Browsing by Subject "Animal assisted therapy"

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    Service Dogs for Veterans and Military Members With Posttraumatic Stress Disorder: A Nonrandomized Controlled Trial
    (American Medical Association, 2024-06-03) Leighton, Sarah C.; Rodriguez, Kerri E.; Jensen, Clare L.; MacLean, Evan L.; Davis, Louanne W.; Ashbeck, Erin L.; Bedrick, Edward J.; O'Haire, Marguerite E.; Psychiatry, School of Medicine
    Importance: Military members and veterans (hereafter, veterans) with posttraumatic stress disorder (PTSD) increasingly seek psychiatric service dogs as a complementary intervention, yet the effectiveness of service dogs is understudied. Objective: To estimate the associations between psychiatric service dog partnership and self-reported and clinician-rated PTSD symptom severity, depression, anxiety, and psychosocial functioning after 3 months of intervention among veterans. Design, setting, and participants: This nonrandomized controlled trial used standardized and validated assessment instruments completed by participants and administered by blinded clinicians. Recruitment, eligibility screening, and enrollment were conducted between August 2017 and December 2019. Veterans were recruited using the database of an accredited nonprofit service dog organization with constituents throughout the US. Participants were veterans with a PTSD diagnosis; they were allocated to either the intervention group (n = 81) or control group (n = 75). Outcome assessments were performed at baseline and at the 3-month follow-up. Data analyses were completed in October 2023. Interventions: Participants allocated to the intervention group received a psychiatric service dog for PTSD, whereas those allocated to the control group remained on the waiting list based on the date of application submitted to the service dog organization. Both groups had unrestricted access to usual care. Main outcomes and measures: The primary outcomes were PTSD symptom severity, depression, and anxiety after 3 months, and the secondary outcomes were psychosocial functioning, such as quality of life and social health. The self-reported PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was used to measure symptom severity, and the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) was used to assess PTSD diagnosis (score range for both instruments: 0-80, with higher scores indicating greater PTSD symptoms). Results: The 156 participants included in the trial had a mean (SD) age of 37.6 (8.3) years and included 117 males (75%), 17 Black or African American individuals (11%), 30 Hispanic individuals (19%), and 117 White individuals (76%). Compared with the control group, the intervention group had significantly lower PTSD symptom severity based on the PTSD Checklist for DSM-5 mean (SD) score (41.9 [16.9] vs 51.7 [16.1]; difference in means, -11.5 [95% CI, -16.2 to -6.6]; P < .001) and the CAPS-5 mean (SD) score (30.2 [10.2] vs 36.9 [10.2]; difference in means, -7.0 [95% CI, -10.8 to -4.5]; P < .001) at 3 months. The intervention group also had significantly lower depression scores (odds ratio [OR], 0.45 [95% CI, 0.23-0.86]; difference in means, -3.3 [95% CI, -6.8 to -0.6]), anxiety (OR, 0.25 [95% CI, 0.13-0.50]; difference in means, -4.4 [95% CI, -6.9 to -2.1]), and most areas of psychosocial functioning (eg, social isolation: OR, 0.34 [95% CI, 0.18-0.64]). Conclusions and relevance: This nonrandomized controlled trial found that compared with usual care alone, partnership with a trained psychiatric service dog was associated with lower PTSD symptom severity and higher psychosocial functioning in veterans. Psychiatric service dogs may be an effective complementary intervention for military service-related PTSD.
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    Therapy Dogs for Anxiety in Children in the Emergency Department: A Randomized Clinical Trial
    (American Medical Association, 2025-03-03) Kelker, Heather P.; Siddiqui, Huma K.; Beck, Alan M.; Kline, Jeffrey A.; Emergency Medicine, School of Medicine
    Importance: Prior evidence suggests that the use of therapy dogs in emergency care reduces anxiety in adults, but no trial has tested the use of therapy dogs in emergency care of children. Objective: To examine whether adjunctive use of therapy dogs in standard child-life therapy reduces child-reported and parent-reported child anxiety in a pediatric emergency department (ED). Design, setting, and participants: This randomized clinical trial was conducted from February 1, 2023, to June 30, 2024, at an academic pediatric ED. Children (aged 5-17 years) with suspected moderate to high anxiety were included. Intervention: All participants received standard child-life therapy, and the intervention group was randomly assigned to have exposure to a therapy dog and handler for approximately 10 minutes. Main outcomes and measures: Anxiety was measured using the 0- to 10-point FACES scale (with 0 indicating no anxiety and 10 indicating very severe anxiety) and salivary cortisol concentrations. Measurements were obtained at baseline (T0), 45 minutes (T1), and 120 minutes (T2) for both child and parents. Results: A total of 80 patients (mean [SD] age, 10.9 [3.8] years; 45 [56%] female) were enrolled (40 in the control group and 40 in the intervention group). At T0, the mean (SD) FACES scores were 5.4 (2.8) for child report and 6.4 (2.4) for parent report; the means were not different between groups. From T0 to T1, child-reported anxiety changed by a mean (SD) of -1.5 (3.4) points in the control group vs -2.7 (2.5) points in the intervention group (P = .02, Mann-Whitney U test); similarly, mean (SD) parent-estimated child anxiety changed by -1.8 (2.7) points in the control group vs -3.2 (2.3) points in the intervention group (P = .008). A total of 9 children (23%) in the control group had a greater than 2.5-point decrease in FACES score vs 18 (46%) in intervention group (P = .04, Fisher test). At T2, mean (SD) child-reported FACES scores decreased to 3.6 (3.4) points in the control group and 3.0 (2.7) points in the intervention group (P = .70). A total of 14 control participants (35%) received ketamine, midazolam, lorazepam, or droperidol vs 7 (18%) in the intervention group (P = .08, Fisher test). Child and parent salivary cortisol decreased from T0 to T1 in both groups but was not different between groups. Parental salivary cortisol was significantly consistently higher than their children's salivary cortisol (P < .001, unpaired t test, for comparisons of child vs parent at T0 and T1 in both groups). Conclusions and relevance: This study of adjunctive use of therapy dogs in standard child-life therapy found a modest but significantly greater reduction in both child-reported and parental-reported child anxiety in the pediatric ED for the intervention vs control group. These findings support the use of therapy dogs to help reduce pain and anxiety without the use of chemical or physical constraint.