Atlas›Domain XV · Nature, philosophy, social & rites of passage›Guide 030
Guide XV-030

Animal-assisted therapy, education, activities and coaching

A 29 · L 54 · M 1720 interventions in the Trinity explorer
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[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: IAHAIO White Paper on Animal Assisted Interventions (first published 2014, updated April 2018, which added animal-assisted coaching and the One Health and One Welfare framing), read alongside current standards from Pet Partners (therapy-animal teams), Eagala (ground-based equine-assisted psychotherapy), PATH Intl. optimal terminology (equine-assisted services) and the American Hippotherapy Association (hippotherapy). Infection-control content follows Dalton et al. (2020) and the SHEA expert guidance (Murthy et al., 2015). [source: IAHAIO White Paper 2018; Pet Partners; Eagala; PATH Intl.; AHA]

Animal-assisted intervention (AAI) is not a single psychotherapy. It is an umbrella under which a professional deliberately includes an animal in health, education or human services work. IAHAIO defines AAI as a goal-oriented, structured intervention that includes animals to achieve therapeutic gains, delivered with an interdisciplinary approach by people who understand both the humans and the animals involved. Under that umbrella it separates four categories [source: IAHAIO White Paper 2018]:

  • Animal-assisted therapy (AAT): planned, structured, goal-directed therapy led or directed by a health, education or human-services professional with formal training and active licensure (or equivalent), with progress measured and documented. Goals may be physical, cognitive, behavioural or socio-emotional.
  • Animal-assisted education (AAE): planned, goal-oriented work led by a qualified educator (for example a special-education teacher running dog-assisted reading), with student progress documented.
  • Animal-assisted activity (AAA): planned, informal visits by a human-animal team for motivational, educational or recreational purposes (for example nursing-home visits or crisis comfort). Teams need at least introductory training, preparation and assessment. If a team works with a specialist on documented goals, IAHAIO classes that work as AAT or AAE instead.
  • Animal-assisted coaching or counselling (AAC): added in 2018; planned, structured work led by a licensed coach, with documented progress, aimed at personal growth, group processes or socio-emotional skills. The coach, or a handler under the coach's supervision, needs adequate training in animal behaviour, needs, health and stress regulation.

Equine work has its own vocabulary. PATH Intl. recommends "equine-assisted services" as the unifying term and divides it into therapy (counselling, occupational therapy, physical therapy, psychotherapy, recreational therapy and speech-language pathology, each delivered by a licensed professional within scope), learning (equine-assisted learning in education, organisations and personal development) and horsemanship (adaptive or therapeutic riding, driving, vaulting, adaptive sport) [source: PATH Intl. Optimal Terminology]. Hippotherapy is not psychotherapy: the American Hippotherapy Association describes it as the purposeful use of equine movement as a treatment tool by licensed physical therapists, occupational therapists and speech-language pathologists (and their assistants) within their practice acts, integrated into an existing plan of care; it is "not a separate service or a program" [source: AHA, What is Hippotherapy; AHA Statements of Best Practice 2023]. A psychotherapist refers to it; a psychotherapist does not deliver it.

How change is thought to happen: the frameworks above describe the animal as a living partner whose presence and responses add motivation, safety, feedback and relational material to goal-directed work; in Eagala's account the horse responds to the client's body language and emotional state, and what happens between client and horse becomes the material of the session [source: Eagala, What is the Eagala model]. These mechanisms are the frameworks' own accounts, not settled findings. Evidence line on dolphin-assisted therapy: IAHAIO excludes wild and exotic animals and states that dolphin-assisted therapy is unlikely to meet the animals' welfare needs; its clinical claims are [uncertain: not verified] [source: IAHAIO White Paper 2018].

What the psychotherapist does with AAI: (1) delivers AAT personally only where trained, with a suitable evaluated animal or a qualified handler; (2) co-facilitates with an animal professional (for example the Eagala team of mental-health professional plus equine specialist); (3) refers to, prepares and debriefs a client who attends a programme run by others (a hospital visiting programme, a prison animal programme, therapeutic riding, hippotherapy); and (4) works with the meaning of animals, including pets, losses and fears, in the client's life. [synthesis]

2. Framework

AAI has no single phase model across its forms. The following structure combines what the standards bodies require before, during and after animal involvement. Session counts are not specified by any of these bodies; follow the host therapy's own course. [source: IAHAIO White Paper 2018; Pet Partners; Eagala; AHA; synthesis for the sequence]

Phase A. Decide whether an animal belongs in this work.

  • Goal: a clinical reason, a category (AAT, AAE, AAA, AAC), and a delivery route (you as handler, co-facilitation, or referral).
  • Tasks: screen the client for allergies to the species or breed, immunosuppression and other higher-risk conditions (IAHAIO names exclusion criteria for higher-risk groups such as immunosuppressed patients), fear, phobia, trauma involving animals, a history of harming animals, and cultural or religious objections (IAHAIO: discuss alternatives where beliefs conflict with AAI). Check the setting's infection-control policy and local law. [source: IAHAIO White Paper 2018; Dalton et al. 2020]
  • Move on when: the client (and parent or guardian where relevant) has given informed consent, a minor or a person with limited capacity has given assent, no exclusion applies or a medical opinion has cleared it, and you have a named handler and animal that meet a recognised body's standards.

Phase B. Prepare the team, the animal and the setting.

  • Goal: a competent handler-animal team and a safe room or arena.
  • Tasks: confirm the animal's veterinary health check and behaviour or temperament evaluation (IAHAIO: by a veterinarian or behaviourist, with regular re-evaluation; Pet Partners: veterinary health screening form and team evaluation every two years); confirm registration where required (IAHAIO: dogs, cats and equines registered with a recognised organisation); agree roles and a stop signal; set up water, a rest or retreat space and safe flooring for the animal. [source: IAHAIO White Paper 2018; Pet Partners]
  • Move on when: the handler, the animal, the therapist and the facility rules are aligned (Pet Partners applies whichever of its own and the facility's rules is more conservative). [source: Pet Partners Policies and Procedures]

Phase C. Sessions.

  • Goal: goal-directed work with the animal as participant, within welfare limits.
  • Format: individual, family or group; office, ward, school, farm or arena. IAHAIO gives a session length of 30 to 45 minutes for the animal's sake; Pet Partners limits a team to two hours of visiting in any 24-hour period. Eagala sessions are unmounted and the horses are not tethered. [source: IAHAIO White Paper 2018; Pet Partners; Eagala]
  • Each session: hand hygiene, introduction and ground rules, the activity, observation of both client and animal, ending, debrief. Documentation of goals and progress is what distinguishes AAT, AAE and AAC from AAA. [source: IAHAIO White Paper 2018]

Phase D. Review, transfer and ending.

  • Goal: carry gains into the client's life without the animal, and end the client-animal relationship well.
  • Move on when: goals are met or the animal no longer adds value; plan the goodbye to the animal as a real ending. [synthesis]

3. Guiding principles

  • The animal is a living being, not a tool. IAHAIO's phrase is "not simply a tool, but a living being"; plan every activity for the animal's welfare as well as the client's. An intervention that harms the animal is unethical under IAHAIO's One Welfare position even if the client benefits. [source: IAHAIO White Paper 2018]
  • Only domesticated, evaluated, suitable animals. No wild or exotic animals, however tame; not every pet is suitable. Use animals evaluated by a qualified person and checked by a veterinarian. [source: IAHAIO White Paper 2018]
  • The animal may say no. Pet Partners: animals should always have a choice in participating, and when the animal "says no", listening is the right response. Practically: end or pause the activity when the animal withdraws. [source: Pet Partners, Doing No Harm]
  • Competence on both ends of the lead. The professional understands the client's needs; the handler understands the animal's behaviour, health and stress indicators; AAT and AAE providers who supervise handlers must understand these too. Practically: do not handle an animal you were not trained and evaluated with. [source: IAHAIO White Paper 2018]
  • Goal-directed and documented. AAT, AAE and AAC have written goals and documented progress; without them the work is AAA. Practically: write the animal's role into the treatment plan. [source: IAHAIO White Paper 2018]
  • Stay within your profession's scope. PATH Intl. and AHA both tie therapy services to licensed professionals working within their discipline; hippotherapy belongs to PT, OT and SLP. Practically: refer movement-based goals out. [source: PATH Intl.; AHA]
  • One Health. Human, animal and environmental health are linked; infection control protects clients, staff, handlers, visitors and the animal. Practically: follow the setting's infection-control policy and the stricter of two rules. [source: IAHAIO White Paper 2018; Pet Partners Policies and Procedures]
  • Client-led observation, no interpretation imposed. Eagala's stated principles include client-led work and no interpretation or judgement by the team. Practically: ask what the client noticed rather than telling them what the horse "meant". [source: Eagala]
  • Clear roles and boundaries. In co-facilitated work the mental-health professional holds emotional and psychological safety and the animal professional holds physical safety and the animal; each keeps the ethical boundaries of their own discipline. [source: Eagala]
  • Consent before and during, with a right to stop. For any touch of the animal, any physical contact between people during animal work (for example helping a client up), and any photograph (Pet Partners forbids photos or video of clients without signed consent). Touch between people is never sexual. [source: Pet Partners Policies and Procedures; synthesis]
  • Supervise every interaction. IAHAIO requires recipients to be supervised at all times to prevent teasing or mishandling; Pet Partners requires the handler to hold the lead at all times and never leave the animal. [source: IAHAIO White Paper 2018; Pet Partners Policies and Procedures]
  • Multiple relationships are managed deliberately. When you are both therapist and handler, or the animal is your pet, you hold two roles at once; APA Ethics Code Standard 3.05 (Multiple Relationships) applies to whether that role mix risks impairing objectivity or exploiting the client. [source: APA Ethics Code; synthesis for application]
  • Respect culture and belief. Some clients regard particular animals as unclean, sacred or threatening; offer an alternative without pressure. [source: IAHAIO White Paper 2018]

4. Intervention inventory

The standards bodies publish definitions, welfare rules and team structures rather than a manual of techniques, so most entries below are therapist-side procedures built on those rules; where the step sequence is not in a source it is marked [synthesis]. Fine (ed.), Handbook on Animal-Assisted Therapy (5th ed., 2019), and the Animal Assisted Intervention International standards are further standard references whose content is not reflected here [uncertain: not verified].

4.1 Suitability and risk screening

  • Purpose: decide whether an animal should be present at all, and which species. Use before any AAI, including before referring to a programme. [source: IAHAIO White Paper 2018; Dalton et al. 2020]
  • Steps: (1) Ask about allergies to the specific species and breed and about asthma; IAHAIO states clients must not have species- or breed-specific allergies. (2) Ask about immunosuppression, open wounds, recent surgery, pregnancy and other conditions the setting's infection-control policy names; for higher-risk groups, IAHAIO expects exclusion criteria, so get medical advice before going further. (3) Ask about fear or phobia of the animal, past bites, kicks or falls, and trauma in which an animal was involved (an attack, an animal used as a threat, a pet harmed in domestic violence). (4) Ask, in a matter-of-fact way, about any history of hurting animals; if present, do not bring an animal into the room until assessed. (5) Ask about cultural or religious views of the species. (6) Record the outcome and the decision. [source: IAHAIO; synthesis for steps 3-6]
  • Example language (illustrative): "Before we think about having a dog in the room, I need to check a few things: allergies, health, and how you feel about dogs, including anything bad that has happened with animals. There is no wrong answer, and we can do this work without an animal."
  • Watch for: clients who minimise allergies or fear to please you; a child whose parent answers for them; trauma disclosed only when the animal arrives. It is working when the decision is recorded and the client can say why an animal is or is not included.

4.2 Informed consent and assent

  • Purpose: voluntary, informed agreement to animal involvement, separate from consent to therapy.
  • Steps: (1) Explain the category (AAT, AAE, AAA or AAC), who the animal and handler are, and what they will and will not do. (2) Name risks plainly: allergy, bites or scratches, infection (transmission is rarely confirmed but therapy animals can carry pathogens), and for horses, falls, kicks and being knocked over. (3) Explain the client's right to decline the animal or stop at any time, and the animal's right to stop. (4) Get written consent from the client or guardian, and a young person's or a person with limited capacity's own assent in words they understand. (5) Get separate written consent for any photo or video (Pet Partners forbids images without signed consent). (6) Agree confidentiality: who the handler is, what the handler hears, and that the handler is bound to confidentiality. (7) Revisit consent at each session. [source: Dalton et al. 2020; Pet Partners Policies and Procedures; AHA Statements of Best Practice 2023 (consensus decision for hippotherapy); synthesis for the sequence]
  • Example language (illustrative): "You can say 'no dog today' at any point and we just carry on. And if the dog decides it has had enough, we stop too; that's part of how this works."
  • Watch for: consent given under group or family pressure; a handler who is not covered by confidentiality. Working when the client uses the stop option comfortably.

4.3 Choosing the route and vetting a programme or handler

  • Purpose: match the client to a competent provider and avoid unsafe or unsuitable programmes.
  • Steps: (1) Decide the route: you as therapist-handler (only with your own evaluated team), co-facilitation, or referral. (2) Check credentials against the body's own requirements: Pet Partners registration and current evaluation (every two years); Eagala certification (licensed mental-health professional plus experienced equine specialist, renewed every two years); PATH Intl. credentials such as the Equine Specialist in Mental Health and Learning; AHA credentials for hippotherapists. (3) Ask how the programme screens animals (veterinary checks, behaviour evaluation, raw-diet exclusion), its infection-control and incident policies, its insurance, and its welfare limits. (4) Do not refer to programmes using wild or exotic animals, including dolphin-assisted therapy, which IAHAIO excludes on zoonotic and welfare grounds. [source: Pet Partners; Eagala; PATH Intl.; AHA; IAHAIO]
  • Example language (illustrative): "Before I suggest the riding centre to you, I'd like to call them about how they train staff and look after the horses. I'll tell you what I find."
  • Watch for: programmes that call themselves "equine therapy" or "horse therapy" (AHA calls these terms incorrect) without naming the licensed professional; promises of cure. Working when you can name the provider's credential and policies.

4.4 Infection-control routine for each session

  • Purpose: reduce pathogen transfer between animal, clients, staff and rooms. Dalton et al. found substantial variation in infection-control practice across hospital programmes and few data confirming transmission; therapy dogs in some cohorts carried MRSA, C. difficile, Salmonella and other organisms, with raw diets, being fed treats by patients and licking named as risk factors. [source: Dalton et al. 2020 (medRxiv preprint)]
  • Steps: (1) Follow the facility's written policy; where the SHEA expert guidance (Murthy et al., 2015) is the reference, use its detailed recommendations [uncertain: not verified]. (2) Confirm the animal is healthy that day, groomed, nails trimmed, and not on a raw-protein diet (Pet Partners and IAHAIO exclude raw diets). (3) Have client and staff clean hands before and after contact. (4) Discourage licking of faces, wounds and hands, and do not let clients feed treats unless the policy permits. (5) Keep the animal off beds and food areas unless policy allows a barrier. (6) Clean shared surfaces afterwards. (7) Stop visits from animal or handler who is unwell. [source: Pet Partners; IAHAIO; Dalton et al. 2020; synthesis for steps 3-6]
  • Example language (illustrative): "Quick hand gel before we say hello, and again before you leave. It protects you and it protects her."
  • Watch for: routine drift over time; handlers who cannot name a zoonotic risk (a minority in one survey could not). Working when the routine happens without prompting.

4.5 Introducing the animal

  • Purpose: a calm first meeting that sets rules for safe interaction.
  • Steps: (1) Brief the client before the animal comes in: how to approach, where to touch, what not to do (Glenk recommends giving recipients behavioural instructions before the dog is introduced). (2) Let the animal enter on lead with the handler and explore the space. (3) Invite the client to let the animal approach rather than reaching over it; avoid crowding from one direction. (4) Prefer contact at neck, chest or side; contact at head, muzzle or paws produced more withdrawal in studies Glenk summarises. (5) Do not let people jump on, bend over, dress or costume the animal (IAHAIO). [source: Glenk technical note; IAHAIO White Paper 2018]
  • Example language (illustrative): "Let's let Biscuit come to you. If you'd like to stroke her, her shoulder is a good place to start."
  • Watch for: the client freezing or flinching; the animal avoiding gaze or backing away. Working when both settle.

4.6 Reading the animal's stress and consent signals

  • Purpose: protect the animal and model attunement for the client.
  • Steps: (1) Before sessions, agree with the handler what this animal's stress and withdrawal signals look like; for dogs, research summarised by Glenk lists a lowered tail, lip licking, body shake, gaze avoidance, vocalising and backing away. (2) During the session, watch continuously; the handler has authority to pause or end. (3) Give the animal a retreat space and water. (4) Respect workload limits (IAHAIO session length; Pet Partners daily cap). (5) Note unfamiliar environments and strangers as stressors. (6) Where clinically useful, invite the client to notice the animal's signals with you. [source: Glenk technical note; IAHAIO; Pet Partners; synthesis for step 6]
  • Example language (illustrative): "See how she's licking her lips and turning away? She's telling us she needs a break. What do you notice when you see that?"
  • Watch for: pressure from clients to keep the animal engaged; your own wish to continue. Working when stops happen early and calmly.

4.7 Animal presence as support within talking therapy

  • Purpose: a trained dog or other suitable animal in the room as a source of comfort, motivation or regulation during hard material, within an existing therapy. [source: IAHAIO definitions of AAT; synthesis for the procedure]
  • Steps: (1) Write the animal's role and goal into the plan (for example, attendance, staying with difficult material). (2) Let the client decide closeness and contact each session. (3) Keep the therapy the main work; use the animal as a choice point, not a distraction. (4) Note when the client turns to the animal and explore it if useful. (5) Review against the goal. [synthesis]
  • Example language (illustrative): "You reached for him just then, when we got close to talking about your dad. Would you like to stay there for a moment, with him, and see what comes?"
  • Watch for: avoidance through the animal; the animal absorbing distress (pause it). Working when the client stays with the material longer with the animal's support, and progress on the documented goal.

4.8 Fear of animals: graded approach

  • Purpose: for clients who wish to reduce fear of a species. Formal exposure therapy for a specific phobia is a separate treatment requiring training in exposure methods. [synthesis]
  • Steps: (1) Assess fear severity, trauma history and medical issues; get consent for exposure. (2) Build a hierarchy with the client from looking at images through to being near a calm, evaluated animal held by its handler. (3) Proceed at the client's pace; the client controls distance and stop. (4) Keep the animal's welfare equal: the animal is never pushed toward the client. (5) Do not use a session to test an animal with an unknown temperament. [synthesis]
  • Example language (illustrative): "You're in charge of the distance. Tell me when you want to stop, and we'll stay there until it feels a bit easier."
  • Watch for: panic, dissociation, trauma flashback (stop, ground, re-plan); animal stress. Working when fear ratings fall and the client chooses the next step.

4.9 Eagala-style ground-based equine session (co-facilitated)

  • Purpose: equine-assisted psychotherapy in which the client interacts with horses on the ground and the interaction becomes therapeutic material. Requires Eagala certification for the Eagala model. [source: Eagala]
  • Steps: (1) The team is a licensed mental-health professional and an equine specialist, with the horses. (2) The session happens in an arena or pasture; horses are not ridden, tethered or pressured. (3) The client may be given a task or goal or may simply engage with the horses as they choose. (4) The mental-health professional watches for therapeutic opportunities and holds psychological safety; the equine specialist observes the horses and holds physical safety. (5) Treat everything (avoidance, approach, struggle, success) as part of the process. (6) Process the experience with the client without interpreting for them (see 4.10). [source: Eagala; specific session tasks [uncertain: not verified]]
  • Example language (illustrative): "Here's the space and here are the horses. What would you like to do, if anything?"
  • Watch for: physical risk (see 4.11); the client experiencing the horse's moving away as rejection; the team over-directing. Working when the client links what happened in the arena to patterns in their life in their own words.

4.10 Client-led processing of what happened with the animal

  • Purpose: turn observation into meaning without imposing an interpretation. Eagala lists client-led work and no interpretation or judgement among its principles. [source: Eagala]
  • Steps: (1) Ask what the client noticed in the animal and in themselves. (2) Reflect their words, including any names or stories they give the animal. (3) Ask how this relates to their life, if at all. (4) Avoid statements of what the animal "meant" or "felt about" the client. (5) Note links for the next session. [source: Eagala; synthesis for steps]
  • Example language (illustrative): "What did you notice when she walked off? ... And what was that like for you? Does it remind you of anything?"
  • Watch for: your own projections onto the animal; clients reading every animal behaviour as a verdict on them. Working when the client's own metaphors develop over sessions.

4.11 Equine safety: falls, kicks and positioning

  • Purpose: prevent injury around horses, which are large prey animals. [source: AHA Statements of Best Practice 2023; Eagala (equine specialist's safety role)]
  • Steps: (1) Leave physical safety and horse handling to the equine professional; agree a stop word. (2) Brief clients on footwear and safe behaviour around horses before entering. (3) For any mounted work (therapeutic riding, hippotherapy), the programme's equestrian helmet policy and emergency transfer plan apply; AHA calls for a trained first-aid responder present and practised emergency plans. (4) Check the arena is clear and the horses are sound and calm. (5) Stop if a horse shows stress, unsoundness or agitation. [source: AHA Statements of Best Practice 2023; synthesis for steps 1-2]
  • Example language (illustrative): "Before we go in: we'll stay where Sam, our horse specialist, can see us, and if either of us says 'stop', everyone stops."
  • Watch for: clients approaching from behind a horse; a client who dissociates near a large animal. Working when no near-misses occur and clients follow the briefing.

4.12 Referral to and collaboration with hippotherapy or therapeutic riding

  • Purpose: connect a client with movement, sensory, motor or speech goals to the right equine service. Hippotherapy is delivered only by licensed PT, OT or SLP professionals (and their assistants) within their practice acts, as one tool within their plan of care; therapeutic or adaptive riding is a horsemanship service delivered by equine professionals. [source: AHA; PATH Intl.]
  • Steps: (1) Identify whether goals are therapy goals (refer to the client's PT, OT or SLP, who may use hippotherapy) or recreational and skill goals (adaptive riding). (2) Recognise that AHA requires a risk-benefit analysis and lists precautions and absolute contraindications; medical clearance belongs to the treating therapist and physician, not you. (3) With consent, share relevant emotional and behavioural information (anxiety, sensory sensitivities, trauma triggers) with the provider. (4) Agree how you will hear about progress or incidents. (5) Keep mental-health goals in your own sessions. [source: AHA Statements of Best Practice 2023; synthesis for steps 3-5]
  • Example language (illustrative): "The riding work would be run by a physiotherapist who uses the horse's movement as part of her treatment. I'd stay your therapist; with your OK I'll tell her what helps you feel safe."
  • Watch for: families expecting riding to replace mental-health care; fall anxiety after an incident. Working when roles are clear to the family and providers.

4.13 Animal-assisted education consultation

  • Purpose: advise a school or parent on AAE (for example dog-assisted reading) for a child client. AAE is led by a qualified educator with documented goals. [source: IAHAIO White Paper 2018]
  • Steps: (1) Clarify the educational goal and who leads (a teacher, with a registered team). (2) Share screening concerns from 4.1 with consent. (3) Advise on safeguarding: the handler never alone with the child unless school policy and checks allow. (4) Agree how the child can opt out without stigma. (5) Keep assessment of learning or developmental needs on track; the dog does not replace it. [source: IAHAIO; synthesis for steps 2-5]
  • Example language (illustrative): "The reading dog sounds like it could help with her confidence. Can we also make sure the reading assessment still goes ahead?"
  • Watch for: a child who is frightened but compliant; animal fatigue in busy schools. Working when the child chooses to attend and goals are recorded.

4.14 Animal-assisted coaching (AAC)

  • Purpose: goal-directed personal-growth, group-process or socio-emotional skills work led by a licensed coach. [source: IAHAIO White Paper 2018]
  • Steps: (1) Clarify whether the person needs coaching or psychotherapy; refer clinical problems to clinical care. (2) Confirm the coach or supervised handler has the animal-behaviour, health and stress-regulation training IAHAIO requires. (3) Set and document goals. (4) For equine-assisted learning in organisations or personal development, PATH Intl. classes this as a learning (non-therapy) service. [source: IAHAIO; PATH Intl.; synthesis for step 1]
  • Example language (illustrative): "This programme is coaching, not therapy. If things come up that feel bigger, bring them here and we'll work on them together."
  • Watch for: clinical material surfacing in a non-clinical setting without support. Working when the client brings learning back into therapy.

4.15 Preparing and debriefing a client in a visiting, farm or prison animal programme

  • Purpose: support a client who takes part in AAA visits, a care farm, or a custodial animal-training programme run by others. [synthesis]
  • Steps: (1) Before: explore hopes, fears, past animal experiences and what the client would do if the animal is unwell, retires or is removed. (2) Check the programme's rules for contact, hygiene and welfare. (3) During: invite the client to bring the experience to sessions. (4) After: debrief successes, setbacks and goodbyes; in custodial programmes where trainees raise an animal and then hand it on, expect grief at the handover. (5) Coordinate with programme staff only with consent. [synthesis]
  • Example language (illustrative): "When the dog you've been training leaves for its new home, that may hit you harder than you expect. Let's plan for that week."
  • Watch for: the programme becoming the client's only source of worth; animal welfare concerns the client raises (take them seriously and pass them to the programme). Working when gains in responsibility or connection show outside the programme.

4.16 Incident response: bite, scratch, fall or kick

  • Purpose: respond safely and transparently when something goes wrong. [source: Pet Partners Policies and Procedures; AHA Statements of Best Practice 2023]
  • Steps: (1) Stop the session; separate client and animal; the handler takes the animal away. (2) Give first aid and seek medical care as needed; AHA expects a trained first-aid responder present for equine work. (3) Follow the facility and registering-body reporting rules; Pet Partners requires the handler to stop visiting immediately and report all details. (4) Inform the client's guardian where relevant. (5) Afterwards, process fear, shame or anger with the client and decide whether to continue with animals. (6) Do not resume with that animal until it has been re-evaluated. [source: Pet Partners; AHA; synthesis for steps 4-6]
  • Example language (illustrative): "That was frightening, and it isn't your fault. Let's look after your hand first, and talk about it properly when you're ready."
  • Watch for: client self-blame, or blame of the animal leading to fear of animals generally; delayed injury symptoms. Working when the client can talk about it and choose freely what happens next.

4.17 Working with the meaning of animals in the client's life

  • Purpose: explore pets, past animals, animal-related loss and the client's relationship with the therapy animal, with or without AAI. [synthesis]
  • Steps: (1) Ask about significant animals across the lifespan. (2) Treat pet loss as real bereavement and assess grief (prolonged grief disorder only as DSM-5-TR and ICD-11 define it after the death of a person; animal loss is assessed as grief without that diagnosis [uncertain: not verified]). (3) Explore attachment patterns the client sees in their bond with animals. (4) Ask about animals in family violence: pets threatened or harmed are a recognised risk marker [uncertain: not verified]; follow safeguarding procedures. [synthesis]
  • Example language (illustrative): "Tell me about her. What was a normal day like with her around?"
  • Watch for: disenfranchised grief; animal hoarding or neglect concerns (consider welfare referral). Working when the client can hold the loss without dismissing it.

4.18 Ending and goodbyes with a therapy animal

  • Purpose: close the client-animal relationship well when therapy ends, or when the animal retires, is ill or dies. [synthesis]
  • Steps: (1) Name the ending in advance. (2) Plan a final session with the animal that the client shapes (within the animal's comfort). (3) If the animal retires or dies, tell clients honestly and promptly, with the handler's agreement on what is shared. (4) Offer to process it; for some clients it echoes earlier losses. (5) Do not substitute a new animal without consent. [synthesis]
  • Example language (illustrative): "Next week is our last session with Biscuit. How would you like to say goodbye?"
  • Watch for: abrupt endings repeating old abandonments. Working when the client leaves with a sense of a finished relationship.

4.19 Documentation and goal tracking

  • Purpose: make the work AAT (or AAE or AAC) rather than an informal visit, and support review. [source: IAHAIO White Paper 2018]
  • Steps: (1) Record the clinical goal and the animal's role. (2) Record screening, consent and assent. (3) Per session: who was present (handler, animal), activities, client response, animal stress or welfare notes, incidents. (4) Review progress against goals. (5) For hippotherapy, documentation follows the PT, OT or SLP's own rules and AHA terminology. [source: IAHAIO; AHA; synthesis for steps 2-4]
  • Example language (illustrative): "Let's look back at what we hoped having the dog here would help with, and see how far we've got."
  • Watch for: notes recording only client outcomes; missing animal welfare entries. Working when records show goal movement and welfare monitoring.

4.20 Managing dual roles, competence and insurance

  • Purpose: keep the therapist-handler role safe and ethical. [source: APA Ethics Code; IAHAIO; Pet Partners; Eagala]
  • Steps: (1) Decide whether you can hold both roles; if not, use a separate handler. (2) If you are the handler, train and be evaluated with the specific animal through a recognised body; the animal must meet veterinary and behaviour requirements. (3) Check your professional liability insurance covers animals in sessions and the setting (Pet Partners provides volunteer insurance for registered volunteer teams; that may not cover paid professional work [uncertain: not verified]). (4) Get supervision on animal-related material and your attachment to your animal. (5) Consider APA Ethics Code Standard 3.05 on multiple relationships where your pet becomes part of the therapy relationship. (6) Consider an ethics committee or advisor with animal-welfare knowledge, as IAHAIO advises for programmes. [source: APA Ethics Code; IAHAIO; Pet Partners; synthesis for steps 1, 3-5]
  • Example language (illustrative, to a supervisor): "I noticed I kept the session going when Biscuit was tired, because the client was finally opening up. I want to look at that."
  • Watch for: your animal's needs being overridden by your clinical goals, or the reverse. Working when you stop sessions for the animal without hesitation.

5. Handling problems

The standards bodies address welfare, safety and infection problems; most clinical problem-handling below is [synthesis].

  • The animal shows stress or refuses. Pause or end the activity at once and give the animal its retreat space; the handler's call stands. Use the moment, if suitable, to explore how the client reacts to someone saying no. Do not push the animal toward the client or extend the session. [source: Pet Partners; Glenk; synthesis for the clinical use]
  • Client is stuck or uses the animal to avoid. Name the pattern gently, return to the treatment goal, and consider sessions without the animal for a while. [synthesis]
  • Client is overwhelmed (panic, flashback, dissociation), especially near large animals. Stop the activity, move to a safe distance with the equine specialist managing the horse, ground the client, and re-plan before returning; assess for animal-related trauma you missed. [synthesis]
  • Resistance or refusal to engage with the animal. Accept it; the work continues without the animal. Ask what the hesitation is about only if the client wishes. Never make the animal a condition of therapy. [synthesis]
  • Non-adherence to hygiene or handling rules. Re-brief before the next contact; if the client keeps breaking rules that protect the animal (rough handling, teasing), stop animal contact; IAHAIO requires supervision to prevent mishandling. [source: IAHAIO; synthesis]
  • Cruelty or intent to harm the animal. End animal contact, protect the animal, document, and assess risk to others; follow safeguarding procedures for children and vulnerable adults. [synthesis]
  • Rupture involving the animal or handler. A client may feel rejected by the animal, jealous of it, or uneasy about the handler's presence. Explore it as you would any rupture; consider a different arrangement (another handler, no animal). [synthesis]
  • Rupture from an incident (bite, fall, kick). Follow 4.16; acknowledge responsibility for safety without blaming client or animal; offer a choice about continuing; report through the proper channels. [source: Pet Partners; AHA; synthesis]
  • Allergy or infection concern arises mid-course. Stop contact, get medical advice, and resume only with clearance; review the infection-control routine with the facility. [source: IAHAIO; Dalton et al. 2020; synthesis]
  • The therapy animal becomes ill, retires or dies. Tell clients honestly and promptly; plan endings (4.18); watch for grief that reactivates earlier losses; for a client bereaved by suicide, use safe messaging and share crisis resources (988 in the US; Samaritans 116 123 in the UK and Ireland). [synthesis]
  • Facility and programme rules conflict. Follow the more conservative rule, as Pet Partners does. [source: Pet Partners Policies and Procedures]
  • Scope creep. A family asks you to "do horse therapy" for motor goals, or a coach is handling trauma disclosures. Redirect: motor and speech goals to PT, OT or SLP (hippotherapy), clinical material to clinical care. [source: AHA; PATH Intl.; IAHAIO]
  • Requests for dolphin or exotic-animal programmes. Explain IAHAIO's exclusion of wild and exotic animals on welfare and zoonotic grounds, explore what the family hopes it will offer, and look for domesticated-animal or non-animal alternatives. [source: IAHAIO; synthesis]
  • Cultural or religious conflict. Offer an alternative without pressure, as IAHAIO advises; do not treat the objection as resistance. [source: IAHAIO]
  • Your own attachment to your animal clouds judgement. Take it to supervision; consider a separate handler. [synthesis]

Sources

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