M. 1997. Dogs never lie about love.
Mayon-White, R. 2005. Pets-pleasures and problems: Commentary. BMJ (British
Medical Journal), 331(7527), pp.1254-1255.
Meloy, J.R. 1988. The psychopathic mind: Origins, dynamics, and treatment.
Melson, G.F. and Fine, A.H. 2006. Animals in the lives of children. Handbook on
Animal-Assisted Therapy: Theoretical Foundations and Guidelines for Practice,
2pp.207-226.
Miklösi, A., Polgárdi, R., Topál, J. and Csányi, V. 1998. Use of experimenter-given
cues in dogs. Animal Cognition, 1(2), pp.113-121.
Mindell, A. and Mindell, A. 1995. Metaskills: The spiritual art of therapy. New Falcon
Publications Las Vegas, NV.
Mindell, A. 2010. ProcessMind: A User's Guide to Connecting with the Mind of God.
Quest Books.
Mindell, A. 2000. Quantum mind: The edge between physics and psychology.
Mindell, A. 1982. Dreambody, the body's role in revealing the self.
Molnar, M. 1999. 20 maresfield gardens: A guide to the freud museum, london.
Psychoanalysis and History, 1(1), pp.118-120.
Molnar, M. 1992. The diary of sigmund freud. 123
Morley, R. 2007. The analysand's tale. Karnac Books.
Morse, J.M., Stern, P.N., Corbin, J., Bowers, B., Clarke, A.E. and Charmaz, K. 2009.
Developing grounded theory: The second generation (developing qualitative inquiry).
Müller, C.A., Schmitt, K., Barber, A.L. and Huber, L. 2015. Dogs can discriminate
emotional expressions of human faces. Current Biology, 25(5), pp.601-605.
Nagasawa, M., Murai, K., Mogi, K. and Kikusui, T. 2011. Dogs can discriminate
human smiling faces from blank expressions. Animal Cognition, 14(4), pp.525-533.
Nimer, J. and Lundahl, B. 2007. Animal-assisted therapy: A meta-analysis. Anthrozoös,
20(3), pp.225-238.
Norcross, J.C. and Wampold, B.E. 2011. Evidence-based therapy relationships:
Research conclusions and clinical practices. Psychotherapy, 48(1), pp.98.
O’Haire, M.E. 2013. Animal-assisted intervention for autism spectrum disorder: A
systematic literature review. Journal of Autism and Developmental Disorders, 43(7),
pp.1606-1622.
Odendaal, J.S. and Meintjes, R.A. 2003. Neurophysiological correlates of affiliative
behaviour between humans and dogs. The Veterinary Journal, 165(3), pp.296-301.
Odendaal, J. 2000. Animal-assisted therapy—magic or medicine? Journal of
Psychosomatic Research, 49(4), pp.275-280.
Ogden, T.H. 2004. The analytic third: Implications for psychoanalytic theory and
technique. The Psychoanalytic Quarterly, 73(1), pp.167-195.
124
Ogden, T.H. 1993. The matrix of the mind: Object relations and the psychoanalytic
dialogue. Jason Aronson.
Ogden, T.H. 1984. Instinct, phantasy, and psychological deep structure: A
reinterpretation of aspects of the work of melanie klein. Contemporary Psychoanalysis,
20(4), pp.500-525.
Oglesbee, B.L. 2011. Blackwell's Five-Minute Veterinary Consult: Small Mammal. John
Wiley & Sons.
Oliva, J.L., Rault, J., Appleton, B. and Lill, A. 2016. Oxytocin blocks pet dog (canis
familiaris) object choice task performance being predicted by owner-perceived
intelligence and owner attachment. Pet Behaviour Science, (1), pp.31-46.
Palagi, E., Nicotra, V. and Cordoni, G. 2015. Rapid mimicry and emotional contagion
in domestic dogs. Royal Society Open Science, 2(12), pp.150505.
Palmer, C. 2010. Animal ethics in context. Columbia University Press.
Panksepp, J. 2005. Affective consciousness: Core emotional feelings in animals and
humans. Consciousness and Cognition, 14(1), pp.30-80.
Panksepp, J. 2004. Affective Neuroscience: The Foundations of Human and Animal
Emotions. OUP USA.
Parish-Plass, N. 2014. Order out of chaos: A call for clear and agreed-upon definitions
differentiating between animal-assisted Interventions1.
Parish-Plass, N. 2013. Animal-assisted psychotherapy: Theory, issues, and practice.
Purdue University Press. 125
Parish-Plass, N. 2008. Animal-assisted therapy with children suffering from insecure
attachment due to abuse and neglect: A method to lower the risk of intergenerational
transmission of abuse? Clinical Child Psychology and Psychiatry, 13(1), pp.7-30.
Penn, D.C. and Povinelli, D.J. 2007. On the lack of evidence that non-human animals
possess anything remotely resembling a 'theory of mind'. Philosophical Transactions of
the Royal Society of London.Series B, Biological Sciences, 362(1480), pp.731-744.
Pilisuk, M. and Joy, M. 2014. Humanistic psychology and ecology. The Handbook of
Humanistic Psychology: Theory, Research, and Practice, pp.135.
Pilley, J.W. 2013. Border collie comprehends sentences containing a prepositional
object, verb, and direct object. Learning and Motivation, 44(4), pp.229-240.
Pilley, J.W. and Hinzmann, H. 2013. Chaser: Unlocking the genius of the dog who
knows a thousand words. Houghton Mifflin Harcourt.
Pilley, J.W. and Reid, A.K. 2011. Border collie comprehends object names as verbal
referents. Behavioural Processes, 86(2), pp.184-195.
Pines, M. and Lipgar, R. 2002. Building on Bion: branches: contemporary
developments and applications of Bion's contributions to theory and practice. Jessica
Kingsley Publishers.
Popper, K.R. 1959. The logic of scientific discovery. London: Hutchinson,
Pratt, J. 2012. The problem of grounded theory.
Proctor, H. 2012. Animal sentience: Where are we and where are we heading? Animals,
2(4), pp.628-639. 126
Proctor, H.S., Carder, G. and Cornish, A.R. 2013. Searching for animal sentience: A
systematic review of the scientific literature. Animals, 3(3), pp.882-906.
Randolph, J.J. 2009. A guide to writing the dissertation literature review. Practical
Assessment, Research & Evaluation, 14(13), pp.1-13.
Raupp, C.D. 2002. The" furry ceiling:" clinical psychology and human-animal studies.
Society and Animals, 10(4), pp.353-360.
Reay, D. 1996. Dealing with difficult differences: Reflexivity and social class in
feminist research. Feminism & Psychology, 6(3), pp.443-456.
Redl, F. 1942. Group emotion and leadership. Psychiatry, 5(4), pp.573-596.
Roazen, P. 1976. Freud and his followers, alfred A.
Robinson, I. 1999. Pet therapy. Nursing Times, 95(15), pp.33-34.
Sacks, A. 2008. The therapeutic use of pets in private practice. British Journal of
Psychotherapy, 24(4), pp.501-521.
Schneider, M.S. and Harley, L.P. 2006. How dogs influence the evaluation of
psychotherapists. Anthrozoös, 19(2), pp.128-142.
Schreiber, R.S. 2001. How to of Grounded Theory: Avoiding the Pitfalls.
Serpell, J.A. 2009. Having our dogs and eating them too: Why animals are a social
issue. Journal of Social Issues, 65(3), pp.633-644.
127
Serpell, J.A., Coppinger, R. and Fine, A.H. Welfare considerations in therapy and
assistance animals. Handbook of Animal-Assisted Therapy: Theoretical Foundations
and Guidelines for Practice, pp.453-476.
Sewell, A. 2015. Black beauty. Broadview Press.
Sheldrake, R. 2009. Morphic resonance: The nature of formative causation. Inner
Traditions/Bear & Co.
Shenton, A.K. 2004. Strategies for ensuring trustworthiness in qualitative research
projects. Education for Information, 22(2), pp.63-75.
Silva, K., Bessa, J. and de Sousa, L. 2012. Auditory contagious yawning in domestic
dogs (canis familiaris): First evidence for social modulation. Animal Cognition, 15(4),
pp.721-724.
Silverman, D. 2000. Doing qualitative research: A practical guide. Thousand Oaks, CA:
SagePublications,
Singer, P. 1975. Animal liberation: A new ethic for our treatment of animals. New York:
New York Review (Distributed by Random House),
Souter, M.A. and Miller, M.D. 2007. Do animal-assisted activities effectively treat
depression? A meta-analysis. Anthrozoös, 20(2), pp.167-180.
Stein, D.J., Dodman, N.H., Borchelt, P. and Hollander, E. 1994. Behavioral disorders in
veterinary practice: Relevance to psychiatry. Comprehensive Psychiatry, 35(4), pp.275-
285.
128
Steiner, G. 2012. Animals and the moral community: Mental life, moral status, and
kinship. Columbia University Press.
Stern, C. and Chur-Hansen, A. 2013. Methodological considerations in designing and
evaluating animal-assisted interventions. Animals, 3(1), pp.127-141.
Stern, C. and Chur-Hansen, A. 2013. Methodological considerations in designing and
evaluating animal-assisted interventions. Animals, 3(1), pp.127-141.
Stern, C., Pearson, A. and Chur-Hansen, A. 2011. The appropriateness of Canine‐Assisted interventions (CAIs) on the health and social care of older people residing in
long term care: A systematic review. JBI Database of Systematic Reviews and
Implementation Reports, 9(33), pp.1367-1392.
Stevenson, A. and Waite, M. 2011. Concise Oxford English Dictionary: Book & CD-
ROM Set. Oxford University Press.
Stewart, L.A., Chang, C.Y. and Rice, R. 2013. Emergent theory and model of practice
in animal-assisted therapy in counseling. Journal of Creativity in Mental Health, 8(4),
pp.329-348.
Stoeckel, L.E., Palley, L.S., Gollub, R.L., Niemi, S.M. and Evins, A.E. 2014. Patterns
of brain activation when mothers view their own child and dog: An fMRI study. PloS
One, 9(10), pp.e107205.
Strauss, A. and Corbin, J. 1994. Grounded theory methodology. Handbook of
Qualitative Research, 17pp.273-285.
129
Suddaby, R. 2006. From the editors: What grounded theory is not. Academy of
Management Journal, 49(4), pp.633-642.
Thornberg, R. 2012. Grounded theory. Research Methods and Methodologies in
Education, 85
Thornberg, R. 2012. Informed grounded theory. Scandinavian Journal of Educational
Research, 56(3), pp.243-259.
Thornberg, R. and Charmaz, K. 2014. Grounded theory and theoretical coding. The
SAGE Handbook of Qualitative Data Analysis, pp.153-169.
Timmermans, S. and Tavory, I. 2012. Theory construction in qualitative research from
grounded theory to abductive analysis. Sociological Theory, 30(3), pp.167-186.
Timmermans, S. and Tavory, I. 2007. Advancing ethnographic research through
grounded theory practice. Handbook of Grounded Theory, pp.493-513.
Totton, N. 2006. The politics of psychotherapy: New perspectives. McGraw-Hill
Education (UK).
Urquhart, C. 2012. Grounded theory for qualitative research: A practical guide. Sage.
Urquhart, C. 2007. The evolving nature of grounded theory method: The case of the
information systems discipline. The Sage Handbook of Grounded Theory, pp.339-359.
Wachtel, E.F. and Wachtel, P.L. 1990. Family dynamics in individual psychotherapy: A
guide to clinical strategies. Guilford Press.
130
Walsh, F. 2009. Human‐animal bonds I: The relational significance of companion
animals. Family Process, 48(4), pp.462-480.
Walsh, F. 2009. Human‐animal bonds II: The role of pets in family systems and family
therapy. Family Process, 48(4), pp.481-499.
White, J.H., Quinn, M., Garland, S., Dirkse, D., Wiebe, P., Hermann, M. and Carlson,
L.E. 2015. Animal-assisted therapy and counseling support for women with breast
cancer: An exploration of patient's perceptions. Integrative Cancer Therapies, 14(5),
pp.460-467.
Wilkes, J.K. 2009. The role of companion animals in counseling and psychology:
Discovering their use in the therapeutic process. Charles C Thomas Publisher.
Willig, C. and Stainton-Rogers, W. 2007. The SAGE handbook of qualitative research
in psychology. Sage.
Wilson, C.C. and Turner, D.C. 1997. Companion animals in human health. Sage
Publications.
Wilson, E.O. 1984. Biophilia. Harvard University Press.
Winnicott, D. 1958. Collected papers: Through paediatrics to psycho-analysis.
Wise, S. 2014. Rattling the cage: Toward legal rights for animals. Da Capo Press.
Wise, S.M. 2012. Nonhuman rights to personhood. Pace Envtl.L.Rev., 30pp.i.
Wise, S.M. 2003. Drawing the line: Science and the case for animal rights. Basic
Books.
131
Wolf, A. and Schwartz, E.K. 1962. Psychoanalysis in groups.
Yalom, I.D. and Leszcz, M. 2008. The Theory and Practice of Group Psychotherapy.
Basic Books.
Zamir, T. 2006. The moral basis of animal-assisted therapy. Society and Animals, 14(2),
pp.179.
Zeig, J.K. 2014. The evolution of psychotherapy: the second conference. Routledge.
Zilcha-Mano, S., Mikulincer, M. and Shaver, P.R. 2011. Pet in the therapy room: An
attachment perspective on animal-assisted therapy. Attachment & Human Development,
13(6), pp.541-561.
132
Appendix A – Ethics Approval
133
Appendix B – The Psychotherapists Grounded Theory
134
Appendix C - Schedule of interview questionsThe interview questions:
Tell me about the dog’s role in your psychotherapy sessions…
Can you share your observations of clients’ responses to the dog…?
Do you have any stories to tell me about that...?
How does the dog respond to the client in psychotherapy sessions…?
Can you share any examples with me...?
Have you ever gained therapeutic insights via the presence of the dog in the
therapeutic session...?
How do you experience the dog’s presence during sessions as influencing
you…?
Can you tell me about what you feel the dog contributes to the therapeutic
relationship...?
Ending questions
How was the interview process for you?
Is there anything you feel we did not cover or that you would like to add?
Would it be okay with you if I contacted you in the future if I need to
clarify anything?
Prompts used
Would you mind speaking a bit more about that?
Could you describe further?
Could you elaborate/clarify please?
Closing Statement
Thank you so much for your time and for sharing your experience with
me I really appreciate it. If you have any questions or queries feel free to
contact me at any time.
135
Appendix D – Plain Language StatementTitle of research projectUnderstanding the value of pet facilitated psychotherapy, what theory emerges?IntroductionMy name is Annemarie O’Brien and I invite you to participate in a research project as part of a Masters in Integrative Counselling and Psychotherapy with the Turning Point Training Institute (TPTI) of Psychotherapy and Dublin City University (DCU). I will be supervised throughout this study by Felicity Kennedy M.Sc., M.A., B.A.(Mod.) Psychology, Dip. Psychotherapy, I.A.C.P., I.A.H.I.P., P.S.I., S.A.I. from TPTI who can be contacted on 01-2807888 or via email [email protected] and Dr. Carol Barron Ph.D., MSc., BA (Hons), Dip Pharm, RNT, RSCN, RGN from DCU who can be contacted on 01- 7007928 or via email [email protected] is involved?The purpose of the research is to explore the experience of Psychotherapists who use their dog’s presence in psychotherapy sessions for therapeutic purposes. I am interested in exploring the practice of experienced, qualified psychotherapists who include the presence of their own dogs in psychotherapy sessions. The study will focus on the therapists’ perceived interpretation of the influence they believe the pet has on the therapeutic process and outcome. This requires that I conduct an in-depth interview with you that will take place face to face or via Skype. The research method is that of Grounded Theory and utilises a semi structured interview protocol and thus the duration will take approximately one hour of your time. The following is the researcher’s inclusion and exclusion criteria for this study: Inclusion criteria-
Three years qualified fully accredited psychotherapy practice. Have three years fully accredited membership of a European professional
psychotherapy body which must be validated and members of the European Association of Psychotherapy (EAP).
Resident of the European Union (EU). Have practiced psychotherapy with a dog present for a minimum of three years fully
accredited psychotherapy practice. Practice pet facilitated psychotherapy with consenting clients only. Practice pet facilitated psychotherapy for greater than one third of their practice
hours.
Exclusion criteria- Pre-accredited psychotherapists. Less than three years of fully accredited psychotherapy practice. Not a member of a professional European psychotherapy body. Living outside the EU Practice psychotherapy with a pet other than a dog present. Do not gain consent from clients. Only practice pet facilitated psychotherapy occasionally/intermittently (in less than
thirty percent of their practice).
136
Psychotherapists who have experienced pet bereavement within the past twelve months.
Participants who do not sign the Informed Consent Form, either a physical hardcopy or in the case of Skype interviews, sign a copy emailed to them which has been scanned and emailed back to the researcher.
Risks and benefits from being involved in the studyThe risk to potential participants via involvement is minimal as all participants in order to meet the criteria to contribute to the research must have full accreditation of a membership body for a minimum of three years as a prerequisite to involvement, thus the participants will be highly trained experienced members of the psychotherapy profession making the study low risk. The limits to privacy and the interview schedule will be fully disclosed before consent to participate is given thus facilitating transparency so as to facilitate a fully informed decision.The benefits to participants are that the study will offer insight and generate discussion about the concepts and application of pet presence in Psychotherapy. By participating they will effectively be sharing new knowledge with peers.Data protection, confidentiality and anonymityMaximum possible confidentiality is maintained by keeping both the names, contact details and the data procured in separate password protected files so no response will be connected with any individual participant. Each participant will be assigned a pseudonym. Furthermore, individual findings will not be reported. Any information from questionnaires will not use participants’ real names. Forms and audio recordings will be held on computer on password protected files. When the research project is completed and the MSc awarded, all materials will be destroyed under the direction of the MSc Programme Director and a Confirmation of Data Destruction form completed after a five year period has elapsed. While the content of the interview and all identifying information will be confidential (no identifying information will be in the research thesis, or in any subsequent journal articles, workshops, conference presentations or further research that may proceed from this research) it must also be declared that due to the small sample size for this study it is not possible to guarantee unqualified anonymity.You will be required to read and sign an Informed Consent Form to show your willingness and understanding of what is required to participate in the study. Any involvement in this research is voluntary and participants may withdraw at any point. There will be no penalty for withdrawing before all stages of the research study are complete. Presentation and circulation of findingsIt is possible that findings from this study may be used by the researcher and others in future research projects, distributed online and submitted for publication to peer reviewed journals. Further informationIf you would like to talk to me further regarding any questions or concerns regarding the interview or study please contact me via email at [email protected] or by telephone on +353- (0)449357514.If participants have any concerns about the study and wish to contact an independent person please contact: The Secretary, DCU Research Ethics Committee, c/o Office of the Vice-President for Research, DCU, Dublin 9. Tel 01-7008000.
137
Appendix E – Informed Consent Form“Understanding the value of pet facilitated psychotherapy, what theory emerges?”
Principal Investigator - Dr. Carol BarronPrincipal Investigator - Felicity KennedyResearcher - Annemarie Una Harmon O’BrienUniversity - Dublin City University
I am invited to participate in this research project which is being carried out by Annemarie O’Brien. My participation is voluntary. Even if I agree to participate now, I can withdraw at any time without any consequences of any kind.I understand that the study is designed to explore the experience of psychotherapists who practice therapy with their dogs.If I agree to participate, this will involve me sharing my experiences, understandings and perceptions of my experience of including my dog in psychotherapy via an in-depth interview. I understand that I will be audio recorded during the interview and that the interview will be transcribed by the researcher Annemarie O’Brien, for a grounded theory analysis. I understand that the interview will take place in the psychotherapy office of either myself or the researcher when we are both alone, thus ensuring confidentiality and safety. The interview will take place in person or via Skype under the same conditions. It will be mutually agreed upon, private, safe, secure and quiet. It will take approximately one hour of my time.If I live outside of Ireland and it is difficult for the researcher and I to meet face to face or if it is my own individual preference, the interview can take place via Skype. If the interview takes place via Skype it will also be audio recorded only. It will also be conducted while we are both in our respective psychotherapy offices for privacy, safety, security and quiet. It will also take approximately one hour of my time. If the interview takes place via Skype I will receive all forms via email and sign them before scanning them and returning them via email to the researcher. I understand that as I am a participant in a very small purposive and homogenous group my anonymity cannot be absolutely guaranteed. I also understand that if something of an emotional and distressing nature should arise the following distress protocol will be followed –
The researcher will stop the recording and clarify exactly what I am experiencing.
The researcher will ask if I would like to take a break. The researcher will allow time for me to regroup, centre and ground myself. The researcher will inform me that I may move the discussion away from the
distressing topic. The researcher will extend empathy and respect, encourage self care and
encourage me to further explore their process in personal therapy and supervision.
The researcher will remind me of my right to opt out of the study. The researcher will allow as much time as is necessary for me to make an
informed choice as to whether or not I would like to proceed. The researcher will respect the autonomy and decision of me the participant and
co-researcher throughout the process.
138
I may benefit directly from participating in this research by exploring my thoughts about animal assisted research and contributing to the professional discourse. This research may benefit the wider psychotherapeutic community and the field of Animal Assisted Therapy and Animal Assisted Interventions. Any information or data which is obtained from me during this research which can be identified with me will be treated confidentially. The data will be kept in a secure location in the home of Annemarie O’Brien, Dal gCais, Carrickboy, Co.Longford, which will be locked when the researcher is not present. If copies are made available to the Principal Investigators: Dr. Carol Barron and Felicity Kennedy, similar conditions regarding the storage and use of recordings will apply. Documents will be kept in a locked file, digital, computer and audio files will be password protected. The allocation of pseudonyms will protect participant confidentiality in the findings of the research. The real names and any personal details of the participants will be recorded in a separate document to the transcripts and analysis. Data from this research project may be published in future. The original recordings and all copies will be available only to the present investigators: Dr. Carol Barron, Felicity Kennedy and Annemarie O’Brien. I also understand that when the study is complete and the MSc awarded, all digital files (audio and computer) will be deleted immediately and hardcopy destruction will take place after five years have elapsed under the direction of the MSc Programme Director and a Confirmation of Data Destruction form completed. From September 2015 to September 2020 the raw data (notes and transcripts) will be stored in TPTI, Turning Point Training Institute, 23 Herbert St., Dublin 2, complying with legal data protection requirements before being destroyed by the Masters Programme Director.If I have any questions about this research I am free to ask and contact - Annemarie O’Brien, Ph: 044-9357514. I am also free, however, to contact Felicity Kennedy Ph:01-2801603 and Dr. Carol Barron Ph: 01-7007928 who are the Principal Investigators involved in the research. If I want to seek further clarification, acquire more information or have any concerns I may contact: The Secretary, DCU Research Ethics Committee, c/o Office of the Vice-President for Research, DCU, Dublin 9. Tel 01-7008000.
Please complete the following (circle Yes or No for each question)I have read the Information Sheet for Participants (or had it read to me)
Yes / NoI understand the information provided
Yes / No I have had an opportunity to ask questions and discuss this study
Yes / NoI have received satisfactory answers to all of my questions
Yes / NoI am aware that the interview will be audio recorded
Yes / NoI consent to participating in an individual interview
Yes / NoI understand what is involved in this research and I agree to participate in the study. I have been given a copy of the Participant Information Leaflet and a copy of this consent form to keep.----------------------------------------- ----------------Signature of participant DateAnnemarie O’Brien,Dal gCais,
139
Carrickboy, Co.LongfordPh:044-9357514 Email: [email protected]
Felicity Kennedy,TPTI,23 Herbert St,Dublin 2. Ph:01-2801603 Email: [email protected]
140
Appendix F – Information sheet on Interview Structure
This interview structure will provide a sequential overview of the topics that need to be raised with the participant/s before the actual interview commences. It is planned that developing such a schedule will enable and facilitate a more comfortable and standardised interaction between researcher and participant/s, allowing for personal and subjective accounts of experience to emerge during the interview. As recommended for Grounded Theory, there will be a series of broad, open-ended questions to encourage the participant to detail their experiences and allow the researcher flexibility in following ideas offered by the participant.It is anticipated that the participants will be approached and recruited in December and January and interviews will be conducted between January and March 2015. The interviews will be approximately one hour and held in a location that is mutually convenient, private, quiet and comfortable. It is anticipated that this will be in the offices of the researcher or participants unless otherwise agreed between researcher and participant.
I will greet and thank the participant for agreeing to take part in the interview. I will read through a copy of the Information Sheet for Participants and the
Informed Consent Form to ensure that the participant is clear about the research, what is involved.
I will reassure the participant of their confidentiality in the research by the allocation of a pseudonym. I will discuss how their anonymity cannot be absolute given the small sample of the research. I will explain that their personal details will be known by me only, will not be associated with the recording of the interview, that files will be password protected, and stored securely by myself.
I will ensure that the participant is clear that they may withdraw from the study and that they can stop the interview at any moment if the participant desires or needs to take a break.
I will ask the participant if they have any questions or concerns about the research or their participation and I will provide them with the necessary clarifications and answers.
I will ask the participant to sign the Informed Consent Form. If the interview takes place via Skype the form will be sent via email prior to the
interview and signed by the participant, scanned and emailed back to me. I will show the participant how the audio recorder works, agree to its location
for the duration of the interview, and ensure that they are comfortable and happy to proceed.
If participants state that they are indeed happy -
I will begin the interview process by thanking the participants for agreeing to take part
Stating “I am interested in your use of animal assisted interventions in psychotherapy...”
Then I will proceed with the first question, from the questions from my Interview Schedule printed in the table below.
141
Appendix G – Closing the interview and debriefing
This document will assist the researcher in debriefing her participants at the end of each interview before the session concludes to ensure that all areas of enquiry and information are covered and explicitly stated to the participant. There are a number of points of information that need to be reiterated to the participants, and some areas which may be explored relating to how the participant feels about the interview.
Following the interview the researcher will take time to reflect and record her own thoughts, feelings and experiences with each participant. This will allow her to consider her interview technique and schedule, rapport with participants and document the process in order to incorporate these observations into the final thesis.
142
Closing the Interview
I will provide a Concluding Information Sheet to participants on termination of the interview and read through the information with them before we leave.
I will thank the participant for giving their time and valuable contribution.
I will ask the participant if they have any questions or concerns, and ensure that they feel okay to leave.
Appendix H - Concluding Information Sheet for Participants
143
Concluding Information Sheet
Thank you very much for giving me your time and taking part in my study. Your contribution has been very important in helping me to learn more about animal assisted interventions in psychotherapy.
Do you have any questions or concerns? How was the experience of being interviewed for you? How do you feel right now? Do you feel ok to finish up now?
My contact details are here also and you can contact me following participation should you have further related questions and/or concerns – Annemarie O’Brien, Turning Point Training Institute, 23 Herbert St., Dublin 2. Tel: 044-9357514. Email: [email protected]. In case you would like to speak to my Supervisors or a person from Dublin City University about this research please contact:
Felicity Kennedy, Research Supervisor, Turning Point Training Institute, 23 Herbert Street, Dublin 2. Tel: 014415667;
Dr. Carol Barron, School of Nursing and Human Sciences, DCU, Glasnevin, Dublin 9. Tel: 017007928
The Secretary, Dublin City University Research Ethics Committee, c/o Office of the Vice-President for Research, Dublin City University, Dublin 9. Tel: 01-7008000.
Appendix I – Sample of transcription and coding
Transcription Text Line by line codes Focussed Codes
Ha ha ha ...She knows when they are coming down the drive before I do . So she kinda gives a bark and says they are here em so I know my clients have arrived before they have even reached the doorbell eh we don’t really need a doorbell yeah and she just literally melts hearts by just rolling or giving them her big brown eyes yeah and they stroke her and fuss her and go ooooh isn’t she cute yeah and there’s something about just stroking their their fur that’s eh a quite soothing and quite relaxing yeah ... had an asian client once who that wasn’t that keen on dogs but cause she was small and that he was like no I’m not frightened of her and then after a few weeks of her sitting on my chair she kinda kinda sat then at the bottom of his chair cause the thing about Summer is that she can’t jump on anyone cause she’s too small so she can’t get up unless people want to which is quite handy but she was kinda wagging her tail and looking at him as if to say I wanna get back up on your chair and I said I think she is after a cuddle do you wanna pick her up or shall I have her on my chair he said no she can come on my chair and eh the next few weeks he had her on his chair next to him and he would just stroke her while he was talking to me and then he said to me I have
Dogs awarenesstimebefore therapist knowsalerts therapistarrivalclient arrivalbeforeringing bellno need forliteralmelt hearts/softensbigeyes/touch“fuss” (make much of)AppealingSomethingTouching furSoothingRelaxingA clientIndifferentSmall size of dogFearlessTime lapseSittingChairGoes to clientChairDogJumpSmallClient requestUsefulTail waggingDog looks at clientSolicitation of responseTherapist reflectsCuddleQuestion of responding to dogWho / client of therapistClient respondsOver timeDog sits with clientStroke/touch dogTalkingClient stated
Awareness/attunement
Extrasensory/Enhances insightAlerts
Generates rapport
Therapeutic touch
TouchSootheRelaxAmbivalence
Size of dog
Solicits response from client
Solicits response from client
Triadic relating
Therapeutic touch
Solicits response from client
Solicits response from clientTherapeutic touch
AmbivalenceGenerates rapport/bridge
144
never liked dogs Kim he said but I want a Summer I find her so relaxing and so cute he said
AmbivalenceWanted dogGenerates relaxationAppealing
Generates relaxationRapport
Focussed codes from segment of transcriptionEnhances therapeutic relationship/allianceEnhances therapeutic insightGenerates calm and relaxation
145
