Australian psychologists' knowledge of and attitudes towards animal-assisted therapy

Australian psychologists’ knowledge of and attitudes towardsanimal-assisted therapycp_26 69..77

Anne Francis BLACK1, Anna CHUR-HANSEN2 and Helen Russell WINEFIELD1,2

1School of Psychology, and 2Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia

Key wordsanimal-assisted therapy, clinical practice,

qualitative.

CorrespondenceAnna Chur-Hansen, Discipline of Psychiatry,

School of Medicine, University of Adelaide,

Adelaide, SA 5005, Australia.

Email: [email protected]

Received 10 November 2010; accepted 2 May

2011.

doi:10.1111/j.1742-9552.2011.00026.x

Abstract

Background: Research on registered psychologists’ knowledge of andattitudes toward Animal-Assisted Therapy (AAT) is virtually nonexistent.Aim: To explore Australian psychologists’ knowledge of and attitudes towardAAT.Materials and Methods: This paper presents a thematic analysis of qualitativedata collected from 9 psychologists speaking about AAT during individualinterviews.Results: The first research question explored psychologists’ knowledge of AATand identified 3 key themes: AAT use across the client lifespan in varioushealth settings; training is inadequate; and efficacy studies are lacking. Thesecond question exploring psychologists’ attitudes towards AAT identifiedfurther themes: AAT enhances therapeutic relationships; AAT used purpose-fully or incidentally is effective; and there are barriers to AAT implementation.Conclusion: Whilst AAT is deemed to be a useful intervention by somepsychologists, its evidence base and training in such interventions are lacking.

Introduction

Companion animals are a feature of modern Australianlife. In a 2009 telephone study of 884 households inSydney, respondents indicated that approximately 66%of them lived with an animal. The most frequentlyowned animal was a dog, followed by a cat, a fishor a bird, with some households including multipleanimals of various types (Toribio et al., 2009). Animalsplay an important role in peoples’ lives, and resear-chers have investigated the physical and mentalhealth benefits of interaction with a companion animal

(for a recent review, see Barker & Wolen, 2008). Resear-chers have also considered whether animals providebenefits in therapeutic settings (Nimer & Lundahl,2007).

Animal-assisted therapy (AAT) is relatively new to thepsychological literature, yet the concept it encompasseshas been relevant in various health care settings formany years (Nimer & Lundahl, 2007). The study reportedin this article focuses on Australian psychologists’knowledge of and attitudes towards AAT.

Psychologists’ Knowledge of AAT

When animals were first introduced to health caresettings, they were generally brought for visits thatwere incidental to the treatment programme (Barker &Dawson, 1998). This is known as “animal-assisted activi-ties” (AAA). Purposeful therapeutic use of animals(referred to as “animal-assisted therapy” (AAT)) began inthe 1970s and snowballed in the 1980s, in the USA but toa lesser extent in Australia. The 1990s saw publications ina variety of journals (animal studies, law enforcement,social work, gerontology, nursing, and health services),but comparatively little appears in academic clinicalpsychology journals (Phillips-Parshall, 2003).

Key Points

1 Research on registered psychologists’ knowledgeof and attitudes toward Animal-Assisted Therapy(AAT) is virtually nonexistent.

2 Whilst AAT is deemed to be a useful intervention bysome psychologists, its evidence base and training insuch interventions are lacking.

Funding: None.Conflict of Interest: None.

Clinical Psychologist 15 (2011) 69–77

© 2011 The Australian Psychological Society 69

Currently, relatively few AAT studies provide clearoperationalisations of process and outcome variables,mechanisms, baseline and long-term follow-up data, andcontrol and comparison treatment groups (Fine, 2006).Compelling anecdotal reports however, suggest thatsome psychologists believe AAT to be effective in clinicalpractice. Given the large number of people who findanimals important to physical and/or psychological well-being, and the growing recognition of the importance ofthe human–animal bond (Walsh, 2009), it is understand-able that some psychologists might be convinced in ageneral sense that AAT is helpful without having a clearconceptualisation of what it is or why it may work. Nimerand Lundahl (2007) argue that practitioners interested inAAT appear to rely on anecdotal reports or case studies toreinforce their attitudes about the value of AAT. Healthprofessionals with sceptical views of AAT, and adminis-trators of budgets who might fund AAT interventions orresearch, may require a higher standard of evidence thananecdotal reports to begin to support the use of AAT.

In the USA, professionalism (registration and trainingof the human–animal partners) has increased greatly.Practical advice has been widely disseminated and ethicalstandards for the use of animals have been refined.Although there is a growing body of literature on thehuman–animal interactions in some Australian uni-versities (http://health.adelaide.edu.au/psychiatry/links/HARG/; Monash University; University of Queensland),little is known about AAT and it remains a fringe areain psychology in Australia. The Australian PsychologicalSociety’s Psychologists for the Promotion of AnimalWelfare (http://www.groups.psychology.org.au/paw/) isone group including members of the profession inter-ested in AAT.

As in the USA, it is likely that some Australian psy-chologists utilise AAT. While the American work isimportant, and some of these data can be generalised,there may be cultural variations, but this has not beenempirically explored. Moreover, Australian and interna-tional literature is virtually non-existent about thetherapist–animal–client relationship or how therapistsachieve good animal–client communication. It is notclear what communication and counselling skills trainingtherapists currently do (or should) receive in AAT, eitheras students or through continuing professional devel-opment. Training programmes in AAT are not readilyavailable in Australia.

Psychologists’ Attitudes Towards AAT

A handful of studies surveyed the attitudes towards AATof nursing home staff (Crowley-Robinson & Blackshaw,1998) and occupational therapists (Velde, Cipriani, &

Fisher, 2005). Staff perceived that AAT influencedpatients’ motivation to attend therapy sessions and facili-tated social interaction when an animal was introduced.In one quantitative pre-post-study of health profession-als’ attitudes towards AAT in Australia (Moody, King, &O’Rourke, 2002), staff expressed the view that the com-panion animal visits would distract children from theirillness and relax them, and also that the work environ-ment was happier and more interesting. However, it mustbe noted that post-implementation, only 45 of the 225initial participants responded, and further, the durationof the intervention was not provided and a control groupnot used, meaning that the results must be viewed withcaution.

Definition and Settings of AAT

AAT interventions are becoming increasingly common,particularly in the USA (Fine, 2006). Programmes arebeing offered in a variety of settings including hospitals,acute and critical care units, nursing homes, hospices,psychiatric facilities, prisons, oncology units, private psy-chotherapy clinics, and rehabilitation facilities (Connor &Miller, 2000). The Delta Society (2006), a leading inter-national organisation and training facility in AAT, states:“AAT is a goal directed intervention in which an animalthat meets specific criteria is a vital part of the treatmentprocess” (p.2). AAT is directed and/or delivered by ahealth/human service provider working within the scopeof his/her profession. During interventions, therapistskeep records and evaluate client progress (Delta Society,2006). The aim of AAT interventions varies but is gener-ally associated with improvement in human physical,social, emotional, and/or cognitive functioning. Dogsare the most widely used therapy animals, but othertypes of animals include cats, elephants, birds, dolphins,rabbits, guinea pigs, and horses (Vidrine, Owen-Smith &Faulkner, 2002; Fine, 2006). AAT theory postulates thatanimals have a natural tendency to create a bond withpeople, and a good therapy animal will seek affection andinteraction with the client (Fine, 2006; Nimer & Lundahl,2007).

Relevance of AAT forClinical Psychology

AAT is generally used as a supplement or in conjunctionwith other interventions (Fine, 2006). For a practitionerhaving difficulty engaging with a client, incorporatinga therapy animal in the treatment programme mighthelp build the therapeutic relationship (Mallon, 1992;Voelker, 1995; Fine, 2006). Beck, Hunter, and Seraydarian(1986) suggest that a practitioner who conducts therapy

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© 2011 The Australian Psychological Society70

with an animal present may appear less threatening, andconsequently, the client may be more willing to revealhim/herself.

A recent meta-analysis of AAT (Nimer & Lundahl,2007) associated it with moderate effect sizes in imp-roving outcomes in five areas: autism spectrum symp-toms (Redefer & Goodman, 1989), medical conditions(Havener et al., 2001), compromised mental functioningin elderly patients with dementia (Kanamori et al.,2001), behavioural problems (Nagengast, Baun, Megel, &Leibowitz, 1997), and physical problems (Nathanson,de Castro, Friend, & McMahon, 1997). Outcomes wereassociated with increased verbal interactions betweengroup members, increased attention skills, developmentof leisure/recreation skills, increased self-esteem, andreduced anxiety and loneliness (Nimer & Lundahl, 2007).

Nimer and Lundahl (2007) found that the most meth-odologically rigorous evidence came from four studiescomparing AAT with other treatments in a psychiatricinpatient setting (Haughie, Milne, & Elliot, 1992; Marret al., 2000) and a long-term residential facility (Bern-stein, Friedmann, & Malaspina, 2000). When comparedto other therapy groups, AAT was associated withincreased displays of happiness, desirable social interac-tion patterns, and motivation to attend AAT therapysessions.

Aims for the Present Study

In Australia, to the best of the authors’ knowledge, thereare no providers who offer a formalised service in AAT.AAT appears to be utilised in various clinical mentalhealth settings in the UK and the USA thus it is likely thatsome psychologists in Australia use AAT. However, thereis no published literature about Australian psychologists’knowledge of AAT, nor is there any in-depth researchinto their attitudes towards AAT. The present studyaims to address this gap, using qualitative methodologyaddressing two specific research questions:1. What do psychologists know about AAT?2. What attitudes do psychologists hold towards AAT?

Method

Participants

As a qualitative study, the aim was to explore a smallnumber of cases in depth. Using an opportunistic sam-pling strategy, registered psychologists willing to discusstheir knowledge of and perceptions of AAT wererecruited through the Australian Psychological Society’sweb site. An advertisement was posted seeking registeredpsychologists who were willing to be interviewed. Vol-

unteers received no remuneration for their participation.Of the nine people who responded to the call for partici-pation, seven were registered psychologists in Australia:The remaining two were psychology graduates undergo-ing an approved pre-registration training and supervisionprogramme. All respondents were female. Seven partici-pants were employed in metropolitan areas of Australiancities, one was working in a rural area, and one workedin both metropolitan and rural areas. Participants workedwith adults, children, and families. At the time of theinterviews, five of the participants used AAT in theirclinical practice or training. Three participants owned andworked with dogs and two owned and worked withhorses.

Procedure

The University of Adelaide Human Research Ethics Com-mittee approved the project. The respondents werelocated in various states of Australia, therefore all but oneinterview (face-to-face) was conducted over the tele-phone. Each participant was given an information sheet,which explained the purpose of the research and invitedparticipation in the study. Prior to the interview, eachrespondent gave verbal informed consent to participate.

Content of Semi-structured Interview

Initial demographic questions were asked regarding reg-istration status, current employment, client populations,and location of employment (metropolitan, rural, semi-rural). The topic of the interview was “animal-assistedtherapy” and contained two specific research questions:(1) What do you know about animal-assisted therapy?(What research they were familiar with includingpast/present and overseas/within Australia, how theydefined/understood AAT, whether they currently used/previously used AAT, whether colleagues currently used/previously used AAT, how AAT was implemented/usedand knowledge of training programmes in Australia/overseas); and (2) what is your attitude towards animalassisted therapy (discussion of personal and perceivedsocial meanings, why they did/did not use AAT includingperceived barriers/benefits)?

Respondents were encouraged to give specificexamples, but minimal prompts were given so that theycould express anything that they felt was important inthe interview. However, three direct prompts were givenduring the interviews: (1) What training are you aware ofin AAT?; (2) what prompted you to respond to the adver-tisement for this research on the APS web site; and (3)was there anything else you think we should know, orcould you flag what are the most important issues?

Psychologists and animal-assisted therapy


Data Analysis

Interviews lasted between 19–69 min. Data were audio-taped and transcribed verbatim. Data were analysedusing the thematic analysis procedure described by Braunand Clarke (2006). Inductive and deductive methodswere used to identify themes. Transcripts were read care-fully to identify meaningful units of responses relevant tothe research topic. Next, units of responses dealing withthe same issue were grouped together in analytic catego-ries and given provisional labels. The same unit ofresponse could be included in more than one category.The data were then systematically reviewed to ensurethat a label, definition, and exhaustive set of data tosupport each category were identified. Themes wereidentified to answer the research questions — thus,nature of the theme overrode prevalence. The analysisresulted in a group of three key themes for researchquestion one, and three key themes for research questiontwo. The second author reanalysed the data. Any discrep-ancies found between the two analyses were discussed,resulting in consensus of the final key themes. Saturationof data in qualitative research refers to the point when nonew thematic material arises (Pope & Mays, 2006). Datasaturation was achieved at the eighth interview. Afurther ninth interview was conducted to ensure that thiswas the case.

Results

Overall, whether they currently used AAT or not, partici-pants emphasised that they wanted to increase theirawareness of AAT approaches either through training orprofessional development activities, as well as wantingmore evidence relating to efficacy of AAT in clinicalinterventions.

Psychologists’ Knowledge of AAT

In response to the first research question, “What is yourknowledge of AAT?”, analysis and interpretation ofresponses yielded three key themes: (1) AAT is usedacross the client lifespan in various health settings; (2)training is inadequate; and (3) efficacy studies are lacking.

AAT Is Used Across the Lifespan inVarious Settings

Both users and non-users of AAT expressed some knowl-edge about the physical health and/or psychological ben-efits of companion animals in general and for people ofall ages. Users and non-users talked about health benefitsfrom a companion animal’s presence lowering blood

pressure and psychological benefits from stroking a com-panion animal to reduce anxiety or stress. The majority ofusers and non-users were also aware of AAT assistingchildren in schools with autism spectrum symptoms,attention deficit hyperactivity disorder, and social skillstraining.

Non-users of AAT often described their knowledge ofthe informal or unstructured use of AAT such as visitingpet services for elderly people in nursing homes, andanimal visitation programmes for schools, rehabilitationcentres, and hospitals.

Non-users of AAT generally could not recall where theygained their knowledge about AAT. Often, their sources ofknowledge were television programmes, radio or news-paper articles, not academic journals or publications.

Users of AAT gave more specific examples of theirknowledge of human–animal interactions from empiricalresearch resources. It was emphasised however that valu-able knowledge was gained from personal experience.This suggests that knowledge gained from empiricalresearch was supplemental to knowledge gained frompractice-based evidence. AAT was described as being usedin psychologists’ private practice, with children andadults in both structured and unstructured ways.

Users and non-users of AAT stated that they knewabout the importance of companion animals to theirclients. All were aware that companion animals wereoften regarded as family members to their clients:

I certainly feel that people have a huge attachment totheir pets and that some people, uh are not obsessive,but consider them a part of their family you know, theytalk about them like other people might talk abouttheir children (ID:5, L:29).

Both users and non-users commonly referred to thevalue of their own companion animals, and someencouraged clients to own one. Non-users often incorpo-rated a client’s companion animals into a therapy plan orsession agenda:

. . . it might be to walk the dog or spend time with thepet or something like that. (ID:6, L:87)

Non-users identified companion animals as sources ofsocial support, providing a function similar to that of aclient’s family member or friend. This suggests that psy-chologists actively drew upon the importance of compan-ion animals to their clients to help clients work towardstherapy goals.

Training Is Inadequate

Users and non-users emphasised their willingness tolearn more about AAT. For non-users of AAT, this was

Black et al.


unsurprising, as the majority reported that part of theirmotivation for participation in this study was to learnmore about it. For users of AAT, one might expect thatthey would possess sound knowledge of current researchin the field and/or undertaken training in AAT. However,this was not always the case. Specific knowledge aboutAAT was gained primarily as a result of personal experi-ence, observations made in private practice over time andself-motivated research, rather than completion of train-ing programmes. Two users were trained in AAT withhorses; the other three reported having no training.

Paradoxically, both users and non-users perceived thatthe level of knowledge and expertise required in AAT wasimportant. Most users of AAT emphasised the importanceof level of training in AAT, with topics including speciesawareness and the “psychology of animals” (ID:3, L:180)as well as certification of any animals used. In contrast,non-users indicated that AAT training would be prefer-able to no training. Guide dog instructors were known totrain therapy dogs and were the only regular providersseen to have a “sense of people becoming engaged in themechanics of the relationships between people andanimals” (ID:2, L:97).

The absence of formal training programmes suggeststhat users were forced to teach themselves AATapproaches: “The research I’ve done, all of it’s self-taught,I’ve gone to every conference I can find, I’ve spoken toevery person I can get my hands on” (ID:3,L:83). In somecases, this was achieved in an ad hoc manner. Inadequacyof training programmes in AAT, it was suggested, mightindicate a lack of interest by mainstream clinical psychol-ogy networks in Australia.

Lack of Efficacy Studies

Non-users of AAT knew little about the empirical evi-dence of AAT’s efficacy: “You know I could sort of see thisbeing a trend that comes in, it’s really nice and people feelgood about it, but does it actually really work?” (ID:6,L:224). There was discussion about knowledge of mea-suring change and progress in AAT interventions, andthat longitudinal studies were needed to evaluate long-term therapeutic change. Another important factor raisedby users of AAT was to clarify and raise awareness aboutthe specific mechanisms of AAT in future research.This indicates that users and non-users of AAT lackedawareness of the evidence-based research regardingAAT’s efficacy.

Psychologists’ Attitudes Towards AAT

The lengthiest responses by participants were given to thesecond research question: “What is your attitude towards

AAT?” Whether psychologists currently used AAT or not,all openly discussed their individual thoughts, feelings,perceptions, and beliefs about AAT. Analysis of theseresponses resulted in three key themes: (1) AATenhances therapeutic relationships; (2) AAT used pur-posefully or incidentally is effective; and (3) there arebarriers to AAT implementation.

AAT Enhances Therapeutic Relationships

Both users and non-users emphasised the value ofanimals in engaging with their clients. With a companionanimal present, all believed that they were able to estab-lish rapport and build trust more quickly, than when ananimal was not present. Dogs were most frequently men-tioned as therapy animals; however, other companionanimals including cats, guinea pigs, horses, or snakeswere mentioned. One non-user, sceptical of AAT’sbenefits, nonetheless perceived companion animalsenhanced a therapist–client relationship. Another non-user of AAT identified the relevance of companionanimals in clinical interventions.

Users of AAT believed that companion animals wereintegral to the therapeutic relationship. While talkingtherapy was purported as an important factor, users ofAAT insisted that companion animals offered a uniqueand experiential dimension to therapy. Companionanimals were believed to communicate unconditionalpositive regard for clients, offering and reciprocatingaffection and providing warmth and soft touch in a waythat the psychologist could not.

Users and non-users of AAT believed that the presenceof a companion animal might enhance the therapeuticrelationship by providing an opening for clients to discussmore difficult emotions or topics. Users and non-usersperceived that a companion animal’s presence mightassist children or adolescents who have difficulty verbal-ising emotions, enabling them to deal with intense emo-tions. By shifting focus onto the companion animal, non-users believed that communication with younger clientsmight be more effective. This suggests that althoughother factors do influence the therapeutic relationship,for these psychologists, the animal–client–therapist rela-tionship was paramount in creating a non-threateningatmosphere, as well as facilitating openness anddiscussion.

AAT Used Purposefully or IncidentallyIs Effective

This theme depicts AAT as being an effective treatmentmodality used either purposefully (i.e., clinical interven-tion with deliberate use of companion animals) or



incidentally (i.e., clinical intervention with unplanneduse of companion animals). Users of AAT perceived it aseffective in the treatment of specific phobias. Holding,patting, or stroking a companion animal was seen aseffective in helping children regulate emotions and self-soothe.

Users and non-users perceived AAT as a creative inter-vention. Users of AAT argued that it worked well withchildren experiencing behavioural problems and inatten-tion: “I tried all sorts of things, you know furry animalsand stuff, and he just wasn’t interested; but put him onthe horse and he was calm and focused and very happy”(ID: 8, L:108).

Users of AAT perceived that companion animals possessinsight into themselves and others. Thus, the importanceof working collaboratively with companion animals wasemphasised: “Horses are part of a therapeutic team, not atool, they are co-therapists” (ID:9, L:35). Some usersviewed companion animals as a “diagnostic” (ID:1, L: 44)tool, able to detect and reflect a client’s current emo-tional state. Non-users of AAT predicted companionanimals to be a useful tool, while users of AAT describedcompanion animals as a natural adjunct to therapy.

Users insisted purposeful use of AAT with horses waseffective as it enabled clients to use the metaphor of thehorse and relate it to real life: “Oh that horse is myhusband or gee that pony’s my Dad” (ID:8, L:42), high-lighting family dynamics with a herd of horses, “That’swhen it starts to become powerful” (ID:8, L:42).

This theme suggests that companion animals were seenas active participants in the therapeutic process. Theywere deemed able to detect emotions and environmentalstressors that a client might be experiencing, withoutprompting from psychologists. Users did not emphasisethat their companion animals were formally trained inperceiving human emotion or human needs as a workinganimal like a guide dog might. Thus, for users of AAT,it was assumed that companion animals possessed cer-tain skills and abilities similar to that of their humanco-therapists.

In cases where AAT was used incidentally (i.e., clinicalintervention with unplanned use of companion animals),non-users perceived that the presence of a companionanimal benefitted clients. Non-users noticed an increasein clients’ self-esteem: “Me making a fuss of the dog, it’salmost an ego booster for the client because it’s their dog,it’s a reinforcement of the positive things about them”(ID:6, L:63). Non-users also perceived that companionanimals were an effective distraction from awkwardmoments during therapy sessions.

Users described that purposeful use of companionanimals also had unexpected outcomes for their clients.Purposeful use of AAT in schools assisted with school

refusal: “They’re always there on the day they knowyou’re coming” (ID:3, L:68). Benefits for users of AATwere described from incidental use of companionanimals: “. . . they are therapists, you know I think thatthey support me in my work, they provide me with anurturing component, for clients as well as therapists,from having them around” (ID:4, L:190). This themesuggests that AAT used purposefully or incidentally yieldspositive outcomes, regardless of psychologists’ generalattitude towards AAT.

Barriers to AAT Implementation and Use

Users and non-users believed there were numerous bar-riers to successful AAT interventions. Duty of care includ-ing to the client was of central importance and perceivedas a major barrier. This suggests that psychologists werecommitted to adhering to professional practice standardsand responsibilities of causing no harm to clients. Non-users of AAT emphasised client safety and risk being abarrier to them using AAT in the future. They talkedabout temperament of the companion animal, ratherthan breed, as a potential problem: “I mean even the besttrained dog is not 100%” (ID:6, L:181). Indemnity insur-ance was perceived as a barrier to AAT use, as well aslegal issues, for example, if the client was bitten or had anallergic reaction. Users of AAT talked about fewer risks toclient safety. They expressed that risks were often exag-gerated, but mentioned it was important to manage risk.

Users and non-users of AAT perceived that organisa-tional attitudes towards AAT were a barrier to implemen-tation. Organisational perceptions of AAT being viewedas a novelty meant that applications to use AAT wereoften rejected. When asked what were perceived barriersto implementing AAT in schools for example, one userresponded:

Oh it’s too hard, it’s too litigious, it’s not therapeuticenough . . . so a lack of understanding and a fear ofyou know, the litigation or risks of having an animal onsite (ID:3, L:159).

Users of AAT expressed that other health professionals’attitudes towards AAT or companion animals in generalwere a potential barrier to use. “I think there’s a lot ofpeople within our profession for example that do notnecessarily value, or discount how much positive influ-ence it can have” (ID:4, L:88). Forming networks withother psychologists and exchanging ideas, was regardedas especially important in overcoming perceived barriersand gaining acceptance from governing bodies and rel-evant organisations.

When questioned on motivation to participate in thepresent study, one user explained that it gave her an

Black et al.


opportunity for sharing knowledge with others in thefield and that having social support helped justify currentwork.

Some users expressed that they were motivated toparticipate in the present study because of a vestedinterest in the promotion of AAT in mainstream psychol-ogy. This interrelates with notions of a lack of support asa possible barrier to implementation and use. Both usersand non-users mentioned that having formal supportwould enhance recognition and increase knowledgein AAT, subsequently improving work conditions forpsychologists using AAT.

Animal welfare was frequently emphasised by themajority of users and non-users of AAT as a barrier. Fornon-users, concern for animal welfare was one reasonpreventing them using AAT in the future. Regardingissues of animal welfare, companion animals were per-ceived to experience emotional exhaustion and bothusers and non-users were concerned that the animalmight become overworked, stressed or experiencevicarious trauma.

Another perceived barrier to AAT’s efficacy was in rela-tion to attachment and the therapeutic relationship. Non-users emphasised the importance of setting boundariesaround clients interacting with therapy animals, particu-larly for clients experiencing abandonment or depen-dency issues: “I could imagine for some clients say mightbecome overly attached to the dog, and might makeclosure and separation more difficult for them” (ID:6,L:218). Non-users perceived that companion animalsmight be a potential distraction, rather than facilitatingan atmosphere of exploration into more challengingemotions.

Lastly, the lack of availability of training for psycholo-gists in AAT was highlighted as a barrier to use. Whenasked about their views on AAT training options in Aus-tralia, users claimed that training programmes weregenerally inaccessible, expensive, and unsatisfactory. Atypical response was: “Well it just hasn’t been adequate,I’m sort of not aware of any formal channels at this stageand I would access them I’m sure if it was available”(ID:4, L:84).

Discussion

Three interrelated themes emerged from the data, whichanswer the first research question of psychologists’knowledge of AAT: AAT is used across the lifespan invarious clinical settings; training is inadequate; and effi-cacy studies are lacking. The second research question ofpsychologists’ attitudes towards AAT also yielded threeinterrelated themes from the data: AAT enhances thera-

peutic relationships, used purposefully or incidentally;AAT is effective; and there are barriers to AAT implemen-tation and use.

The data show that there were few differences betweenusers’ and non-users’ perceptions of AAT. Users of AATwere more informed about AAT’s processes and mecha-nisms and were convinced of AAT’s efficacy more sothan non-users. However, overall, participants’ attitudestowards AAT were not vastly different from one another.

The finding that psychologists in Australia currently useAAT in various clinical settings replicates previous findingsin the USA (Connor & Miller, 2000). However, it is note-worthy that psychologists provide this service withoutformal training. This study has identified the need for astructured, accredited training programme in AAT in Aus-tralia, ideally aimed at psychologists and including topicssuch as animal handling and species awareness. The needfor training for psychologists and improved evidence basefor AAT has implications for client care and treatment,professional development, and animal welfare.

The data suggest that psychologists’ knowledge of effi-cacy studies were lacking. Despite this, AAA and AAT arecurrently used in Australia, by registered and traineepsychologists in both private and public mental healthsettings.

The data reveal gaps in current understandings aboutinformed consent in relation to AAA and AAT. There wasvirtually no discussion about informed consent, suggest-ing that psychologists using animals assume that theclients want this service and that the client concerned hassome affinity with the species of animal being employedfor the purpose. Furthermore, measuring therapeuticoutcomes were briefly mentioned, and they were infor-mally assessed or observed.

In this study, companion animals were viewed by someparticipants as co-therapists. Companion animals wereargued to possess insight into human emotion and behav-iour and they provided comfort and emotional support.Companion animals were considered a useful screeningtool, alerting psychologists to a client’s emotional state:They were active participants in the therapeutic process.

Psychologists frequently referred to the importance ofcompanion animals to their clients and to themselves.Psychologists also perceived that their colleagues ben-efited from the presence of companion animals in theworkplace. Companion animals offered a form of socialsupport, comfort and alleviated work stress. It might bethat working with animals has an incidental positiveoutcome: alleviating work stress. However, the data alsoidentified that organisational perceptions and lack ofsocial support were barriers to such interventions. Thus,the attitudes and experiences of health care professionalsare also important to explore.



It is of concern that participants did not follow thescientist–practitioner model in which they have beentrained, to collect evidence for their treatments and tokeep abreast of the current literature in the area. It is wellknown that the scientist–practitioner model is an idealnot actually used as intended by its proponents (Shapiro,2002; Wampold, 2001). Trainees and practicing psycholo-gists often express reservations about the scientist–practitioner model. They cite a divide between researchand practice: Much research is seen as inapplicable toclinical practice (Shapiro, 2002).

There are several limitations to this research. Relyingon a volunteer sample might mean that we accessed onlythose psychologists who have a specific interest in AATand/or an affinity for animals in general. When askeddirectly, the psychologists in our study offered variousreasons for participation, such as offering collegialsupport. Promotion of AAT to the mainstream psychol-ogy community was occasionally mentioned, but was notan exclusive motivation for participation. The findingscannot be generalised to all registered psychologists inmainstream clinical psychology in Australia. Moreresearch is needed to explore the ways in which knowl-edge of and attitudes towards AAT might intersect withother individual differences, ethnic background, person-ality characteristics, and gender.

The qualitative descriptions offered by the participantsin the present study are illuminating. This research isnecessarily exploratory in nature as there are no quanti-tative data available regarding psychologists’ knowledgeof and attitudes towards AAT in Australia or otherWestern countries. Further study is required to elicitviews and accounts of psychologists Australia wide, usingquantitative measures with questionnaire items devel-oped from the themes in the present study, so that arepresentative sample’s views can be obtained to furtherour understanding of psychologists’ knowledge of andattitudes towards AAT.

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Documents

Australian psychologists' knowledge of and attitudes towards animal-assisted therapy