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Developing AAT Programmes



Animal-assisted therapy programmes can be tailored and applied to various populations and needs. There is a wealth of ideas and research available to those who wish to explore the field.



Ethical, Procedural and Occupational Health & Safety (OH&S) Considerations



These issues have been covered extremely well by many organisations, and various guidelines can be found. Fine's (2000) book Handbook on Animal-Assisted Therapy is an excellent beginning point when considering how to go about implementing animal-assisted interventions (AAI's). Here I will attempt to provide a very brief overview of some of the areas for consideration when developing or implementing programmes involving animals.


Animal selection




Training and Temperament

Animals should be trained and temperament-tested prior to beginning any visiting or therapeutic work. Assessments should be performed by individuals with skill and expertise in animal behaviour and training. Animals should be assessed in situations that mirror actual working scenarios as closely as possible. The animal-handler should have a clear understanding of the animal's strengths and limitations and feel confident about working within these.


Species and Breed

This will depend largely upon the type of organisation and the physical setting, which may exclude farm animals for example. Organisations may opt for indoor fish-tanks, outdoor aviaries or visiting domestic pets. This decision will also rely on the skills and expertise of available staff/volunteers and whether or not the organisation requires resident or visiting pets.


Health and Cleanliness

Animals must have regular health checks, be up to date with vaccinations and/or immunisations and appear healthy and well-groomed. A good base line is a thorough bath once per week and daily grooming. Animals will need to be on regular parasite control (such as worming and flea treatments). Any animal appearing unwell should be removed from 'work'. Organisations and handlers should also consider whether animals should be desexed, or altered.



Client Selection




Relationship with the Animal

A number of factors will impact a client's relationship with a therapy animal. These include allergies, fears or aversions to animals, previous history with animals (e.g. fond or foul memories) and/or histories of animal abuse (as a perpetrator, witness or both). These should be explored prior to commencement. It is important that these issues be managed, but does not necessarily imply that a client is unsuitable to work with an animal. The goodness-of-fit will also have an impact on the relationship. For example some people will naturally be drawn to a cuddly rabbit and others to a boisterous Labrador. One animal will not 'fit' all people or situations.


Infection Control

In addition to the animal's own health, human health and infection control will need to be considered. Handler's should be familiar with relevant zoonoses (i.e. the types of illnesses or parasites that can pass between an animal and a human) and how they are managed or prevented. These will vary according to species. Particular care will need to be taken with some clients, for example those who are immune compromised, asthmatic or allergic, frail, bed-ridden or have poor personal hygiene.



Organisational and procedural considerations




Insurance and Liability

Organisations should take all reasonable steps to ensure the health and safety of staff, volunteers, clients and animals. These may include procedural guidelines for first aid, incident management and animal management. Organisations should ensure their animal-handler teams are operating within the guidelines of their insurance cover and within their areas of skill and expertise.


Infrastructure

Before commencing any AAI's, organisations should ensure there is sufficient infrastructure to support the proposed service. This will include the space, time and resources available to adequately co-ordinate and run the programme, in addition to the space to house the animals. Animals will require sufficient time and space to be able to perform 'natural functions', including resting, exercising and toileting. Organisations must also maintain animal free zones, for example food preparation areas, treatment rooms or other sterile areas.


Cost-Benefit Analysis

Any analysis of costs and benefits will need to take into account the impacts on the organisation. These will include impacts on staff and clients who may come into contact with the animals, training costs, setup costs or changes to infrastructure, time and energy put into developing policies, procedures and management plans. These impacts must then be compared to benefits likely to arise from offering AAI's. These may include increased staff/organisational morale, positive client outcomes, increased service provision, improved community profile and perception of the organisation as innovative or humane. Different types of AAI's will have differing impacts and benefits.



Clinical issues




Effective Working Relationships

Clients should provide informed consent to interact with animals. They should be voluntary participants and have a full understanding of what the intervention involves, including the degree and type of animal interactions. In addition to this, therapists will need to monitor a number of issues to foster an effective therapeutic relationship between the client, animal and therapist. This includes the need to consider any complications arising from the dual relationship of being therapist and handler in the room.

The dynamic of the therapeutic alliance will – and should - be altered by the presence of the animal. Clients will attach to the animal, resulting in transference, separation and termination considerations that previously would only have been addressed in the client-therapist relationship.

Outside of the room, the therapist/animal-handler must attend to the basic needs of their working animal. The animal needs adequate rest breaks, access to water, time to rest, exercise and toilet. The handler should monitor stress, safety and health of the animal at all times. This may result in the therapist seeing fewer clients, or seeing some clients without the animal present in order to ensure the effectiveness of the animal's 'work'.


Efficacy and Evaluation

Animal-assisted interventions are comparatively novel. They do not as yet have rigorous scientific support across a broad range of populations. In some situations AAI's are unheard of. For this reason it is vital individuals and organisations evaluate interventions and increase the scientific knowledge base. There is a push for evidence-based interventions in health and welfare settings and we have a responsibility to ensure the efficacy of our work. Comprehensive case studies, qualitative evaluation and pre- and post-testing are easily achieved. More rigorous scientific studies can be achieved in partnership with universities or student placements, alternatively clinicians may extend their knowledge and skill in evaluation for use within organisations. Please note when considering evaluation, it may be important to maintain independent researchers/evaluators who are not seen to have a vested interest in the outcomes.

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