F E AT U R E
Animal-Assisted OT: Providing Safe and Ethical Services Dr Jessica Hill, Associate Lecturer in Occupational Therapy, The University of Queensland What is Animal-Assisted Therapy?
Animal-assisted therapy (AAT) involves the deliberate incorporation of a trained and assessed therapy animal into pre-existing, evidence-based therapy modalities such as occupational therapy (International Association of Human Animal Interaction Organisations, 2015). Within the field of occupational therapy, AAT is viewed as a purposeful activity in which an animal is incorporated into an intervention with the aim of enhancing an individual’s therapy engagement and performance skills (Andreasen et al., 2017). AAT has been suggested to facilitate engagement in occupational therapy sessions with a range of client populations including children with cerebral palsy, autistic children, ‘at risk’ youth, and older adults diagnosed with dementia (Hill, 2020).
An expanding research base and increasing media exposure of the proposed benefits of AAT has resulted in a rapid rise of animals being included in occupational therapy interventions in Australia. However, with limited education and training pathways available, questions must be asked about whether the profession truly understands how to incorporate AAT into occupational therapy sessions effectively, in a manner that is safe and ethical for the clients and animals. For the past six years I have incorporated AAT into my practice. When I first decided to embark on my animal-assisted journey, 26 otaus.com.au
I enrolled in what was then the only therapy dog training course in Australia. Needing to attend this five-day, intensive face-to-face required me to travel with my dog from Brisbane to Melbourne at considerable cost. Ethical concerns about animal welfare–in particular, how many days a week was appropriate for one therapy dog to work–prompted me to buy a second dog and again travel to Melbourne for training. Since then, I have completed a number of additional courses and workshops in AAT and am trained in canine and equine-assisted therapy. Acknowledging the limited information available to occupational therapists about the ethical delivery of AAT services, I embarked on a PhD with the aim of further expanding the evidence base for this intervention. This six-year journey has allowed me to fully appreciate the complexity involved in delivering AAT, and guided my passion in working with therapists to ensure animal-assisted services are delivered in a way that is effective, safe and ethical for the clients and animals. My work in the field of AAT has raised significant concerns about the way in which this highly specialised intervention is being implemented. One common perception is that because AAT is ‘unregulated’, additional training or education is not required to incorporate this intervention into occupational therapy practices.
Occupational therapists are required by Section 2.2 of our Code of Conduct (Occupational Therapy Board, 2014) to work within our scope of practice and maintain appropriate knowledge and skills to ensure safe and competent care. Furthermore, when deciding to include an animal in our practice, we must acknowledge that we hold an ethical responsibility of care to both our clients and animals. Failure to recognise these responsibilities will cloud our understanding of ‘best practice’ and impact our professional integrity (Coghlan, 2020).
Our Ethical and Professional Responsibilities When considering our ethical responsibilities as occupational therapists, Gillon’s (1994) four prima facie principles of nonmaleficence, beneficence, autonomy, and justice are a good guide. Nonmaleficence (do no harm) and beneficence (promote well-being) Practising AAT without the appropriate training or knowledge carries a high risk of harm to clients. Like any treatment modality, it is imperative that occupational therapists incorporate therapy animals into sessions in a way that is goal-directed, occupationcentred and informed by the best available evidence (Hill et al., 2019). Occupational therapists must have a clear understanding of client goals, the occupational therapy intervention they intend to use, and
