The History and Training of the Therapy Dog for School Personnel

THE HISTORY AND TRAINING OF THE THERAPY DOG FOR SCHOOL PERSONNEL

Sue Montgomery M.A., California State University, Stanislaus, 2010

Carmen Wille M.A., California State University, Sacramento, 2010

PROJECT

Submitted in partial satisfaction of the requirements for the degree of

SPECIALIST IN EDUCATION

School Psychology

CALIFORNIA STATE UNIVERSITY, SACRAMENTO

SPRING 2011

THE HISTORY AND TRAINING OF THE THERAPY DOG FOR SCHOOL PERSONNEL

A Project

Sue Montgomery Carmen Wille

Approved by:

______, Committee Chair Catherine Christo Ph.D.

______Date

Students: Sue Montgomery Carmen Wille

I certify that these students have met the requirements for format contained in the

University format manual, and that this project is suitable for shelving in the Library and

credit is to be awarded for the Project.

______Dr. Bruce Ostertag, Department Chair Date

Department of Special Education, Rehabilitation, School Psychology, and Deaf Studies

iii Abstract

THE HISTORY AND TRAINING OF THE THERAPY DOG FOR SCHOOL PERSONNEL

Sue Montgomery

Carmen Wille

Since the time dogs were first domesticated, they have played an important role in providing companionship and comfort. It was a natural extension of this human animal bond to use dogs to provide this same comfort to others as what is now know as dog- assisted therapy. This project reviews the literature to examine the benefits and concerns involved with using a therapy dog. The goal of the project is to educate school personnel about the two major dog therapy organizations in the United States and assist them in training the required elements in order to certify their canine as a therapy dog. The project is set up with four sessions, and each session is two hours long. Only one session will be presented a week.

______, Committee Chair Catherine Christo, Ph.D.

______Date iv DEDICATION

To our families

Thank you for your patience and understanding

In Memory of Harold Kerster, Ph.D. and Jordan

Shed no tears

of sorrow

for I am not gone

Believe in your heart

I will be there

Believe in your heart

and

I am there

v TABLE OF CONTENTS Dedication ...... v Chapter 1. INTRODUCTION ...... 1 Background ...... 1 Statement of Collaboration ...... 2 Statement of the Research Problem ...... 3 Purpose of the Project ...... 3 Definition of Terms...... 4 Limitations ...... 8 2. REVIEW OF THE LITERATURE ...... 10 Introduction ...... 10 Brief History of Animal-assisted Therapy ...... 10 Types of animal-assisted therapies ...... 14 Benefits of Dog-Assisted Therapy: Physiological Benefits ...... 25 Social Skills Benefits ...... 31 Reduction in Behavioral Issues ...... 33 Getting Started In Dog Therapy: Choosing the Correct Dog ...... 36 Certification of the Dog for Therapy Work ...... 39 Concerns ...... 43 Conclusion ...... 49 3. METHODS ...... 50 Research ...... 50 Development of Seminar ...... 51 4. FINDINGS ...... 54 The History and Training of the Therapy Dog for School Personnel ...... 54 Conclusions ...... 55 Recommendations ...... 56 vi Appendix A. Dog-assisted Therapy PowerPoint Presentation ...... 59 Appendix B. Dog-assisted Therapy Pamphlet ...... 110 Appendix C. Delta Society Pet Partner Skills and Aptitude Test ...... 116 Appendix D. Therapy Dogs International Testing Requirements ...... 119 Appendix E. Facilitator Guide ...... 122 Appendix F. Session Notes ...... 127 Appendix G. Parental Consent Form (English) ...... 136 Appendix H. Parent Consent Form (Spanish)...... 139 Appendix I. Presenters’ Supplies ...... 142 Appendix J. List of Needed Supplies for Handlers...... 144 References ...... 146

vii 1

Chapter 1

INTRODUCTION

Background

It is common knowledge that dogs can elicit positive emotions in humans (Hines,

2003). Because of this, organizations who work with children many times utilize dogs to help gain interest and build rapport. This is important because when children feel comfortable and connected, professionals are better able to implement physiological, social, or behavioral interventions to help improve overall quality of life (Walsh, 2009).

There are two commonly used terms to describe this type of intervention: dog-assisted activity and dog-assisted therapy (Delta Society, n.d.). To make this presentation more comprehensive, only the term dog-assisted therapy will be utilized.

Currently, no type of presentation has been created and implemented to help guide school professionals on the training necessary to successfully certify a therapy dog.

This project includes valuable information in the form of a PowerPoint presentation (See

Appendix A for PowerPoint) and a pamphlet (see Appendix B for pamphlet) that will educate counselors, school psychologists, and special education teachers about the types of animal-assisted therapies, the benefits and concerns associated with working with dogs, the two major types of therapy dog organizations in the United States, and their requirements to certify therapy dogs. This presentation will also provide pet/handler training and forms from the Delta Society (see Appendix H for Delta Society form) and

Therapy Dogs International (TDI) (see Appendix I for TDI form) listing the exercises

required to become a certified therapy dog so the professional has the tools needed to complete the certification process.

Statement of Collaboration

When researching and implementing this project, responsibilities were divided

between the two collaborators. Collaborator one was responsible for the introduction, the

statement of collaboration, limitations, and half of the definition of terms in the first

chapter, while the second collaborator was responsible for the statement of the research

problem, purpose of the project, and the second half of the definition of terms. In the

second chapter, the first collaborator was responsible for the introduction, the brief

history of animal-assisted therapy, and the benefits of dog-assisted therapy, while the

second collaborator was responsible for the types of animal therapies, the sections

involving Getting Started in Dog Therapy, and the conclusion. In the third chapter, the

first collaborator was responsible for the research section while the second collaborator

was responsible for the Development of Seminar section. In chapter four, both

collaborators came together and wrote the Finding, Conclusions, and Recommendations.

The remaining sections of the project were distributed as follows: the first collaborator

completed the facilitator’s guide (see Appendix E for facilitator’s guide), pamphlet (see

Appendix B for pamphlet) session notes (see Appendix F for session notes), and the parental consent form in English (see Appendix G for consent form in English) and in

Spanish (see Appendix H for consent form in Spanish) and the second collaborator completed the PowerPoint presentation (See Appendix A for PowerPoint) and the list of what to bring to the sessions (see Appendix I for presenters’ supplies).

Statement of the Research Problem

The goal of this project is to provide a seminar which will guide school

professionals in developing a dog-assisted therapy program at their schools. Included in

this seminar are hands on training of the dog, a PowerPoint presentation (See Appendix

A for PowerPoint) and a Pamphlet (see Appendix B for pamphlet). This project is geared toward individuals who directly work with students, such as school psychologists, counselors, and special education teachers. This presentation will also answer the following questions:

• What are the two major therapy dog organizations in the United States?

• What are the certification requirements for each therapy dog organization?

• What are the training requirements for a dog to pass evaluation?

Purpose of the Project

This project will provide a brief history on human and dog interactions and then educate school professionals on the benefits that dogs can provide to students. It will also address concerns that can negatively impact individuals interacting with the therapy dog.

The project will address choosing the correct dog. This involves selecting an appropriate dog, and being able to elevate the temperament of the dog to increase the chances that the dog will pass the evaluation required for certification. The trainers of the project will also discuss and demonstrate with a dog the training necessary for a therapy dog.

Information will be provided on the certification requirements from two different dog therapy organizations, and what to expect when actually getting the dog evaluated. Also, explained in this project, will be the steps required to have the dog fully certified as a

therapy dog. This will include the required forms, fees, and health evaluation. There will

be time in the seminar to answer questions and concerns on any area of dog-assisted therapy. The project will conclude in addressing ways to get the buy-in from administrators to provide dog-assisted therapy services. Overall, the project should help

school professionals with most aspects of selecting, training, and actually providing dog-

assisted therapy at their schools.

Definition of Terms

Animal-assisted Activity (AAA)

This is when a volunteer brings a certified dog to a facility to “play.” No

treatment goals are implemented and no records are kept (Delta Society, n.d.).

Animal Assisted Crisis Response (AACR)

To provide trained professionals with a means to reach out and help people

affected by a crisis, generally through the use of a dog (National Animal Crisis Response,

2010).

Animal-assisted Therapy (AAT)

When a professional uses a certified dog to improve social, emotional, physical,

and cognitive functioning in others; goals are implemented and results are recorded

(Delta Society, n.d.).

American Hippotherapy Association (AHA)

This is a major therapeutic horse riding association (Smith-Osborne & Selby,

2010).

American Riding for the Handicapped Association (NARHA)

This is a therapeutic horse riding association (Smith-Osborne & Selby, 2010).

Assistance Dog

A generic term for guide, hearing, or service dog specifically trained to complete certain tasks to help mitigate the effects of an individual’s disability (Assistance Dogs

International, Inc., 2010).

Bipolar Disorder

This is a mood disorder with episodes of either severe or moderate depression accompanied many times by high to moderate excitement (MedlinePlus, 2010).

Canine Visitation Therapy Organization (CVT)

This is when a professional uses a certified dog to improve social, emotional, physical, and cognitive functioning in others. Goals are implemented and results are recorded (Delta Society, n.d.).

Coronary Artery Bypass Surgery

For individuals with hardened arteries, blood flow is diminished. During surgery, a vein is removed from the leg and attached either below or above the hardened area in the coronary artery so blood flow increases (MedlinePlus, 2010).

Delta Society

This is a worldwide animal therapy organization (Delta Society, 2010).

Dogs for the Disabled Program

A charity that provides specially trained assistance dogs to those individuals with disabilities (Dogs for the Disabled, 2010).

Dolphin-assisted Therapy

When a client goes into the water and interacts with a dolphin and its trainer

(Fine, 2006).

Emotionally Disturbed

This is a diagnosis given to individuals who possess a behavioral and emotional

disturbance that interferes with learning (EmotionallyDisturbed.net, 2009).

Equine-assisted Activities (EAA)

These are activities and interventions that involve a horse (Fine, 2006).

Equine Facilitated Mental Health (EFMH)

This is when horses are used to help humans with mental health issues (Smith-

Osborne & Selby, 2010).

Equine Facilitated Mental Health Association (EFMHA)

A subsection of NARHA (Smith-Osborne & Selby, 2010)

Equine-facilitated Psychotherapy (EFP)

This involves any activity involving a horse, such as handling, grooming, lunging, riding, driving, and vaulting. This therapy is delivered by a mental health professional who is also a trained riding instructor (Fine, 2006).

Equine Facilitated or Assisted Learning (EFL)

These are mounted or unmounted lessons where the horse and human interact in an educational format (Fine, 2006).

Experiences in Close Relationships-Revised (ECR-R) questionnaire

A questionnaire used to rate individuals’ levels of security in relationships and dependence on others (Fraley & Brennan, 2000).

Goal Attainment Scale (GAS)

A 5-point scale used to measure one’s level of goal achievement (Kloseck, 2007).

Hippotherapy

A type of horse therapy done by an occupational, physical, or speech therapist who has been trained to use the movement of the horse to facilitate improvements in their clients (Fine, 2006; Smith-Osborne &Selby, 2010; Karol, 2007).

Human Animal Bond

This refers to the emotional bond between humans and animals (American

Humane Association, 2011).

Immunoglobulin A (IgA)

A class of antibodies found in body secretions that combine with proteins to fight infection (MedlinePlus, 2010).

Learned Helplessness

When animals or humans learn that life choices are irrelevant because of repeated failures or excessive control by others (Wiked, 2008).

Reading-to-dogs Program

A program that has a child read out loud to a dog, generally in a library or school setting (Therapy Dogs International, 2010a).

Service Dogs

These are specially trained assistance dogs that help individuals with disabilities.

These dogs are legally allowed entrance to public buildings and transportation

(Moore,1996).

Speech-language Pathologist

Also known as speech therapists, these professionals work with individuals who

struggle with producing speech sounds (United States Department of Labor, 2011).

State-Trait Anxiety Inventory

This is a self report inventory that measures levels of anxiety among individuals

from ninth grade through adulthood (Spielberger, 2010).

The Relationship Questionnaire

A 7-point scale used to measure attachment patterns in adult relationships

(Bartholomew & Horowitz, 1991).

Therapeutic Horse Riding

When individuals with disabilities or diverse needs ride horses in order to learn

traditional or adaptive equestrian skills (Smith-Osborne & Selby, 2010).

Therapy Dogs International (TDI)

A volunteer organization dedicated to regulating, testing, and registration of

therapy dogs and their volunteer handlers (Therapy Dogs International, 2010).

Zoonoses

Diseases and infections transmitted between vertebrae animals and humans

(World Health Organization, 1959).

Limitations

As with most projects, there are limitations. These pertain to those schools that do not allow dogs on campus; therefore permission to bring a therapy dog to the school would have to be obtained. In addition, some children are fearful of dogs, while some

9 cultures view dogs as unclean; because parental permission would need to be obtained, consent forms in English (see Appendix G for consent form in English) and in Spanish

(see Appendix H for consent form in Spanish) would need to be sent home.

Chapter 2

REVIEW OF THE LITERATURE

Introduction

For years therapy programs have used dogs to help alleviate physical, emotional, and social difficulties in children. As these animal therapy programs evolved, certain terms were enacted. The Delta Society, a national non-profit organization developed to help people live healthier and happier lives, created the titles Animal-assisted Therapy

(AAT) and Animal-assisted Activity (AAA). For the purpose of this paper, we are using the title dog-assisted therapy. Through our project, professionals will be provided with the important information needed to successfully select, train, and certify a dog for a dog- assisted therapy program at their schools.

In the literature review that follows, topics relevant to dog-assisted therapy will be discussed. These topics include: (a) a brief history of the bond between animals and humans, as well as the early uses of animals in therapy, (b) types of animal therapies used currently, (c) physiological, social, and behavioral benefits of dog-assisted therapy, (d) the development and implementation of a dog-assisted therapy program, and (e) concerns and preventative measures associated with working with dogs.

Brief History of Animal-assisted Therapy

Early human animal interactions. Humans and animals have interacted from the beginning of time. It was during these first interactions with animals that humans found many ways to use them for important purposes. For generations, animals have been used as a source of food, they have been used as transportation, their coats have

been used as clothing to protect against the elements, and even their waste has been used

as a source of fuel (Hemmer, 1990). Long before animals were kept as pets, humans were hunter-gathers and roamed from place to place following their food supply. Bar-

Yosef (1998) reported that as human populations grew and the need to stabilize food

sources increased so did the need to domesticate animals. Archeological evidence suggests hunter-gatherers in the fertile lands along the Northern end of the Mediterranean might have been some of the first humans to corral wild cattle and sheep in order to use

them as a food source. With an abundance of grains, fruits, and vegetables, and an ample

supply of animals, hunter-gatherers were able to find food not far from their base camps

(Breasted, 1944). Once the need to travel to find food was removed, land became more

valued and permanent housing and farming communities sprang up. During this time,

Hemmer (1990) reported that domesticated farm animals such as goats, cows, and pigs

were used primarily as food, while dogs, domesticated over 15,000 years ago, were used

primarily to guard and hunt (Anderson, 2008). Cats, on the other hand, were thought to

be domesticated much later. Actual proof of domestication was found in the 16th century

in Egyptian tombs thought to be almost 4,000 years old. Tomb paintings depicted images

of domesticated cats sitting, eating, and playing near humans (Beadle, 1977). Today,

animals are still used in abundance for medical purposes, entertainment, and as

companions (Hemmer, 1990).

Human animal bond. Lagoni, Butler, and Hetts (1994) maintained that the

relationship between humans and animals changed from the time of domestication as

animals moved from a more utilitarian role to one of companion. As the desire to

understand this human-animal relationship increased, so did the need to discover a

suitable term. In 1973, Dr. Konrad Lorenz first introduced the word “bond” when

referring to the relationship between humans and animals. He emphasized that the positive feelings many humans experience while with their pets were similar to the connection people have with humans (Anderson, 2008). Through the 70’s and 80’s, many human-animal bond (HAB) organizations materialized in order to study animal behavior and the bond between people and their pets. This movement gained momentum when veterinary and academic researchers started holding HAB conferences both nationally and internationally (Hines, 2003). The involvement of social scientists provided the opportunity for researching the human-animal bond, which became a major focus (Anderson, 2008).

One such body of research was conducted by Bjerke, Odengardstuen and

Kaltenborn in 1998. They studied adolescents from Norway and their attitudes toward animals. The adolescents were given questionnaires that rated their reactions to specific statements made about animals and the human-animal relationship. Researchers found that many adolescents had a strong connection with animals, especially their pets.

Additionally, many of the adolescents stated that they considered their pets as friends.

To further investigate the human-animal relationship, Beck and Madresh (2008) conducted a study examining the degree to which humans feel connected toward their

pets. Two separate questionnaires were used to rate attachment in that study, they were:

the Relationship Questionnaire and the Experiences in Close Relationships-Revised

(ECR-R) questionnaire. It was discovered that humans feel very connected to their pets and some even viewed these relationships as more secure than their relationships with other humans. Beck and Madresh theorized that this may be because animals provide a nice buffer from the negative social interactions that often plague human relationships.

Valeri (2006) further examined the positive effects that pets provide their owners when he researched the presence of laughter between pet owners and those who do not own pets. Researchers found that spontaneous laughter occurred more frequently for individuals who owned both a cat and a dog than those who owned neither. This is an important finding since it has been establish that laughter can enhance health benefits by increasing good cholesterol levels and reducing inflammation and stress (Bazzini, Stack,

Matincin & Davis, 2007; Berk & Tan, 2009).

Early uses of animals in therapy. As early as the18th century, there was much written about the use of animals in therapy. In 1792, William Tuke opened an institution that focused solely on the premise that mental illness could be controlled if patients were exposed to kindness instead of punishment. In addition, he theorized that the use of animals in therapy could be quite beneficial. This institution, known as the York Retreat, held tea parties in the court areas where small animals, rabbits and ducks, roamed freely.

Tuke philosophized that caring for animals could teach the patients self control and help with healing (Bustad, 1980).

Other early uses of animals in therapy were also reported by Levinson (1969).

During the summer of 1957, Levinson was the attending psychologist at a camp for

emotionally disturbed children. It was decided that he would bring his dog, Jingles, to

the camp so he could record the children’s interactions with the dog. Depending upon the

child, Levinson discovered that his dog’s behavior changed. With the shy children,

Jingles was calm and submissive, while around rambunctious children, Jingles was energetic and lively. The children in the camp were not only able to drop their defenses around Jingles and experience empathy, they were able to relay their own desires and feelings of fear and anxiety through the dog. Levinson maintained that the boys were able to do this because their relationship with Jingles felt safe compared to previous relationships with adults. It was also discovered that Jingles touched the life of one of the most complicated boys at the camp. The boy, who was excessively fearful of everything, eventually grew used to the presence of Jingles. In the end, the boy was able to caress and care for Jingles, which helped alleviated many of his other fears.

It was also reported that Sigmund Freud would often conduct therapy with his dog, Jofi, in the room. Patients recalled that Freud would often comment on how therapy sessions progressed with the help of interpretations from his dog (Grinker, 1979).

Types of animal-assisted therapies

There are many different types of animal therapies available which use a variety of different animals, such as dogs, horses, dolphins, etc. The purpose of animal therapy is for the animal to help humans overcome difficulties or encourage them to become better at something, such as reading or social skills. The animal can also provide comfort

and support to individuals. The following animal therapies will be introduced: reading-

to-dogs- programs, therapeutic horse riding programs, Animal Assisted Crisis Response

(AACR), counseling in conjunction with animal-assisted therapy, visiting nursing homes

and hospitals, dolphin assisted therapy, assistance/service dogs, and dog-assisted therapy.

Reading-to-dogs programs. Reading-to-dogs- programs involve having a child read out loud to a dog generally in a library or school setting. Therapy Dogs

International (2010) which is a volunteer organization dedicated to regulating, testing and registration of therapy dogs, believes that the primary goal of their reading program is to provide a relaxed and dog-friendly atmosphere, which allows students the opportunity to practice the skill of reading. At this time, there is very little published research on reading programs and their benefits. Currently the University of California, Davis (UCD) has teamed up with All Ears Reading Program, an animal-assisted therapy program developed by the Tony La Russa’s Animal Rescue Foundation of Walnut Creek, CA.

They are conducting research to determine if reading to a dog can increase reading fluency. Two studies have been completed at this time, but the results have not been published. The results from the first study, which was conducted at a public elementary school, found that reading fluency increased by 12% for those students who read to a dog. The second study conducted at UCD with homeschoolers found that reading fluency increased by 30%. It was also reported that 75% of the parents reported that their children read aloud more often and with greater confidence after the study was completed. The researchers believe that this change in attitude may be due to the patient, non-judgmental attention the dogs provide to the children (Bailey, 2010).

One popular reading-to-dogs-program is called Reading Education Assistance

Dogs (R.E.A.D.) offered by Intermountain Therapy Animals and first implemented in

1999 at a Utah library. This program has become extremely popular and is now being

offered at elementary schools, preschools, after-school latchkey programs, healthcare facilities, local libraries, boys and girls clubs, and youth detention facilities.

Intermountain Therapy Animals believes the R.E.A.D. program can dramatically increase reading levels, but also offers numerous other benefits including, increased reading enjoyment for children, improved social skills and self-confidence, decreased absenteeism from school, and increased homework completion (Intermountain Therapy

Animals, 2009). This data was collected through reading scores at the beginning, middle, and end of the school year using Developmental Reading Assessment (DRA) and

Measure Academic Progress (MAP) computerized assessment. Standardized Testing and

Reporting (STAR) scores were also compared to the previous year’s reading scores to

determine any changes. In addition, R.E.A.D. also used teacher surveys, parent

comment/observations forms, and summative reading score graphs for each student to

reach these conclusions.

Other reading-to-dogs-programs are Read to Your Breed and PAWS to Read both

located in San Diego, California. These programs have found that children are excited to

read to dogs and this appears to motivate them to read more (Hartman, 2010).

Librarydogs.com (2010) which is a website that encourages the use of therapy dog

reading programs believes that these types of programs “encourage children to feel

comfortable reading out loud, to read more often, attempt more difficult books, and

actually look forward to reading” (para. 1 ). These reading programs, which appear to benefit young readers, are popular among children, teachers, librarians, and parents. At this time the results look promising but there are few peer reviewed studies on the topic.

Therapeutic horse riding programs. Therapeutic horse riding generally refers

to “mounted activities with people with disabilities or diverse needs and involves learning

traditional or adaptive equestrian skills” (Smith Osborne & Selby, 2010, p. 293).

Another commonly used term with therapeutic riding is equine-assisted activities (EAA)

which is a catch all phrase. EAA includes most activities and interventions that involve a

horse. There is also equine-facilitated psychotherapy (EFP) which includes any activity

involving a horse such as handling, grooming, lunging, riding, driving, and vaulting.

This therapy is delivered by a mental health professional who is also trained as a riding

instructor (Smith-Osborne & Selby, 2010; Fine 2006). Karol (2007) was concerned that many of the EFP practitioners have a much greater knowledge of horses than they do of therapy. Hippotherapy is a type of horse therapy done by an occupational, physical, or speech therapist who has been trained to use the movement of the horse to facilitate improvements in their clients (Fine, 2006; Smith-Osborne & Selby, 2010; Karol, 2007).

It needs to be noted that currently there is no standardization of terminology and different

organizations for therapeutic riding are using different terms. For example, there is also

equine facilitated or assisted learning (EFL) which refers to mounted or unmounted

lessons where the horse and human interact in an educational format. There is also

equine facilitated mental health (EFMH) where horses are used to help humans with

18 mental health issues (Osborne & Selby, 2010). Both of these terms are used by the North

American Riding for the Handicapped Association (NARHA).

Prominent therapeutic horse riding programs include the above mentioned North

American Riding for the Handicapped Association (NARHA) and its subsection called,

Equine Facilitated Mental Health Association (EFMHA), and the American

Hippotherapy Association (AHA).

Biery reported that the benefits humans receive from therapeutic horse riding programs include: increased flexibility, balance, gross motor coordination, and cardio- respiratory function as well as an increase in speech and language abilities (as cited in

Granger and Kogan 2006; Macauley and Gutierrez, 2004). Some disadvantages of therapeutic horse riding programs include the expense of housing, feeding, and caring for a large animal. Horses are often kept in stables in rural areas, and transporting children to these stables can be difficult. According to McCowan, there are also safety issues if an inappropriate horse is used for therapy, particularly since they are such large animals that can inflict significant damage by kicking, biting, or stepping on someone (as cited in

Friesen, 2010). Therapeutic horse riding is also an area that requires more research to truly understand the full benefits of the use of horses in therapy whether it is for use with children with disabilities or children and young adults who are facing difficulties.

Animal assisted crisis response. Animal Assisted Crisis Response provides trained professionals with a means to reach out and help people affected by a crisis, generally through the use of a dog. The establishment of AACR is relatively new and started with the response to the events of September 11, 2001. A limited amount of

AACR was done before that event. For example, dog and handler teams were called in to

work with the families and friends of the victims in local hospitals after a 1998 shooting

spree by a high school student. One of the dog and handler teams who attended this

crisis, Cindy Ehlers, started HOPE Animal Assisted Crisis Response (HOPE AACR) and

later founded the National Animal Assisted Crisis Response (AACR). She believed

teams required specialized training to be able to provide safe effective services at crisis

and disaster situations. In answer to this, she developed training and certification programs to thoroughly train dog and handler teams (National Animal Crisis Response,

2010).

AACR teams are not first responders, and they do not search for the injured or

dead, instead they provide support and comfort to the victims, friends and family of the

victims, and emergency workers (Greenbaum, 2006). The National Animal Assisted

Crisis Response (2010) considers their mission “to provide stress relief and assist in the safe and effective emotional rescue, recovery, and ongoing support of individuals, responders, emergency services, and volunteer agencies that have been affected by crisis and disaster” (para.1). The qualifications for becoming a dog and handler team with the

National Animal Assisted Crisis Response are quite involved. They include having a registered therapy dog that is regularly visiting a facility, completing a reading list, and taking the following classes: FEMA class IS-100 Intro to Incident Command System, first aid, CPR and pet first aid. The candidate is also required to complete a 4-day

training workshop with classroom instruction, practice simulations, and exposure to

various real life scenarios. During this time the handler and dog are being evaluated, and

provided with feedback. The team can only be certified after being recommended for

eligibility by a qualified instructor.

Therapy Dogs International also offers a form of AACR called Disaster Stress

Relief (DSR). Their first crisis response was to the Oklahoma City bombing in 1995.

Since that time they have also had dog/handler teams respond to the events of September

11, 2001 and Hurricane Katrina (Therapy Dogs International, 2010).

There currently appears to be little research on AACR. More needs to be conducted to determine how effective the dog/handler teams are in offering comfort and support to victims, families, and emergency personnel in crisis and disaster situations.

Individual and group counseling with animal-assisted therapy. Animal- assisted therapy (AAT) is also used in individual and group counseling and research suggests that it provides positive benefits to the clients. Research conducted by Minatrea and Wesley (2008) found that group participants who were addicted to drugs and received AAT had a more positive client and counselor relationship, appeared more attached to the counseling process, and placed a higher value on the counseling experience. They also exhibited less stress during the counseling process. Other benefits seen were an increase in verbal and nonverbal communication, and an increase in the ability to solve problems. This study also found drawbacks in using ATT. There were concerns regarding infections from animal bites or scratches, lack of proper training and certification of the therapy animal, and concerns about clients who may be fearful of animals or allergic to their dander. These issues will be discussed in further detail later in the literature review.

Additional research found that AAT can improve the level of functioning in

patients with mood disorders. They appeared to become more motivated and less withdrawn (Sockalingam et al. 2008). Other benefits discovered were increased levels of trust toward the psychologist and enhanced healing of the client. Responses to questionnaires by clients, suggested that the therapy animal’s presence created a warm, friendly, safe environment. The animal was perceived as providing unconditional acceptance, empathy and enhanced creativity during sessions. The animal brought about a sense of play and laughter through its antics. Another surprising benefit was the increased sense of well-being the animals gave the psychologists (Wilkes, 2009). Overall research suggests that there are many benefits that a therapy animal can bring to individual and group counseling sessions.

Visiting nursing homes and hospitals. Animal-assisted therapy is also becoming popular at hospitals and nursing homes. Different types of animals such as, dogs, cats, rabbits, and birds are taken to nursing homes, whereas generally only certified therapy dogs are taken to hospitals. Research found that children who were hospitalized and received pet therapy had enhanced heart rates and displayed higher levels of positive affect. The visit by the therapy dog was also viewed as a positive experience by both

children, and guardians (Cole, Gawlinski, Steers, & Kotlerman, 2007). Other research

found that patients hospitalized with heart failure who received visits from a therapy dog

had improved cardiopulmonary pressures, neurchormone levels, and decreased anxiety

(Kaminski, Pellino, & Wish, 2002). The research regarding nursing homes and therapy

dogs visits showed many positive benefits to the residents. These include decreased

tension, depression, anger, fatigue, confusion, and increased vigor (Crowley-Robinson,

Fenwick, & Blackshaw, 1996). Other studies found increases on well-being and attitude

measures, improvements in mental functioning, increases in social activity, and increases

in smiling and alertness when the animals were present. (Kawamura, Niiyama, &

Niiyama, 2006; Phelps, Miltenberger, Jens, & Wadeson, 2008; Wallace & Nadermann,

1987). Overall research suggests that animals, particularly dogs, seem to have positive

benefits on both hospital patients and nursing home residents.

Dolphin-assisted therapy. Dolphin-assisted therapy involves having the client

go into the water and interact with the dolphin and its trainer. This interaction can

involve playing, swimming, taking care of the dolphin, watching the dolphin perform

tricks, touching the dolphin, and snorkeling with the dolphin (Antonioli & Reveley,

2005). Research finds that dolphin-assisted therapy can be an effective treatment for

mild to moderate depression. The research found that depressive symptoms improved within two weeks with dolphin-assisted therapy without any side effects, whereas conventional therapy or drug therapy took up to four weeks for improvements to occur

(Antonioli & Reveley). Nathanson (1998) found that dolphin-assisted therapy can help

children with severe disabilities improve their level of functioning in a shorter period of

time than conventional therapies, such as speech language or physical therapy. In two

weeks, the children with severe disabilities made more progress, than children who

received six months of a conventional therapy.

Even though there can be many benefits with this type of therapy, there are also potential disadvantages that need to be considered. First, the cost of maintaining

23 dolphins is extremely high. Second, there is the risk of transmitting infections between dolphins and humans. Third, there is currently limited research on the effectiveness of this type of therapy. Fourth, one has to consider the risks to the welfare and survival of the dolphin, who is generally captured from the wild and now must live in captivity

(Friesen, 2010; Fine, 2006). More research needs to be completed to truly understand whether the benefits of dolphin-assisted therapy outweigh the disadvantages.

Assistance/Service dogs. Assistance dog is a generic term for guide, hearing, or service dog specifically trained to complete certain tasks to help mitigate the effects of an individual’s disability (Assistance Dogs International, Inc., 2010) This organization defines a guide dog as a dog that is specially trained to aid a blind or visually impaired person by helping them avoid obstacles, stop at curbs and steps, and negotiate traffic. A hearing dog refers to a dog that is specially trained to aid a deaf or hard of hearing person by alerting them to a variety of household sounds, such as a telephone, doorbell, alarm clock, etc. A service dog refers to a dog that is specially trained to aid a person with a disability other than sight or hearing (Assistance Dogs International, Inc., 2010).

A person must have a disability to qualify for an assistance dog. This person and their assistance dog are protected under the Americans with Disabilities Act which states that people with disabilities cannot be discriminated against and are allowed access to any business with their assistance dogs (Assistance Dogs of North America, 2010).

Other types of assistance dogs include autism service dog, medical response dog, mobility assistance dog, psychiatric service dog, seizure alert dog, and seizure response dog. Note, that the terms assistance dog and service dog are often used interchangeably.

At this time there is no standardization of terminology and different organizations use

different terms.

Research regarding autism service dogs has found a number of positive benefits

for the family and child with autism. These include an increase in family outings, a

greater sense of security both at home and in public, and a dramatic increase in positive

social acknowledgment. It was also found that the child and parents had better quality

and quantity of sleep after obtaining the service dog. An important benefit and the main

purpose of autism service dogs is preventing the child from bolting (Burrows, Adams, &

Speirs, 2008).

Research has also found a number of concerns that can negatively affect the dog.

These include physical stress, failure to monitor the dog’s health, lack of rest, and

negative attention from the child with autism (Burrows, Adams, & Millman, 2008). If

these areas are not carefully monitored, they can impact the dog’s well-being and health

and limit its usefulness to the child and family.

Dog-assisted therapy. Dog-assisted therapy for the purpose of this paper entails having a certified therapy dog that interacts with students at schools and juvenile facilities. The therapy dog helps the handler build rapport with students, and provides comfort and support. Certified therapy dogs are not legally protected by federal law, and do not have the same protection and rights as a service dog. For instance, it does not

have access to public businesses that do not allow pets. The therapy dog is usually a

family pet, and works with its owner to provide service to others (Delta Society, 2010).

As noted previously, the two commonly used animal therapy terms defined by

Delta Society are animal-assisted therapy (AAT) and animal-assisted activity (AAA).

AAT is overseen by a health service provider who incorporates the animal as a part of

his/her own specialty and it is goal-directed with a specific need in mind in which the

professional documents each session. AAA provides opportunities for motivational,

educational, and/or recreational benefits to enhance quality of life. AAA is delivered in a

variety of environments by a specifically trained professional, paraprofessional, and/or

volunteer in association with animals that meet specific criteria. Specific treatment goals

are not required and records of the visits do not need to be documented (Delta Society,

2010).

This paper will use the term dog-assisted therapy since it will only focus on a training program for dogs, whereas animal-assisted therapy allows not only dogs but any animal that can safely interact with people such as cats, rabbits, hamsters, and horses.

The benefits of dog-assisted therapy will be discussed in the next section.

Benefits of Dog-Assisted Therapy: Physiological Benefits

Reduction in blood pressure. As reported previously, the benefits of using dogs in therapy are numerous. One such benefit is a reduction in blood pressure. Freidmann,

Katcher, Thomas, Lynch, and Messent (1983) conducted such an experiment when they examined the effect that exposure to a dog had on blood pressure and heart rate. First, the researchers introduced half of their research participants to a friendly dog. The researchers then created three different experiment groups. The first group of participants were exposed to the dog twice, the second group was exposed to the dog

once, and the third group was never exposed; all three groups incorporated quiet time and

reading time. Immediately after each group, the researchers measured the participants’

blood pressure and heart rate. Overall, it was reported that the participants who were

exposed to the dog had a greater reduction in blood pressure than the participants who

were not; with an even greater reduction in blood pressure for those who were exposed

twice.

Other additional studies found that touching a dog could reduce blood pressure.

Vormbrock and Grossberg (1988) conducted an experiment that used heart rate

recordings and blood pressure readings to determine the effect that petting an animal had

on blood pressure. They found that reduction in blood pressure was more prominent when the participants were petting a dog, reduction in blood pressure was less noticeable when participants talked to the dog, and even less noticeable when participants talked to the examiner. It’s apparent with these findings that exposure to a dog is beneficial to the physiological wellbeing of humans.

Somervill, Kruglikova, Robertson, Hanson, and MacLin (2008) also conducted a study to investigate the effect that touching a dog had on blood pressure and pulse rate.

Researchers also wanted to know if blood pressure levels were different for a dog than with a cat. The team created two phases in the study. In the first phase, participants were given surveys asking about pet preferences, whether an animal resided in the home, and whether participants had allergies to pets. In the second phase, once participants with allergies and fear of animals were excluded, remaining participants had their blood pressure and pulse rate monitored, while an animal was either placed on their lap for five

minutes or removed from the room. Somervill et al. discovered that when animals were

placed on participants’ laps, their blood pressure was reduced, regardless of whether it was a cat or a dog.

Reduction in pain. The presence of a dog has proven to be not only beneficial in reducing blood pressure; it has also been proven to be beneficial in reducing pain. Sobo,

Eng, and Kassity-Krich (2006) discovered this when they examined the effects of dog

exposure and perception of pain. In their experiment, children who had undergone

surgery were visited by dogs from the Canine Visitation Therapy organization (CVT), a

program that exposes patients to therapy dogs. Immediately after surgery, the children were interviewed and their current levels of pain were recorded. The children were then introduced to the CVT dog and again interviewed about levels of pain. Sobo, Eng, and

Kassity-Krich discovered that the children’s perception of pain reduced dramatically when they were in the presence of the dog. Researchers theorized that perception of pain may be dulled because the dog distracted the children from thinking about their pain, in addition to helping the children feel more of a connection to family and home (Connor &

Miller, 2010).

Braun, Stangler, Narveson and Pettingell (2009) found similar results when they

researched the effect that handling a dog had on pain intensity. The researchers created

two groups: group one monitored pain levels in children between the ages of 3-17 who

were exposed to a dog, and group two monitored pain levels in children who were not

exposed. Results of the experiment revealed that for children who were in pain, handling

a dog reduced pain levels. In addition, for children suffering from pain, respiratory rates

also increased when they were exposed to a dog. The increase in respiratory rates is an important indicator of pain reduction because many times when individuals are in pain, they hold their breath (R. Montgomery, RN., personal communication, October 26,

2010).

Reduction in Anxiety. As with pain reduction, exposure to animals has also proven to be quite beneficial in reducing anxiety among children. Nagengast, Baun,

Megel and Leibowitz (1997) examined this effect when they researched the outcome of

exposing children to a dog during a physical examination. Children between the ages of

3 and 6 were divided into two groups: In group one, children were exposed to a dog

during a physical examination and in group two, children were not exposed. Researchers

determined that if a child must receive a physical examination, the presence of a dog in

the room can reduce anxiety levels greatly.

Hoffmann et al. (2009) also conducted a study that investigated the effect that the

presence of a dog had on anxiety. Twelve severely depressed adults, each suffering from

anxiety and nervousness, were used in the experiment. They were placed into two equal

groups, one with exposure to a dog and one without. At the end of the study, adults were

administered The State-Trait Anxiety Inventory (Spielberger, 2010), a self-report rating

scale that measures levels of anxiety. It was reported in the experiment group that not

only did levels of anxiety reduce, motivation was enhanced.

Reduction in depression. Researchers were also curious what would happen if

depressed individual were exposed to a dog. Folse, Minder, Aycock, and Santana (1994)

examined this effect in their experiment that exposed undergraduates to different

temperaments of dogs. Twenty-two college students who were suffering from depression

were assigned to the control group and were not exposed to a dog. The remaining college students with depressive symptoms were randomly split into two experiment groups: a nondirective group, which exposed the students to an active, energetic dog named Annie and a directive group, which exposed the students to a calm, gentle dog named Stanleigh.

Results indicated that for at least half of the students in the nondirective group, depressive symptoms decreased.

Similar results were witnessed when Parshall (2003) routinely visited her grandfather in a nursing home. Parshall’s grandfather had been living with low grade

depression for over two years and suffering from somatic complaints, but once her

grandfather was able to regularly interact with a dog, his depression lifted and his

appetite, sleep patterns, and mental acuity improved dramatically.

Walsh (2009) also reported a reduction in depressive symptoms among his patients when he incorporated his dog during therapy sessions. He stated that one of his clients, who suffered depression after the loss of her mother and boyfriend, described how the presence of his dog helped give her the strength she needed to work through her pain. The client explained that through the dog, she was able to express her concerns, which gave her a better connection with her therapist.

Sockalingam, et al. (2008) were also interested in the effects that dog exposure had on individuals with depression. In their study, a 43-year-old male with a prior diagnosis of bipolar disorder was used. This individual had recently been assaulted and was experiencing depression, lack of motivation, low self esteem, and somatic

complaints. During the study, the man was re-introduced to medication for bipolar disorder. Then, he was given a dog to care for on a daily basis. Results of the

experiment included improved self esteem, increased mood and outlook, decreased

anxiety, and improved overall health.

Fewer Illnesses and increased health. Previous research suggests that exposure

to a dog can dramatically decrease somatic complaints (Haug, Mykletun & Dahl, 2004).

Because of this decrease in physiological symptoms, Charnetski, Riggers, and Brennan

(2004) explored the effect of dog exposure and Immuniglobulin A (IgA) production (i.e., the substance found in body secretions that helps fight disease) (Buckley, 2008).

Researchers selected 58 college students and assessed their attitudes toward pets with the

Pet Attitude Scale. Then, the researchers randomly assigned the college students to one

of three groups: group one had the students sit on a couch for 18 minutes and pet a dog,

group two had participants sit on a couch for 18 minutes without a dog, and group three

had participants sit on a couch for 18 minutes and pet a stuffed animal that was identical

in appearance to the live animal. Saliva secretions were collected before and after each

group. With attitudes toward pets not relevant to the results, it was indicated that

participants who petted the real dog had higher levels of IgA in their saliva. This is an

important finding since it has been shown that higher levels of IgA in the body are

correlated with a reduction in upper respiratory infections (Yodfat & Silvian, 1977).

Friedmann and Thomas (1995) also conducted an experiment to examine the

relationship between pet ownership and increased health. One year survival data was

collected from 368 patients who had undergone coronary artery surgery. It was

determined that of the 282 patients who didn’t own a pet, 19 died. In comparison, of the

87 patients who owned pets, only 1 died. Results indicate that patients who own pets are

much more likely to experience positive recovery results after surgery and improved

health.

Social Skills Benefits

Increased social integration and relationships. Beck and Meyers (1996) reported that for those who lack the opportunity to socially interact, animals can provide the missing interactions that protect against loneliness. In addition, Beck concluded that pet ownership affords lonely individuals the opportunity to develop new relationships.

Camp (1997) also researched the relationship between service dogs and increased social integration. She discovered that individual’s with physical disabilities reported higher levels of social integration when using a service dog. In addition, many participants reported that their relationship with the dog was even more important to them than the tasks the dogs could perform.

Lanea, McNicholasb, and Collisb (1998) further reported positive results when they conducted a survey to determine the benefits of using a dog and social integration.

Fifty-seven physically disabled individuals received dogs from Dog for the Disabled program to help with daily activities. Questionnaires were used to assess the changes in their lives since obtaining the dogs. It was reported that subjects had an increase in social integration and increased improvement in health.

Similar social results were found when LaFrance, Garcia, and Labreche (2007) investigated the effects of a therapy dog on communication skills in adults with aphasia.

They reported that shy participants became more sociable and animated while in the presence of the dog.

Increased verbal communication. In addition to increased social integration, researchers have found that dogs also impact verbal communication in a positive way.

Lewis (2003), a speech-language pathologist, collected data examining the effects that animal-assisted therapy had on communicative skills. Five preschool children, each lacking in communication skills, were used in this investigation. Lewis collected data during a six-month interval; three months with a therapy dog and three months without.

She found that unlike therapy where only speech services were provided, during the three months that a therapy dog was used with speech services, the children’s communicative and receptive skills increased. Barol (2006) believes these results are an indication that therapy dogs increase self-confidence and motivation.

Macauley (2006) also found positive results when she conducted a study that investigated the effect that animal-assisted therapy (AAT) had on aphasia (i.e., a language disturbance) in adults. Three men who had stroke-related aphasia were exposed to two separate speech service seminars: the first seminar consisted of traditional speech services and the second seminar consisted of traditional speech series in the company of a dog. Results indicated that traditional speech services were just as effective as AAT therapy. The difference was in the attitudes of the men who participated in the AAT.

They reported that they were more excited to attend the AAT with the dog, which improved satisfaction, effectiveness, and overall motivation. Additionally, LaFrance,

Garcia, and Labreche (2006) reported that individuals with aphasia were less passive

while communicating when the therapy dog was present.

Increase self-esteem. As with the benefits of social integration, researchers were

also curious about the benefits of self-esteem. Camp (1997) conducted interviews and observations with five physically disabled individuals who worked with therapy dogs.

She discovered that not only did individuals experience an increase in self-esteem, they also experienced increased independence and security.

Sockalingam, et al. (2008) also conducted a study to investigate the effects that

dog exposure had on self-esteem in an individual suffering from bipolar disorder. A 43-

year-old male who had recently been assaulted and was experiencing depression, lack of

motivation, and low self esteem, was used in this study. For the experiment, the man was

re-introduced to medication for bipolar disorder. In addition, he was given a golden

retriever to care for on a daily basis. Results of the experiment included improved self

esteem, increased mood, decreased anxiety, and improved overall health and outlook.

This increase in social benefits has lead researchers to investigate other populations

where dog-assisted therapy might be beneficial.

Reduction in Behavioral Issues

Emotional disturbed (ED). Kogan, Granger, Fitchett, Helmer, and Young

(1999) conducted such an experiment when they paired two emotionally disturbed

children with Animal–assisted therapy (AAT) dogs once a week for four months. The

boys in this study, who displayed aggressive, negative behaviors, were given the tasks of

brushing and teaching various training methods to the dogs. Through these tasks, the

34 boys learned how to use their vocal tones and positive reinforcement to obtain desirable results. At the end of the study, both boys displayed a decrease in behavioral problems and angry intonations while displaying more positive relationships with their peers. In addition, the first boy exhibited less distractibility and an increase in eye contact while the second boy exhibited less learned helplessness and temper tantrums. These findings are important because not only has it been determined that children develop more empathy when they are attached to a pet, they also have fewer behavioral problems (Daly

& Morton, 2006; Hastings, Zahn-Waxler, Robinson, Usher, & Bridges, 2000).

Kotrschal and Ortbauer (2003) also researched the effect that exposure to a dog had on behavior. In their experiment, 24 elementary age children in a multiethnic classroom were exposed to three different dogs, every day for one month. Results indicated the children not only worked better as a group, but intense behaviors lessened.

In addition, the teacher reported that the students were more motivated to follow instructions. This is similar to a finding from Levinson (1969) first reported the value of incorporating pets in the classroom to make learning more fun and motivating.

Autism. As with ED, Autism is another developmental disability that was positively affected by animal-assisted therapy. Barol (2006) conducted a single-case study to examine the effects that dog exposure had on social skills in a child with autism.

Once a week for 15 weeks, a five-year-old boy interacted with an eight-year-old dog named Henry for 50 minutes. Prior to exposure, the boy was noncompliant and lost interest when asked to play with other children, cut paper using scissors, and play ball with a teacher. Teachers incorporated unique techniques to get Zachary to participate.

One such activity to improve Zachary’s scissor skills involved cutting dog treats for

Henry. Another activity to improve interactions and eye contact involved rolling a ball to

Henry and then getting the ball when Henry rolled it back. Zachary was also expected to

walk up stairs, call to Henry, and then walk down the stars with the dog at his side. By

the third week, Zachary was able to remain engaged for over twenty minutes while

playing ball with Henry. Zachary was also able to cut dog treats without complaint. In

addition, by the third week, Zachary not only enjoyed walking with Henry on the stairs,

Zachary also initiated the interaction with Henry by walking down the stairs, looking into

Henry’s eyes and then grabbing the leash to escort the dog up the stairs. Results of the

experiment indicated that interacting with a therapy dog can drastically improve social

and motor skills in individuals with autism.

Yeh (2008) also investigated the effects that animal-assisted therapy (AAT) had

on social skill in a child with autism. In this three year study, 33 children with autism

were exposed to both the control and experimental conditions. In the control condition,

the children’s regular living activities were monitored, while in the experimental

condition, the children’s interactions with a dog were monitored. Vineland Adaptive

Behavior Scale (VABS) (Sparrow, Cicchetti, & Balla, 2011) and the Goal Attainment

Scale (GAS) (Kiresud, & Sherman, 1968) were used to measure outcomes. Overall, the

children exposed to the AAT had improvements in oral expression, self control, eye

contact, and concentration.

Viau et al. (2010) also conducted research that investigated the physiological

impact of pairing children with autism to service dogs. Since cortisol is a stress hormone

that is detected in saliva (Mayes et al., 2009), and researchers wanted to determine if

stress levels decreased in the presence of a service dog, the saliva secretions of 42

elementary age children were examined. Each child had samples of saliva taken before the study, while in the presence of the dog, and after the dog was removed from the room.

Results indicated that the children’s cortisol levels reduced by ten percent while in the

presence of the dog and then increased significantly when the dog was removed. These

results indicate that children with autism are calmer and less stressed while in the

presence of a service dog.

Getting Started In Dog Therapy: Choosing the Correct Dog

Dog selection. Getting started in dog-assisted therapy involves choosing the correct dog, training the dog, and certifying the dog with a dog therapy organization such as Delta Society or Therapy Dogs International. When selecting a dog for therapy work, it can be either a purebred or a mixed breed. Frequently, purebreds are chosen because they have been bred for specific characteristics, and it can be easier to have an idea of

what the puppy might be like as an adult. There are also plenty of mixed breed dogs that would make good candidates for therapy dogs, but care needs to be taken in selecting a suitable dog. Mixed breed dogs can be readily adopted from animal shelters and rescue groups.

There has been little research on how to choose a dog. Most of it pertains to selecting service dogs that tend to have more stringent training requirements. Research

by Crowley-Robinson and Blackshaw (1998) found that those who worked near the AAT

dog preferred a short-coated animal of medium size that was gentle and placid. The dogs

most frequently chosen by the respondents were Labrador Retrievers and Golden

Retrievers. The Delta Society, (2010a) a worldwide animal therapy organization, states that the primary selection criteria for therapy dogs are reliability, predictability, controllability, and suitability. Reliability refers to the extent to which behavior can be repeated in different situations and with different people. Predictability means that behavior in specific circumstances can be anticipated in advance. Controllability means that behavior can be interrupted, guided or managed. Suitability means that the right animal has been selected for the right job. Delta Society (2008) also states that a great therapy dog wants to visit people, is friendly and confident in appearance, knows how to respect personal boundaries, and is completely non-aggressive toward other animals,

dogs and people. In addition, a good therapy dog will initiate contact, stay engaged, and

make eye contact with people (Delta Society, 2008).

Weiss (2002), who has developed rigorous tests for evaluating service dogs,

believes that dogs need to be evaluated for submission, fear, dog aggression, energy

level, and dominance to determine if they will make good working dogs. If the dog

evaluates too high in any of these areas it makes a poor candidate for a therapy dog.

The owner needs to honestly evaluate his or her own dog to determine if it has the

traits necessary to be good therapy dog. If the dog shies away from men or lunges

aggressively at other dogs, it probably is not a good candidate for therapy work, and it

will not pass the testing requirements to become certified.

Temperament of dog. One of the most important things to consider when

selecting a dog for therapy work is the dog’s temperament. The therapy dog must have

an outstanding temperament. This means that the dog is friendly and outgoing to all

people. The dog is tolerant of other dogs and not aggressive toward other pets (Therapy

Dogs International, 2010a). It is important to note, that many shelters perform

temperament tests and dogs with unsound temperaments are not put up for adoption.

Also, personnel who work at the shelters frequently get to know the dogs well, and can

help with selecting a dog with the appropriate temperament for therapy work.

Therapy Dogs International (2010a) states that a therapy dog is born not made.

This means that if a well-trained dog with an unsuitable temperament becomes stressed its poor or marginal temperament will surface, despite being well-trained.

Role of the veterinarian. The veterinarian plays an important role in the

certification of the therapy dog by ensuring that the dog is healthy and up-to-date on

vaccinations. The dog must also be free of all parasites. Both Delta Society and Therapy

Dogs International require paperwork signed by a veterinarian indicating that the dog is

healthy for initial certification, and thereafter yearly health checks to ensure that the

animal remains healthy (Delta Society, 2010a; Therapy Dogs International, 2010b). The

American Veterinary Medical Association (2007) recommends that veterinarians, and

owners of animals used for AAA and AAT should work closely together to develop a

wellness plan that enhances the animal’s health and overall well-being, and to ensure

zoonotic diseases are not spread to humans from the therapy animals.

Training. There is little research on the best way to train the therapy dog. Delta

Society (2008) states that the therapy dog training needs to be solid, but fails to define

what solid means. Lucidi, Bernabo, Panunzi, Villa, & Mattioli, (2005) reported that

39 therapy dogs need to be obedience trained and need to be able to interact with a variety of different people, but does not state how one should go about teaching these skills.

One of the authors of this literature review has extensive experience training dogs, and will provide basic advice, but not a step by step guide to dog training. There are many excellent books available on basic dog training such as The Art of Raising a Puppy

(The Monks of New Skete, 1998) and How to Be Your Dog’s Best Friend: A Training

Manual for Dog Owners (The Monks of New Skete, 2002). These books are excellent guides to starting a dog in basic obedience and dealing with problem behaviors.

If this is a person’s first dog, he or she should seek a professional trainer to work with individually or in a group setting. The professional can teach a novice owner how to make the dog, heel, sit, down, and stay, which are commands that are necessary to pass certification to become a therapy dog. The more experienced dog owner may not need to work with a professional trainer, but could still benefit from participating in group lessons which will help socialize the dog. The more experienced dog owner may start the basic training of the dog at home, but it is critical to train in a variety of locations and to allow the dog to meet a variety of different people and dogs.

Certification of the Dog for Therapy Work

Therapy Dogs International (TDI). Therapy Dogs International (TDI) is a volunteer organization dedicated to regulating, testing and registration of therapy dogs and their volunteer handlers. It is the largest and oldest (established in 1976) therapy dog organization in the United States. TDI allows dog/handler teams to visit a variety of different settings, which include: assisted living communities, private homes, hospitals,

40 libraries, nursing homes, schools, shelters, and funereal homes. TDI also has a children’s reading program called Tail Waggin’ Tutor, a disaster stress relief program that has offered support at the Oklahoma City Bombing, September 11, 2001, and Hurricane

Katrina, and a home visit program that provides services for individuals living at home.

All current associate members are covered by the primary liability insurance policy and secondary volunteer accident insurance, which protects the dog/handler team in case an accident occurs while working (Therapy Dogs International, 2010b).

Evaluation requirements with TDI. No research was available to evaluate the effectiveness of TDI’s evaluation requirements in comparison to other therapy organizations. The requirements for a dog to become certified as a therapy dog with TDI are as follows:

• The owner needs to present proof that the dog is up-to-date on current state

required vaccinations and licenses.

• The dog must be at least a year old and wear the appropriate collar or harness as

stated by TDI.

• The dog must pass the 11 testing requirements established by TDI.

• The tester must be certified by TDI (Therapy Dogs International, 2010).

Registration requirements. No research was available to examine the effectiveness of TDI’s registration requirements. After passing the 11 tests for suitability, the therapy dog must meet the following health requirements before it can become registered with TDI. The dog must have had a check-up within the past year. The dog must have an up-to-date rabies vaccination given by a licensed veterinarian. The dog

41 must have had its initial series of core Distemper, Hepatitis, and Parvovirus vaccinations, and it must have a negative Heartworm test which was done within the past year unless there is no heartworm present in the area the dog lives or if the dog has been on preventative medication/2veterinarian must fill out the health form and sign it. The health form, evaluation form, picture of the dog, and the fee to register the dog must be sent in to TDI (Therapy Dogs International, 2010).

Delta Society. Delta Society is a national non-profit organization that helps people live healthier and happier lives by incorporating therapy, service and companion animals into their lives. The mission of Delta Society is to help lead the world in advancing human health and well-being through positive interactions with animals. Delta

Society offers a therapy animal program called Pet Partners which trains and screens volunteers and their pets so they can visit patients/clients in hospitals, nursing homes, hospice, and physical therapy centers, schools, libraries, and other facilities. Delta

Society offers resources in animal-assisted therapy for professionals in fields such as healthcare and education so these professionals can learn how to safely and effectively incorporate therapy animals into their practices. Delta Society also has a National

Service Animal Resource Center which provides information and resources for people with disabilities, who are interested in getting a service animal or currently have one

(Delta Society, 2010).

Evaluation requirements. There are four steps to becoming a certified Pet

Partners team:

• Attend a Pet Partners Team Training Course or completing a home-study course.

• Have the health of the animal screened by a veterinarian.

• Have the handler/animal team evaluated for skills and aptitude (22 exercises need

to be passed).

• Submit the registration application if the animal has been screened as healthy, and

the team has passed the evaluation.

Lucidi et al. developed a new evaluation procedure called Ethotest for selecting dogs suitable for AAA and AAT. They compared their results to the skill and aptitude evaluation conducted by Delta Society. The researchers stated they chose Delta Society because they are acknowledged worldwide for the selection of suitable dogs for programs of AAA/AAT. The results were nearly the same with the two different evaluations. The follow-up after 1 year showed that the dogs that passed were still being worked in AAA or AAT. The results suggest that the evaluation used at Delta Society tends to result in dogs that are successful as therapy dogs.

Registration requirements. No research is available to evaluate whether the registration requirements from Delta Society makes for a better therapy dog than other therapy organizations. To register a dog with Delta Society, the dog must first pass the skills and aptitude evaluation. Next, seven forms need to be filled out from the registration packet. Note: the veterinarian needs to fill out and sign the health screening form. These forms need to be sent to Delta Society with the signed team evaluation form, a team photo of the handler and dog, and the required fees within the 90 day expiration date (Delta Society, 2008, 2010).

Concerns

There are a number of concerns regarding the use of dogs that need to be addressed before the handler starts working with the therapy dog. These concerns include zoonotic diseases, allergies, fear of dogs, cultural differences, and the welfare of the dog. (Jalong, Astorino, & Bomboy, 2004; Fine 2006). It is important for the handler to have a good understanding of these different areas of concern and to always take precautions so that the dog and all people in contact with the dog can remain safe and healthy.

Zoonotic diseases. Zoonoses has been defined by the World Health Organization

(1959) as diseases and infections transmitted between vertebrae animals and man. It is believed there are between 150 (Fine, 2006) and 200 zoonotic diseases (Hart, Trees, &

Duerden, 1996), but it is believed that only 35 zoonotic disease agents can be transmitted to humans through dog-assisted therapy (Schantz, 1990). In order to determine which zoonotic diseases were of the greatest concern, Waltner-Toews (1993) sent questionnaires to employees at hospitals and a variety of different animal shelters and found that rabies, ringworm, and external parasites topped the list. Few of these concerns were based on actual experiences with a particular zoonosis (Waltner-Toews, 1993).

Research also found that even though dogs can have the potential to transmit zoonotic diseases, the risk is minimal, particularly when safety measures are observed

(Brodie, Biley, & Shewring, 2002). A study done by DiSalvo et al. (2006) found that physicians and veterinarians viewed dogs as having the lowest risk of transmitting a disease to humans.

The groups at highest risk for acquiring zooneses are children under 5 years of age, pregnant women, elderly people, people with AIDS/HIV, people with organ transplants, and people being treated with chemotherapy (Centers for Disease Control,

2010a; Fine, 2006). To prevent the possible transmission of disease, effective hygienic measures need to be in place such as hand washing each time an animal is handled.

Other measures that need to be in place are regular health evaluations of the dog by a veterinarian, having the dog up-to-date on state required vaccinations, and having annual testing for internal parasites to help with early detection of zoonotic diseases (DiSalvo, et al. 2006; Jalongo, Astorino, & Bomboy, 2004; Johnson, Odendaal, & Meadows, 2002).

The dog also needs to be bathed, groomed, have its nails trimmed regularly, and be treated monthly for external parasites to further prevent transmission of disease (Johnson, et al.).

Overall, the risks are believed to be minimal for dogs transmitting diseases to humans, but care should still be taken, especially with populations who are at higher risk of acquiring a zoonotic disease.

Allergies. It is estimated that 5.3 percent of the United States population has an allergy to animal dander, and these figures are higher for people with a history of asthma

(Waltner-Toews, 1993). Staff and students can be allergic to the saliva, dander or excretions of the animals (DiSalvo, et al., 2006) Symptoms of an animal allergy include nocturnal wheezy cough, asthma, rhinitis and conjunctivitis (Creip, 1982). The most common allergen is dander and to help reduce the effects, the dog should be bathed and well-groomed to reduce the amount of dander shed before a visit to a school (Jalongo, et

45 al., 2004; Brodie et al., 2002). Also, it is important to know which students have allergies to minimize their contact with the therapy dog (DiSalvo, et al.).

Fear of dogs. There are many areas where dogs are valued for their fierceness and their ability to protect people and property. Children may be afraid of dogs through this association and may not be able to understand that a dog can be calm, gentle and safe to touch. Other children may be afraid of dogs from prior bad experiences such as being chased or bitten by a dog. It is best to allow children fearful of dogs to watch others interacting with the therapy dog. This will give them the opportunity to realize the dog will not hurt them, and allow them time to become comfortable around the dog (Jalongo, et al., 2004). Greenbaum (2006) states that people who are afraid of the dog should be given plenty of room so they may avoid the dog. This means that the handler never insists that children visit with the therapy dog, instead allowing contact to be their own decision when they feel confident and safe enough to approach the dog.

Animal-induced accidents (bites). Approximately 400,000 children in the United

States seek medical attention for dog bites each year, and usually the bite is a family pet or a family member’s pet (Jalongo, 2006). The Centers for Disease Control (2010) recommends that the following safety tips be taught to children and reviewed regularly:

• Do not approach an unfamiliar dog.

• Do not run from a dog or scream.

• Remain motionless (e.g., "be still like a tree") when approached by an unfamiliar

dog.

• If knocked over by a dog, roll into a ball and lie still (e.g., "be still like a log").

• Do not play with a dog unless supervised by an adult.

• Immediately report stray dogs or dogs displaying unusual behavior to an adult.

• Avoid direct eye contact with a dog.

• Do not disturb a dog that is sleeping, eating, or caring for puppies.

• Do not pet a dog without allowing it to see and sniff you first.

• If bitten, immediately report the bite to an adult.

When initially bringing the therapy dog to a school, it is a good idea to first go over

these dog safety rules with the students, not only regarding the therapy dog, but also

regarding any dogs they may encounter, including their own (Jalongo, 2006). Hoff,

Brawley, and Johnson (1999) reports that most animal bites only produce minor injury, but there is the potential of infection of the wound caused by bacteria. This is a particular

concern for individuals who are immuno-compromised. Fine (2006) recommends that if

a dog bites or scratches a child, the wound should be immediately rinsed with plenty of

running water, and washed with a mild soap or an iodine solution, such as Betadine

diluted with water. The child’s parents should be notified and the family doctor

contacted.

Currently there are no figures that provide the number of incidences arising from the

use of dogs in therapy, but it is believed that the risk of a dog bite is minimal (Brodie et

al., 2002; DiSalvo et al., 2006). The risks are believed to be low because of the high

level of training and the excellent temperament required of the therapy dog before it can

become certified. To further avoid problems, the therapy dog should always be

47 supervised and never left alone with children. This will help prevent unfortunate interactions between students and the dog.

Cultural differences. Some cultures regard dogs as unclean (notably the Middle

East or Southeast Asia) and some believe that spirits may appear as animals, and others may view dogs as nuisances (Greenbaum, 2006; Jalongo, et al., 2004). These cultural differences can make a dog very unpleasant to certain students in the school. Permission forms are sent home in advance, asking the parents if their children may visit with the certified therapy dog. These forms will provide the necessary information on which children may or may not interact with the therapy dog. It is important to respect different cultural views, and keep the dog away from those children whose parents request it.

There are also populations who may be uncomfortable being around specific breeds of dogs, for instance, Greenbaum (2006) found that some inner city children do not work well with Pit Bulls, Rottweilers, and Doberman Pinschers, but work well with other breeds, such as Poodles or Cocker Spaniels. Care must be taken to respect cultural sensitivities in order for the therapy dog to be a positive addition to the educational environment.

Welfare considerations of the dog. The welfare of the therapy dog should always be a consideration. AAT and AAA can be stressful to dogs because of the change in settings and schedules from the dog’s normal routine. The handler needs to determine if the dog is coping comfortably in the environment, if the dog is recovering from the visits, and if the dog is enjoying the interactions with students. To do this the handler needs to recognize signs of stress in the dog. Indications of stress can be changes in

48 posture, body movement, head movement, and eye movement from what the dog normally exhibits. Other warning signs of stress include: sweating paws, salivating, panting, yawning, shaking, sudden loss of hair, restlessness, withdrawal, muscle tenseness, suspiciousness, aggression, hyperalertness, intensified startle reflex, ducking behind handler, self-mutilation, and change in activity or appetite (Fine, 2006). If a dog is exhibiting any of these characteristics, it would be in the best interest of the dog to give it a break from therapy work or stop all together.

In order to provide a safe environment for the dog, Jalongo et al. (2004) suggest that children need to be taught how to correctly approach, touch, and interact with the therapy dog. A number of students may not have experience with dogs and may not have been taught these skills. It is also important to remember that children also need to be closely supervised around the dog to ensure the safety of all parties.

Research by Haubenhofer and Kirchengast (2006) examined whether therapy work changed the levels of the stress hormone cortisol, in dogs. The research found that dogs produced significantly higher levels of cortisol on days in which they did therapy work, compared to the control group. Generally, the levels of cortisol were significantly higher after therapy sessions than levels before sessions. It was also found that cortisol levels increased when the dog had fewer work breaks or worked more sessions per week.

Currently therapeutic work can be considered physiologically arousing for the dog, but research has not determined whether this is due to the dog actually experiencing stress or caused by excitement from the activity (Haubenhofer & Kirchengast). It is important to always monitor the well-being of the dog. This can be done by making sure the dog has

enough days off from work, and making sure the dog does not appear stressed. It is also

important to make sure the dog gets enough exercise and playtime.

Conclusion

Through this literature review, the writers determined that there appear to be no guides available on how personnel in the field of education should start a therapy dog program at their school. This project will fill an important need in educating and

preparing people to successfully implement such a program. Information is also provided on the numerous benefits found in using dog-assisted therapy, and the concerns that need to be addressed before bringing the therapy dog around children. This review provides the characteristics necessary for a dog to be a successful therapy dog, and the training the dog will need. The major therapy dog organizations are identified with their evaluation and registration requirements. Overall, this project should fill a gap which will enable teachers, counselors, and school psychologists, etc. to provide dog-assisted therapy at their schools.

Chapter 3

METHODS

Research

In order to complete the literature review, research was conducted by searching

the following databases for journal articles: ERIC, Eureka, Academic Search Premier,

PubMed, PsychINFO, PsycArticles, and MedlinePlus. During the search, specific key terms were used: assistance dogs, dog-assisted therapy, dog-assisted activities, service dogs, companion dogs, pet therapy, animal companions, animal-assisted interventions, human-animal bond, human-animal interactions, physiological effects of animal ownership, health benefits of animal ownership, autism and animal-assisted therapy,

Reading with Rover, Dogs for the Disabled, hippotherapy, dolphin-assisted therapy, equine therapy, and canine-assisted therapy. The following terms were also researched online: dog-assisted activities, pet therapy, companion dogs, R.E.A.D. program, interactions between people and pets, animal-assisted crisis response, how to raise a dog, zoonotic diseases, service dog training, IgA, emotionally disturbed, learned helplessness, somatic complaints, and agriculture. In addition to database and online searches, reference sections at the end of journal articles were used as a source for scholarly books.

Only professional journal articles and books containing original references were used during the writing of the literature review. Exceptions would be when dog selection recommendations, certifications, and concerns were incorporated; it was then that professional online organizations were used such as Delta Society and Therapy Dogs

International. Most journal articles were written after 2000, except for articles describing the history of agriculture, animal-human bonds, and early uses of animals in therapy.

Development of Seminar

This seminar was developed to provide an overview of the results of the literature review regarding the history, benefits, concerns, and training of the canine for dog- assisted therapy. The goal is to facilitate individuals in training and using dog-assisted therapy in a school setting. The seminar is designed for school personnel, such as school psychologists, counselors, and special education teachers to enable them to successfully choose, train, and certify a dog for therapy work. The seminar is designed to be presented in four sessions of one session a week. Each session will be approximately two hours long. The sessions were set up in this manner to allow the opportunity for participants to work with training their dogs in the ensuing week. The presenters realize that dogs will have different levels of training, and each dog and participant will be given individual attention during the seminar to help them reach their full training potential in the four sessions. The participants should develop a complete understanding of the training exercises the dog will be required to learn in order to pass the evaluation requirements from a therapy dog organization. Discussion topics will include: a brief history of animal-assisted therapy, the benefits and concerns regarding dog-assisted therapy, information about the two major dog therapy organizations, dog selection and temperament, appropriate training equipment and what equipment is allowed by the therapy dog organizations, the importance of appearance, grooming, and vet care, certification and what to expect on evaluation day, acting in a professional manner with

52 the therapy dog, and talking to administrators about allowing the therapy dog in the school. The presenters will use the demo dog to provide a demonstration of what the training exercises should look like; they will also help the participants train their dogs.

Each day there will be time to answer questions and concerns participants may have.

During the last session the presenters will share their personal experiences with therapy dogs in a school setting.

It needs to be noted that the presenters of this seminar need to be experienced dog trainers that are qualified to work with dogs and participants. An experienced dog trainer refers to an individual who has five years experience training dogs and has also taught dog training classes. The trainer should also have certified a therapy dog with one of the major therapy dog organizations.

This seminar was not delivered to participants prior to its submission as a project, but was modeled after a successful training program offered by a professional dog trainer.

The training methods used in this seminar have resulted in the certification of therapy dogs. A PowerPoint presentation on a CD (See Appendix A for PowerPoint), a pamphlet

(see Appendix B for pamphlet), forms from the Delta Society (see Appendix C for Delta

Society form) and Therapy Dogs International (see Appendix D for TDI form) stating the exercises required to become a certified therapy dog, a form given to participants stating what they need to bring to the sessions (see Appendix J for supplies list), a form stating the items needed to give the seminar (see Appendix I for presenters’ supplies), and a parental consent form in English (see Appendix G for consent form in English) and in

Spanish (see Appendix H for consent form in Spanish) giving students permission to

53 interact with the therapy dog. It is important for the effectiveness of this seminar that the presenters have trained dogs present to demonstrate the training exercises to the participants.

Chapter 4

FINDINGS

The History and Training of the Therapy Dog for School Personnel

The History and Training of the Therapy Dog for School Personnel is summarized in a PowerPoint presentation (see Appendix A for PowerPoint presentation), pamphlet (see Appendix B for pamphlet), and forms stating the exercises required for

Delta Society (see Appendix C for Delta Society form) and TDI (see Appendix D for TDI form) evaluation. This information is intended to assist school personnel by first, understanding the history of dog-assisted therapy, including the benefits and concerns regarding the use of dogs in therapy. Second, it will teach school personnel about the two major dog therapy organizations in the United States and provide the evaluation and certification requirements of these organizations. Third, it will help school personnel train their dogs to perform the required elements in order to qualify for certification.

During each session there will be time for participants to ask questions regarding any aspect of dog-assisted therapy, including questions on difficulties they may be having with their training of the dog. In order that the information in this project can be effectively used, one of the presenters must have at least five years experience training dogs. Plus, the person must have experience teaching dog training classes and have a certified therapy dog. This experience is necessary to be effective in reading dog behavior and in helping inexperienced dog handlers train their dogs.

Conclusions

The focus of this project is to provide school personnel with the means to train

and certify a therapy dog. This project answers the following questions:

• What is the history of dog-assisted therapy?

• What are the benefits and concerns regarding the use of dogs in therapy?

• What are the two major dog organizations in the United States?

• What are the evaluation requirements?

• What training is necessary to certify the canine as a therapy dog?

Training. The literature review provides information about the history of therapy dogs that thoroughly addresses the benefits and concerns, but the literature provides little or no information about the best methods of training the therapy dog. The literature from

Delta Society (2008) states that the therapy dog training needs to be “solid,” but fails to define what “solid” means. Lucidi (2005) reported that therapy dogs need to be obedience trained and able to interact with a variety of different people, but does not state how one should go about teaching these skills. Therefore, for this seminar to be successful, at least one of the presenters needs to have extensive experience training handlers and their dogs in addition to having certified a therapy dog in the past.

Therapy dog organizations. In addition to Delta Society and TDI, there are other dog therapy organizations that might be appropriate for certifying a therapy dog.

The presenters focused on two worldwide organizations where school personnel could easily get a dog certified in Northern California, but there are other smaller organizations that might be just as appropriate. When looking into smaller therapy dog organizations, it

is important that they meet the specific requirements needed for personnel working in a

school. One such organization located in Sacramento, California that would not be

appropriate for school personnel would be Lend a Heart. This organization sends multiple handlers and their dogs as a group to facilities or schools rather than as individual dog/handler teams. This would not work because school personnel need to be able to work independently with their dogs and cannot arrive in large groups of dogs and handlers. If an individual is going to use a therapy dog organization other than the two listed in this seminar, it is important that the individual thoroughly research the organization before deciding upon whether it’s an appropriate match. For instance, if it is an organization that only visits hospitals, this is not going to work for the professional that is interested in working in a school.

Law. It is critical that a person training a canine for dog-assisted therapy have a clear understanding that their dog does not have the same protections under the law as a service dog. Service dogs have legal access to public and private stores or facilities whereas a therapy dog can only go where permission is granted.

Recommendations

Seminar recommendations. At this point in the projects submission, the seminar has not been presented to determine its overall effectiveness. Therefore, this seminar should be presented and its success will be determined by the participants understanding of therapy dogs and by the number of dogs that pass evaluation through

TDI or Delta Society.

Training recommendations. It is recommended that the therapy dog be taught

to walk in a large group of people because this is something the dog will experience in a

school environment. Neither TDI or Delta Society has an exercise that requires the dog

to walk in a large crowd. It can be very frightening for the canine so it is recommended

that the handler practice in a crowd before taking the therapy dog to work at a school.

The handler needs to expose the canine to loud noises such as a concert in a park to

determine if the dog will be reactive to noises such as what can be found at a school

assembly.

Canine welfare. In the school environment the dog should have a quiet, peaceful

place where it can rest without being disturbed by staff or students. This could mean

providing the canine with a dog bed under a desk or a crate in the corner. Personal

experience has shown when working with students who are suicidal or students who are

emotionally disturbed that the dog has potential to experience stress. This would be a

good time to let the dog rest and recover. If the canine is showing signs of stress, the professional needs to evaluate if the dog needs time away from therapy work or determine if this is an appropriate activity for the canine.

Further research. Further research could look into determining ways other professions, such as speech therapists or occupational therapists, can incorporate a therapy dog in their work with children. For example, occupational therapists could have a student throw a ball to a canine to improve gross motor skills and coordination. Speech therapists could have the student read to the dog to improve articulation. Professionals could also use the canine as a form of reinforcement.

Other types of future research could incorporate teaching a refresher course that focuses on the skills taught in the original seminar. This is a way for the handler and canine to work on the skills originally taught. For busy professionals, who may not have time to train regularly, this would be a way to keep the canine’s training fresh.

APPENDIX A

Dog-assisted Therapy PowerPoint Presentation

Slide 1

The History and Training of the Therapy Dog for School Personnel

Carmen Wille & Sue Montgomery

Slide 2

Session 1  Introduction of people and dogs  How participants became interested in dog therapy  Brief history  Benefits  Concerns  Discuss therapy dog organizations  Demonstration of heel, sit, and down  Training

Slide 3

Introductions  Presenters: Carmen Wille and Sue Montgomery  How did you become interested in training a therapy dog?  Our demo dogs: Macy Rou, a Jack Russell Terrier; Ryker, a Border Collie, and Zoey, a Mixed Breed

Slide 4

Dog-assisted Therapy

 Dogs used to help alleviate physical, emotional, and social difficulties in children  The Delta Society created the titles Animal-assisted Therapy (AAT) and Animal-assisted Activity (AAA).  We are using the title Dog-assisted Therapy.  Our project will provide professionals with important information needed to create their own dog-assisted therapy program at their schools.

Slide 5

Types of Animal-Assisted Therapy  The following animal therapies will be introduced:  Reading-to-dogs- programs  Therapeutic horse riding programs  Animal Assisted Crisis Response (AACR)  Individual and group counseling with animal-assisted therapy  Visiting nursing homes and hospitals  Dolphin assisted therapy,  Assistance/service dogs  Dog-assisted therapy

Slide 6

Reading–to-Dogs-Program  Reading-to-dogs- programs involve having a child read out loud to a dog generally in a library or school setting  Research by University of California, Davis (UCD) who teamed up with All Ears Reading Program found that reading fluency increased by 12% for those students who read to a dog in a public school and increased by 30% for homeschoolers  Benefits include: increased reading enjoyment for children, improved social skills and self-confidence, decreased absenteeism from school, and increased homework completion

Slide 7

Therapeutic Horse Riding Programs  Therapeutic horse riding generally refers to “mounted activities with people with disabilities …learning traditional or adaptive equestrian skills” (Smith Osborne & Selby, 2010, p. 293)  Benefits include: increased flexibility, balance, motor coordination, and cardio-respiratory function, increased speech and language abilities (Granger and Kogan 2006, citing Biery 1985; Macauley and Gutierrez 2004)  Disadvantages include: the expense of housing, feeding, and caring for a large animal, transporting children to and from the stable often in a rural area, and safety issues if an inappropriate horse is used for therapy (Friesen, 2010, citing McCowan 1987)

Slide 8

Animal Assisted Crisis Response  Provides trained professionals with a means to reach out and help people affected by a crisis, generally through the use of a dog  AACR teams are not first responders, and they do not search for the injured or dead, instead they provide support and comfort to the victims, friends and family of the victims, and emergency workers (Greenbaum, 2006)  Qualifications for becoming a dog and handler team with the National Animal Assisted Crisis Response are quite involved.

Slide 9

Individual and Group Counseling with Animal-Assisted Therapy  Minatrea and Wesley (2008) found that group participants who were addicted to drugs and received AAT had positive benefits  Improved level of functioning in patients with mood disorders  Animal’s presence created a warm, friendly, safe environment, providing unconditional acceptance, empathy and enhanced creativity during sessions

Slide 10

Visiting Nursing Homes and Hospitals  Different types of animals such as, dogs, cats, rabbits, and birds are taken to nursing homes, whereas generally only certified therapy dogs are taken to hospitals.  Overall research suggests that animals, particularly dogs, seem to have positive benefits on both hospital patients and nursing home residents  Benefits include: decreased tension, depression, anger, fatigue, confusion, and increased vigor

Slide 11

Dolphin-Assisted Therapy  Involves having the client go into the water and interact with the dolphin and its trainer.  Can involve playing, swimming, taking care of the dolphin, watching the dolphin perform tricks, touching the dolphin, and snorkeling with the dolphin (Antonioli & Reveley, 2005)  Research finds that dolphin-assisted therapy can be an effective treatment for mild to moderate depression  Can help children with severe disabilities improve their level of functioning in a shorter period of time than conventional therapies  Disadvantages: high cost of maintaining dolphins, risk of transmitting infections, limited research on the effectiveness of this therapy, risks to the welfare and survival of the dolphin, (Friesen, 2009; Fine, 2006)

Slide 12

Assistance/Service Dogs  A generic term for guide, hearing, or service dog specifically trained to help mitigate the effects of an individual’s disability (Assistance Dogs International, Inc., 2010)  Types of assistance dogs: guide dogs, hearing dogs, and service dogs  A person must have a disability to qualify for an assistance dog and is protected under the Americans with Disabilities Act (Assistance Dogs of North America, 2010)

Slide 13

Dog-Assisted Therapy  Dog-assisted therapy for the purpose of this paper entails having a certified therapy dog that interacts with students at schools and juvenile facilities  Certified therapy dogs are not legally protected by federal law, and do not have the same protection and rights as a service dog  The therapy dog is usually a family pet, and works with its owner to provide service to others

Slide 14

Benefits of Dog-assisted Therapy Physiological Benefits Reduction in Blood Pressure

 Freidmann, Katcher, Thomas, Lynch, and Messent (1983) conducted an experiment to examine the effect that exposure to a dog had on blood pressure and heart rate.  First, researchers introduced half of the participants to a friendly dog.  Then the researchers created three different experiment groups with the first group of children exposed to the dog twice, the second group exposed once, and the third group never exposed.  Immediately after each group, the researchers measured the children’s blood pressure and heart rate.  The children who were exposed to the dog had a greater reduction in blood pressure than the children who were not; with an even greater reduction in blood pressure in children who were exposed twice.

Slide 15

Reduction in Pain

 Braun, Stangler, Narveson and Pettingell (2009) conducted an experiment that examined the effect that handling a dog had on pain intensity.  Researchers created two groups: group one monitored pain levels in children between the ages of 3-17 who were exposed to a dog, and group two monitored pain levels in children who were not exposed.  Results of the experiment revealed that for children who were in pain, handling a dog reduced pain levels.  For children suffering from pain, respiratory rates also increased.

Slide 16

Reduction in Anxiety

 Nagengast, Baun, Megel and Leibowitz (1997) researched the outcome of exposing children to a dog during a physical examination.  Children between the ages of 3 and 6 were divided into two groups: In group one, children were exposed to a dog during a physical examination and in group two, children were not exposed.  Researchers determined that in the presence of a dog, children had lower levels of anxiety.

Slide 17

Reduction in Depression

 Sockalingam, Li, Krishnadev, Hanson and Balaban (2008) investigated the effect that dog exposure had on individuals with depression.  A 43-year-old male with a prior diagnosis of bipolar disorder was used.  This individual had recently been assaulted and was experiencing depression, lack of motivation, low self esteem, and somatic complaints.  The man was given a dog to care for on a daily basis.  Results included improved self esteem, increased mood and outlook, decreased anxiety, and improved overall health.

Slide 18

Fewer Illnesses and Increased Health

 Charnetski, Riggers, and Brennan (2004) questioned the effect that dog exposure had on overall health.  58 college students were randomly assigned to one of three groups: group one sat for 18 minutes and petted a dog, group two sat for 18 minutes without a dog, and group three sat for 18 minutes and petted a stuffed animal.  Saliva secretions were collected before and after each group.  Participants who petted the real dog had higher levels of IgA in their saliva.  Higher levels of IgA in the body are correlated with a reduction in upper respiratory infections.

Slide 19

Social Skills Benefits Increased Social Integration and Relationships

 Lanea, McNicholasb, and Collisb (1998) investigated the benefits of dog exposure and increased social integration.  Fifty-seven physically disabled individuals who received dogs from Dog for the Disabled program were used in this study.  Questionnaires were used to assess the changes in their lives since obtaining the dogs.  Subjects had an increase in social integration and increased health improvement.

Slide 20

Increased Verbal Communication

 Lewis (2003), a speech-language pathologist, collected data examining the effects that animal-assisted therapy had on communicative skills.  Five preschool children, each lacking in communication skills, were used in this investigation.  Lewis collected data during a six-month interval; three months with a therapy dog and three months without.  Unlike original therapy where only speech services were provided, during the three months that a therapy dog was used, the children’s communicative and receptive skills increased.

Slide 21

Increase Self-esteem

 Camp (1997) conducted interviews and observations with five physically disabled individuals who worked with therapy dogs.  She discovered that individuals experience an increase in self- esteem  They also experienced increased independence and security.

Slide 22

Reduction in Behavioral Issues Emotional Disturbance (ED)  Kogan, Granger, Fitchett, Helmer, and Young (1999) researched the effect that Animal–assisted therapy (AAT) dogs had on children who displayed aggressive, negative behaviors.  Once a week for four months two children diagnosed with ED were given the tasks of brushing and teaching various training methods to therapy dogs.  Through these tasks, the boys learned how to use their vocal tones and positive reinforcement to obtain desired results from the dogs.  Both boys displayed a decrease in behavioral problems and angry intonations while displaying more positive relationships with their peers  The first boy also exhibited less distractibility and increased eye contact.  The second boy also exhibited less learned helplessness and temper tantrums.

Slide 23

Autism  Barol (2006) conducted a single-case study to examine the effect that dog exposure had on social skills in a child with autism.  Once a week for 15 weeks, a five-year-old boy interacted with an eight-year-old dog.  Prior to exposure, the boy was noncompliant and lost interest when asked to play with other children, cut paper using scissors, and play ball with a teacher.  By the third week, Zachary was able to remain intrigued for over twenty minutes while playing ball with Henry, cut dog treats without complaint, and initiate interactions with the dog.

Slide 24

Concerns  There are a number of concerns regarding the use of dogs that need to be addressed before the handler starts working with the therapy dog. These concerns include zoonotic diseases, allergies, fear of dogs, animal-induced accidents (bites), cultural differences, and the welfare of the dog

Slide 25

Zoonotic Diseases  Diseases and infections naturally transmitted between animals and man.  Waltner-Toews (1993) sent questionnaires to employees at hospitals to determine which zoonotic diseases were of greatest concern.  Rabies, ringworm, and external parasites topped the list.  Even though dogs have the potential to transmit zoonotic diseases, the risk is minimal when safety measures are observed.

Slide 26

Allergies

 5.3 percent of the United States population has an allergy to animal dander.  Higher percentages for people with a history of asthma.  Symptoms of allergies include: nocturnal wheezy cough, asthma, stuffy nose, and pink eye.  To help reduce allergies, the dog should be bathed and well- groomed.  It is important to know which students have allergies to minimize their contact with the therapy dog.

Slide 27

Fear of Dogs  Children may be afraid of dogs through association and bad experiences such as being chased or bitten by a dog.  Allow children to watch others interacting with the therapy dog, and allow them plenty of time to become comfortable around the dog.  Give them plenty of room so they may avoid the dog if they choose.  Never insist that children visit with the therapy dog.

Slide 28

Animal Induced Accidents (Bites)  Approximately 400,000 children in the United States seek medical attention for dog bites each year.  When initially bringing the therapy dog to a school, it is a good idea to first go over safety rules with the students.  Currently there are no figures that provide the number of dog bites arising from the use of dogs in therapy.  It is believed to be minimal.

Slide 29

Cultural Differences  Brodie et al., 2002) maintain that some cultures regard dogs as unclean, others view dogs as nuisances, while others believe that spirits may appear as animals.  There are populations who may be uncomfortable being around specific breeds of dogs.  Greenbaum (2006) found that some inner city children do not work well with Pit Bulls, Rottweilers, and Doberman Pinschers, but work well with other breeds, such as a Poodles or Cocker Spaniels.  Care must be taken to respect cultural sensitivities so the therapy dog can be a positive addition to the educational environment.

Slide 30

Introduction to Therapy Dog Organizations Therapy Dogs International (TDI) Delta Society

Slide 31

Therapy Dogs International (TDI)  A volunteer organization dedicated to regulating, testing and registration of therapy dogs and their volunteer handlers  Largest and oldest (1976) therapy dog organization in the United States  Visit: assisted living communities, private homes, hospitals, libraries, nursing homes, schools, shelters, and funereal homes

Slide 32

Therapy Dogs International  Have: Children’s reading program called Tail Waggin’ Tutor and a disaster stress relief program  Covered by the primary liability insurance policy and secondary volunteer accident insurance if working as a volunteer

Slide 33

Delta Society  National non-profit organization that helps people live healthier and happier lives by incorporating therapy, service and companion animals into their lives  Offers Pet Partners which trains and screens volunteers and their pets so they can visit patients/clients in hospitals, nursing homes, hospice, and physical therapy centers, schools, libraries, and other facilities

Slide 34

Delta Society  Offers resources in animal-assisted therapy for professionals in fields such as healthcare and education  National Service Animal Resource Center provides information and resources for people with disabilities

Slide 35

Time for Demo Dogs  The exercises for today are:  Heel  Sit  Down

Slide 36

Heel  The dog should be walking near the handler, but the dog does not need to be in perfect heel position.  The dog should not pulling on the leash.  The handler should not be dragging the dog along.

Slide 37

Sit  When the sit command is given, the dogs bottom should hit the ground.

Slide 38

Down  When the down command is given, the dogs entire body should by on the ground, both front and back legs.

Side 39

Training Time  First, let take dogs out to potty and then let’s start training.

Slide 40

Session 2

Slide 41

Session 2  Dog selection and temperament  Questions/concerns with training  Practice heel, sit, and down  Training equipment/what is allowed in both organizations  Teach stay and practice  Practice heel, sit, down, and stay  Discussion of appearance and grooming  If dogs are ready we will add: accepting a friendly stranger, reaction to distractions, leave-it, and sitting politely

Slide 42

Getting Started in Dog Therapy  Choosing the Correct Dog Dog Selection Temperament of Dog

Slide 43

Dog Selection  When selecting a dog for therapy work, it can be either a purebred or a mixed breed  Little research on how to choose a dog  Crowley-Robinson and Blackshaw (1998) found that those who worked near the AAT dog preferred a short-coated animal of medium size that was gentle and placid  Frequently chosen: Labrador Retrievers and Golden Retrievers

Slide 44

Dog Selection Continued  The Delta Society, (1996) a worldwide animal therapy organization, states that the primary selection criteria for therapy dogs are:  Reliability- behavior can be repeated in different situations and with different people  Predictability-Behavior in specific circumstances can be anticipated in advance  Controllability-behavior can be interrupted, guided or managed  Suitability-right animal selected for the right job

Slide 45

Dog Selection Continued  Weiss (2002) believes that dogs need to be evaluated for:  Submission  Fear  Dog aggression  Energy level  If the dog evaluates too high in any of these areas it makes a poor candidate for a therapy dog

Slide 46

Dog Selection Continued Qualities of a Great Therapy Dog  Visits people  Friendly and confident in appearance  Knows how to respect personal boundaries  Completely non-aggressive toward other animals, dogs and people  Initiates contact  Stays engaged  Makes eye contact with people

Slide 47

Temperament of Dog  One of the most important things to consider when selecting a dog for therapy work is the dog’s temperament.  The dog must be friendly, outgoing, tolerant of other dogs and not aggressive toward other pets.  A therapy dog is born not made.

Slide 48

Participant Training Questions/Concerns

Slide 49

Training Time  Let take dogs out to potty and then let’s practice heel, sit, and down.

Slide 50

Training Equipment  The collar should fit correctly, it should not be too loose or too tight.  If the dog is dragging the handler around, it may be time to try a different type of collar.  Buckle collar  Choke chain  Prong collar  Head harness  Martingale  Harness  No pull harness

Slide 51

Training Equipment Allowed by TDI and Delta Society  TDI allows only a plain buckle collar or harness to be used during the evaluation and when making visits as a therapy dog.  Delta Society allows: Premier Gentle Leader Easy-Walk Harness Halti Harness Freedom Harness Sense-ation Harness Sense-ible Harness Body or step-in harnesses (leash clips to a ring on the back of the animal) Buckle, snap, quick-release collars (leather or fabric) Limited slip collars (Martingales), if they do not include metal links Halters/head collars Leashes, no more than 6 feet in length, that are all-leather or all-fabric Metal hardware, such as buckles, slip rings, and D-rings

Slide 52

Let’s teach Stay  When a dog is placed in a sit or down and given the stay command it will remain in that position until released by the handler.

Slide 53

Training Time  Let practice heel, sit, down, and stay.

Slide 54

Appearance and Grooming of Handler and Dog  The handler should always be neat and tidy.  It is helpful to carry a lint brush to remove dog hair from yourself and students.  Always present yourself in a professional and courteous manner.  Realize that many students and staff members will want to say “Hi” to the therapy dog. Allow extra time for this.  Always supervise the therapy dog. Even when speaking to other students or staff members.

Slide 55

Appearance and Grooming of Handler and Dog  Dog’s hair should be clean and dry.  Any loose hair should be brushed out before a visit.  Dog’s nails should be kept trimmed and not jagged or sharp.  Wipe away any eye discharge with a damp cloth.  Also wipe dog’s face to remove any fine dirt and to freshen the appearance.  Carry a cloth to wipe dirty paws on rainy days before entering a building.  The dog’s therapy bandanna or vest should be clean and dry.  Always carry doggy clean up supplies, if there should be an accident.

Slide 56

Training Time  Let’s try: Accepting a friendly stranger, reactions to distractions, leave it, and sitting politely.

Slide 57

Accepting a Friendly Stranger  This test demonstrates that the dog will allow a friendly stranger to approach it and speak to the handler in a natural, everyday situation.  The evaluator and handler shake hands and exchange pleasantries.  The dog must show no sign of resentment or shyness, and must not break position or try to go to the evaluator.

Slide 58

Reactions to Distractions  This test demonstrates that the dog is confident at all times when faced with common distracting situations, such as the dropping of a large book or a jogger running in front of the dog.  The dog may express a natural interest and curiosity and/or appear slightly startled, but should not panic, try to run away, show aggressiveness, or bark.

Slide 59

Leave It!  The handler with the dog on a loose leash walks over food on the ground and, upon command, the dog should ignore the food.  This exercise tends to take considerable practice, particularly for the chow hound, to become proficient at.

Slide 60

Sitting Politely for Petting  This test demonstrates that the dog will allow a friendly stranger to touch it while it is out with its handler.  The dog should sit at the handler’s side as the evaluator approaches and begins to pet the dog on the head and body only.  The dog may stand in place to accept petting.  The dog must not show shyness or resentment.

Slide 61

Session 3

Slide 62

Session 3  Discussion of vet care and how that relates to certification of the therapy dog  Questions/concerns with training  Review previous exercises: sit, down, stay, heel, accepting a friendly stranger, reaction to distractions, leave-it, and sitting politely  Discussion on registration of the therapy dog  Teach with distractions, coming when called, reaction to another dog, reaction to medical equipment, and walking through a crowd  Discussion on identifying stress in the dog

Slide 63

Role of the Veterinarian  The dog needs to be up-to-date on all state required vaccinations, which will include the rabies shot.  The owner needs proof of current vaccinations.  The dog needs to be free of internal parasites, including heartworm.  The dog should be on a monthly heartworm medication.  The dog needs to be free of external parasites, such as fleas and ticks.  The dog needs to pass a vet exam indicating it is healthy.

Slide 64

Role of Veterinarian  The veterinarian plays an important role.  They ensure the dog is up-to-date on vaccinations and free of all parasites and zoonotic diseases to humans.  Delta Society and Therapy Dogs International require paperwork signed by a veterinarian indicating that the dog is healthy for initial certification.

Slide 65

Participant Training Questions/Concerns

Slide 66

Training Time  Let’s review: sit, down, stay, heel, accepting a friendly stranger, reactions to distractions, leave it, and sitting politely.

Slide 67

Registration Requirements for TDI  Have evaluation form showing the 11 tests were passed  Check-up within the past year  Up-to-date rabies vaccination given by a licensed veterinarian and initial series of Distemper, Hepatitis, and Parvovirus vaccinations  Negative Heartworm test done within the past year unless the dog has been on preventative medication or there is no heartworm present in the area

Slide 68

Registration Requirements for TDI  A negative fecal exam must have been done within the last year  A veterinarian must fill out the health form and sign it  Health form, evaluation form, picture of the dog, and the fee to register the dog must be sent in to TDI  The current fee is $10 for 1 dog and 1 handler.  The fee may be higher if there is a fee for site use or the evaluator has to travel a distance

Slide 69

Registration Requirements with Delta Society  Dog must first pass the skills and aptitude evaluation  Seven forms need to be filled out from the registration packet  These forms are:  Photo ID form  Application fee form  Volunteer policies and procedures agreement form  Volunteer review  Handler’s questionnaire  Animal health screening forms  Volunteer contract form

Slide 70

Registration Requirements with Delta Society  Note: the veterinarian needs to fill out and sign the health screening form  The dog must pass a physical exam  Be up-to-date on state required immunization and rabies shot  Must be negative of internal and external parasites  Must have had a negative fecal exam within 6 months  Currently a dog in the Pet Partners Program may not be fed a raw diet

Slide 71

Registration Requirements with Delta Society  Forms need to be sent to Delta Society with the signed team evaluation form, a team photo of the handler and dog, and the required fees within the 90 day expiration date (Delta Society, 2008, 2010). The current fee is $75 for 1 dog and handler.

Slide 72

Training Time  Let’s work on: training with distractions (bouncing ball, toy that walks, heeling with demo dog around dogs on stay, etc.) coming when called, reaction to another dog, reaction to medical equipment, and walk through a crowd

Slide 73

Training with Distractions  While training an exercise the dog is solidly able to do, slowly add distractions such as the presenter bouncing a ball while the dogs are sit staying, or having a toy that makes noise and walks or heeling the demo dogs around the dogs on a down stay.  Start with mild distractions and increase the level with the dogs’ ability.

Slide 74

Coming When Called  The dog will come when called by the handler.  The handler will walk 10 feet from the dog, turn to face the dog, and call the dog.  The handler may use encouragement to get the dog to come.  Handler’s may choose to tell the dog “stay” or “wait” or they may simply walk away, giving no instructions to the dog as the evaluator provides mild distraction (e.g., petting)

Slide 75

Reaction to Another Dog  This test demonstrates that the dog can behave politely around other dogs.  Two handlers and their dogs approach each other from a distance of about 10 yards, stop, shake hands, and exchange pleasantries, and continue on for about 5 yards.  The dogs should show no more than a casual interest in each other.

Slide 76

Reaction to Medical Equipment  The dog must be tested around medical equipment (such as wheelchairs, crutches, canes, walkers, or other devices which would ordinarily be found in a facility) to judge the dog’s reactions to common health care equipment.

Slide 77

Walking Through a Crowd  This test demonstrates that a dog can move about politely in pedestrian traffic and is under control in public places.  The dog and handler walk around and pass close to several people (at least three).  The dog may show some interest in the strangers, without appearing overexuberant, shy or resentful.  The handler may talk to the dog and encourage or praise the dog throughout the test.  The dog should not be straining at the leash.

Slide 78

Welfare Considerations of the Dog  The welfare of the therapy dog should always be a consideration.  Entering different settings and schedules can be stressful to the dogs.  The handler needs to determine if the dog is coping comfortably to therapy by looking for of stress.  If excessive stress occurs, handlers should give breaks from therapy work or stop altogether.

Slide 79

Identifying Stress in the Dog  Indications of possible stress in the dog  Changes in posture, body movement, head movement, and eye movement from what the dog normally exhibits.  Sweating paws  Salivating  Panting  Yawning  Shaking  Sudden loss of hair  Restlessness

Slide 80

Indications of Stress in the Dog, Continued  Withdrawal  Muscle tenseness  Suspiciousness  Aggression  Hyperalertness  Intensified startle reflex  Ducking behind handler  Self-mutilation  Change in activity or appetite

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Slide 81

Stress in the Dog  In order to provide a safe environment for the dog, children need to be taught how to correctly approach, touch, and interact with the therapy dog (Jalongo et. al., 2004).  Always closely supervise children around the therapy dog to ensure safety of all parties.  Always monitor the well-being of the dog.  Make sure the dog receives enough exercise and free-time away from therapy work.

Slide 82

Session 4

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Slide 83

Session 4  Discussion of evaluation day  Questions/concerns with training  Review previous exercises: sit, down, heel, stay, accepting a friendly stranger, reaction to distractions, leave-it, sitting politely, teach with distractions, come on a long line, reaction to another dog, reaction to medical equipment, and walk through a crowd  Personal accounts of having a therapy dog in a school setting  Teach clumsy petting, staggering and gesturing, angry yelling and appearance and grooming  Talking to administrators about allowing dog therapy at the school

Slide 84

Evaluation Requirements with TDI  Present proof that the dog is up-to-date on current state required vaccinations and licenses  Dog must be at least a year old and wear a plain collar or harness  Dog must pass the 11 testing requirements  Tester must be certified by TDI

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Slide 85

Evaluation Requirements with TDI  The handler must be of good character.  The dog cannot be deaf.  The evaluation begins as soon as the evaluator is able to observe you and your dog on the testing site, well before you begin the evaluation requirements.

Slide 86

Evaluation Requirements with Delta Society  There are four steps to becoming a certified Pet Partners team: 1. Attend a Pet Partners Team Training Course or complete a home-study course 2. Have the health of the animal screened by a veterinarian. 3. Have the handler/animal team evaluated for skills and aptitude (22 exercises need to be passed) 4. Submit the registration application if the animal has been screened as healthy, and the team has passed the evaluation.

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Slide 87

Evaluation Requirements with Delta Society  The emphasis is that the dog should be under control all the time.  The training equipment that the animal wears for evaluation, must be used during all therapy dog visits.  Only training equipment approved by Delta Society may be used for the evaluation and later therapy dog visits.

Slide 88

When to Wait Another Day to be Evaluated  If your dog is in season or is pregnant.  Your dog has an infection, open sores, wounds, or stitches. Wait until the animal is healed.  Your dog is on antibiotics and/or anti-fungal medications.  Your dog shows visible signs of not feeling well. A sick dog could pass on a virus or parasite to other animals at the testing site.  You know your dog is not ready yet to pass the exercises.

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Slide 89

Participant Training Questions/Concerns

Slide 90

Training Time  Let’s review: sit, down, stay, heel, accepting a friendly stranger, reactions to distractions, leave it, sitting politely, train with distractions, coming when called, reaction to another dog, reaction to medical equipment, and walking through a crowd.

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Slide 91

Experiences with Therapy Dogs

Slide 92

Training Time  Time to learn: clumsy petting, staggering and gesturing, angry yelling, and appearance and grooming

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Slide 93

Clumsy Petting  The evaluator will approach the dog and awkwardly pet the dog, in such as way that a young child or someone with poor coordination might touch the dog .  The dog should not react negatively, but should tolerate the petting.

Slide 94

Staggering and Gesturing  The assistant staggers, and then moves to normally pet the dog.  The dog may look, but should not react negatively, such as barking or lunging towards the person.  The dog should calmly accept the petting.

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Slide 95

Angry Yelling  The assistant yells, then calms down and calls the dog.  The dog should remain calm during the yelling, and not become overly reactive.

Slide 96

Appearance and Grooming  The dog will welcome being groomed and examined and will permit a stranger such as a veterinarian, groomer, or friend of the owner, to do so.  It also demonstrates the owner’s care, concern, and sense of responsibility.  The evaluator inspects the dog, then combs or brushes the dog, and lightly examines the ears and each front foot.

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Slide 97

Getting Permission  It is important to talk to administrators and gain their buy-in for a therapy dog at school.  Bring examples of research that talk about the positive benefits of therapy dogs.  Bring proof that the dog is covered by insurance.  Bring the therapy dog ID card and a good picture of the dog.  Ask if you can bring the dog in to meet the administrator.  Outline how the dog might be used, for example, in a group for students who have emotional disturbance.

Slide 98

Participant Training Questions/Concerns

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Slide 99

The End  Thank you for your participation.  Good luck with evaluation.  Remember to keep practicing the exercises, particularly ones that are more difficult for your dog.  When you are ready for evaluation, look on either of these websites for the nearest testing site.  http://tdi-dog.org/  http://www.deltasociety.org/

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APPENDIX B

Dog-assisted Therapy Pamphlet

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It is common knowledge that dogs can elicit positive emotions in humans (Hines, 2003). Because of this, organizations who work with children many times utilize therapy dogs to help gain interest and build rapport. This is important because when children feel comfortable and connected, professionals are better able to implement physiological, social, or behavioral interventions to help improve overall quality of life (Walsh, 2009). Contained in this pamphlet is important information that will help with the certification process of a therapy dog. In addition, this pamphlet contains informative topics about the early uses of dogs in therapy, the benefits and concerns of using dogs with children, the types of dog certification programs, dog selection and temperament, a discussion about handler and dog appearance, and advice on how to act in a professional manner when working with the public.

Early Uses of Dogs in Therapy

As early as the 18th century, there was much written about the use of animals in therapy. In 1792, a psychiatrist by the name of William Tuke, opened an institution that focused on the premise that the use of animals in therapy could be quite beneficial. This institution, known as the York Retreat, held tea parties in the court areas where small animals, roamed freely. Tuke philosophized that caring for animals could teach the patients self control and help with healing (Bustad, 1980).

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Early use of dogs in therapy was reported by Levinson (1969). During the summer of 1957, Dr. Levinson, an attending psychologist at a camp for emotionally disturbed children, decided to bring his dog, Jingles, to the camp so he could record the children’s interactions with the dog. The children in the camp were not only able to drop their defenses around Jingles and experience empathy, they were able to relay their own feelings of fear and anxiety through the dog. Levinson maintained that the boys were able to do this because their relationship with Jingles felt safe compared to previous relationships with adults. It was also reported that Sigmund Freud would often conduct therapy with his dog, Jofi, in the room. Patients recalled that Freud would often comment on how therapy sessions progressed with the help of interpretations from Jofi (Grinker, 1979).

Benefits of dog-assisted therapy Physiological Benefits

• Reduction in blood pressure • Reduction in pain • Reduction in anxiety • Reduction in depression • Fewer illnesses and increased health

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Social Skills Benefits

• Increased social integration and relationships • Increased verbal communication • Increase self-esteem Reduction in behavioral Issues

• Emotionally disturbed (ED) • Autistic Concerns with dog-assisted therapy

• Zoonotic diseases • Allergies • Fear of dogs • Cultural differences • The welfare of the dog. • Animal induced accidents

Choosing the Correct Dog

• Either a purebred or a mixed breed may be used. • Many prefer a short-coated dog of medium size that is gentle and placid. • Overall, dogs most often chosen were Labradors and Golden Retrievers. • Qualities of a good dog include: reliability, predictability, controllability, suitability, friendliness, and nonaggressive. • A good therapy dog will initiate contact, stay engaged, and make eye contact with people.

Temperament of the Dog • The dog must be friendly and outgoing to all people. • The dog must be tolerant of other dogs and nonaggressive toward other pets. • Because the temperament of a good therapy dog is ingrained, a good therapy dog is born, not trained.

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Training of Dog • Little research has been found explaining the best way to train a therapy dog. • Therapy dogs need to be able to obey the following commands: sit, down, come, and stay. • Good books for training a dog: The Art of Raising a Puppy and How to Be Your Dog’s Best Friend: A Training Manual for Dog Owners

Role of Veterinarian

• Veterinarians examine for parasites and keep dogs up to date on shots. • Veterinarians should provide yearly health checks to prevent the spread of diseases.

Certification Therapy dog International (TDI):

• The owner needs to present proof that the dog is up-to-date on current state required vaccinations and licenses • The dog must be at least a year old and wear the appropriate collar or harness during therapy • The dog must pass 11 testing requirements • Complete forms from the registration Packet . Evaluation form . Health form • A veterinarian must fill out the health form and sign it • Completed forms should be sent to TDI with the signed evaluation form, health form, photo of the handler and dog, and the required fees

Delta Society:

• Attend a Pet Partners Team training course or complete a home-study course • Have the health of the animal screened by a veterinarian • Have the handler/animal team evaluated for 22 different skills and aptitude • Complete seven different forms from the registration packet . Photo ID form

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. Application Fee form . Volunteer Policies and Procedures Agreement form . Volunteer Review form . Handler’s Questionnaire form . Animal Health Screening form . Volunteer Contact form . All forms must be completed in full for your packet to be accepted • Have veterinarian fill out and sign the health screening form • Send completed forms to Delta Society with the signed team evaluation form, a team photo of the handler and dog, and the required fees

Resources

Books/Journals: • Bustad, L. K. (1980). Animals, aging, and the aged. Minneapolis: University of Minnesota Press. • Delta Society (2008). Delta Society Student Manuel. Bellevue, WA: Delta Society • Grinker, R. R. (1979). Fifty years in psychiatry: A living history. Springfield, Ill: Charles C Thomas. • Hines, L. M. (2003). Historical perspectives on the human-animal bond. The American Behavioral Scientist, 47, 7-15 • Levinson, B. M. (1969). Pet-oriented child psychotherapy. Springfield, Illinois: Thomas. • The Monks of New Skete. (1998). The art of raising a puppy. New York: HighBridge Co. • The Monks of New Skete. (2002). How to be your dog's best friend: A training manual for dog owners. New York: Little, Brown & Co. • Walsh, F. (2009). Human-animal bond II: The role of pets in family systems and family therapy. Family Process, 48, 481-499.

Websites:

• http://www.tdi-dog.org/, Therapy Dog International Resource Center • http://www.deltasociety.org/, Delta Society Resource Center

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APPENDIX C

Delta Society Pet Partner Skills and Aptitude Test

117

118

119

APPENDIX D

Therapy Dogs International Testing Requirements

120

121

122

APPENDIX E

Facilitator Guide

123

The History and Training of the Therapy Dog for School Personnel

Facilitator’s Guide

1. This presentation is suitable for use with counselors, school psychologists, and

special education teachers.

2. The CD-ROM includes the PowerPoint presentation, facilitator notes on how to

deliver the presentation, a pamphlet that provides the information discussed

during each session, individual forms that explain the testing requirements for

each therapy dog organization, parental consent forms both in English and

Spanish, the form that will be sent to each participant detailing what should be

brought to each session, and a list of items for the presenters. In order to run this

program, the following are required:

a. One of the following operating systems: Windows 2000 with 64 MB of

RAM, Windows Vista with 512 MB of RAM, or Windows XP with 128

MB of RAM

b. A PC with Super VGA (800 x 600) or higher screen resolution

c. An installation of Microsoft PowerPoint 2007

3. This presentation is divided into two hour sessions that occur once a week for four

weeks. Each session includes:

a. Session 1

i. Introduction of people and dogs

ii. Types of animal-assisted therapies

124

iii. Benefits and Concerns of dog-assisted therapy

iv. Discuss the two major therapy dog organizations in the United

States

v. Demonstration of heel, sit, and down

vi. Practice heel, sit, and down b. Session2:

i. Discussion of dog selection and temperament

ii. Questions/concerns with training

iii. Practice heel, sit, and down

iv. Training equipment/what is allowed in both organizations

v. Teach stay and practice

vi. Practice heel, sit, down, and stay

vii. Discussion of appearance and grooming of handler and dog

viii. If dogs are ready teach accepting a friendly stranger, reaction to

distractions, leave-it, and sitting politely c. Session 3:

i. Discussion of vet care and how that relates to certification of the

therapy dog

ii. Questions/concerns with training

iii. Review previous exercises: sit, down, stay, heel, accepting a

friendly stranger, reaction to distractions, leave-it, and sitting

politely

125

iv. Discussion on registration of the therapy dog

v. Teach with distractions, coming when called, reaction to another

dog, reaction to medical equipment, and walk through a crowd

d. Session 4:

i. Discussion about evaluation day

ii. Questions/concerns with training

iii. Review previous exercises: sit, down, heel, stay, accepting a

friendly stranger, reaction to distractions, leave-it, sitting politely,

teach with distractions, coming when called, reaction to another

dog, reaction to medical equipment, and walk through a crowd

iv. Personal accounts of having a therapy dog in a school setting

v. Teach clumsy petting, staggering and gesturing, angry yelling, and

appearance and grooming

vi. Discuss how to talk to administrators about allowing dog therapy

at the school

4. The goals of the presentation are as follows:

a. Educate counselors, school psychologists, and special education teachers

about the types of animal-assisted therapies, and the benefits and concerns

associated when working with dogs.

b. Educate counselors, school psychologist, and special education teachers

about the two major types of therapy dog organizations in the United

States and their requirements to certify therapy dogs.

126 c. Teach training techniques so handlers are able to train their dogs so they

can pass evaluation.

127

APPENDIX F

Session Notes

128

Session One Notes

1. Rationale/Big Ideas:

a. Discussion of the many types of animal-assisted therapies, the benefits,

and the concerns

b. Discuss the two major therapy dog organizations in the United States

c. Demonstration and practice of heel, sit, and down

2. Key Points

a. Introduction of handlers and their dogs

b. Types of animal-assisted therapies (slide 5)

i. Reading-to-dogs- programs

ii. Therapeutic horse riding programs

iii. Animal Assisted Crisis Response (AACR)

iv. Individual and group counseling with animal-assisted therapy

v. Visiting nursing homes and hospitals

vi. Dolphin assisted therapy

vii. Assistance/service dogs

viii. Dog-assisted therapy

c. Benefits of dog-assisted therapy (slide 14)

i. Physiological

ii. Social

iii. Behavioral

d. Concerns with dog-assisted therapy (slide 24)

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i. Zoonotic disease

ii. Allergies

iii. Fear of dogs

iv. Animal induced accidients

v. Cultural differences

e. Discussion of two major therapy dog organizations in the United States

(slide 30)

i. Therapy Dog International (TDI)

ii. Delta Society

f. Demonstration of how to get your dog to heel, sit, and down (slide 35)

g. Handlers practice new skills with their dogs (slide 39)

3. Discussion Topics

a. How did each individual become interested in dog therapy? (slide 3)

b. What are the handlers concerns?

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Session Two Notes

1. Rationale/Big Ideas:

a. Discussion of dog selection, temperament, appearance, and grooming

b. Discussion of the training equipment needed when working with the dog

c. Demonstration and practice of heel, sit, down, stay, accepting a friendly

stranger, reaction to distractions, leave it, and sitting politely

2. Key Points

a. Dog selection and temperament (slide 3)

i. Reliability

ii. Predictability

iii. Controllability

iv. Suitability

b. Questions and concerns with training

c. Train heel, sit, and down

d. Discussion of the training equipment needed when working with the dog

and what it allowed by TDI and Delta Society (slide 11)

i. Buckle collar

ii. Choke chair

iii. Prong collar

iv. Head harness

v. Martingale

vi. Harnesses

131

e. Demonstration of how to get your dog to stay (slide 13)

f. Handlers practice new skills and review previous skills

g. Appearance and grooming of the handler and dog (slide 15)

i. Hander needs to be neat and tidy

ii. Present self in a courteous manner

iii. Dogs should be clean and dry

iv. Dogs nails should be trimmed

v. Carry dog clean-up supplies

h. Demonstration of how to get your dog to accept a friendly stranger,

reactions to distraction, leave it, and sit politely (slide 18)

i. Handlers practice new skills with their dogs

3. Discussion Topics

a. Are there any temperament, grooming, or materials questions?

b. Are there any training questions?

132

Session Three Notes

4. Rationale/Big Ideas:

a. Discussion of role of the veterinarian, the registration requirements, and

identifying stress in the dog

b. Demonstration and practice of heel, sit, down, stay, accepting a friendly

stranger, reaction to distractions, leave it, and sitting politely

c. Demonstration and practice of teach with distraction, come when called,

reaction to another dog, reaction to medical equipment, and walking

through a crowd

5. Key Points

a. Discussion of vet care (slide 3)

i. Role of veterinarian

ii. Each therapy organizations veterinarian requirements

b. Questions and concerns with training

c. Review previous skills

d. Discussion of registration requirements (slide 7)

i. Therapy Dog International (TDI)

ii. Delta Society

j. Demonstration of how to get your dog to work with distractions, coming

when called, reaction to another dog, reaction to medical equipment, and

walk through a crowd (slide 12)

k. Handlers practice new skills

133

l. Discuss Welfare considerations of the dog (slide 18)

i. Identifying stress in dog

a) Changes in posture

b) Sweaty paws

c) Hair loss

d) Salivating

e) Panting

f) Shaking

6. Discussion Topics

a. Are there any questions about vet care, registration, or stress awareness in

the dog?

b. Are there any training questions?

134

Session Four Notes

7. Rationale/Big Ideas:

a. Discuss evaluation day, a personal account of having a therapy dog at

school, and how to talk to administrators about allowing a therapy dog at

school

b. Demonstration and practice of heel, sit, down, stay, accepting a friendly

stranger, reaction to distractions, leave it, sitting politely, work with

distractions, come when called, react positively to another dog, react

positively to medical equipment, and walk through a crowd

c. Demonstration and practice clumsy petting, staggering gesturing, and

angry yelling

8. Key Points

a. Discussion of the evaluation day (slide 3)

i. Evaluation day with Therapy Dogs International (TDI)

ii. Evaluation day with Delta Society

iii. When to wait another day to be evaluated

e. Questions and concerns with training

f. Review previous skills

g. Discussion of personal accounts while working with a therapy dog (slide

10)

h. Demonstration of clumsy petting, staggering and gesturing, angry yelling,

and appearance and grooming (slide 12)

135

i. How to talk to administrator about allowing a therapy dog at school (slide

16)

i. By-in

ii. Discuss positive benefits

iii. Prove dog is covered by liability insurance

iv. Show proof that therapy dog is certified by displaying the ID card

v. Bring dog to meet administrator

9. Discussion Topics

c. Are there questions about the evaluation day or how to talk to

administrators about allowing a therapy dog at school?

d. Are there any training questions?

136

APPENDIX G

Parental Consent Form (English)

137

Dog-assisted Therapy

Dear Parent/Guardian,

Research has show that dogs can elicit positive emotions in humans. Because of this,

organizations that work with children many times utilize dogs to help gain interest and build

rapport. This is important because when children feel comfortable and connected, professionals

are better able to implement physiological, social, or behavioral interventions to help improve the child’s overall quality of life. This is why we at (name of school) are happy to announce the

arrival of a dog-assisted therapy program at our school.

Starting next month, there will be a certified dog on campus twice a week. The dog

and its handler will be in and out of classrooms throughout the day, helping with counseling

and providing encouragement and support. If you give your permission for your child to

interact with the dog, then no further follow through is needed. If for any reason you do not

want your child to interact with the dog, please fill out the following form and return it to

your child’s teacher. If you have any questions, we may be reached at (school) on (days) at

(phone number).

Sincerely,

(School Psychologist, Counselor, or Teacher)

138

Dog-assisted Therapy

Student: ______Date: ______

Teacher: ______Grade: ______

____I do not want my child to participate in the dog-assisted therapy program at (School).

______

Parent/Guardian (Please print) Parent/Guardian Signature Date

139

APPENDIX H

Parent Consent Form (Spanish)

140

Terapia Asistida Por Perros

Estimado padre o tutor,

La investigación ha mostrado que los perros pueden provocar emociones positivas en los seres humanos. Debido a esto, las organizaciones que trabajan con los niños muchas veces utilizan perros para ayudar a los intereses de ganancia y establecer una relación. Esto es importante porque cuando los niños se sientan cómodos y conectados, los profesionales están en mejores condiciones para poner en práctica intervenciones fisiológicas o de comportamiento para ayudar a mejorar la calidad general del niño de la vida. Es por eso que (name of the school) se complace en anunciar la llegada de un programa de terapia asistida por perros en nuestra escuela.

A partir del próximo mes, habrá un perro certificados en aquí dos veces por semana. El perro y su manejador será dentro y fuera de las aulas durante todo el día, ayudando con el asesoramiento y el fomento y el apoyo. Si usted da su permiso para que su niño para interactuar con el perro, entonces no hay más seguimiento a que se necesita. Si por alguna razón usted no quiere que su hijo a interactuar con el perro, por favor rellene el siguiente formulario y devolverlo al maestro de su hijo.

Si usted tiene alguna pregunta, puede llamarnos al (school) el (days) al (phone number).

Atentamente,

(Psicólogo de la escuela, Consejero o Maestro)

(School Psychologist, Counselor, or Teacher)

141

Terapia Asistida Por Perros

Estudiantes ______Fecha: ______

Maestro: ______Grado: ______

____ No quiero que mi hijo participe en el programa de terapia asistida por perros en la (School).

______Padre / Madre / Tutor Padre/Madre/Tutor Fecha (letra de molde)

142

APPENDIX I

Presenters’ Supplies

143

Items presenters need to bring in order to give seminar:

• Extra training collars and leashes (many handlers have ill-fitting collars or ones that do not control their dogs and may need to borrow appropriate collars) • Items for training with distractions, such as balls and toys • A couple of long lines to use with Coming when Called exercise • Food and bowl for Leave-it exercise • A wheelchair and crutches or walker for Reaction to Medical Equipment exercise • A brush and comb for Appearance and Grooming exercise • A clipboard or book for Reactions to Distractions exercise • Bring a couple of extra chairs in case someone forgets to bring one • Clean-up supplies, including poop bags, cleanser, and paper towels • A Laptop to be able to give PowerPoint and CD with PowerPoint presentation • Enough copies of the booklet for all the participants • A large enough room needs to be used to allow space for training or access to a grassy area

144

APPENDIX J

List of Needed Supplies for Handlers

145

DATE

Dear Participants:

Please bring the following items to all four sessions:

 Dog  Collar and leash you train with  Crate  Water and bowl  Chair  Soft dog treats, cut up into small pieces, such as string cheese or hot dogs  Dog’s favorite toy or tuggy  Snacks and water for yourself  Doggy bags to clean up after Rover

There will be one session a week, and each session will last approximately two hours.

There will be a ten to fifteen minute break in the middle of the session. In order to make progress, you will need to train your dog daily on the exercises that are taught in the sessions.

We look forward to working with you.

Sincerely,

146

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