Animal Assisted Therapy with Melissa Winkle from Dogwood Therapy Services Inc.

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 3^rd 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:

Amazon: Handbook Animal Assisted Therapy Foundations and Interventions Blue Dog Book

I have a series of my own books called Professional Applications of Animal Assisted Interventions also available on Amazon:

      

*Eva’s Favorites    

* Blue Dog Book 

* Grey Dog Book    

* Dogwood Doga

Amazon: Professional Applications of Animal Assisted Interventions Gray Dog Book

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? 

Facebook Melissa Winkle: https://www.facebook.com/melissa.winkle.58

Facebook Dogwood Therapy Services: https://www.facebook.com/dogwoodtherapyservicesinc/

Facebook Animal Assisted Intervention International: https://www.facebook.com/aaii.org/

Email: melissa@dogwoodtherapy.com

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!