Handbook on Animal-Assisted Therapy, Fourth Edition: Foundations and Guidelines for Animal-Assisted Interventions

418 Pages·2015·7.51 MB·English

by  Aubrey H. Fine

Handbook on
Animal-Assisted
Therapy
Foundations and Guidelines for
Animal-Assisted Interventions
Fourth Edition
Edited by
Aubrey H. Fine
Department of Education
California State Polytechnic University, Pomona, CA, USA

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Dedication
This book is dedicated to many:
The book is dedicated to all my human and nonhuman children. All of you have blessed my life and
collectively have made me a better person.
The book is dedicated to my children Sean, Corey, and Nelli. I also want to dedicate this book to all the therapy
animals I have worked with over the years especially to PJ, Sasha, Puppy, Shrimp, Hart, Magic, Ketzy,
Tikvah, Snowflake, Houdini, and Spikey.
This edition is dedicated to all of my colleagues who have contributed to this volume and
previous editions. Your work and your trail blazing efforts have moved animal-assisted interventions
into its new future.
Finally, this book is dedicated to my wife Nya who has shared my love with companion animals and
has enriched and bettered my life.
Contributors
Barbara N. Abrams High Hopes, Old Lyme, CT, USA Aubrey H. Fine Department of Education, California State
Polytechnic University, Pomona, CA, USA
Julia Albright Department of Veterinary Medicine,
University of Tennessee College of Veterinary Medicine, Lisa S. Freund National Institute of Child Health and
Knoxville, TN, USA Human Development, National Institutes of Health,
Rockville, MD, USA
Phil Arkow The National Resource Center on The Link
Between Animal Abuse and Human Violence, Harcum Erika Friedmann University of Maryland School of
College and Camden County College, Stratford, NJ, Nursing, Baltimore, MD, USA
USA
Nancy R. Gee Human-Animal Interaction, WALTHAM®
Dan Bayly Department of Educational Leadership and Centre for Pet Nutrition, Freeby Lane, Waltham-on-
Counseling Psychology, Washington State University, the-Wolds, Leicestershire, UK
Pullman, WA, USA
Julia Gimeno Department of Psychiatry and Behavioral
Alan M. Beck Center for the Human-Animal Bond, Medicine, Stanford University, Stanford, CA, USA
College of Veterinary Medicine, Purdue University, Ken Gorczyca Pets Are Wonderful Support, San Francisco,
West Lafayette, IN, USA CA, USA
Andrea Beetz Department of Behavioral Biology, University Temple Grandin Department of Animal Science, Colorado
of Vienna, Vienna, Austria; Department of Special State University, Fort Collins, CO, USA
Education, University of Rostock, Rostock, Germany
James A. Griffin National Institute of Child Health and
Ann Berger National Institutes of Health, Bethesda, MD, Human Development, National Institutes of Health,
USA Rockville, MD, USA
Jessica Bibbo Research Center for Human-Animal Lynette A. Hart Department of Population Health
Interaction, College of Veterinary Medicine, University and Reproduction, School of Veterinary Medicine,
of Missouri, Columbia, MO, USA University of California, Davis, CA, USA
Christine M. Bowers Department of Psychology, California Harold Herzog Department of Psychology, Western
State Polytechnic University, Pomona, CA, USA Carolina University, Cullowhee, NC, USA
Regina Bures National Institute of Child Health and Karyl J. Hurley Mars Petcare, Global Scientific Affairs,
Human Development, National Institutes of Health, McLean, VA, USA
Rockville, MD, USA
Brinda Jegatheesan Educational Psychology, Early
Gretchen Carlisle Research Center for Human-Animal Childhood & Family Studies, University of Washington,
Interaction, College of Veterinary Medicine, University Seattle, WA, USA
of Missouri, Columbia, MO, USA Molly A. Jenkins American Humane Association, Humane
Susan P. Cohen Pet Decisions, Boerum Hill, Brooklyn, Research and Therapy, Washington, DC, USA
NY, USA Rebecca Johnson Research Center for Human-Animal
Interaction, College of Veterinary Medicine, University
Molly K. Crossman Department of Psychology, Yale
of Missouri, Columbia, MO, USA
University, New Haven, CT, USA
Michael E. Kaufmann Green Chimneys Children’s
Erica Elvove Institute for Human-Animal Connection,
Services, Brewster, NY, USA
Graduate School of Social Work, University of Denver,
Denver, CO, USA Alan E. Kazdin Department of Psychology, Yale
University, New Haven, CT, USA
Layla Esposito National Institute of Child Health and
Human Development, National Institutes of Health, Miyako Kinoshita Green Chimneys Children’s Services,
Rockville, MD, USA Brewster, NY, USA
xvii
xviii Contributors
Katherine A. Kruger WALTHAM® Centre for Pet Jennifer A. Pearson Graduate School of Social Work &
Nutrition, Freeby Lane, Waltham-on-the-Wolds, Institute of Human-Animal Connection, University of
Leicestershire, UK; University of Pennsylvania School Denver, Denver, CO, USA
of Veterinary Medicine, Center for the Interaction of
Jose Peralta Western University of Health Sciences
Animals and Society (CIAS), Philadelphia, PA, USA
College of Veterinary Medicine, Pomona, CA, USA
Donna Latella Occupational Therapy Department,
Allie Phillips National District Attorneys Association,
Quinnipiac University, Hamden, CT, USA
Alexandria, VA, USA; National Center for Prosecution
Teal Mackintosh Clinical Psychology, Stanford, CA, USA of Animal Abuse, Alexandria, VA, USA; Center for
Prosecution of Child Abuse, Alexandria, VA, USA
Maureen MacNamara Department of Social Work,
Appalachian State University, Boone, NC, USA Samuel Ross Jr. Green Chimneys Children’s Services,
Brewster, NY, USA
Patricia McConnell Department of Zoology, University of
Wisconsin–Madison, Madison, WI, USA Andrew N. Rowan Humane Society of the United States,
NW Washington, DC, USA
Amy McCullough American Humane Association, Humane
Research and Therapy, Washington, DC, USA Mudasir Saleem University of Maryland School of
Nursing, Baltimore, MD, USA
Sandra McCune WALTHAM® Centre for Pet Nutrition,
Freeby Lane, Waltham-on-the-Wolds, Leicestershire, UK Sabrina Schuck University of California, School & Early
Intervention Programs, Pediatrics and Psychology and
Gail F. Melson Department of Human Development and
Social Behavior, Irvine, CA, USA
Family Studies, Purdue University, West Lafayette, IN,
USA James A. Serpell Department of Veterinary Medicine,
University of Pennsylvania, Philadelphia, PA, USA
Jeannine Moga Family and Community Services, College
of Veterinary Medicine, Veterinary Hospital, North Meredith L. Sisa Graduate School of Social Work,
Carolina State University, Raleigh, NC, USA University of Denver, Denver, CO, USA
Megan K. Mueller Cummings School of Veterinary Perry Skeath Arizona Center for Integrative Medicine,
Medicine at Tufts University, North Grafton, MA, USA Tucson, AZ, USA; Department of Medicine, University
of Arizona College of Medicine, Tucson, AZ, USA
Zenithson Ng Department of Veterinary Medicine,
University of Tennessee College of Veterinary Medicine, Heesook Son Department of Veterinary Medicine, Chung-
Knoxville, TN, USA Ang University, Seoul, Korea
Dana O’Callaghan Counseling Department, Palomar Philip Tedeschi Graduate School of Social Work &
College, San Marcos, CA, USA Institute for Human-Animal Connection, University of
Denver, Denver, CO, USA
Marguerite E. O’Haire Department of Psychology,
Center for the Human-Animal Bond, College of Dennis C. Turner Private Faculty member (PD), Vetsuisse
Veterinary Medicine, Purdue University, West Lafayette, Faculty Zurich, Switzerland, Institute for Applied
IN, USA Ethology and Animal Psychology I.E.A.P., Horgen,
Switzerland
Meg Daley Olmert Warrior Canine Connection, Inc.,
Brookeville, MD, USA Risë VanFleet Family Enhancement & Play Therapy
Center, Boiling Springs, PA, USA
Christopher Pachel Animal Behavior Clinic, Portland,
OR, USA Mariko Yamamoto Teikyo University of Science, Uenohara,
Yamanashi, Japan
Nancy Parish-Plass University of Haifa Graduate School
of Social Work; “Ahava” Emergency Center for At-Risk Rick Yount Warrior Canine Connection, Inc., Brookeville,
Children, Haifa, Israel MD, USA
Foreword
The book that you are holding is a compendium, containing data, theory, and guidelines for the practice of what has come
to be known as Animal Assisted Therapy (abbreviated as AAT). This is defined as a form of therapy that involves using an
animal as a fundamental part of a person’s treatment. Although the most common form of animal used is the dog, followed
by cats, many kinds of animals have been used in therapy, mostly small animals (rabbits, birds, fish, gerbils), but some large
animals have been employed (mostly horses), and some exotic species (e.g., elephants, dolphins, lizards).
The range of problems that animal-assisted therapy has addressed is quite broad. While most people are aware of
assistance animals, such as guide dogs for the blind, hearing assistance dogs, handicap assistance dogs, and more recently
seizure alert and seizure assistance dogs, the general public is only slowly coming to understand that animals can be used
to deal with a broad variety of psychological as well as physical problems. Most often animals are used to assist in prob-
lems involving emotional distress and/or general stress-related symptoms. When used in this context the animals are often
referred to as comfort animals. However, some animal interventions involve treatment of cognitive functioning, social
interaction problems, and even extreme conditions, such as autism. More recently the therapeutic use of animals has been
extended to educational settings, where the animal is used to improve motivation and focus the attention of children, as
demonstrated by several successful programs that utilize reading assistance dogs.
When I see a book like this, with all of its data, theory and practice information, I must admit that I have a feeling of
disbelief. This is not a disbelief in the validity of the data, or the success of animal assisted therapeutic interventions, but
rather a disbelief that this area has come to be accepted by mainstream psychological, educational, and medical researchers
and practitioners. This was not always so. My own first contact with this type of therapy actually led me to predict that such
endeavors would never come to pass.
Before we get to my experience, it is important to know that therapeutic use of animals has a long history. In ancient
Egypt, the city of Hardai was known as Cynopolis (city of dogs) because in its many temples dedicated to Anubis, the
dog-headed guide of the dead, dogs were used as offerings. However, dogs were also used in healing practices there. It
was believed being licked by a dog, especially in those areas of the body containing sores or lesions, could help to heal the
injury or cure the disease causing it. This practice was picked up by the Greeks, and temples dedicated to Asclepius, their
god of medicine and healing, often contained dogs trained to lick wounds. In the middle ages, Saint Roch was said to have
been cured of a plague of sores through being licked by his dog. The value of being licked by a dog is still believed by
many cultures to have curative powers. There is even a contemporary French saying, “Langue de chien, langue de médecin”
which translates to “A dog’s tongue is a doctor’s tongue.” Perhaps there is some validity to this since recent research has
shown that the dog’s saliva actually contains a number of antibacterial and antiviral compounds, as well as some growth
factors that may promote healing.
However, animal-assisted therapy today involves using them to assist in the healing of psychological and emotional
problems, rather than using animals as sources of antibiotics which are better obtained from pharmacological sources.
Here, again, we have historical antecedents. In the late 1600s, John Locke (who would introduce psychology to the concept
of association in learning) suggested that small pet animals aided in the social development of children, including the
development of empathy. In the nineteenth century, Florence Nightingale suggested that small pets relieved depression in
patients, especially for those with chronic conditions.
Still there were only little data, nor was there widespread acceptance of the fact that the presence of animals can
assist and improve psychological functioning. Instead there were many anecdotes that suggested that this might be the
case. For example, during World War II a Corporal William Wynne was recovering from wounds in an Army Hospital
in the Philippines. To cheer him up members of his company brought his Yorkshire Terrier, Smoky, to the hospital. The
effect was remarkable, and not only did Corporal Wynne’s mood improve, but it had a positive effect on the other injured
soldiers in the ward. The degree of psychological improvement impressed the Commanding Officer of the Hospital unit,
Dr Charles Mayo, who would later go on to head the now famous Mayo Clinic in Rochester, Minnesota. As a result he
decided to regularly take Smoky on his rounds in the military hospital to act as a living antidepressant for his patients.
xix
xx Foreword
In effect Smoky became a therapy dog, and as such he continued to be part of a visitation program for 12 years, well
beyond the end of World War II.
This brings us to my initial contact with the idea of animal-assisted therapy. It was quite early in my career, in the 1960s,
and I was attending the American Psychological Association meetings in New York. Because of my interest in dogs and
their relationship to humans, I was caught by the title of a talk to be given by a child psychologist, Boris Levinson, who
was at Yeshiva University. This would turn out to be the first formal presentation of animal assisted therapy given before
a national audience. Levinson was working with a very disturbed child and found, by chance, that when he had his dog
Jingles with him the therapy sessions were much more productive. Furthermore, other children who had difficulty commu-
nicating seemed more at ease and actually made real attempts at conversation when the dog was present. Levinson gathered
data from several such cases and this formed the basis of the paper that he presented at this APA meeting. The reception
of his talk was not positive, and the tone in the room did not do credit to the psychological profession. Levinson was dis-
tressed to find that many of his colleagues treated his work as a laughing matter. One even asked him what percentage of
the therapy fees he paid to the dog. This did not bode well for the future of such research and therapy, and I thought that it
was likely that I would never hear about such use of animals in therapeutic interactions again.
I might have been correct, except that a savior of this concept, whose voice could not be ignored by the psychologi-
cal community, essentially spoke from beyond his grave. At this point in time, it was only around 15 years after Sigmund
Freud’s death. Just by chance several new biographies of Freud’s life had recently been released. In addition translations of
many of his letters and journals were just being published in English. There were also new insights into Freud’s life coming
from books published by people who knew him, and some even described his interactions with his household full of dogs.
From these various sources, we learned that Freud often had his Chow Chow, Jofi, in his office with him, even during
psychotherapy sessions. The dog was originally in the room as a comfort to the psychoanalyst, who claimed that he was
more relaxed when the dog was nearby. However, Freud soon began to notice that the presence of the dog seemed to help
patients during their therapy sessions as well. This difference was most marked when Freud was dealing with children or
adolescents. It seemed to him that the patients seemed more willing to talk openly when the dog was in the room. They were
also more willing to talk about painful issues.
The positive results were not limited only to children, but also were seen in adults. The presence of the dog seemed
to make adults of both sexes feel more comfortable as well. During psychoanalysis, when the patient is getting near to
uncovering source of their problem there is often a “resistance phase,” as if the person was trying to defend themselves
from the psychological pain and deep emotions that exposing their repressed trauma might cause. In the resistance
phase the patient might become hostile, might stop actively participating in therapy, or might obviously be withholding
information. Freud’s impression was that the expression of this resistance was much less vigorous when the dog was in
the room.
When he began to observe the effects that the dog had on the therapy session, he speculated a bit as to the cause. In a
psychoanalytic session the patient is asked to free associate or simply say whatever comes into their mind. To facilitate
this, the patient is asked to stretch out on a couch and relax. The therapist sits behind the patient, out of his line of sight.
The reason is that this keeps the patient from watching the facial expressions of the therapist which might be interpreted
as disapproval or some other emotion. The idea is to let the patient freely follow their own patterns of association while
they work their way toward the source of their problem, rather than taking any indirect guidance from the therapist’s
responses. Now although the therapist is out of sight the dog is quite clearly in view, usually lying calmly and quietly
nearby. The dog appears to be unmoved by anything that the patient says, and nothing seems to shock the therapist’s
shaggy companion. Freud concluded that this gives the patient a sense of safety and acceptance. Even when the patient
describes very painful or embarrassing moments, the dog doesn’t react, except perhaps with a calm glance in the patient’s
direction. This gives the patient some confidence that all is well and anything can be expressed in this place. Thus the
dog provides a sense of reassurance. Freud recorded this information in his notes and it would eventually encourage the
systematic use of dogs in therapy.
From this newly available information it became clear that Freud had observed very much the same phenomena that
Levinson described, concerning those therapy sessions when he was treating children in the presence of his dog. When
Levinson and others learned about Freud’s experiences with this, it seemed like a form of certification. Levinson’s ground
breaking book on what he called “Pet-Oriented Child Psychotherapy” followed not long thereafter in 1969.
The climate had certainly now warmed. With evidence that Freud was willing to entertain the usefulness of animal
helpers in psychotherapy, and Levinson’s book collecting his case studies, the laughter stopped and some serious work
began. Psychiatrists Sam and Elizabeth Corson, were two of the first to formally use dogs in their treatment procedures,
when they opened the first pet assisted therapy program at a psychiatric unit at Ohio State University in 1977.
Foreword xxi
The ultimate validation of animal-assisted therapy, at least for those in the fields of mental health and behavior, would
come from the public health ecologist Alan Beck and the psychiatrist Aaron Katcher. They used direct physiological mea-
sures to show that when a person interacted with, or even was simply in the presence of, a friendly dog, there were direct
changes in their physiological responses. Breathing became more regular, heart beat slowed, muscles relaxed, and there
were other physiological changes suggesting a lowering of sympathetic nervous system activity. Since it is the sympathetic
nervous system which responds to stress, this indicated that the dog was clearly reducing the stress levels of the people in
its presence. There is a bias among psychological researchers, in that they tend to use physiological measures as if they are
the “gold standard” for the validity of a concept. Since they could now see the direct effects that pets were having on the
physiological indexes of stress, the notions associated with animal-assisted therapy became much more acceptable. This
is evidenced by the fact that the number of pet-assisted therapy programs was under 20 in 1980, but by the year 2000 over
1000 such programs were in operation. These programs, not only include dogs who are brought into the psychotherapist’s
office as part of treatment, but also visitation programs where dogs are brought into hospitals and homes for the elderly.
There are also some rehabilitation programs where the dogs are brought in as companions to build morale and confidence,
and the use of animals in educational settings.
This book documents the current status of animal-assisted therapy, its practice, and the data supporting it. It also goes
well beyond Freud’s initial speculations as to theoretical basis for therapeutic effects of interactions with animals. In order
to do this, the basis of the human–animal bond is explored as well as the cultural significance of animals. There is even
coverage of animal abuse and the welfare of assistance animals. This is likely the best collection of material covering the
use of animals as an aide to therapy available at this time. It is a good starting place for anyone interested in engaging in
animal-assisted therapy, and a fine resource to allow those already practicing it to update their knowledge and hone their
skills.
I will admit that reading about the data supporting the benefits of animal-assisted therapy is intellectually convincing;
however, actually observing the effects that an animal can have in ameliorating a psychological problem sometimes has the
emotional effect that might be expected if you observe something miraculous. At least such was the effect on me some two
decades ago when I saw such a “miracle.” A friend of mine had enrolled her Golden Retriever, Sandy, in a therapy dog pro-
gram run by our local St. John Ambulance Society. Sandy had been certified to be a visitation dog, which meant that Frieda
could bring her into hospitals and old age homes to visit the patients. For many patients the arrival of a dog is a wonderful
event that helps fight the depression and loneliness of being separated from their family. In some cases pets are actually
used as part of psychotherapy, with the kind of success described in many of the chapters in this book. In this particular
instance we found ourselves standing outside a hospital room while a nurse explained the situation.
This is a sad case. Her name is Eva and she is in her middle sixties. A month ago she was in a bad car accident where the vehicle
that she was in was hit by a very large truck. She was banged up and sustained some internal injuries, which are healing, but, her
husband, her only son, along with his wife and their young baby, were all killed in that catastrophe. When she learned what had
happened to her family she just shut out the world. She hasn’t spoken to anyone since then, barely looks at the hospital staff, and
often has to be assisted even to eat. The doctors say that there is nothing physical causing this problem. The psychologist says that
it is some kind of posttraumatic stress reaction. We are told that she likes dogs, so he suggested that we include her on the schedule
when a therapy dog next visited.
The nurse didn’t look very hopeful about all of this as she quietly opened the door to reveal a small gray-haired woman
in a flannel nightgown lying in bed and vacantly staring at nothing. The woman didn’t move, or even glance our way, and
for a moment it crossed my mind that she might have died. We walked over to the bed with Sandy out in front.
Frieda introduced the dog saying “Hi there Eva. I’ve brought you a visitor. Her name is Cassandra but we all call her
Sandy.” There was no response from Eva, not even a flick of her eyes.
The big yellow dog had reached the bed and gently pressed her nose against the woman’s hand. Sandy gave a tentative
lick and then rubbed her head gently against the unmoving fingers. Next she reared up so that her front paws were resting
gently on the bed and looked at the woman’s face. She gave a bit of a hopeful whimper and then laid her big head down on
Eva’s chest.
Nothing happened for several moments, and then Eva’s eyes moved to look at the dog. A frail hand slowly moved to
the dog’s head and gently stroked it, then ran fingers along her ear. The tiny woman’s eyes were filled with tears and a soft
voice slowly spoke the first words that anyone had heard from her in more than four weeks, “You’re just like my Goldie.
She had ears just like yours and she would try to climb into bed whenever Ralph wasn’t there.”
Both of her hands were now resting on the head of the big blond dog, and the woman was looking directly into her dark
eyes as she said, “Goldie always knew when I was sad, too.”
xxii Foreword
It was the breakthrough that was needed. Sandy came back almost every day for a couple of weeks. Eva, however,
was now speaking and beginning to respond to psychotherapy to cope with her stress. She would eventually go home,
accompanied by a toy spaniel puppy that had been purchased for her by her brother, and together they would begin a new
life. That miraculous first step toward her cure that I witnessed, however, might never have taken place, if it had not been
for another dog. This was a longhaired reddish-brown Chow Chow who liked to lie next to the desk of the founder of
psychoanalysis during therapy sessions that were held at number 19 Bergasse Street in Vienna, some 70 years earlier.
Stanley Coren, PhD, FRSC
Professor Emeritus
Department of Psychology
University of British Columbia, Canada
Preface
Fifteen years have passed since our first edition of this Handbook was published. Since that time, animal-assisted inter-
ventions (AAI) have continued to generate tremendous interest in the general sector, as well as the scientific community,
perhaps because of people’s curiosity regarding the human–animal bond and the significance of our interactions. Over the
years, several progressive changes have been made, and a multidisciplinary group of scholars, researchers, and practitioners
is beginning to look more closely at the impact of AAI. We believe that this volume will be an important contribution to the
literature on AAIs in promoting a clearer understanding of the scope of this practice. The contributors to the book continue
to take a critical analysis of what are best practices in AAI and provide the readers with a glimpse to what is needed in the
future to develop more evidence-based practices.
Animals have been an integral part of my clinical practice for over four decades. My initial experiences were discovered
serendipitously, but ever since my work with a tiny gerbil and children with learning disabilities, I have become fascinated
with the genuine power of the human–animal bond. When I first accepted the editorship of this Handbook, I was excited
about the opportunity because of my genuine enthusiasm about AAI. I was also compelled to put together a book that
helped clarify some of the misconceptions about the topic. Furthermore, I wanted to develop a book that not only imparted
a strong theoretical overview, but also provided clinicians, researchers, and scholars as well as all others interested in AAI
with a clearer understanding of the value of the human–animal bond as well as potential methods for application.
There have been many changes and updates in this new addition, including several new chapters. All previous chapters
incorporated in this volume have been updated, and there are several new contributions including chapters on forward
thinking about human–animal interactions, cultural and religious factors on attitudes toward animals, the impact of pets on
social capital, equines in AAI, the roles of animals in supporting persons who are victims of trauma as well as many other
chapters.
The chapters in this book are divided into four major parts. The strength of each part relates to how the chapters are
closely interrelated. It will become apparent to the reader that the therapeutic use of animals is an emerging approach that
is built on a long history of our association with and curiosity about other living beings. Qualitatively, AAI demonstrates a
significant contribution to the overall quality of life. Nevertheless, there is a strong need for more evidence-based research
that quantifies the value of these approaches. Many of these issues will be discussed in detail in upcoming chapters.
It is important to point out that the scientific and clinical community investigating these interventions is built on interdis-
ciplinary professions that bridge the worlds of mental and physical health professionals, with their counterparts in ethology,
animal behavior, and animal welfare. As it has been previously noted, one of the major weaknesses of AAI is the limited
scientific evidence demonstrating its efficacy (although great strides have been made since the onset of the first edition).
It is also hoped that the contents of this book act as an impetus for further empirical investigations into the therapeutic use
of animals in clinical practices.
Part I consists of seven chapters that focus on the conceptualization of the human–animal bond and incorporate chapters
addressing numerous topics. The book begins with a chapter by Fine and Beck that provides an overview of the human–
animal bond movement and clarifies a direction for the future. This chapter is followed by a chapter written by Serpell
that provides an historical exploration of the value of human–animal relationships. The chapter is followed by one written
by Fine, Tedeschi, and Elvove that provides an excellent overview of the evolving field of AAI and a visionary’s preview
of a possible future. The reader will find this chapter extremely helpful in conceptualizing potential paths for our future.
The section culminates with four other chapters. Jegatheesan provides an insightful chapter on the influences of cultural
and religious factors that may have an impact on attitudes toward animals. Arkow provides a chapter on understanding
the impact of pets on social capital, while Hart and Yamamoto provide a comprehensive review of the research explaining
the psychosocial benefits of animals as well as an explanation of the value of animals as social supports. The final chapter
provides a comprehensive explanation of the physiological benefits found as a consequence of the human–animal bond.
Part II focuses on the conceptual models of AAI and contains three descriptive chapters providing an overview of design-
ing and implementing AAI services. This information is invaluable in understanding how to select animals for engagement
xxiii