The Effects of Animal Assisted Therapy with Children and Adolescents Who Have Experienced Trauma: A Systematic Review

Background and Purpose:  Animal-Assisted Therapy (AAT)—the use of animals in a therapeutic context—is increasingly being used to treat a variety of problems in a wide range of therapeutic settings across diverse populations. An area in which AAT has garnered increased attention is in its use to treat trauma related symptoms in children and adolescents. Despite its popularity, the trajectory of research to establish the efficacy of specialized AAT programs for trauma is in its early stages. The purpose of this systematic review was to examine the effects of AAT with children and adolescents who have experienced trauma to inform practice and identify gaps in the knowledge base. 

Methods: Systematic review methods, following Campbell Collaboration guidelines, were used to search, retrieve, select and assess randomized and quasi-experimental studies examining effects of AAT with children and youth on cognitive, behavioral, and emotional symptoms. The search strategy included seven electronic databases, research registers and websites, gray literature sources, reference lists of related reviews and primary studies and contacts with researchers. Published or unpublished studies conducted between 1990 and 2015 were eligible for this review. Two authors independently screened and coded all studies. Studies were synthesized using descriptive strategies as meta-analysis was not warranted due to the limited number of studies meeting eligibility criteria.

Results: Of the initial 7,368 titles and abstracts reviewed, the full text of nine studies was screened for inclusion and two studies met full inclusion criteria. In the first study, a group therapy intervention using dogs with stories, the authors reported significant differences favoring the AAT group compared to the control group on anxiety, depression, anger, PTSD, but no significant differences on sexual concerns. In the second study, a 12 week individual and group intervention that took place on a farm using dogs and horses, authors reported no significant differences between the AAT and control groups on attachment or feelings of security and support from attachment figures. High risk of bias was present across several domains within both studies.

Conclusions and Implications: This systematic review is the first to examine the effects of AAT on trauma symptoms with youth who have experienced trauma. Despite the popularity of AAT for trauma treatment, there is limited rigorous research to support AAT with youth who have experienced trauma. The findings of this review were inconclusive, and the studies demonstrated important limitations and biases, calling into question the internal validity of the studies. The results of this review support a need for caution and further research to examine the effects and potential risks of AAT for trauma with youth.