Hello! Today I have a
very special interview on the blog with Melissa Winkle, the President of Animal
Assisted Intervention International and the owner of Dogwood Therapy Services
Inc. There has been such a great focus on the importance
of mental health lately, that I felt it would be best to cover this topic with
an expert. Also, is it just me or have
you seen more people adopting pets lately?
There are so many benefits to pet ownership, so let us shine a light on
how animal assisted therapy may help you.
Here we go…
Hi Melissa! Thank you
for sharing your time with us today. It
was exciting when I first heard of animal assisted therapy. I am a huge animal lover!
Hi! Thank you for having me! There are so many ways that
human-animal interactions take place, I am looking forward to clearing the air
about what animal assisted therapy is, and is not.
Tell us about yourself.
I graduated from the University of New Mexico Occupational
Therapy (OT) Program and have been in practice for almost 20 years. Many people
don’t know what OT is, and I must say it is one of the most awesome career
choices anyone can make.
Occupational Therapy (OT) is a healthcare field that works
with people with disabilities resulting from birth, injury, illness or aging.
It is a holistic, person centered intervention process that focuses on strategies
to improve a person’s ability to participate in any activity that is meaningful
to them. Individuals may have compromised musculoskeletal functioning,
nervous system disorders, developmental disorders, sensory disorders, cognitive
or perceptual disorders, mental disorders, systemic disorders or immunologic
diseases which impair their ability to perform daily life activities.
Occupational Therapists use a knowledge base of neurology,
anatomy, physiology, Kinesiology, [human] development, psychology, psychosocial
development, task and biomechanical analysis and use a variety of therapeutic
techniques to work with people of all ages.
First off, what is animal assisted therapy and how did you
get interested in it?
I
want to make clear that animal assisted therapy (AAT) is not a ‘think’ in and
of itself. It is something that is used in conjunctions with someone’s licensed
degreed work in healthcare and human services. It
is easiest to explain it in with some other things it is confused with.
Let’s
start with a categorical term “Animal Assisted Interventions” or AAIs. This is
an umbrella term that captures three areas in which dogs work with humans and
have an effect on them in some way.
ANIMAL
ASSISTED INTERVENTION
A goal-directed
intervention 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 (Animal
Assisted Intervention) is directed and/or delivered by a practitioner with
specialized expertise and within the scope of practice of his/her profession.
There are specific goals for individual involved and the process is documented
and evaluated. The fields of Animal Assisted Education (AAE) and Animal
Assisted Therapy (AAT) cover these types of Animal Assisted
Interventions. An intervention can also be less goal-directed, more casual
or spontaneous. This type of intervention is designed to promote a range of
other than therapeutic or educational benefits and to enhance the quality of
life. The field of Animal Assisted Activities (AAA) covers this type of Animal
Assisted Interventions. An Animal Assisted Intervention (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.
Animal Assisted
Activity
An AAA intervention is less goal-directed as specific objectives may not be
planned. AAA (Animal Assisted Activity) is provided in a variety of settings,
may be group or individual in nature and may be implemented for persons of any
age. The AAA practitioners and/or animal handlers all are specially trained by
an organization and meet the minimum standards set forth by AAII. Teams who
provide AAA may also participate in Animal Assisted Therapy (AAT) or Animal
Assisted Education (AAE) when the team is working directly with a healthcare,
human service provider or with an educational practitioner.
Animal Assisted
Education
An AAE intervention is formally goal-directed and designed to promote
improvement in cognitive functioning of the person(s) involved and in which a
specially trained animal-handler team is an integral part of the educational
process. AAE (Animal Assisted Education) is directed and/or delivered by a
licensed/degreed (or equivalent) professional with education, and specialized
expertise within the scope of practice of his/her profession. AAE may be
provided in a variety of settings, may be group or individual in nature and may
be implemented for persons of any age. There are specific goals for individual
involved and the process is documented and evaluated.
Animal Assisted
Therapy
An AAT intervention is formally goal-directed and 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 of the treatment process. AAT (Animal Assisted Therapy) is
directed and/or delivered by a licensed/degreed (or equivalent)
healthcare/human service professional with education and specialized expertise
and within the scope of practice of his/her profession. AAT may be provided in
a variety of settings, may be group or individual in nature and may be implemented
for persons of any age. There are specific goals for individual involved and
the process is documented and evaluated.
** Many people use the
term ‘therapy dog’ and I recommend not using that term at all. About 50 years
ago, volunteer humans and their pets began visiting people in hospital and
other community settings who may either be ill, not have access to their own
pets, etc. People noticed how much
better people felt when dogs were around, and believed that dogs may have some
sort of therapeutic effect even though these dogs were not part of formal goal
directed treatment. The volunteer teams began to be called therapy dog teams. Volunteer
visiting is very different than a way a dog actually becomes part of a gal
directed formal treatment plan. But the volunteer teams were doing this long
before the therapists were. So, it is funny that the volunteer dogs kept this
term of ‘therapy dog’. So, just try to use the actual terms for what a team has
been formally trained for.
Here
is a picture to make things clearer.
Many
people also confuse animal assisted therapy with service dogs. They are not at
all the same thing.
There
is another categorical term called ASSISTANCE DOG.
Assistance
dogs are trained and placed forever with a person with a disability. There are
three kinds of assistance dogs.
1. Guide dog for
people who are blind or who have visual impairments. They guide people around
obstacles, find empty seats on buses, etc.
2. Hearing dogs
who work for people who are hard of hearing or deaf. They alert to the source
of sounds.
3. Service dogs
are dogs who are trained to work with people with disabilities other than sight
and hearing. A service dog can do different kinds of work including working
with people with disabilities such as:
a. Physical disabilities.
Perhaps someone uses a wheel chair and is not able to stand or walk. Let’s say
that they also have difficulty holding onto items, and they drop things all the
time. The dog might retrieve dropped items since the person can’t reach them.
It may be able to open doors and another helpful tasks.
b. Psychiatric
disabilities- the dog may BE TRAINED to perform specific tasks for someone with
PTS for example. They may rouse a veteran who is stuck in a 1000 yard stare, or
provide more personal boundary space so the person is not crowded. These dogs
may not provide any sort of protection. The task must be trained and directly
related to a persons disability.
c. Medical Alert
or Response- individuals with diabetes or seizures are at risk for further
injuries or death due to outcomes of their diagnosis. Some dogs may warn of a
pending seizure or low blood sugar, they may bark or go find assistance or
simply let the human know to get to a safe spot for the event or to take medications.
Below
is another picture of how these are broken down.
These
have been examples of ASSISTANCE DOGS that have nothing to do with animal
assisted therapy. The terminology is important.
We will be focusing on
ANIMAL ASSISTED THERAPY, nothing to do with assistance dogs, therapy dogs,
animal assisted activities or animal assisted education. Only animal
assisted therapy.
How does animal assisted therapy benefit people with mental
health issues and what is your favorite part about working in the field?
It is important that people understand that therapists must
have a lot of training or continuing education in animal assisted therapy. It
is not something learnt in most university programs. Therapists can lose their
license for practicing something they are not competent in. In addition, it
takes a lot of socialization and training for animals to work in formal
practice. The team should also have been evaluated by an objective 3rd
party for this kind of work.
Therapists can work with people on physical, cognitive or
psychiatric disabilities. They typically
evaluate people and identify physical, cognitive or psychiatric/psychosocial goals.
If a dog can be incorporated into their treatment plan (if the client is
appropriate to participate and the work is within their scope of the dogs
training).
You asked about
mental health.
In a counseling
session, the dog may act as a social lubricant. Let’s suppose that the
patient has difficulty talking to and trusting other people. The chances are
good, if they like dogs, that they will engage with the dog. Even just the dog
being present with the therapist gives that new patient a lot of information. They
think “Well, the dog trusts the therapist, so maybe I can too.” Other times, it
may help to speak to the dog rather than having to stare at the therapist or
find some other target. They may benefit from the tactile input from petting a
dog.
In an occupational
therapy session, a veteran may come in for services related to PTSD. Let’s
say that he also has some ambulation (walking issues), and he has lost a lot of
social skills because he does not get out much. He has lost interest in
activities he used to love, he has also gained a lot of weight which makes
ambulation even more painful. As his OT,
I would include a dog by having him do some agility in our yard with my dogs.
We would make modifications so his pain is decreased and so he can conserve
energy while gaining muscle mass. After a few sessions he may realize that he
really enjoys agility and be willing to go into public to do a class with his
own dog. That helps him get back into the community and provides him with ample
opportunities to engage with people with similar interests. He is also getting
exercise which will decrease weight, build muscle, feel better and continue
getting out. Because I am also an assistance dog trainer, I may work with him
to have a SERVICE dog – this is a dog we train to assist him and that he keeps
forever. Either way, he gains confidence and self esteem.
How long is the training for a therapy dog and what is that
like?
We don’t use the term therapy dog since that means a
volunteer visiting dog. But a dog that works in animal assisted therapy typically
takes a year or a year and a half. Dogs need to achieve their developmental
milestones, get through fear periods, gain social skills, have self-control and
learn some cues and tasks they can participate in. Everyone has some different
ideas of what they would like a dog to do in their practice. As a dog trainer
and human healthcare practitioner, my dogs have a lot of training. To train, we
PLAY and have FUN. I don’t boss my dogs around, we have relationships and a lot
of respect for each other’s skills, health, welfare and well-being.
I clicker train my dogs, use a lot of positive
reinforcement and humane training techniques. We do not do any fear based
training, no physical force, no harsh yelling, no coercive methods, no shock or
prong collars…….. in fact, we have an open dog door policy…dogs can walk out of
a session any time they want to. If I am doing AAT correctly, they have so much
fun that they do not want to leave. We reward dogs for behavior we want and
reshape the behaviors we do not want into something else. So if a dog paws at
people a lot, I might decide to teach that dog to press buttons or operate
switches in games. If a dog loves to use its mouth to pick up things, I might
teach it to play Kerplunk by pulling out straws from the tower of that game alongside a kid to work on fine
motor skills and turn taking. I have one dog who knows how to operate Hungry
Hungry Hippo game.
I believe that dogs can continue learning new things their
entire lives, so we do that! But to prepare a dog for this kind of work is a
year to year and a half minimum. Assuming they pass testing at that point. Some
dogs don’t.
What kind of educational background do you have to have to
be an animal assisted therapy trainer?
I am a licensed and degreed occupational therapist, and a
fellow of the American Occupational Therapy Association. After 18 years of training dogs, I decided to
sit for an exam to gain my title of Certified Professional Dog Trainer-
Knowledge Assessed. So it looks like this: Melissa winkle, OTR/L, FAOTA,
CPDT-KA. Therapists do not need to be
certified trainers to do AAT and to train their dogs, but they do need to work
with a trainer who understands the job. Obedience is one of the last things we
actually train. It is more about relationship development with the therapist
and then with patients/clients. There is a trust that needs to be there, a safe
space for both dog and patient/client…which is facilitated by the therapist.
Dogs need manners but not all dogs need to learn to play a musical instrument
or do agility. Therapists have different styles of practicing, and the skills
the dog needs should match that. I train a lot of therapists and their dogs…and
we create a job description for the dog, then we create profiles of the human
and a profile of the dog so we can assess where they each need to gain skills.
A really great therapist may have terrible dg handling and communication
skills… so it doesn’t work out to have the dog in practice. The dog may have
great skills but if the therapist cannot multi task or advocate for client and
dog equally, it can be a disaster.
If someone is interested in an internship with Dogwood
Therapy, what are the requirements and what do they need to do to apply?
We have a lot of information on our website. But there are
different methods.
1.
University students of healthcare/human services
or dog trainers in formal programs who need internships can send a letter of
interest, go through an interview and may be selected. They must be able to
come for a minimum of 6 months, but 12 is recommended. Dogwood is very
competitive – there are typically a dozen people applying for any one slot.
2.
I offer a big workshop 3-10 days over Memorial
Day Weekend in my own clinic in Albuquerque. Three days of seminar and hands
on, and then a week or two of hands on in our summer programs which are all
about AAT with kids and teens with and without disabilities.
3.
I teach workshops around the world.
Organizations sponsor me to come and give 3-14 day workshops or consults to
teach skills and help design and open AAT programs. Sometimes they open them up
to the public.
4.
People who are already in their career may want
to learn AAT and we offer Post Professional Rotations. This is where people come
to the clinic for 2 weeks – 12 months and learn dog behavior, communication,
welfare, well-being, training, AAT theory, practice, treatment planning,
evaluation of patients, and a lot of other things. IT depends on their profile.
What books have you written and where can we order them?
I have written chapters in several AAT books. The most
recent is Aubrey Fine’s book, which is considered the AAT “bible” and it is
available on Amazon:
I have a series of my own books called Professional
Applications of Animal Assisted Interventions also available on Amazon:
I have two more coming out winter or spring. There are also dozens of articles and
research that I had the opportunity to participate in.
Lastly, what words of wisdom do you have to share with
someone who is thinking about going into the field of animal assisted therapy
and also for those who are considering getting a dog to work
in AAT?
Get continuing education. It is so much more than taking your
nice dog to work. It is a specialty area that requires specialty training for
human and dog. There are many therapists who want to do AAT but do not have the
skills, there are many dogs who are lovely pets but would not be happy doing
the work, make sure you and dog are a good match. Ensure that you seek out
education and mentorship until you gain competency in this area. There is no
checklist of what one needs to do, as every clinic is different. Be aware of risk assessments for this kind of
program, liability, zoonotic risk factors, dog cognition and communication.
Also know that there are standards of practice- one place to look is Animal Assisted
Intervention International (AAII).
Aai-int.org
Know that there are also competencies that describe areas
of study from Dr. Leslie Stewart which have also been adapted and adopted by
AAII. Know that the research is rather
weak in AAT, because it is not easy to do for a variety of reasons. And know that you will seek out continuing
education the rest of your career for AAT. We learn new things all the time
from a lot of disciplines.
Where can we find you?
Thank you Melissa! We
appreciate your time and work as a therapist helping to heal the world through
animal assisted therapy.
Thank you for the opportunity!
