Animal-Assisted Therapy for Addiction: Definition, Techniques, Application, and Benefits

Animal-assisted therapy (AAT) integrates animals into therapeutic settings to enhance addiction treatment for various conditions. It involves the guided interaction between a patient and trained animals, such as dogs or horses, to facilitate therapeutic goals.  

Key Takeaways

• According to the research paper by Pandey, Pati, Ramendra, this approach sets itself apart from traditional therapies by actively involving animals in the recovery process.
• Animal-assisted therapy techniques include structured sessions, varied interactions, and therapeutic focus. As deliberated by López-Fernández,  Eduardo, these techniques underscore the unique bond formed between humans and animals as a powerful tool for recovery.
• The applications of AAT are addiction recovery, a supportive environment, and motivation and engagement. Animal-assisted therapy is applied in diverse therapeutic settings to enhance emotional support and foster a positive environment for healing.
• The benefits of AAT are emotional support, stress reduction, improved social skills, and increased motivation. These benefits make therapy more effective and accessible across different populations. As studied by Hediger, Karin, et al. (2019), AAT was associated with a 7.5% improvement in social behavior compared to conventional therapy, highlighting its potency in advancing social skills, which is beneficial in addiction recovery contexts.
• The side effects and risks of animal-assisted therapy are allergic reactions, infection risks, and emotional attachment. These factors need careful management to ensure the therapy remains safe and beneficial.

What Is Animal-Assisted Therapy for Addiction?

Animal-assisted therapy (AAT) is a therapeutic intervention that incorporates animals into the treatment process to enhance emotional, social, and physical well-being in addiction recovery.

It utilizes the human-animal bond to support emotional and psychological healing. This approach distinguishes itself from traditional therapies by incorporating animals as active participants in the recovery process. According to Compitus, Katherine, AAT provides unique benefits through interactive experiences that foster emotional support and behavioral change.

According to the National Pet Owners Survey, 68% of households owned a pet in 2017, up from 56% in 1988. In the U.S., 40% of Americans own a dog, and 29% own a cat. There are 90 million dogs, 94 million cats, 139 million freshwater fish, and 20 million birds kept as pets. 

The randomized controlled study by Sahebalzamani, Rezaei, and Moghadam investigated the effects of Animal-Assisted Therapy (AAT) on the happiness and quality of life of chronic psychiatric patients living in residential care homes in Tehran, Iran. The study involved 70 male patients with chronic psychiatric disorders, with a mean age of 47.12 years in the control group and 45.82 years in the intervention group. The mean age of illness onset was 18.94 years for the control group and 16.83 years for the intervention group.

The patients were randomly divided into two groups: one receiving AAT using a bird for eight weeks, and the other receiving no intervention. Happiness was measured using the Oxford Happiness Inventory, and quality of life was assessed through the Wisconsin Quality of Life Index, with pre-and post-intervention data collected. The analysis was performed using ANCOVA with pretest control, and the significance level was set at p < 5%. This means that the results are statistically relevant with less than a 5% chance of being due to random variation.

Key results included a considerable increase in happiness within the intervention group (p < 0.1%). This indicates that there was less than a 0.1% probability that the observed increase in happiness was due to chance alone. Additionally, there were notable improvements in the quality of life in four specific sub-domains, although the paper does not specify these sub-domains in detail. Overall, the study demonstrated that AAT not only enhanced the happiness of the patients but also improved their quality of life. The findings suggest that AAT is a valuable tool in improving the well-being of chronic psychiatric patients in care homes, with potential advantages for their social reintegration and overall mental health.

What Is the Historical Background of Animal-Assisted Therapy?

The concept of AAT dates back to the early 20th century, with major milestones shaping its evolution. In the 1960s, Dr. Boris Levinson, considered a pioneer, recognized the therapeutic value of animals in clinical settings. His work laid the groundwork for integrating animals into mental health treatments. 

Subsequent developments led to formal studies and the establishment of guidelines, with organizations such as the American Veterinary Medical Association (AVMA) contributing to the standardization of AAT practices.

Its historical roots stretch back thousands of years, with evidence of human-animal interactions being utilized for therapeutic purposes since ancient times. The most important historical developments are given below as discussed by Fung Allison:

• Ancient Civilizations: The therapeutic use of animals is traced back to ancient Greece, where horses were employed to uplift the spirits of individuals suffering from various ailments. Historical records indicate that animals were recognized for their calming effects and potential benefits to mental health as far back as the 9th century, with evidence of horses being used for rehabilitation purposes as explained by Fung et al. (2024).
• Animals and behaviorally modern humans (those who shared traits with present-day humans) have coexisted for over 50,000 years, with the domestication of animals occurring around 15,000 years ago as cited by Ernst. Initially, domesticated pets served various roles such as scavengers, objects of affection and worship, and even as a food source. Some animals were considered noble and given important roles like houseguards and soldiers.
• Middle Ages: In the Middle Ages, particularly in Belgium, the concept of using pets for rehabilitation emerged, where pets and people were treated together as part of a natural therapy regimen.
• 19th Century: The modern concept of animal-assisted therapy (AAT) began to take shape in the late 1800s. Florence Nightingale, a pioneer in nursing, advocated for the deployment of small animals to provide comfort and improve the well-being of mentally ill patients. This period marked the beginning of recognizing the therapeutic potential of animal companionship in formal medical settings.
• 20th Century: The formal study of AAT gained momentum in the 1960s, largely due to the work of psychologist Dr. Boris Levinson. His groundbreaking research involved using his dog, Jingles, during therapy sessions with children. Levinson’s findings demonstrated that the presence of a pet empowers therapeutic outcomes, leading him to coin the term “pet therapy” and advocate for its integration into mental health treatment.
• Veterans and Rehabilitation: Following World War II, the American Red Cross established programs where recuperating veterans interacted with animals to aid their recovery. This initiative highlighted the role of animals in providing emotional support and facilitating healing in individuals coping with trauma especially as extolled by the VA Office of Patient Centered Care and Cultural Transformation publication by Rindflesich (2018) in the article “Animal Assisted Therapies.”

What Are the Theoretical Foundations of Animal-Assisted Therapy?

AAT relies on several theories, notably the human-animal bond and biophilia hypothesis. The human-animal bond theory posits that interactions with animals impact psychological well-being, reducing stress and enhancing emotional stability, elegantly elaborated by Gaekwad.

The biophilia hypothesis suggests that humans possess an innate affinity for living things, which AAT leverages to bolster therapeutic outcomes. These theories underpin the effectiveness of AAT by explaining how animals foster emotional connection and support.

The theoretical foundations of AAT draw from various disciplines and is organized into several key frameworks. The most important theoretical frameworks of Animal-Assisted Therapy are given below as investigated by Holder, Timothy R. N:

• Biopsychosocial Model: AAT is grounded in the biopsychosocial model, which posits that biological, psychological, and social factors are vital for human health. In AAT, the interaction between the human field and the therapy animal’s field lowers physiological stress and elevates positive effects for both parties.
• Attachment Theory: Attachment theory suggests that the quality of the human-animal bond directly correlates with the psychological and physiological benefits experienced by either party. The mutual exchange of affection between patient and therapy animal enhances physical and mental well-being according to Friedmann, Erica; Son, Heesook (2009) in their published research “The Human–Companion Animal Bond: How Humans Benefit.”
• Social Support Hypothesis: The social support hypothesis proposes that therapy animals ease and increase interactions between patients and other humans, acting as a “social catalyst”. Increased human interaction directly benefits patients and enhances their general healthcare environment.
• Human-Animal Bond Hypothesis: The human-animal bond hypothesis accentuates the importance of the affectional bond between humans and animals in facilitating therapeutic outcomes. Therapy animals respond to the natural attributes of humans, and both patient and animal temperaments affect the success of therapeutic interactions.
• Neurobiological Transduction Mechanisms: Neurobiological transduction mechanisms refer to the neurological or biological pathways that cause the observed physiological or psychological outcomes in AAT. The oxytocinergic system hypothesis suggests that all AAT mechanisms aim to release the affiliative chemical oxytocin, leading to the observed benefits.

These theoretical frameworks provide a foundation for understanding how AAT positively impacts human health and well-being by leveraging the unique relationship between humans and animals.

How Does Animal-Assisted Therapy Work for Addiction Recovery?

Animal-assisted therapy for addiction recovery works by incorporating therapeutic interactions with animals to reduce stress, promote emotional healing, and foster a sense of responsibility. The non-judgmental presence of animals supports clients to open up emotionally, facilitating deeper self-reflection and improved coping skills. These interactions also provide motivation and comfort, aiding individuals in managing cravings, reducing anxiety, and building a positive routine throughout their recovery process. The most common principles of AAT for addiction recovery are listed below as explored by Lovell T. and Ranse K.

• Reducing stress: Interaction with animals promotes relaxation and lowers anxiety, helping individuals manage the stress associated with addiction recovery.
• Promoting emotional healing: The bond formed with animals creates a safe space for clients to process emotions, supporting emotional growth and healing as studied by Kelly, Melissa A. & Cozzolino, Callandre A.
• Fostering responsibility: Caring for an animal instills a sense of responsibility and routine, which helps clients regain control and stability in their lives.
• Encouraging self-reflection: The non-judgmental nature of animals allows clients to feel more comfortable in exploring their thoughts and feelings, leading to greater self-awareness.
• Boosting motivation and comfort: The presence of animals offers emotional support and motivation, helping individuals stay engaged and focused on their recovery goals.

Research: Animal-Assisted Therapy in the Treatment of Substance Dependence

In the study by Wesley, Martin C., et al. (2015) assessed the impact of animal-assisted therapy (AAT) on the therapeutic alliance in group therapy for adults in residential substance abuse treatment. Using randomized samples and controlled conditions, 231 participants were divided into a control group without a therapy dog (41.6%) and an experimental group with a therapy dog (58.4%) over 26 group sessions.

The findings revealed that the presence of a therapy dog improved the therapeutic alliance, as measured by the Helping Alliance Questionnaire (HAQ-II) (ANOVA: F(1,229) = 25.44, p < 0.1%). While clients seeking treatment for a dual diagnosis, social service involvement, or alcohol addiction showed no pertinent differences between groups, males, females, pet owners, court-ordered clients, and those with polysubstance, cannabis, or methamphetamine dependence in the AAT group reported a more positive therapeutic alliance. The study suggests that incorporating AAT augments the effectiveness of addiction treatment.

Techniques such as petting and grooming allow clients to practice emotional regulation and develop coping strategies in a non-threatening environment as elaborated by Jon Johnson (2020) in his MedicalNewsToday article- “What to know about animal therapy.” This therapeutic alliance between therapist, client, and animal enhances the treatment experience.

What Are the Key Techniques in Animal-Assisted Therapy for Addiction?

The key techniques for animal-assisted therapy (AAT) are canine-assisted therapy, equine-assisted therapy, and small-animal interactions are explained below as explained by Friedmann, Erica; Son, Heesook (2009) in their published research “The Human–Companion Animal Bond: How Humans Benefit”:

Canine-Assisted Therapy

Canine-assisted therapy utilizes trained dogs to support clients in expressing emotions and managing addiction-related stress. Dogs provide a non-judgmental presence that helps clients open up and engage more fully in therapy according to Montolio & Sancho-Pelluz.

Research: Interacting with a House-Trained Dog on University Students Mood and Anxiety

Case studies demonstrate that interactions with therapy dogs lessen anxiety and improve mood, contributing to overall recovery. In the study by Thelwell, Emily L. R. (2019) investigated the effects of interacting with a house-trained dog on university students’ mood and anxiety. 

Eighty-two students were randomly assigned to either an experimental group, where 50% interacted directly with a dog (n = 41), or a control group, where the other 50% watched a video of a dog (n = 41). Both groups were evaluated using the Positive and Negative Affect Schedule-Expanded Form (PANAS-X) and the State-Trait Anxiety Inventory (STAI) before and after the intervention.

The results showed that 100% of the participants experienced reduced anxiety and improved mood over time. However, the experimental group that directly interacted with the dog saw a greater decrease in anxiety and more mood improvements than the control group. The study suggests that direct interaction with dogs provides psychological benefits for students, which inform future initiatives aimed at amplifying student well-being.

Equine-Assisted Therapy

Equine-assisted therapy comprises relations with horses to address psychological and emotional issues related to addiction. Horses, due to their sensitivity to human emotions, offer feedback that supports clients gain insight into their behaviors and emotions. According to a study by the National Equine Therapy Association (2021), 70% of participants reported feeling more empowered and experienced improved physical coordination after participating in riding sessions.

Research: A Prospective Study of Horse-Assisted Therapy (HAT) for Young Adults

On the other hand, the study by Kern-Godal, Ann aimed to assess the impact of HAT on the retention and completion of substance use disorder treatment. Conducted at Oslo University Hospital, the study included 108 young adults, divided into two groups: 65 participants receiving standard treatment plus HAT, and 43 receiving only standard treatment. Results indicated that participants in the HAT group were more likely to complete treatment (56.9% vs. 14%) and stay in treatment longer (mean 141 vs. 70 days). 

After controlling for confounding factors, the odds of completing treatment were 8.4 times higher in the HAT group. While the study suggests a strong association between HAT and improved treatment outcomes, it does not establish causality but highlights the need for further research into this innovative therapy.

Therapy sessions cover grooming and leading horses, which promote self-awareness and emotional regulation. Research highlights substantial improvements in emotional resilience and reduced stress following equine-assisted sessions, particularly Godal.

Small Animal Interactions

Small animal interactions involve therapeutic activities where clients engage with smaller animals, such as rabbits, guinea pigs, or birds, to promote emotional well-being, reduce stress, and enhance communication skills. These interactions create a calming environment, facilitating emotional openness and relaxation during therapy. Interactions with these animals grant comfort and foster a sense of responsibility and care. 

Studies indicate that handling small animals lowers stress levels and augments emotional stability, contributing positively to addiction recovery efforts as indicated by Dell.

What Are the Benefits of Animal-Assisted Therapy for Addiction Treatment?

The benefits of animal-assisted therapy for addiction treatment include reduced stress, improved emotional regulation, and increased motivation to engage in recovery. The most common benefits of AAT are given below according to Friedmann, Erica; Son, Heesook (2009) in their published research “The Human–Companion Animal Bond: How Humans Benefit”:

Emotional Expression and Regulation

AAT facilitates emotional expression and regulation by providing a safe environment for clients to explore and manage their feelings. The presence of animals helps clients articulate their emotions and develop coping mechanisms. Data from various studies such as Klemetsen & Lindstrøm point to improvements in emotional regulation and increased self-awareness among participants.

Research: Interaction with Shelter Dogs Reduces Negative Affect of Adolescents in Substance Use Disorder Treatment

The study by Ellsworth, Lindsay Madden examined the effects of dog interactions on 14 adolescent males (mean age = 16.2 years) undergoing inpatient treatment for substance use disorder (SUD). The participants were assigned to two different conditions: weekly one-hour sessions of either dog-interaction activities or treatment-as-usual recreational activities for eight weeks, with four weeks per condition. A total of 12 participants’ emotional states were evaluated using the Positive and Negative Affect Scale-Expanded Form (PANAS-X) in a crossover design.

Results showed that the dog-interaction condition reduced negative emotions compared to the control condition. Hostility scores were notably lower after dog interactions (p < 5%), and sadness was reduced (p < 5%). The study also identified a carryover effect, where the emotional benefit from the dog-interaction session continued to influence the participants’ mood during the following session (p < 5%).

Results showing p < 5% mean that there is a high level of confidence that the effects observed (such as reductions in hostility and sadness) are real and not due to random variation.

In the attitudes survey, participants favored dog-related activities over the control, with differences in responses (p < 5%). This exploratory study concluded that interacting with shelter dogs helps lessen negative emotions and improve attitudes toward therapy, showing potential for use in adolescent SUD treatment.

Stress Reduction

Animal interactions considerably cut down stress and enhance all-inclusive mental health. Therapy animals assist in lowering cortisol levels and induce relaxation responses, aiding in the management of addiction-related stress. Research supports that clients participating in AAT exhibit reduced anxiety and boosted mood, underscoring the therapy’s effectuality in creating a more balanced emotional state.

Research: Effectiveness of Animal-Assisted Therapy on Alleviation of Anxiety in Pre-School Children

The study by Tahan, Mohammad evaluated how animal-assisted therapy (AAT) helps reduce anxiety in preschool children aged 5 to 7.

Thirty-three children were split into two groups: an experimental group that received eight AAT sessions and a control group. Anxiety levels were measured before and after the sessions.

Results showed that AAT reduced overall anxiety by approximately 70%. For specific types of anxiety, the reductions were as follows:

• Separation anxiety was reduced by around 30%.
• Generalized anxiety disorder decreased by 40%.
• Social phobia saw a reduction of about 53%.
• Specific anxiety dropped by roughly 47%.

However, no considerable change was found in obsessive-compulsive symptoms.

The study highlights that AAT is highly effective in reducing anxiety in young children and supports its use in therapy for childhood anxiety.

What Are the Animal-Assisted Therapy Programs for Addiction?

AAT programs for addiction are structured sessions and components such as individual therapy, group therapy, emotional regulation techniques, and regular progress evaluation.

Program Structures

AAT programs for addiction are structured sessions with defined goals and activities. Programs are diverse in format but generally involve regular interactions with therapy animals, either individually or in groups. Sessions incorporate specific therapeutic activities designed to address addiction-related issues and promote recovery as explained by Blanco-Suarez (2018) in the Psychology Today article- “Does Animal-Assisted Therapy Work? – The Pet-Human Bond.”

• Session formats: Sessions range from 30 minutes to 1 hour, conducted in individual or group settings. The frequency varies from weekly to biweekly, depending on the program structure. Some inpatient programs offer daily sessions as part of comprehensive treatment.
• Session durations: Programs last several weeks to months, with the possibility of extended or ongoing support to maintain progress in recovery and emotional stability.

Key Components of Animal-Assisted Therapy Programs

The key components of Animal-Assisted Therapy programs are individual therapy sessions, group therapy sessions, animal care responsibilities, goal-oriented activities, emotional regulation techniques, integration with other therapies, and regular progress evaluation. The most important components of AAT programs are given below as discussed by Pandey, Pati, Ramendra:

• Individual Therapy Sessions: Individual therapy sessions are one-on-one interactions between the client, the therapist, and the therapy animal. These sessions are tailored to the specific needs and goals of the client, allowing for personalized therapeutic interventions. Activities such as petting, grooming, or other interactive exercises are designed to promote emotional healing and behavioral change.
• Group Therapy Sessions: Group therapy sessions incorporate multiple clients working with a therapy animal under the guidance of a therapist. These sessions foster a sense of community and shared experience among participants. Group activities focus on building social skills, improving communication, and providing mutual support, all while benefiting from the presence of the therapy animal.
• Animal Care Responsibilities: Incorporating animal care responsibilities into therapy programs helps clients develop a sense of responsibility and routine. Tasks such as feeding, grooming, and walking the therapy animal provide structure and purpose, which are particularly beneficial in addiction recovery as per the American Veterinary Medical Association. These activities assist clients build a bond with the animal, enhancing the therapeutic effect.

What Are the Risks in Animal-Assisted Therapy for Addiction?

The challenges and controversies in Animal-Assisted Therapy are allergic reactions, infection risks, emotional attachment, ethical concerns, lack of standardization, limited research, and public opinion and policy issues. The most common side effects of AAT are given below according to Fine and Aubrey H:

• Allergic Reactions: Some individuals are allergic to animals, which limits their participation in AAT. Allergic reactions range from mild to severe and necessitate alternative therapeutic approaches.  
• Variability in Individual Response: Not all patients respond positively to AAT. Some individuals have allergies, phobias, or past trauma related to animals, which hinder their participation in AAT programs. This variability necessitates careful screening and consideration before incorporating AAT into treatment plans.
• Lack of Standardization: The implementation of AAT varies widely across different treatment settings, leading to inconsistencies in practice. There are no universally accepted guidelines for AAT, which affects its effectiveness and the safety of both patients and therapy animals.
• Infection Risks: Animals carry germs that pose health risks, especially to individuals with compromised immune systems. Ensuring proper hygiene and regular health checks for therapy animals is essential to mitigate these risks. The research article, “Describing Adverse Events in an Animal-Assisted Intervention Organization: Recommendations for Prevention and Management,” authored by Ng, Zenithson, Laurence Svensson, Marcy Souza, and Julia Albright, and published in Human-Animal Interactions, reviews adverse events in animal-assisted interventions (AAIs). The study analyzed 13 reported adverse events over five years (2015-2019) in a southeastern U.S. AAI program. 

Four incidents resulted in human injury and nine involved animals in their first year of service. While most adverse events were not severe, the study found that retiring the animal-handler team was not always necessary. Recommendations for improving prevention, management, and outcomes of such events are provided

What Is the Future of Animal-Assisted Therapy for Addiction?

The potential future considerations for animal-assisted therapy are increasing acceptance and integration, technological enhancements, expanding research and evidence base, a broader range of therapy animals, training and certification programs, policy and ethical guidelines, and community and support networks. The most important factors that determine the future of AAT for addiction are given below as explained by Fine and Aubrey H:

• Increasing Acceptance and Integration: As awareness of the benefits of Animal-Assisted Therapy (AAT) grows, its acceptance and integration into mainstream addiction treatment programs are likely to increase. With more healthcare providers recognizing its effectiveness, AAT becomes a standard component of comprehensive addiction recovery plans as explored by Whiteman (2014) in the MedicalNewsToday article- “Animal-assisted therapy: is it undervalued as an alternative treatment?”

• Expanding Research and Evidence Base: Ongoing and future research will be critical in validating and refining AAT practices. In Chapter 28 of the Handbook on Animal-Assisted Therapy (Fourth Edition) (2015), titled “A Glimpse at the Future of Animal-Assisted Interventions: Selected Commentaries,” the author critiques the current state of animal-assisted therapy (AAT) research. Despite the widespread acceptance of AAT among the public and professionals, the commentary highlights big gaps in evidence supporting its efficacy. 

Common issues in AAT studies include inadequate control groups, lack of long-term effectiveness assessments, small sample sizes, publication bias, and selective reporting. The chapter discusses recent improvements in research quality and offers recommendations for further enhancement, such as better research designs, standardized treatment protocols, and more rigorous reporting practices. 

As more studies are conducted, a robust evidence base will develop, helping to standardize protocols and improve treatment outcomes. Research focusing on the biological and psychological mechanisms of AAT will expand understanding and acceptance.

What Do I Expect in an Animal-Assisted Therapy Session?

During an animal-assisted therapy session, you should expect to engage in activities with therapy animals, such as petting, grooming, or interactive play. As provided in the Handbook on Animal-Assisted Therapy (Fourth Edition) (2015), the session begins with assessing your needs and goals, followed by tailored interventions involving the animal. The therapist guides the process to ensure therapeutic objectives are met.

How Long Does Animal-Assisted Therapy Take?

The duration of AAT lasts 30-60 minutes per session, with the total length of treatment depending on the client’s progress and specific requirements. According to the Handbook on Animal-Assisted Therapy (Fourth Edition) (2015), average timeframes for addiction recovery oscillate from several weeks to months, depending on the treatment plan.

References

1. Pandey, Pati, Ramendra, et al. (2024) in “The Role of Animal-Assisted Therapy in Enhancing Patients’ Well-Being: Systematic Study of the Qualitative and Quantitative Evidence,”
2. López-Fernández,  Eduardo, et al. (2024) in “Implementation feasibility of animal-assisted therapy in a pediatric intensive care unit: effectiveness on reduction of pain, fear, and anxiety,”
3. Compitus, Katherine, (2024) Psychology Today article “Exploring the Benefits of Animal-Assisted Interactions,”
4. Sahebalzamani, Rezaei, and Moghadam (2020) “Animal-Assisted Therapy on Happiness and Life Quality of Chronic Psychiatric Patients Living in Psychiatric Residential Care Homes: A Randomized Controlled Study,”
5. Fung Allison, et al., (2024) in the research article “The Rich History and Evolution of Animal-Assisted Therapy,” published in the HSOA Journal of Alternative, Complementary & Integrative Medicine
6. Ernst (2014) in the research paper “Animal-Assisted Therapy: An Exploration of Its History, Healing Benefits, and How Skilled Nursing Facilities Can Set Up Programs
7. Gaekwad et al. (2022) in their research analysis “A Meta-Analysis of Emotional Evidence for the Biophilia Hypothesis and Implications for Biophilic Design.”
8. Holder, Timothy R. N., et al. (2020) in the review research article “A Systematic Literature Review of Animal-Assisted Interventions in Oncology (Part II): Theoretical Mechanisms and Frameworks
9. Lovell T., Ranse K. (2022) in the research review “Animal-assisted activities in the intensive care unit: a scoping review”
10. Kelly, Melissa A. & Cozzolino, Callandre A.  (2014) in “Helping at-risk youth overcome trauma and substance abuse through animal-assisted therapy.”
11. “Animal-Assisted Therapy in the Treatment of Substance Dependence,” Wesley, Martin C., et al. (2015)
12. Montolio & Sancho-Pelluz (2019) in the research article “Animal-Assisted Therapy in the Residential Treatment of Dual Pathology.”
13. “Paws for Thought: A Controlled Study Investigating the Benefits of Interacting with a House-Trained Dog on University Students Mood and Anxiety” Thelwell, Emily L. R. (2019)
14. Kern-Godal, Ann, et al. (2015) “Substance Use Disorder Treatment Retention and Completion: A Prospective Study of Horse-Assisted Therapy (HAT) for Young Adults”
15. Godal et al. (2016) in “More Than Just a Break from Treatment: How Substance Use Disorder Patients Experience the Stable Environment in Horse-Assisted Therapy.”
16. Dell et al. (2023) in “The role of the human-canine bond in recovery from substance use disorder: A scoping review and narrative synthesis protocol.”
17. Friedmann, Erica; Son, Heesook (2009) in their published research “The Human–Companion Animal Bond: How Humans Benefit”
18. Klemetsen & Lindstrøm (2017) in “Animal-Assisted Therapy in the Treatment of Substance Use Disorders: A Systematic Mixed Methods Review”
19. Ellsworth, Lindsay Madden, et al. (2016) “Interaction with Shelter Dogs Reduces Negative Affect of Adolescents in Substance Use Disorder Treatment”
20. “Assessing the Effectiveness of Animal-Assisted Therapy on Alleviation of Anxiety in Pre-School Children: A Randomized Controlled Trial” by Tahan, Mohammad, et al.
21. Pandey, Pati, Ramendra, et al. (2024) in “The Role of Animal-Assisted Therapy in Enhancing Patients’ Well-Being: Systematic Study of the Qualitative and Quantitative Evidence”
22. Fine, Aubrey H., et al. (2019) in the research “The State of Animal-Assisted Interventions: Addressing the Contemporary Issues That Will Shape the Future”
23. Fine, Aubrey H., et al. (2019) in the research “The State of Animal-Assisted Interventions: Addressing the Contemporary Issues That Will Shape the Future”