Occupational Therapy Association of California October 21 st, 2017; 8:15-11:30 am, then 2:30-4:00 pm Summary This workshop provides information and understanding to OT s and COTA s in the process of specialty training, program development, treatment planning, and task analysis of animal assisted therapy for psychiatric and psychosocial interventions. The workshop content is geared toward entry-level clinicians, as well as practitioners who have attained a general working knowledge of current practice trends in animal assisted interventions. Content will include detailed discussion of uniform terminology, professional responsibility, canine perspectives and welfare, professional development, and program development for mental health practitioners. Focus is on increasing knowledge of theoretical foundations and review of relevant literature, with demonstration of techniques to provide opportunity for skill development and competent application of the subject matter.
Terminology There has historically been a lack of uniform terminology. Accurate terminology is important: To identify appropriate studies and results from historical studies Establish future validity of research for effectiveness of AAT (in our scope of practice and collateral information from other disciplines) Winkle, Crowe, Ashraf, Vigil-Brady (2017, publication pending)- literature review of 300 articles that claimed therapy, only 14 met criteria for therapy. Others were volunteer visitors with no goals, no licensed/degreed healthcare provider present, etc. Students (and professors) may not know the difference when citing the literature for AAT OT s working with dogs in practice are using AAA studies to represent AAT New terms continue to be created, which minimizes the impact of AAT and causes more confusion (Fine, Tedeschi & Elvove, 2015) In the past decade, these leading organizations have agreed on setting and utilizing specific terminology: Animal Assisted Intervention International International Association of Human-Animal Interaction Organizations Pet Partners American Veterinary Medical Association Purdue University, Center for the Human-Animal Bond, Organization for Human-Animal Interaction Research Oakland University (Michigan) - Center for Human Animal Interventions 14 other universities with AAI or AAT programs Animal Assisted Interventions (AAI) Categorical term that includes animal assisted therapy (AAT), animal assisted education (AAE), animal assisted activity (AAA), and animal support (AS). AAIs include informal or formal goal-directed intervention [leisure, therapy or education] that is designed to promote improvement in physical, social, emotional, and/or cognitive functioning of the person(s) involved and in which a specially trained animal-handler team is an integral part. AAI is directed and/or delivered by a practitioner with specialized expertise and within the scope of practice of his/her profession. Formal AAIs include AAE and AAT. Informal AAIs include less goal-directed, more casual or spontaneous interactions. AAI may be provided in a variety of settings, may be group or individual in nature, and may be implemented for persons of any age. (AAII, n.d.)
Animal Assisted Activities (AAA) Provide informal opportunities for motivational, educational, or recreational benefits (AAII, n.d.; AVMA, n.d.; IAHAIO, 2014; Pet Partners, n.d.). Teams are specially trained, evaluated, and registered through a volunteer visiting organization to conduct short visits in various facilities. Role may change if working within AAT or AAE Animal Assisted Therapy (AAT) Formally goal-directed, structured, and measured intervention designed to promote improvement in physical, cognitive, and psychosocial functioning of the participants (AAII, n.d.) Delivered by a licensed/degreed healthcare professional with specialized expertise and within scope of practice Potential participants and animals involved are carefully screened for appropriateness of intervention and precautions Process is planned, modified, documented, and evaluated Animal Assisted Education (AAE) Formally goal-directed, structured, and measured intervention designed to promote improvement in cognitive functioning of the participants (AAII, n.d.) Delivered by a licensed/degreed educational professional with specialized expertise and within scope of practice Potential participants and animals involved are carefully screened for appropriateness of intervention and precautions Process is planned, modified, documented, and evaluated Animal Support (AS) Professional organizations (ex: members of Assistance Dogs International or Animal Assisted Intervention International) that train animals and their handlers/health and human service professionals Evaluates the dog with the handler, setting, population, activities, contextual, etc. Advocates for health and welfare of dog, troubleshoots issues in context and determines solutions
Professional Responsibility/Standards Core Values of OT Altruism- Concern for welfare of others Truth- Accurate information Prudence- Clinical & ethical reasoning skills, sound judgement, and reflection to make decisions in professional and volunteer roles (American Occupational Therapy Association, 2015) OT Principles and Standards of Conduct Beneficence- Preventing harm, protecting/ defending rights of others, removing conditions that will cause harm, safety of clients. Conduct Standards: Provide OT services, including education and training, within level of competence and scope of practice Take steps to ensure proficiency Maintain competency with CE relevant to practice area (American Occupational Therapy Association, 2015) Nonmaleficence- Refrain from actions that cause harm. Conduct Standards: Avoid undue influences that may impair practice and compromise safe and competent services. (American Occupational Therapy Association, 2015) OT Standards for Continuing Competence Professional Standing and Responsibility: Establish, Maintain, and update professional performance, knowledge and skills (American Occupational Therapy Association, 2015) Literature Review for AAT and Mental Health What s in it for the Dog o Animal Selection o Training/Evaluation o Animal Welfare
The Journey to AAT in OT Practice/Professional Development/Competencies Continuing Education for AAT Theoretical foundations Precautions (in relation to YOUR setting and population) Treatment planning Hands on coursework Program development Professional Membership: Animal Assisted Intervention International (http://www.aai-int.org) Standards Accreditation Conferences specific to AAA, AAT, AAE, AS/Training, etc. Identifying a Trainer to Help Get Ready for AAT (Resources) Experienced / Reputable Relationship based, positive reinforcement training techniques Certification Council for Professional Dog Trainers (CCPDT) International Association of Animal Behavior Consultants- Least intrusive, minimally aversive (LIMA) approach to behavior modification and training Willing to learn about OT, YOUR population, YOUR setting, and the activities Find another OBJECTIVE 3 rd party to evaluate your dog in the setting, with population, and with the activities it is expected to do. Documentation Medical Model Participatory/Person-Centered
Treatment Planning/Case Studies Domestic violence and the link to animal abuse Task Analysis AAT can happen either with or for the dog Prep for ending AAT Moving Retiring Discharging Death Program Development Policies & Procedures CE Logs Dog Logs o Training o Vaccinations/Health Release Forms Risk Management o Client Screening o Criteria that makes you say hmmmm o Zoonosis o Insurance/Liability
References American Occupational Therapy Association (AOTA). (2015). Occupational therapy code of ethics. American Journal of Occupational Therapy, 69(Suppl. 3), 6913410030p1-6913410030p8. doi: 10.5014/ajot.2015.696S03. American Occupational Therapy Association (AOTA). (2014). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy, 68(Suppl. 1), S1 S48. http://dx.doi.org/10.5014/ajot.2014.682006 Animal Assisted Intervention International (AAII). (n.d.). Animal Assisted Intervention. Retrieved September 22, 2017, from http://www.aai-int.org/aai/animal-assisted-intervention/ AVMA. (n.d.). Animal-Assisted Interventions: Definitions. Retrieved September 22, 2017, from https://www.avma.org/kb/policies/pages/animal-assisted-interventions-definitions.aspx Fine, A.H., Tedeschi, P. & Elvove, E. (2015). Forward Thinking: The Evolving Field of Human- Animal Interactions. In Fine, A.H. (Ed.), Handbook on Animal-Assisted Therapy: Theoretical Foundations and Guidelines for Practice (pp. 21-35). San Diego: Academic Press. International Association of Human-Animal Interaction Organizations (IAHAIO). (2014). The IAHAIO Definitions for Animal Assisted Intervention and Guidelines for Wellness of Animals Involved. Retrieved from http://iahaio.org/new/index.php?display=declarations Institute for Credentialing Excellence (ICE). (n.d.). What is Credentialing? Retrieved May 12, 2017, from http://www.credentialingexcellence.org/p/cm/ld/fid=32 Pet Partners. (n.d.). Terminology. Retrieved September 22, 2017, from https://petpartners.org/learn/terminology/ Stern, C., & Chur-Hansen, A. (2013). Methodological Considerations in Designing and Evaluating Animal-Assisted Interventions. Animals, 3(1), 127-141. doi:10.3390/ani3010127 Winkle, M.Y. (2013). Professional Applications of Animal Assisted Interventions: Gray Dog Book. Albuquerque, NM: Dogwood Therapy Services. Winkle, M. Y., & Jackson, L. Z. (2012). Animal Kindness: Best Practices for the Animal-Assisted Therapy Practitioner. OT Practice, 17(6), 10-14.
Melissa Winkle, OTR/L, FAOTA President, Dogwood Therapy Services President, Animal Assisted Intervention International Albuquerque, NM melissa@dogwoodtherapy.com Karen Ni, OTD, OTR/L President, SunDog Therapy Los Angeles, CA karen@sundogtherapy.com