In recent years, animal assisted therapy (AAT) is being seen and requested more and more in Flanders. What’s more, the methodology in all of its forms can increasingly be seen in the literature and in the media.

To present a picture of how such therapy can look in practice, we first must be clear about how the methodology is defined, even though there appears to be much confusion concerning this in the field. A concise schematic sketch follows:


Animal Assisted Interactions (AAI) is an umbrella term for:

‘Animal Assisted Therapy’ (AAT), which monitors and strives to realise therapeutic objectives in order to improve the psychological, physical or social well-being of the client.

‘Animal Assisted Activities’ (AAA), with which activities are developed without a specific goal. The frame of reference makes a distinction between the active form of AAA and the passive form. ‘Active AAA’ consists for example of the visit by a staff member with his dog to a rest home, or the so-called ‘meet & greet’ programmes. A dog that stays in a rest home or caged birds living with a group of psychiatric patients are considered ‘passive AAA’. The active component refers to the fact that such programmes concern a focused activity with the animal such as a walk together or care tasks, while passive activities are entirely without obligation and are based on the needs of each individual living in the vicinity of the animal. No time frame is applied to the passive activities.

‘Animal Assisted Learning’ (AAL) for which educational objectives are drawn up and evaluated, covers for example pedagogical activities at school that point out to children their responsibility with respect to their pets.



Animal assisted therapy is by definition a focused intervention:

  • An animal, which satisfies a number of criteria, is integrated in a therapeutic care process.
  • Provided by a counsellor, trained for this task in the context of his/her work and experience within the welfare sector.
  • Designed to treat and support therapy programmes for people with physical, cognitive, psychosocial and psychological difficulties.
  • In which selected and tested animals function both as catalyst and as therapeutic medium, together with the counsellors who work with them.
  • Where the success of the programme depends on the right choice of animal.
  • Where consideration must be taken of zoonotic elements, i.e. diseases that can be transmitted between people and animals.


In all cases:

  • The person–animal relationship must be beneficial to both.
  • The animals are partners, and are not “used” as tools, objects, toys, etc.

Scientific research

Since the beginning of the 1980s, research has been conducted into the bond between people and animals and into the social, educational and therapeutic value of animals in hospitals, schools and residential care homes. The most important researcher remains Aaron Katcher of Philadelphia University: “The Companionable Zoo program” (1984), research into the therapeutic effects of the use of animals with children and youth with ADHD, learning disabilities, emotional problems and autism.

Further research in this area has been conducted by:

Leonard Green, Carol Campbell (children in special youth welfare work), Mc. Culloh (animals and depression), Judith Siegel (1990): influence of animals on sickness and health, Mary Tompson, Robert Kennedy and Sue Igou (animals in hospitals).

This research shows the following concerning the use of animals in a therapeutic care process:


An increase can be seen in:

  • Self-confidence
  • Feeling of self-esteem
  • Empathy
  • Socialisation
  • The ability to work with others
  • Patience
  • Communication skills
  • Motivation
  • Self-awareness

What animals bring to the therapy:

  • Unconditional affection
  • Immediate affection and attention
  • The possibility to care for another living creature
  • Metaphors for interaction and learning processes
  • Non-verbal interaction
  • A link with reality
  • A way to remember the past
  • No stereotypes or preconceptions
  • Fun

Practical examples


Gregory (11 years old) entered an AAT programme in which he learns skill cards on various animals. The programme’s context is a farm with various farm animals selected for their task. It teaches him how to care for animals, about their stress signals, indications of sickness, how they in turn can learn, and how he can best pick them up, show affection and cuddle them. Once he learns a skill card, he is tested on it and if he succeeds, he is awarded an official certificate on a specific animal. When he has obtained certificates on specific animals, he is officially allowed to share his knowledge with other children.

Gregory obtained a certificate for the guinea pig and the donkey. Below follows a short account of this process.

Gregory had followed lessons in a special class for children with social/emotional problems. Gregory’s additional learning difficulties, however, were so great that according to his teacher, his frustrations in the lessons escalated into severe behavioural problems. Complaints were registered with respect to work attitude (among others frequently extremely noisy, staring for long periods, inability to concentrate on the class, dancing around in the classroom, roaming about in the classroom), with respect to social skills (among others continuing to argue, making inappropriate remarks, use of foul language, refusing to perform tasks), with respect to attention-getting behaviour (among others walking strangely, pretending to be ignorant, making crazy faces, consistently violating the personal space of others, sexually inappropriate comments and behaviours). In addition, Gregory would frequently engage in prolonged acts of revenge against those he felt had offended him. The class had all but given up on him.

At the farm where Gregory followed the AAT programme, however, a different pattern of behaviour could be seen. Already during his first session at the farm he was able to approach the animals in a friendly way, and frequently took long periods of time to hold, cuddle or comb the animals. He worked hard at the farm. He devoted most of the time to working in the stables to maintain them but Gregory also spent a lot of time getting to know the donkey, caring for it and taking it for walks. He regularly borrowed books from the small farm library, and when he returned the books he knew the content (he had read the book himself, or had it read to him aloud), understood it and remembered it.

He studied the guinea pig skill card to prepare a presentation to the class on the guinea pig. Gregory was able to conduct structured research and make use of his experience and the knowledge he obtained from books. This resulted in a composition with quality content and a clever presentation that allowed him to place his story on the board in a neatly structured way.

The other children following the AAT programme looked up to Gregory as a leader. He was able to very patiently help the others in approaching and caring for the animals for which he had obtained a skill card.

During his first four sessions on the farm there were two incidents noted for which Gregory demanded some form of punishment for what – he thought – was a lack of respect shown to him on the part of the other children. Since then (now 8 months ago), no further incidents have been mentioned and none of the behaviour reported in his previous school class were seen at the farm sessions. After 6 months of sessions on the farm, the first positive behavioural changes in the social group and in the class were noted in the form of:

  • Increased attention for external surroundings
  • Increased capacity for controlling behaviour
  • Increased serenity in the group
  • Decrease in aggression
  • Indicating the need for information
  • Increased social interaction
  • Increased cooperation
  • Increase in social skills
  • Increased dialogue
  • Increased moral concern

Gregory’s mother perhaps summarises it best: “By finding activities on the farm that he was good at, Gregory learned to accept himself again, and in this way was able to again appreciate others and even help them”.



Mike was born into a difficult situation. He had already lived in 12 institutions by the age of 5. When we met him, he was in a school for children with emotional difficulties.

Working with Mike was a challenge. In the AAT programme, Mike first of all acquired a minimum of knowledge and expertise concerning dogs, then learned to raise and train dogs, and in a later stage passed his expertise on to others. Student became master, or the care recipient became counsellor.

In the beginning, Mike made it very difficult for us to bid farewell at the end of the programme: he suffered from outbursts of anger, would clutch one of the dogs and refuse to let go,… Our challenge was to keep the dogs safe while Mike worked on his self-confidence.

Many of the children in this group had mistreated animals and were themselves mistreated. The experience of safety and trust must first be developed, for the animals as well as for the children.

One day, the children were exceptionally restless. Their hands were continuously in the air with noisy questions. They were impatient and rough when wanting to touch the animals. All of which confused the animals.

The counsellor stopped and said: ”Talk to your hands. Ask your hands to be patient and please to be gentle. These animals need calm and tenderness in order to again feel safe and trustful”. This was new for the children. They began to reflect on the safety of the animals and of themselves.

The counsellor talked further on safety and care, and waited until she saw that the children were responding to this. Gradually the children became aware of their hands, and of a new way of being together with the animals.

The simplicity of the request by the counsellor, a request that introduced the animal’s need for safety, challenged the children to grow.

While Mike was demonstrating his new capacity to care, we saw how he cuddled and pet our dog, touched it, then let it go, with his new gentle hands. Then he softly kissed the dog’s forehead to say good-bye. When a bit later he went to the bathroom to wash his hands, he spoke to his hands, “Hands, you were magnificent, I’m not going to wash off the dog feeling”.

Mike learned on this day how to cuddle and how to keep alive the sweet experience of care. He had experienced the comfortable feeling of parting, without the alarming feeling of loss.