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Research Article

The effects of assistance dogs on psychosocial health and wellbeing: A systematic literature review

Roles Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Supervision, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Current address: Human-Animal Bond in Colorado, School of Social Work, Colorado State University, Fort Collins, Colorado, United States of America

Affiliation Center for the Human-Animal Bond, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, United States of America

Roles Data curation, Formal analysis, Investigation, Methodology, Writing – review & editing

Affiliation Vassar College, Poughkeepsie, New York, United States of America

Roles Data curation, Investigation, Methodology, Writing – review & editing

Affiliation Purdue University Libraries, Purdue University, West Lafayette, Indiana, United States of America

Roles Conceptualization, Supervision, Writing – review & editing

Roles Conceptualization, Data curation, Project administration, Supervision, Writing – review & editing

• Kerri E. Rodriguez, 
• Jamie Greer, 
• Jane K. Yatcilla, 
• Alan M. Beck, 
• Marguerite E. O’Haire

• Published: December 2, 2020
• https://doi.org/10.1371/journal.pone.0243302
• Peer Review
• Reader Comments

9 Aug 2021: Rodriguez KE, Greer J, Yatcilla JK, Beck AM, O’Haire ME (2021) Correction: The effects of assistance dogs on psychosocial health and wellbeing: A systematic literature review. PLOS ONE 16(8): e0256071. https://doi.org/10.1371/journal.pone.0256071 View correction

Beyond the functional tasks that assistance dogs are trained for, there is growing literature describing their benefits on the psychosocial health and wellbeing of their handlers. However, this research is not only widely disparate but, despite its growth, has not been reviewed since 2012. Our objective was to identify, summarize, and methodologically evaluate studies quantifying the psychosocial effects of assistance dogs for individuals with physical disabilities. Following PRISMA guidelines, a systematic review was conducted across seven electronic databases. Records were independently screened by two authors. Studies were eligible for inclusion if they assessed outcomes from guide, hearing, medical, or mobility service dogs, if they collected original data on handlers’ psychosocial functioning, and if the outcome was measured quantitatively with a validated, standardized measure. Studies on psychiatric service dogs, emotional support dogs, and pet dogs were excluded. Of 1,830 records screened, 24 articles were identified (12 publications, 12 theses) containing 27 studies (15 cross-sectional, 12 longitudinal). Studies assessed the effects of mobility (18), hearing (7), guide (4), and medical (2) assistance dog partnerships with an average sample size of N = 83. An analysis of 147 statistical comparisons across the domains of psychological health, quality of life, social health, and vitality found that 68% of comparisons were null, 30% were positive in the hypothesized direction, and 2% were negative. Positive outcomes included significant effects of having an assistance dog on psychological wellbeing, emotional functioning, self-esteem, and vitality. However, it is of note that several methodological weaknesses of the studies make it difficult to draw any definitive conclusions, including inadequate reporting and a failure to account for moderating or confounding variables. Future research will benefit from stronger methodological rigor and reporting to account for heterogeneity in both humans and assistance dogs as well as continued high-quality replication.

Citation: Rodriguez KE, Greer J, Yatcilla JK, Beck AM, O’Haire ME (2020) The effects of assistance dogs on psychosocial health and wellbeing: A systematic literature review. PLoS ONE 15(12): e0243302. https://doi.org/10.1371/journal.pone.0243302

Editor: Geilson Lima Santana, University of Sao Paulo Medical School, BRAZIL

Received: July 22, 2020; Accepted: November 18, 2020; Published: December 2, 2020

Copyright: © 2020 Rodriguez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper and its Supporting information files.

Funding: The authors received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.

Introduction

The roles of dogs to assist in improving human wellbeing continue to expand. Not only are companion dogs prevalent in modern society, but dogs are also often intentionally incorporated into therapeutic processes in the contexts of animal-assisted activities (AAA) and animal-assisted therapy [AAT; 1]. In other contexts, dogs can be specially trained to provide specific benefits to individuals with impairments, disabilities, or chronic conditions as trained assistance animals. Assistance dog placements and roles have grown rapidly in recent decades, especially in the United States, Canada, and Europe [ 2 ].

Assistance Dogs International (ADI) defines three types of assistance dogs, of which we use as terminology in this review: guide dogs who assist individuals with visual impairments, hearing dogs who assist individuals with hearing impairments, and service dogs who assist individuals with disabilities other than blindness or deafness [ 3 ]. Service dogs can assist individuals with physical disabilities (e.g. performing mobility-related tasks such as pulling a wheelchair or retrieving dropped items), individuals with medical conditions (e.g. alerting or responding to medical crises such hypoglycemia or seizures), and individuals with mental health disorders (e.g. psychiatric service dogs for posttraumatic stress disorder or autism spectrum disorder). Under the Americans with Disabilities Act of 1990, a United States law, an assistance dog must do work or perform tasks for the benefit of an individual with a physical, sensory, psychiatric, intellectual, or other mental disability in order to receive public access rights [ 4 ]. While there are no legal requirements specifying that an assistance dog must be certified, registered, or receive any specialized training to receive public access rights, independent organizations such as ADI, the International Association of Assistance Dog Partners (IAADP), and the International Guide Dog Federation (IGDF) define a set of minimum training and behavior standards for public access that help guide the assistance dog industry.

In parallel with an increasing amount of research quantifying the therapeutic benefits of companion dogs and therapy dogs on human health and wellbeing [ 5 , 6 ], there has been an increased focus on quantifying the physical, psychological, and social effects that assistance dogs may have on their handlers [ 7 – 9 ]. Research has indicated that beyond the physical or tangible benefits that an assistance dog is trained to provide (e.g. route finding, retrieving dropped items, alerting to a seizure), the assistance dog’s companionship, emotional and social support, and social facilitation effects in public may be particularly salient to improving the quality of life of individuals with disabilities [ 7 – 9 ]. After receiving an assistance dog, individuals retrospectively report increases to their social, emotional, and psychological health [e.g., 10 – 12 ]. Longitudinal studies have found that individuals report improvements to their emotional wellbeing, social functioning, and quality of life just 3 to 6 months after receiving an assistance dog [ 13 – 15 ]. Compared to those on the waitlist, individuals with an assistance dog report better psychosocial functioning and wellbeing [ 16 , 17 ]. Additionally, research suggests the relationship between an assistance dog and its owner may also serve as a reciprocal attachment and caregiving relationship characterized by secure and strong attachments [ 18 , 19 ].

To date, there have been several reviews summarizing the literature on the psychosocial effects of assistance dogs on their handlers. One of the first reviews published by Modlin in 2000 [ 7 ] summarized nine published quantitative and qualitative studies on the benefits of guide dogs, hearing dogs, and mobility service dogs on their handlers (omitting unpublished theses). Another early review published by Sachs-Ericsson and colleagues in 2002 [ 8 ] summarized 14 quantitative studies on both standardized and nonstandardized outcomes following mobility service dog or hearing dog placement (omitting guide dogs). Neither of these early reviews employed a formal methodological assessment of studies, but limitations were listed for each included study. While both reviews found mostly positive findings regarding mobility, guide, and hearing dogs’ effects on their handlers’ health and wellbeing, social interactions, and activity participation [ 7 , 8 ], it was concluded that “the small number of studies and methodological limitations of these studies preclude any clear conclusions” [ 8 ].

A more recent systematic review published by Winkle and colleagues in 2012 [ 9 ] summarized 12 published quantitative studies on both standardized and nonstandardized outcomes following mobility service dog placement (omitting guide dogs, hearing dogs, and unpublished theses). The scientific rigor of each study was rated according to a 5-level system while the methodological quality of each study was scored on a 7-point scale. While results described positive effects of service dogs in terms of social, psychological, and functional benefits for their handlers, it was concluded that all 12 of the studies had weak study designs with limitations including lack of comparison groups, inadequate description of the service dog intervention, and nonstandardized outcome measures. The authors concluded that although results are promising, “conclusions drawn from the results must be considered with caution” [ 9 ].

Because medical service dogs are a relatively new category of assistance dog placements [ 2 ], there has been less research on the psychosocial effects of medical alert and response service dogs on their handlers. However, a recent 2018 review summarized five published quantitative studies describing outcomes from seizure alert and seizure response service dogs. The authors found three studies reporting an association between having a seizure alert or response dog and improvements to quality of life and wellbeing, concluding a need for more research.

Research in the field of human-animal interaction (HAI) and assistance dogs is not only rapidly growing but is often disparately published across multidisciplinary journals and outlets. Conducting periodic systematic reviews of this research is crucial to both disseminate knowledge as well as to identify knowledge gaps for future studies [ 20 ]. As research on the assistance animal-handler relationship continues to increase, there is a need for an updated, comprehensive collation of the literature encompassing studies on the effects of all varieties of assistance dogs (guide dogs, hearing dogs, and both mobility and medical service dogs) including both published studies and unpublished theses and dissertations. Further, as researchers increasingly incorporate standardized outcome measures into this research, collating and pooling findings will allow researchers to compare outcomes across different populations and interventions while estimating the magnitude of effects across domains.

This research aimed to conduct a systematic assessment of the current state of knowledge regarding the potential benefits of assistance dogs on standardized outcomes of the health and wellbeing of individuals with disabilities. Specifically, this review sought to systematically identify, summarize, and evaluate studies assessing psychosocial outcomes from owning an assistance dog (including service, guide, hearing, and/or medical alert or response dogs) with measures tested for reliability and validity among individuals with physical disabilities. The specific aims were to (1) describe the key characteristics of studies (2) evaluate the methodological rigor of studies (3) summarize outcomes.

Materials and methods

The systematic literature review was conducted according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [ 21 ]. A study protocol was designed a-priori to define the search strategy, inclusion and exclusion criteria, and items for data extraction.

Search procedure

As the field of animal-assisted intervention is multidisciplinary, a wide and extensive search was conducted encompassing medical and scientific databases. Further, as publication bias and the “file-drawer effect” is an often referenced weakness of the HAI literature [ 22 ], two dissertation and thesis databases and abstracts of two conferences were searched for unpublished studies.

A health information specialist (JY) constructed and executed comprehensive search strategies in six electronic databases: MEDLINE (PubMed platform), Cumulative Index to Nursing and Allied Health Literature (CINAHL) (EBSCOhost platform), ERIC (EBSCOHost), Web of Science Core Collection (Web of Science), PsycINFO (EBSCOhost), and PsycARTICLES (EBSCOhost). The electronic searches were performed on July 23, 2018, and updated on January 23, 2019. The complete MEDLINE search strategy, which was adapted for the other databases, is shown in S1 Table . Grey literature was addressed by searching ProQuest Dissertations and Theses (ProQuest) and WorldCatDissertations and hand searching the abstracts of the International Society for Anthrozoology and International Association of Human Animal Interactions Organizations conferences.

Article selection

Studies were eligible for inclusion if they met the following criteria: (1) The study population consisted of current or prospective owners/handlers of an assistance dog (including service, guide, hearing, and/or medical alert or response dogs) with a physical disability or chronic condition in which the assistance dog is trained to do work or perform tasks directly related to the disability or condition [ 4 ]; (2) The study collected original data on the effect of the assistance dog on their handler with at least one psychosocial outcome, including those quantifying aspects of mental health, social health, and health-related quality of life; and (3) The psychosocial outcome(s) were collected via a standardized measure tested for validity and reliability. The rationale for excluding studies on emotional service dogs and psychiatric service dogs is that the primary benefits of these dogs are psychological in nature, rather than physical or medical, which complicated comparisons of their psychosocial effects. The rationale for excluding qualitative studies from inclusion was to focus on outcomes using standardized measures to facilitate quantitative comparisons across studies.

Article screening

All articles were screened by two independent reviewers (authors KR and JG) using Covidence systematic review software (Veritas Health Innovation, Melbourne, Australia). In the case of disagreements, inclusion or exclusion was resolved by discussion and consultation with a third independent reviewer (author MO). After removing duplicate articles in EndNote following a validated protocol [ 23 ], articles were screened based on their title and abstract. At this stage, articles were excluded if they were (1) non-English; (2) written for a magazine or other non-peer-reviewed source; (3) book reviews, book chapters, editorials, letters, or opinion papers that did not collect original data; (4) conference abstracts or proceedings; (5) studies assessing companion, therapy, or emotional support animals that were not trained for tasks or work related to a specific disability.

After the initial title and abstract review, articles were screened based on full text. Exclusion criteria were then used to select articles based on the following (in order): (1) irrelevant to study topic; (2) assessed an excluded study population (psychiatric service dogs, therapy dogs, emotional support dogs, or companion dogs); (3) did not report quantitative outcomes from assistance dog placement (literature reviews, instrument development, not original research); (4) reported unrelated outcomes (puppy raising, service dog training, or animal-related outcomes); (5) reported only non-psychosocial outcomes (medical or physical); (6) methodological exclusions (qualitative, case studies, single-subject design); (7) no full text available.

Data extraction

Articles were extracted for information based on three aims to describe study characteristics, assess methodological rigor, and summarize outcomes. To describe study characteristics, extracted items included participant characteristics (sample size, age, gender, country of origin), assistance dog characteristics (type and provider), and details of the study (design, measurement time points, comparison conditions). To assess methodological rigor, a total of 15 extracted items were sourced from methodological assessment tools including the National Institutes of Health (NIH) Study Quality Assessment Tools [ 24 ], the Consolidated Standards of Reporting Trials (CONSORT) checklist [ 25 ], the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklists [ 26 ], and the Specialist Unit for Review Evidence (SURE) Checklists [ 27 ]. Authors JG and KR independently coded 20% of the included articles to establish adequate inter-rater reliability (alpha = 0.822). Author KR then coded 100% of articles. To examine the relationship between methodological rigor score and year of publication as well as sample size, bivariate correlations were performed. To compare methodological rigor by study design, an independent t-test was used to compare mean scores across longitudinal and cross-sectional designs.

To summarize study outcomes, extracted items included statistical comparisons for any psychosocial outcomes from included studies. Because of the broad inclusion criteria, the 27 studies were widely varied in terms of human and dog participants, assessment time points, statistical analyses, and standardized outcomes. Therefore, due to observed heterogeneity, a meta-analysis was not pursued. We also planned to extract or manually calculate effect sizes to create funnel plots to investigate potential publication biases. However, due to large heterogeneity and poor reporting of effect sizes and raw data, a narrative synthesis of findings in comparison to unpublished theses and published articles was pursued instead.

A total of 1,830 records were screened via title and abstract in which 1,576 records were excluded due to irrelevancy (see Fig 1 for PRISMA diagram). A total of 254 records were screened via full text, of which 230 were excluded. Exclusions included those based on population, outcomes, and methodology. The final sample included 24 articles (12 peer-reviewed publications, 12 unpublished theses/dissertations) containing 27 individual studies. Articles were published from 1994–2018 with publication dates in the 1990s (5), 2000s (9), and 2010s (10) indicating an increasing publication rate on this topic over time.

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Study characteristics

To achieve the first aim of the review–to describe study characteristics–we extracted several features of from each study and article ( Table 1 ).

https://doi.org/10.1371/journal.pone.0243302.t001

Study designs.

Of 27 studies, 15 were cross-sectional and 12 were longitudinal. Studies compared outcomes of individuals with an assistance dog to before they received the dog (six longitudinal studies), to participants on the waitlist to receive an assistance dog (five longitudinal and seven cross-sectional studies), or to participants without an assistance dog (eight cross-sectional studies). Longitudinal assessment time points were varied. Most longitudinal studies (8/12) assessed participants at two time points: at baseline prior to receiving an assistance dog, and an average of 5.8 +/- 3.3 months after participants received an assistance dog (range of 3–12 months follow-up). The remaining four longitudinal studies assessed participants 3–5 times with final follow-up ranging from 9–24 months after receiving an assistance dog.

Study participants.

Most studies (15/27; 56%) were conducted in the United States, followed by the United Kingdom (6/27; 22%). Other countries where studies took place included Canada (3), Japan (2), New Zealand (1), and Sweden (1). A majority of studies (18/27; 67%) assessed outcomes from mobility service dogs for individuals with physical disabilities. These 18 studies recruited study populations with a range of physical impairments including para- or quadriplegia, musculoskeletal disorders, and neuromuscular disorders. Other studies assessed outcomes from hearing dogs (7/27; 26%), guide dogs (4/27; 15%), and medical alert/response service dogs (2/27; 7%). Human participants in these studies included those with hearing or visual impairments, diabetes, and seizure disorders. Most studies (24/27; 89%) assessed outcomes from a single type of assistance dog (e.g. mobility or guide), thus restricting human participants to a single category of impairments. However, three studies collapsed analyses across several types of assistance dogs and impairments. Most studies (17/27; 63%) recruited from a single assistance dog provider organization, while the remaining studies recruited from a range of providers (7/27; 26%) or did not report the source of the assistance dogs in the study (3/27; 11%). The most common provider organizations represented were Canine Companions for Independence (CCI; six mobility service dog studies), Paws with a Cause (four mobility service dog studies), and Hearing Dogs for Deaf People (HDDP; four hearing dog studies).

Samples sizes ranged from 10 to 316 participants with an average sample size across all studies of N = 83 +/- 74 participants and a median sample size of N = 53. Seven studies (26%) had sample sizes less than or equal to N = 20, all of which were longitudinal. However, more than half of all studies (16/27; 59%) had sample sizes greater than or equal to N = 50. Cross-sectional studies had the highest sample sizes with an average sample size of N = 126 +/- 73 participants (range of N = 38–316), while longitudinal studies averaged N = 29 +/- 18 participants (range of N = 10–55). Only a single study [ 16 ] assessed outcomes from child participants under the age of 18 (an additional study [ 38 ] had a minimum inclusion age of 16, but the youngest participant was 19). Average age across all studies was 42 +/- 13 years old. Samples ranged from 15% male to 85% male, with an average of 42% male participants across all studies.

Study methodologies

To achieve the second aim of the review–to evaluate the methodological rigor of studies–each study was assessed if they met a set of 15 methodological rating items using a scale of yes, no, or N/A ( Table 2 ). Fig 2 displays the total scores across each of the 15 items, separated by introduction, methods, results, and discussion sections (see S2 Table for individual study scores). Overall, studies addressed an average of 62% of methodological consideration items with a range of 23% (3/13) to 100% (15/15; denominators were variable as there were two items not applicable to all study designs). Longitudinal studies addressed an average of 59% of methodological items while cross-sectional studies averaged 65%. However, methodological rigor did not significantly differ by study design ( t (25) = -0.940, p = 0.356). Methodological rigor also did not significantly correlate with year of publication ( r = 0.327, p = 0.096) nor total sample size ( r = 0.258, p = 0.194).

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In introduction sections, all studies described an objective, but only 17/27 (63%) of studies stated a directional hypothesis. In methods sections, only 16/27 (59%) of studies indicated whether ethical approval for conducting human subjects research was sought and received. Most studies reported adequate detail on participant demographics such as age and sex or gender identity (23/27; 85%) as well as disability characteristics such as primary diagnoses or severity (22/27; 81%). However, inclusion and exclusion criteria were less commonly described (17/27; 63%). Only 5/27 studies (19%) described dogs’ breeds and sources. Finally, most studies (21/27;78%) compared outcomes to a control or comparison condition.

In results sections, 15/21 studies with a control or comparison condition (71%) demonstrated that participants in each condition were comparable on demographic variables. This occurred by either matching groups on select criteria or statistically comparing groups’ demographic characteristics before performing main analyses. When reporting statistical results, 78% of studies (21/27) provided estimates of variability for outcomes, including confidence intervals, standard deviations, or standard error of the mean. However, only 44% (12/27) of studies reported statistical values (e.g. t , F , or B values) and only 55% (15/27) of studies reported exact probability values from analyses. Only 6/27 (22%) reported any estimates of effect size in their results. Of 15 cross-sectional studies that surveyed individuals who owned assistance dogs for variable periods of time, 4/15 studies (27%) considered length of time of assistance dog ownership as a potential explanatory or moderating variable in analyses. Finally, in discussion sections, most studies (22/27; 81%) stated at least two limitations of their study.

Study outcomes

To achieve the third aim of the review–to summarize outcomes–psychosocial outcomes within each study were extracted. Studies made an average of 5.4 statistical comparisons on psychosocial outcomes, ranging from 1–15 comparisons. In total, 147 comparisons were made across the 27 studies that examined the effect of having an assistance dog on a standardized scale or sub-scale on a psychosocial outcome: 58 (39%) psychological outcomes, 43 (29%) social outcomes, 34 (23%) quality of life outcomes, and 12 (8%) energy/vitality outcomes. Of 147 comparisons, 44 (30%) were positive (improved or better functioning in comparison to pre- or control conditions), 100 (68%) were null (no observed difference), and 3 (2%) were negative (decreased or worse functioning in comparison to pre- or control conditions). Of the 44 positive comparisons, 36 (82%) were from published papers and 8 (18%) were from unpublished theses. Of the 100 null comparisons, 43 (43%) were from published papers and 57 (57%) were from unpublished theses.

Psychological outcomes.

Table 3 summarizes psychological outcomes across studies in terms of general psychological health, emotional health, mental health, and self-evaluation. Of 27 studies, 20 (74%) assessed a psychological outcome with a total of 24 different standardized measures. Of 58 total psychological outcomes, 21 (37%) were positive (improved or better psychological health in comparison to pre- or control conditions), 37 (63%) were null (no difference), and zero (0%) were negative (decreased or worse functioning in comparison to pre- or control conditions).

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For general psychological health, 5/11 (45%) outcomes were significant across group or condition. Six studies used standardized measures to assess general health and health symptoms, three of which [ 17 , 28 , 35 ] reported null findings on the general health domain of the RAND 36-Item Short Form Health Survey [SF-36; 47 ]. However, Lundqvist et al. [ 35 ] found increased SF-36 health transition scores after 3-months of having a mobility, hearing, or medical service dog, while Guest [ 13 ] found an increase in general health 3-months after receiving a hearing dog using the 30-item General Health Questionnaire [GHQ-30; 48 ]. Three studies found positive findings on measures of overall psychological wellbeing or psychosocial health, including increased psychological wellbeing 3-months after receiving a mobility, hearing, or medical service dog [ 35 ], 6-months after receiving a mobility service dog [ 14 ], and better overall psychosocial health in those with a mobility or medical service dog compared to a control group [ 16 ]. On the other hand, Spence [ 34 ] found no improvement to a composite score of psychological health 12-months after receiving a mobility service dog.

Regarding emotional health, 7/15 (46%) outcomes were significant across group or condition. Yarmolkevich [ 46 ] found a significant effect of having a guide dog on positive affect using the Scale of Positive and Negative Experience [SPANE; 49 ] compared to a control group, while others studies found no effect of having a hearing dog [ 29 ] or mobility service dog [ 39 ] on affect via the Positive and Negative Affect Scale [PANAS; 50 ]. Guest [ 13 ] used the Profile of Mood States Scale [POMS; 51 ], finding less overall mood disturbance, less tension, and less confusion 3-months after hearing dog placement. In terms of emotional functioning, two studies found positive results using the SF-36 role emotional domain; Lundqvist et al. [ 35 ] found increased functioning 3-months after receiving a mobility, hearing, or medical service dog, while Shintani et al. [ 17 ] found better functioning among those with a mobility service dog compared to a control group. On the other hand, Donovan [ 28 ] found no change in emotional functioning 4-months after receiving mobility service dog. Using a different measure of emotional functioning, Rodriguez et al. [ 16 ] found higher emotional functioning in those with a mobility or medical service dog compared to a control group.

A total of 13 mental health outcomes were assessed in which 4 (31%) were significant across group or condition. Of 5 studies that used the mental health domain of the SF-36 or the shorter 12-Item Short Form Health Survey (SF-12), only Shintani et al. [ 17 ] found an effect of having an assistance dog on mental health. The other four studies reported no changes in participants’ mental health 3-months after receiving a mobility, hearing, or medical service dog [ 35 ], 4-months after receiving a mobility service dog [ 28 ], and 7-months after receiving a hearing or mobility service dog [ 32 ]. Six comparisons were made to measure the effect of having an assistance dog on clinical measures of depression or anxiety. However, none of the four studies using the Center for Epidemiologic Studies Depression Scale [CES-D; 52 ] found significant differences in self-reported depression among those with a mobility service dog compared to a control group [ 39 – 41 ] or after 4-months with a mobility service dog [ 28 ]. However, Guest et al. found significantly lower depression and anxiety using the POMS and GHQ-30, respectively, 6-months after receiving a hearing dog [ 13 ].

In the self-evaluation subcategory, 5/19 (26%) outcomes found a significant effect of having an assistance dog on standardized measures of self-esteem, self-concept, and other measures of self-evaluation. Nine studies assessed self-esteem as a primary outcome, with four studies [ 14 , 32 , 36 , 46 ] finding a significant effect of having a guide, hearing, mobility, or medical service dog on self-esteem as measured by the Rosenberg Self Esteem Scale [RSES; 53 ]. However, other studies reported no relationship between having a mobility service dog and self-esteem via the RSES [ 39 , 41 ] or other standardized measures of self-esteem [ 15 , 28 , 36 ]. Using the Psychosocial Impact of Assistive Devices Scale [PIADS; 54 ], Vincent et al. [ 15 ] found no difference in self-esteem, adequacy, or competency over 12-months following receiving a mobility service dog. Other self-evaluation outcomes assessed with null findings included no differences in self-concept between control groups and those with mobility service dogs [ 37 ] or guide dogs [ 46 ], no differences in attitude towards a disability 4-months after receiving a mobility service dog [ 28 ] or among guide dog users compared to a control group [ 38 ], and no differences in flourishing among guide dog users compared to a control group [ 46 ]. The only other positive outcome was from Allen et al. [ 14 ] which found significantly higher internal locus of control 6-months after receiving a mobility service dog.

Social outcomes.

Table 4 summarizes the social outcomes across studies within the sub-categories of general social functioning, loneliness, and social participation. Of 27 studies, 18 (67%) reported outcomes a standardized measure of social health with a total of 18 different standardized measures. Of 43 total social outcome comparisons, 7 (16%) were positive (improved or better social health in comparison to pre- or control conditions), 36 (84%) were null (no difference) and zero (0%) were negative (decreased or worse social health in comparison to pre- or control conditions).

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In terms of general social functioning, 2/10 comparisons made were significant. Three studies using SF-36 failed to find significant effects on the social domain; Lundqvist et al. [ 35 ] found no improvement 3-months after receiving a mobility, hearing, or medical service dog, Donovan [ 28 ] found no improvement 4-months after receiving a mobility service dog, and Shintani et al. [ 17 ] found no difference among mobility service dog users compared to controls. However, on different measures of social functioning Rodriguez et al. found better social functioning in those with a mobility or medical service dog compared to a control group [ 16 ] while Guest found improved social functioning 3- and 12-months after receiving a hearing dog [ 13 ]. In addition, null findings were reported on standardized measures of family role 3-, 6-, and 12-months after receiving a mobility service dog [ 15 ], discrimination and social inclusion 12-months after receiving a mobility service dog [ 34 ], and family and social self-concept among mobility dog users compared to a control group [ 37 ].

The sub-category of loneliness had 19 comparisons in which only 1/19 (5%) was significant. Of five studies using a version of the UCLA Loneliness Scale [ 55 ] only Yarmolkevich [ 46 ] found significantly lower self-reported loneliness in those with a guide dog compared to a control group. Four studies found no effect of having a hearing dog [ 29 ] or mobility service dog [ 39 , 41 ] on the UCLA Loneliness Scale. Two studies from the a single thesis [ 29 ] made the remaining 14 comparisons on measures of loneliness distress and complementary loneliness, finding no significant changes to loneliness six months after receiving a hearing dog and no significant group differences in loneliness compared to those without a hearing dog.

Regarding social participation, 14 comparisons were made in which 4/14 were significant (29%). Two studies found increased social participation 3-, 6-, and 12-months [ 15 ] as well as 7-months [ 33 ] after receiving a mobility service dog, while Donovan [ 28 ] found no change in social participation 4-months receiving a mobility service dog. Other studies found increased social connectedness 3-months after receiving a mobility or hearing dog [ 31 ] and increased community integration 6, 12, 18, and 24 months after receiving a mobility service dog [ 14 ]. Using the CHART, both Milan [ 41 ] and Davis [ 44 ] found no group differences in social integration among those with a mobility service dog control groups. Other null findings included no effect of having a guide dog on social conflict stress and interactions with others [ 42 ], no improvement in social relationships 12-months after receiving a mobility service dog, and null findings regarding self-reported friendship and companionship with a mobility or medical service dog [ 16 ] or 4-months after receiving a mobility service dog [ 28 ].

Quality of life outcomes.

Table 5 displays all quality of life outcomes across studies within the sub-categories of overall quality of life, life satisfaction, and independence. Of 27 studies, 19 (70%) reported outcomes a quality of life measure with a total of 13 different standardized measures used. Of 34 total quality of life outcomes, 9 (26%) were positive (improved or better quality of life in comparison to pre- or control conditions), 22 (65%) were null (no difference) and 3 (9%) were negative (decreased or worse quality of life in comparison to pre- or control conditions).

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In the overall quality of life sub-category, 2/8 (25%) comparisons were significant. Lundqvist et al. [ 35 ] found higher health-related quality of life 3-months after receiving a mobility, hearing, or medical service dog on one of three measures used [EuroQol Visual Analog Scale; 56 ]. Hall et al. [ 45 ] found higher health-related quality of life among those with a mobility service dog compared to a control group, but not among those with a hearing dog. Other studies found no effect of having a mobility service dog on quality of life including more specific measures such as physical and environmental quality of life [ 33 , 34 ].

In the next sub-category, six studies assessed life satisfaction outcomes using Satisfaction with Life Scale [SWLS; 57 ]. However, only 1/6 (17%) found a significant effect, in which Yarmolkevich found higher life satisfaction among those with a guide dog compared to a control group. The other five studies found no effect of having a mobility service dog [ 32 ], hearing dog [ 29 , 32 ], or guide dog [ 38 ] on life satisfaction using SWLS.

In the sub-category of independence, a total of 20 comparisons were made in which 9 (45%) were significant, but 3 (15%) were in the negative direction. The most commonly used measure was the Craig Handicap Assessment and Reporting Technique [CHART; 58 ] which assesses how people with disabilities function as active members of their communities. Using the occupation domain of the CHART, Rintala et al. [ 32 ] found no difference in occupational functioning 7-months after receiving a mobility service dog and Milan [ 41 ] found no group difference in those with and without a mobility service dog. However, 2 studies found worse occupational functioning in terms of employment, schooling, or homemaking. Rintala et al. [ 32 ] found that participants reported worse occupational functioning 7-months after receiving a hearing dog while Davis [ 44 ] found that individuals with a mobility service dog reported worse occupational functioning compared to a control group.

In the economic domain of the CHART, which assesses socio-economic independence, Davis [ 44 ] again found that those with a mobility service dog reported worse economic functioning than controls while two mobility dog studies reported null findings [ 30 , 41 ]. In the mobility domain, only Milan [ 41 ] found a significant effect of having a mobility service dog on the CHART mobility domain (which includes hours per day out of bed and days per week out of the house) while Davis [ 44 ] and Rintala et al. [ 32 ] reported no relationship between the mobility domain and having a service dog or hearing dog. Using other standardized measures of independence, Matsunaka & Koda [ 42 ] found that those with guide dogs reported and lower stress while being mobile. Similarly, Crudden et al. [ 43 ] found that individuals who had guide dogs reported less stress while walking, but not while using public transportation. Using the Reintegration to Normal Living Index [RNLI; 59 ], Hubert found improvements in the ability to return to ‘normal life’ after 7-months with a mobility service dog while Vincent et al. [ 15 ] found improvements to daily work activities 3- and 12-months after receiving mobility service dog (but not in self-care or dealing with life events). Finally, Rodriguez et al. [ 16 ] found that those with a mobility or medical service dog reported significantly higher work/school functioning than a control group.

Vitality outcomes.

Table 6 summarizes vitality outcomes across studies within the sub-categories of general energy/vitality and sleep. Of 27 studies, 7 (26%) reported outcomes from at least one standardized measure of vitality with a total of five different standardized measures. Of 12 total vitality comparisons, 6 (50%) were positive (improved or better vitality in comparison to pre- or control conditions), 6 (50%) were null (no difference) and zero (0%) were negative (decreased or worse vitality in comparison to pre- or control conditions).

https://doi.org/10.1371/journal.pone.0243302.t006

In terms of general vitality and energy, four studies used the SF-36 to measure the effect of having an assistance dog on the vitality domain. Only Vincent et al. [ 15 ] found a significant increase in pep, energy, and feeling less worn out 3- and 6-months after receiving a mobility service dog while three studies found no relationship between the vitality domain and having a mobility service dog [ 17 , 28 ] or a mobility, hearing, or medical service dog [ 35 ]. Using the Profile of Mood States Scale [POMS; 51 ], Guest found increased self-reported vigor 3- and 12-months after receiving a hearing dog and less fatigue 3-months after receiving a hearing dog. Using another measure of energy and fatigue, Craft [ 40 ] found no difference in those with or without a mobility service dog. Regarding sleep, Guest found better self-reported sleep quality 3- and 12-months after receiving a hearing dog while Rodriguez et al. [ 16 ] found no difference in sleep disturbance between individuals with mobility or medical service dog and a control group.

This systematic review summarized the current state of knowledge regarding the effects of owning an assistance dog (including service, guide, hearing, and/or medical alert or response dogs) on standardized outcomes of psychosocial health and wellbeing of individuals with disabilities. Our search procedure identified 24 articles containing 27 studies assessing psychosocial outcomes from a wide variety of human and assistance dog populations. These studies were reviewed to complete three specific aims: to describe the key characteristics of studies, to evaluate the methodological rigor of studies, and to summarize outcomes. The discussion section aims to review the findings from each aim and to provide targeted suggestions for future research.

Our first aim was to describe study characteristics of the literature. We found that most studies were conducted in either the United States or the United Kingdom, but there was international representation of the research in Canada, Sweden, New Zealand, and Japan. Most articles were published in the 2010s, indicating an increasing publication interest in this topic over time. In fact, nine new articles were identified (three theses, six publications) that had been published since the last review on this topic in 2012 [ 9 ]. Increased research on this topic is likely in parallel with the increased roles and demands for different types of assistance dogs worldwide [ 2 ] as well as increased interest in the benefits of animal interaction for human health and wellbeing [ 60 ]. The most commonly studied type of assistance dog was mobility service dogs, followed by hearing dogs. Guide dogs were only assessed in four studies (all of which were cross-sectional, and one of which was an unpublished thesis [ 46 ]). The lack of guide dog-specific research is especially surprising given that guide dogs not only have the longest history of any type of assistance dog [ 61 ] but are also the most commonly placed assistance dog placed by professional facilities worldwide [ 2 ]. Future longitudinal research in this population is necessary to understand the complex psychosocial and physical roles that guide dogs play in the lives of their handlers. Medical service dogs for diabetes and seizure alert/response were rarely studied [ 16 , 35 ], and were assessed in conjunction with mobility service dogs rather than on their own. However, these are relatively new categories of assistance dogs [ 2 ], many of which may also be self-trained [ 62 ], and it appears that emerging research on this population has centered on medical benefits [ 63 ] rather than psychosocial. Future research should focus on assessing outcomes from these medical alert and response assistance dogs and how their roles may be similar or different than mobility, guide, or hearing dogs.

Study designs included both cross-sectional and longitudinal studies, with only one randomized longitudinal study identified [ 14 ]. However, it should be noted that this study by Allen & Blascovich has received considerable critique due to incredibly large effect sizes, unrealistic retention and response rates, and severe methodological omissions including a lack of reporting on recruitment, funding, or where assistance dogs were sourced and trained [despite repeated requests for clarification; 64 , 65 ]. The remaining studies were quasi-experimental in that they did not use randomized assignment to treatment or control groups. Therefore, the current literature is limited to correlational, rather than causal conclusions regarding the benefits of assistance dogs on the psychosocial health of their owners. Overall, sample sizes were higher than what is usually observed in targeted animal-assisted intervention studies with dogs (e.g. [ 66 , 67 ]) but smaller than that of pet dog research [ 68 ]. Interestingly, only one included study [ 16 ] assessed outcomes from participants under the age of 18. Although outcomes from assistance dog placement for children and adolescents have been quantified with qualitative [e.g., 69 – 71 ] and observational [e.g., 72 ] study designs, effects on standardized measures of psychosocial wellbeing including social functioning have not been explored. Therefore, future studies are warranted that specifically assess health and wellbeing using validated parent-proxy or self-report measures to fully understand the potential effects that assistance dogs can have on children and adolescents with disabilities.

Methodological rigor

Our second aim was to evaluate the methodological rigor of studies. We found that similar to the range of study characteristics observed, there was considerable variation in the methodological rigor of included studies. The most notable weaknesses included a lack of adequate reporting in the methodological sections, which not only limits interpretation of findings but prevents reproducibility. First, only 59% of studies stated whether ethical approval for human subjects was sought and received. Future research should specify not only ethical protocols for human subjects research, but also for animal subjects, which is often underutilized and/or underreported in AAI research [ 73 ]. Second, only 63% of studies described inclusion and/or exclusion criteria of recruited participants, and some studies did not report all demographic or disability characteristics of participants. Future studies should provide detailed researcher-specified criteria for participation as well as organizational-specified criteria for placing/receiving an assistance dog, if applicable. For example, organizations that place assistance dogs may have housing, familial, physical, or even financial requirements for potential recipients that should be subsequently reported in the manuscript to fully define the population. It is unreasonable to assume that the changes to an individual’s life following receipt of an assistance dog is identical for all ages, gender identities, backgrounds, and disabilities. Therefore, detailed descriptions of study populations is critical for helping the field understand for whom assistance dogs are beneficial regarding social, emotional, or psychological health and under what contexts or conditions [ 74 ].

Finally, one of the most notable examples of poor methodological reporting across studies was the omission of information regarding assistance dogs’ sources (e.g. purpose-bred from a provider, self-trained) and breeds (e.g., Labrador Retriever, Golden Retriever, Mixes). As the assistance dog itself is the key component of the intervention, details regarding the dog’s breeding, rearing, selection, and training, as well as the assistance dog-handler matching process are critical to disentangling potential mechanisms [ 75 ]. In addition, reporting detailed information on assistance dogs allows for the consideration of the dogs as individual agents in the therapeutic process rather than as uniform tools [ 1 , 74 ].

In addition to poor methodological reporting, many studies were restrained by statistical weaknesses. Many studies did not confirm that participants across groups were statistically equivalent on key demographic variables such as age and sex/gender before conducting statistical analyses. This poses a severe threat to the validity of findings as group differences in outcomes could be caused by underlying differences in certain demographics or characteristics and cannot be confidently attributed to the presence of the assistance dog. Secondly, many studies did not report sufficient detail in results in terms of estimates of variability and effect size. Thorough reporting in terms of the magnitude and variability of effects observed will allow researchers to make informed comparisons across populations and interventions and conduct critically needed meta-analyses in the field.

The third aim of the review was to summarize psychosocial outcomes of studies. We found that studies reported mostly psychological outcomes (74%), followed by social outcomes (67%), quality of life outcomes (70%), and vitality (26%) outcomes. Overall, most (68%) of comparisons made across studies were null in which no statistical difference was found in the outcome compared to before getting an assistance dog or compared to a control group. Importantly, only a few comparisons were made in the negative direction (2%) indicating that there is limited reason to believe that acquiring an assistance dog is associated with worse functioning. A total of 30% of comparisons made were positive in which having an assistance dog was associated with improved psychosocial functioning among individuals with disabilities. In fact, positive findings were identified in all domains and sub-domains of psychosocial health and wellbeing. Promising areas include psychological wellbeing, emotional wellbeing, and social participation in which several positive outcomes were identified. However, almost all positive findings were accompanied by a null finding using the same or similar standardized measure in a different study. The below discussion considers various potential explanations for the inconsistencies in findings across studies.

Variability in assessment times.

One of the main considerations in understanding the potential variability across findings is the aspect of time since assistance dog placement. In longitudinal studies, the first follow-up time point varied from 3- to 12-months after receiving an assistance dog. Within cross-sectional studies, number of years since first partnering with an assistance dog ranged from 6-months to 45 years with means ranging from 2–9 years. This variation in assessment times makes it difficult to draw definitive conclusions on conflicting findings. Further, the number of years spent with the assistance dog at the time of surveying was unknown for half of the cross-sectional studies [ 29 , 37 , 40 , 42 – 45 ]. Therefore, in the cases where positive outcomes were reported in these studies, it is unknown what amount of time with an assistance dog the finding was associated with (and therefore difficult to compare to findings from other studies).

Variability in interventions.

Another potential explanation for inconsistent findings across studies lies in the inherent variability of the assistance dog intervention itself. Assistance dog categories (guide, hearing, mobility, and medical) were collapsed for the purposes of this review, but undoubtedly contribute to the lives of individuals with disabilities in diverse ways. However, even within a single category, there are differences in assistance dog breeds, temperaments, and training that may significantly contribute to observed variance across studies. Second, there is inherent variation in both the quality and quantity of interactions from one assistance dog-owner pair to the next. In addition to the different human and dog phenotypes that contribute to this heterogeneity, there are likely differences in the strength of the human-animal bond and attachment relationships formed between assistance dogs and handlers [ 19 , 76 ]. Moderator analyses will be useful in determining the potential explanatory effects that handler-service dog relationships have on psychosocial outcomes.

Variability in standardized measures.

Another potential reason for the inconsistencies in findings from studies assessing the same construct is disparities across standardized measures. Measures of the same outcome not only can have different wording and items, but also can measure functioning over different time periods or contexts. In one example, four studies included in this review failed to find significant results in comparisons of depression using the CES-D [ 28 , 39 – 41 ]. However, positive findings were found in depression using the POMS by a different study [ 13 ]. The CES-D asks participants to rate how often they had experienced 20 depressive symptoms in the prior week using statements such as “I thought my life had been a failure,” while the POMS asks participants to rate from not at all to extremely how they feel right now using single words such as “sad” and “unhappy.” It is also possible that some standardized measures do not capture the intended effects from having an assistance dog. One author argued that an “important methodological issue is the absence of appropriate measures” in measuring the effect of an assistance dog on recipients’ lives [ 32 ]. Future research is necessary to determine if in fact some measures are inappropriate to measure change following an assistance dog, which may be addressed using interviewing and focus group techniques among assistance dog handlers. The replicated measures identified in this review can serve as a basis for future researchers to collate the existing literature when making assessment choices.

Variability in study rigor.

A final potential reason for outcome discrepancies is variation in methodological rigor across studies. In particular, not only did studies vary largely in terms of sample size, but they also varied in the manner in which statistical analyses were conducted. As mentioned above, a surprisingly high number of studies did not ensure that assistance dog and control groups were statistically equal across demographic and disability characteristics prior to outcome analyses. In these studies, positive findings (i.e., better social functioning in those with an assistance dog compared to a control group) may be partially attributed to an unmeasured variable driving the group difference [ 77 ]. In addition, many studies did not account for confounding variables such as having a pet dog, the progressiveness or type of disability, or relationship status.

Other considerations.

An important finding from this review was that most positive findings were reported in published studies, while unpublished theses were more likely to report null findings. This pattern suggests a potential publication bias present in which disproportionately more positive findings are in the published studies than the unpublished theses [ 78 ]. Importantly, unpublished theses had a similar average sample size as published studies, with similar power to detect effects compared to published studies. Thus, this pattern may be better explained by the “file drawer effect” in which there is a bias towards publishing positive findings over null findings [ 79 ]. Although this tendency occurs in many fields, the file-drawer bias may especially be prevalent in human-animal interaction research due to the preconceived notion that animals are beneficial for humans [ 80 ]. In fact, positive, null, and negative findings are equally instrumental in understanding the complexities of the role that assistance dogs play in the lives of individuals with physical disabilities. As Serpell and colleagues point out, individuals that don’t benefit from animal-assisted interventions may be just as informative from a scientific perspective as the ones that do, and “the entire field potentially suffers when these sorts of contrary or ambiguous findings get buried or ignored” [ 74 ]. Therefore, future efforts should be made to publish null findings in peer-reviewed journals and to encourage scientific transparency [ 80 ].

As a final consideration, it is possible that assistance dogs may not confer significant psychosocial benefits as quantified by some of the standardized measures used. First, there may be ceiling effects present whereby individuals are functioning at initially healthy levels of the measured construct (e.g., depression, self-esteem) prior to receiving an assistance dog and thus may not significantly improve on these measures. This effect may be compounded by the possibility that those who apply for an assistance dog may inherently have certain positive characteristics (e.g., stable housing, stable finances, has a familial support system) that contribute to overall psychosocial health. Further, in contrast to a psychiatric service dog or an emotional support dog, the assistance dogs in this review are not explicitly trained for mental health-related support and their effects on the psychosocial health of their handlers may be variable rather than population-wide. For example, the benefits of an assistance dog for a socially isolated individual who experiences periodic anxiety and depression may be significantly different than an individual without these characteristics. An important question for the field moving forward will be to determine for whom an assistance dog may confer the most significant psychosocial health benefits for, and under what contexts or conditions.

Conclusions

This systematic review identified 24 articles containing 27 studies that assessed a psychosocial outcome of having an assistance dog (guide dog, hearing dog, mobility service dog, or medical service dog). Included studies assessed psychosocial outcomes via standardized measures from assistance dogs that were trained for functional tasks related to a physical disability or medical condition (omitting psychiatric service dogs or emotional support dogs). Despite the purpose of these assistance dogs specifically for physical tasks, positive outcomes were noted in psychological, social, quality of life, and vitality domains. However, results suggested that for most outcomes, having an assistance dog had no effect on psychosocial health and wellbeing. Methodological weaknesses including poor reporting of assistance dog interventions and statistical limitations prevent any clear conclusions made regarding the psychosocial effects of assistance dogs on individuals with disabilities. Inconsistencies in findings were discussed in terms of wide variability in assessment times, interventions, measures, and rigor, and recommendations were made to contribute to the knowledge of this growing application of the human-animal bond. Continued efforts are required to improve methodological rigor, conduct replicable research, and account for heterogeneity in both humans and animals to advance the state of knowledge in this field.

Supporting information

S1 checklist. prisma 2009 checklist..

https://doi.org/10.1371/journal.pone.0243302.s001

S1 Table. MEDLINE search terms and search strategy.

The search strategy was adapted to the other databases, including mapping terms to each database’s thesaurus or prescribed vocabulary, as appropriate.

https://doi.org/10.1371/journal.pone.0243302.s002

S2 Table. Summary of methodological rating scores by each of the N = 27 individual studies.

Studies are organized by design (longitudinal or cross-sectional).

https://doi.org/10.1371/journal.pone.0243302.s003

• 1. Kruger KA, Serpell JA. Animal-assisted interventions in mental health: Definitions and theoretical foundations. In: Fine AH, editor. Handbook on animal-assisted therapy: Theoretical foundations and guidelines for practice. 3rd ed. San Diego: Academic Press; 2010. p. 33–48.
• View Article
• PubMed/NCBI
• Google Scholar
• 3. Assistance Dogs International. ADI Terms & Definitions Glossary 2019 [cited 2019 12/10/19]. https://assistancedogsinternational.org/resources/adi-terms-definitions/ .
• 4. Americans With Disabilities Act of 1990, (1990).
• 24. LaB NioHNH. Study Quality Assessment Tools [cited 2019 June]. https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools .
• 27. Specialist Unit for Review Evidence. Critical appraisal checklists [cited 2019 June]. https://www.cardiff.ac.uk/specialist-unit-for-review-evidence/resources/critical-appraisal-checklists .
• 28. Donovan WP. The psychosocial impact of service dogs on their physically disabled owners: California School of Professional Psychology, Los Angeles; 1994.
• 29. Gilbey AP. Testing the theory that pets can help to alleviate loneliness: University of Warwick; 2003.
• 30. Collins DM. Functional, psychological, and economic benefits of service dog partnership: University of Pittsburgh; 2004.
• 31. Rabschutz L. The effect of partnering with an assistance dog on self-esteem and social connectedness among persons with disabilities. 2007.
• 34. Spence H. How feasible is it to compare effects of companion dogs and service dogs on quality of life in people with movement disorders?: ResearchSpace@ Auckland; 2015.
• 36. Hackett DR. Levels of self-esteem in owners of service dogs: California State University, Long Beach; 1994.
• 37. Rushing C. The effect of service dogs on the self-concept of spinal injured adults: ProQuest Information & Learning; 1995.
• 40. Craft KJ. Service dogs as an assistive device for persons with disabilities: Impact on depression, pain, energy, and perceived intrusiveness: ProQuest; 2007.
• 41. Milan RW. Quality of life of service dog partners: University of Pittsburgh; 2007.
• 44. Davis E. Independence differences among persons with gait disorders with and without assistance dogs [Ph.D.]. Ann Arbor: Capella University; 2017.
• 46. Yarmolkevich N. Bonds Beyond Time: Are There Differences In Well-Being, Autonomy, And Bond Between Visually Impaired Individuals With Guide Dogs Versus Pet Dogs? 2017.
• 51. McNair D, Lorr M, Droppleman L. Profile of mood states manual (rev.). San Diego: Educational and Industrial Testing Service. 1992.
• 58. Whiteneck GG. Craig handicap assessment and reporting technique: Aspen publishers; 1992.
• 80. Herzog H. The Research Challenge: Threats to the Validity of Animal-Assisted Therapy Studies and Suggestions for Improvement. In: Fine AH, editor. Handbook on animal-assisted therapy: Foundations and guidelines for animal-assisted interventions. Fourth ed: Academic Press; 2015. p. 402–7.

Are Therapy Dogs Always Stressed?

The well-being of dogs and other therapy animals demands careful study..

Posted June 22, 2019

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While reading an outstanding new book called Transforming Trauma: Resilience and Healing Through Our Connections With Animals in preparation for an interview with its editors, Philip Tedeschi and Molly Anne Jenkins, I came across a sentence in an essay by Ann Howie and her colleagues titled "Why the Dog?" that somewhat surprised me and to which I've returned a number of times. It reads: "The authors believe that it is impossible to completely avoid stress for a therapy dog, yet it is entirely possible to avoid therapy dog distress." (p. 316) The quotation comes from an essay that was being considered for publication at the time "Why the Dog?" was written, but now has been published by Ashley Melco and her colleagues with the title, " Investigation of Physiological and Behavioral Responses in Dogs Participating in Animal-Assisted Therapy with Children Diagnosed with Attention-Deficit Hyperactivity Disorder ." Neither "Why the Dog?" nor the published study is available online, so here are a few snippets to whet your appetite for finding out more about them. And although I'm focusing on dogs, there's no reason to believe that other animals used for therapy and for other animal-assisted interventions (AAI) aren't also always somewhat stressed. Another essay in Transforming Trauma by Zenithson Ng, called "Advocacy and Rethinking Our Relationships with Animals: Ethical Responsibilities and Competencies in Animal-Assisted Interventions," is also concerned with some of the issues about which I write below. I hope all of these essays will become available for free online.

What's in it for the dog?

Many people are concerned with the well-being of dogs and other nonhuman animals (animals) who are used in animal-assisted interventions. At coffee shops, hiking trails, dog parks, and other venues, I'm often asked questions such as, "Are support dogs happy with their jobs?"; "Do therapy dogs really enjoy what they're doing?"; and "What's in it for the dog?" I also often hear comments such as: "Those dogs aren't really happy" or "Those support dogs always look distressed."

When I talk with people who ask these and other questions or who make similar comments about the compromised lives of therapy dogs, I usually explain the difference between positive or beneficial stress ( eustress ) and aversive stress or distress . (See " Working for Food Enriches Dogs' Lives and Breaks the Boredom " for further discussion.)

While dogs and other animals used to support humans can have very difficult jobs, many who I've met have very good lives and aren't necessarily suffering more than homed dogs who aren't specifically used for any type of support. While it might seem like the lives of homed dogs are cushy and without stress, this isn't so at all. (See Canine Confidential , Unleashing Your Dog , " Dogs, Captivity, and Freedom: Unleash Them Whenever You Can, " and references therein.) Homed dogs, for the most part, are captive beings who live highly constrained lives. I focus on homed dogs, because while they represent a tiny fraction of the global population of dogs, estimated to be around 900 million , these are the canine beings with whom most people are familiar and who are used for various types of human support. Someone suggested to me that these also are the dogs with whom most researchers are most familiar. It's also been estimated that around 85 percent of dogs are free-ranging individuals , some of who have some human assistance, and others who have none.

Referring to dogs as captive animals is not meant to criticize humans who choose to take dogs into their homes and hearts. Rather, it is a fact of dogs having to adapt to human-dominated environs. Suffice it to say, companion dogs live highly constrained lives and want and need much more than they usually get from us. However, as discussed in Unleashing Your Dog and elsewhere, there's a lot we can easily do to give them considerably more freedom and allow them to express their dogness. (See " Dogs Want and Need Much More Than They Usually Get From Us. ")

Think about it: We teach dogs that they can’t pee or poop wherever they want. To eliminate, they must get our attention and ask for permission to go outside the house. When we go outside, we often restrain dogs with a leash or fence them within yards or parks. Dogs eat what, when, and how we feed them, and they are scolded if they eat what or when we say they shouldn’t. Dogs play with the toys we give them, and they get in trouble for turning our shoes and furniture into toys. Most of the time, our schedule and relationships determine who dogs play with and where and who their friends will be. It’s an asymmetric, one-sided relationship, one that many of us would not tolerate with another human. Simply put, just about all homed dogs want and need more freedoms.

The dog or other animals' well-being must come first

"My therapy dog is the most important animal in the world to me. He must be happy, and when he is happy, I am happy. When I see that he is distressed, I step back and allow him to rest and to recuperate. There are times when I really need him, but I leave him alone until he is ready to work. I do the best I can without his 100 percent support." (In conversation with a war veteran suffering from PTSD .)

Returning to Ann Howie and her colleague's piece "Why the Dog" and their discussion of the study by Ashley Melco and her colleagues, after they write, "The authors believe that it is impossible to completely avoid stress for a therapy dog, yet it is entirely possible to avoid therapy dog distress," they go on to note that there are steps that people using therapy dogs can take to avoid distress. These include becoming fluent in dog, or dog literate ; matching dogs with clients who will work with dog's "strengths, abilities, and temperament;" developing "handling skills that support the individual dog rather increase stress;" developing and being willing to implement a plan to be sure that the therapy dog's welfare during and after a session are being given careful attention; being aware when a dog's well-being is threatened or compromised; allowing the dog to recover after each session; and giving the dog time-off and vacations. (See " Living With a Dog Is Good, If It's Good for You and the Dog ," " How to Give Dogs the Best Lives Possible in a Human World ," " iSpeakDog: A Website Devoted to Becoming Dog Literate, " " How Well Do You Know What Dogs Do, Think, and Feel? ", and " New Study Shows Importance of Understanding Dog Behavior " for discussions of how knowing what dogs are saying to us can help us learn if they're in pain or doing well.)

I would add that if a dog cannot adapt to the situation in which she or he is being asked to perform, they should not be used. Not all dogs or other animals are cut out for providing therapy or other AAIs. In an interview I conducted with Risë VanFleet, a licensed psychologist, registered play therapist-supervisor, and certified dog behavior consultant, and Tracie Faa-Thompson, a specialist social worker in the adoption field and a British Association of Play Therapist, about their book, titled Animal Assisted Play Therapy , they stressed that our relationships with our companion animals are often one-sided. When we look at the many articles and blogs that are written about animals in therapy, they usually extol the benefits for humans, but they rarely discuss the impact on the animals. The accompanying pictures show a delighted human and a thoroughly stressed or miserable animal. It is better for everyone—client, animal, and therapist—when the needs of the animals are always considered and acted upon. (See " Animal Assisted Play Therapy: An Integrative Approach .")

It can't be emphasized too many times that matching dogs with clients who will work with dogs' "strengths, abilities, and temperament" is critical. The bottom line can be simply stated as follows: There is no universal dog—no "the dog"—so normative generalizations simply do not reflect who dogs truly are . Thus, the unique personality of each dog, each human, and their relationship must always come first. It's also essential to realize that dogs, humans, and the nature of their relationships can change with time. Each and every dog-human relationship needs to be considered on a case-by -case basis.

Ann Howie and her colleagues also write about " The Therapy Dog's Bill of Rights ," which includes 13 rights of a therapy dog. These include having the right to a handler who "Obtains my consent to participate in the work;" Provides gentle training to help me understand what I'm supposed to do;" "Provides a well-rounded life with nutritious food, physical and intellectual exercise, social time, and activities beyond work;" and "Respects my desire to retire from work when I think it is time." I encourage all people who work with dogs and who choose to live with dogs to read this Bill of Rights over and over again and to apply it to all canine companions.

Ashley Melco and her colleagues conclude, "The results indicate that with proper supervision and well-trained therapy staff, including suitable therapy dogs and their handlers, canine stress can be minimal in a therapy setting." It is essential that everything that can be done to minimize all sorts of stress be used, and if the situation is too stressful for a dog, she or he should not be used.

Where to from here? Are therapy dogs more stressed or distressed than homed dogs?

In Unleashing Your Dog, Jessica Pierce and I adapted and expanded the original Five Freedoms into Ten Freedoms that should guide our interactions with dogs and other nonhumans . The Five Freedoms are a popular cornerstone of animal welfare. First developed in 1965 and formalized in 1979 by the UK’s Farm Animal Welfare Council, the Five Freedoms were designed to address some of the worst welfare problems experienced by animals used within industrial farming (or “factory farming”). Since their development, the Five Freedoms have been applied to an increasingly broad range of captive animals, such as those living in zoos and research labs. Zenithson Ng's essay in Transforming Trauma also includes a discussion of the Five Freedoms.

Freedoms one to five focus on freedoms from uncomfortable or aversive experiences. Freedoms six to ten focus on freedoms to be dogs or whoever the other animals are. Like all animals, dogs and other animals need the following:

1. Freedom from hunger and thirst

2. Freedom from pain

3. Freedom from discomfort

4. Freedom from fear and distress

5. Freedom from avoidable or treatable illness and disability

6. Freedom to be themselves

7. Freedom to express normal behavior

8. Freedom to exercise choice and control

9. Freedom to frolic and have fun

10. Freedom to have privacy and “safe zones”

Many, if not most dogs love to play, to frolic, and to have fun. I well remember a woman confined to a wheel chair who had a therapy dog. Despite the risks, she told me she allowed a friend to take him to a local dog park or on a long walk or hike every single day. She recognized he might get over-tired or sprain an ankle, but she insisted that he be allowed to have fun and that he was happier when he could romp around with friends and just be free. She felt good about it, and it was a win-win for all.

Here are 10 ways to make all dogs, including therapy dogs, happier and more content:

1. Let your dog be a dog.

2. Teach your dog how to thrive in human environments.

3. Have shared experiences with your dog.

4. Be grateful for how much your dog can teach you.

5. Make life an adventure for your dog.

6. Give your dog as many choices as possible.

7. Make your dog’s life interesting by providing variety in feeding, walking, and making friends.

8. Give your dog endless opportunities to play.

9. Give your dog affection and attention every day.

10. Be loyal to your dog.

Stay tuned for further discussions of the lives of therapy dogs and other nonhumans and for my interview with Philip Tedeschi and Molly Anne Jenkins. The formal study on which I'm focusing by Ashley Melco and her colleagues is very interesting and important; however, it's limited to a relatively small number of dogs (9), and the specific situation with which it was concerned (children with ADHD ). We need many more comparative studies, because we really don't know if therapy dogs considered as a whole are any more stressed or distressed than, for example, homed dogs. While some people think they are, at present it's a matter of speculation.

My best guess is that research will show that while some therapy dogs are more stressed and distressed than other homed dogs, some aren't. General comparisons across groups are very limited in meaning. The critical assessment of how a dog is feeling must focus on each and every individual . What works for one or some dogs might not work for others. As I wrote above, the unique personality of each dog, each human, and their relationship must always come first, and dogs, humans, and the nature of their relationships can change with time. Each dog-human relationship needs to be considered over time on a case-by-case basis.

The increasing popularity of all sorts of therapy dogs demands that we openly discuss what their lives are like, how we can make them better, and when a decision has to be made that an individual dog simply is not cut out for this sort of work.

What an exciting time it is to study dog behavior and all varieties of dog-human interactions. The more we learn, the better it will be for all dogs and their humans—a win-win for all.

Marc Bekoff, Ph.D. , is professor emeritus of ecology and evolutionary biology at the University of Colorado, Boulder.

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• Coronavirus Disease 2019
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‘Dogs have a magic effect’: how pets can improve our mental health

Canine companions trigger similar neural pathways to the parent-baby bond, and reduce loneliness and depression. Now new pet therapy trials are reporting dramatic effects

W hat is it about animals? As the bad news about the coronavirus continues, “send me dogs and cats” has become a regular cry on social media, an easy-to-grasp shorthand for “I feel terrible, cheer me up”. The response is always the same: a torrent of pictures of animals doing daft things – but somehow it has a magical, calming effect.

The therapeutic value of our relationship with our pets, particularly dogs, is increasingly recognised by researchers. Cats can be wonderful too – but dogs have been domesticated by humans for much longer, and, as even the most devoted cat lover will admit, dogs are far easier to train for companionship. Most cats, as we know, are admirable for entirely different reasons. Marion Janner, a mental health campaigner and all-round animal lover, says that dogs teach us a whole range of lessons. “Dogs love us unconditionally. They’re the ultimate in equal opportunities – entirely indifferent to race, gender, star sign, CV, clothes size or ability to throw cool moves on the dance floor. The simplicity and depth of this love is a continuous joy, along with the health benefits of daily walks and the social delights of chats with other dog walkers. They teach kids to be responsible, altruistic and compassionate and, valuably but sadly, how to cope when someone you love dies.”

Robert Doward* felt this odd effect when his health suddenly took a downward turn. “I’d been working incredibly hard, long hours, too many days. One day I started crying and just couldn’t stop. I couldn’t put sentences together properly. I’d been pushing everything so hard for so long, and I just couldn’t do it any more.”

It took a long time to put himself back together: plus some therapy, another job and changes to his family life. But the key factor, he says only half-jokingly, was a small Greek rescue dog called Maria. “Taking her out for walks, getting out into fresh air, just putting one foot in front of the other, that lifts your spirits. And then there’s nothing like having a dog curled up beside you, even when you feel absolutely miserable. She’ll check my face anxiously, as if she knows something is wrong. And that makes me smile – and that somehow makes you feel better. There is just something magic about dogs. Honestly, she got me through.”

But why? What is responsible for these therapeutic effects? One key aspect appears to be social recognition – the process of identifying another being as someone important and significant to you. The bond that forms between owner and pet is, it seems, similar to the bond that a mother forms with her baby.

The importance of social recognition is increasingly acknowledged for the role it plays in helping us form networks. We now understand that healthy social bonds can play a key role in mental health; without them, we become lonely, depressed and physically unwell. And pets, it seems, can fulfil that role. Academic and psychologist June McNicholas points out that pets can be a lifeline for socially isolated people.

“Pet care and self-care are linked. When you take a dog out for a walk, people talk to you and that may be the only social contact an isolated person has the whole day. If you have a cat, you can have a conversation standing in the cat food aisle in the supermarket, deciding which brand to buy. When pet owners leave the house to buy pet food, they’re more likely to buy food for themselves and when they feed their pet, they’ll sit down to eat too. People with disabilities often find that able-bodied people are socially awkward with them; if they have a dog it breaks down barriers and allows a more comfortable and natural interaction.”

Social recognition is something humans share with a few (though not all) mammals, including sheep and prairie voles. We are primed to look after those we have made social bonds with; we don’t breastfeed just any old baby and we don’t take random dogs home from the park. Author and researcher Meg Daley Olmert explains “When we call our dog, ‘our baby’ it is because we recognise it on a neural level as such. And this recognition triggers the same maternal bonding brain networks that allow a mother to look at her red, slimy newborn and say, ‘mine!’”

A small study of functional MRI brain scans in 18 women showed similar responses in regions involved in reward, emotion and affiliation when the women looked at images of their child and pet dog.There were important differences though; dogs caused activity in the fusiform gyrus (involved in facial recognition) and babies in the tegmentum (centres of reward and affiliation). We love our pets, but in a fire we’re primed to save the baby.

Although scientists have some understanding of social recognition and where it takes place in the brain, we still don’t entirely understand how it happens. The missing link could be oxytocin, the so-called “hug”, “love” or “cuddle” hormone. Oxytocin has a key role in both childbirth, lactation and sperm movement, but it also has an increasingly recognised role in our social behaviour, acting as a chemical messenger in pathways that control sexual arousal, recognition, trust, mother-infant and human-pet bonding.

Oxytocin works in tandem with another brain hormone, vasopressin , to help to modulate our response to stress and deal with social situations. Unsurprisingly, there’s a lot of interest in a possible role for oxytocin in addiction, brain injury, anorexia, depression, autism and severe anxiety.

And there are other reasons that pets and therapy animals are increasingly recognised as being good for our mental health. In addition to helping to alleviate stress, anxiety, depression and loneliness, there are all the benefits that come from having to exercise a dog. Daily walks outdoors boost physical and emotional wellbeing. Chucking sticks, picking up balls – even scooping up dog poo – can provide an all-round workout.

Increasingly that knowledge is being turned to practical use, with some lovely effects. When the Centre for Mental Health ran an evaluation on therapy dogs in prisons , for example, the feedback was off the scale. “I don’t know what it is, but even when I am running around with [the dog] I just feel better inside, calmer, more peaceful,” said one prisoner. Another told the interviewer: “Dogs have a magic effect on you, you can feel their love and that just makes you feel better inside you.”

The good feelings persist even after the dogs have left, the reviewers found, with one subject saying: “I just walk around for the rest of the day on cloud nine.”

Some of the UK’s most dangerous and violent mental health patients are cared for in one of four high-security psychiatric hospitals. Most are diagnosed with schizophrenia and stay an average of seven years. The State hospital in South Lanarkshire, Scotland, is one of these facilities and runs an animal therapy centre which gives patients the chance to pet and care for a range of animals including chipmunks, rabbits, hens, geese, pygmy goats and pigs.

Staff say that animal therapy helps to develop problem-solving skills, empathy, attention to the needs of others, a sense of responsibility and a way of channelling aggressive thoughts among individuals who have proved hard to reach with conventional psychiatric drugs and talking therapies.

But what if you don’t have a pet? Is there any shortcut to reproducing the beneficial effects? One candidate is sildenafil (Viagra). Having sex causes an oxytocin surge in the brain and taking Viagra may reproduce that surge without the faff of mating. A more practical idea might be an oxytocin spray or tablet.

But biologist Sue Carter says that translating naturally occurring oxytocin into a commercially available product is challenging. Oxytocin has unique chemical properties and can shift form, making it hard to work with and measure. Importantly, “the effects of oxytocin are context dependent, sexually dimorphic (different in men and women), and altered by experience.”

Honestly? Gazing into your dog’s eyes may produce a more reliable sense of wellbeing than any commercially available synthetic product.

* Some names and details have been changed.

• In mind: focus on mental health
• Mental health

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Just 10 minutes with a therapy dog may have profound health benefits — study

New research pinpoints the benefits of therapy dogs for alleviating pain, anxiety, and depression.

For decades , doctors have informally deployed therapy dogs — canines that are trained to provide emotional support to people in hospitals, care homes, and other settings — as part of their patients’ health plans. But despite their longstanding clinical use, there’s been little evidence to show they actually work, until now.

Compared to significant research on the health benefits of dog ownership, there are very few controlled trials on the health outcomes of therapy dogs. A group of Canadian researchers recently set out to bridge this gap. Their work, which was published Wednesday in the journal PLOS One, reveals a small, but significant link between therapy dogs and improved mental health in emergency room patients.

“This is the first controlled trial of its kind that our team knows of in Canada,” Colleen Dell , a co-author on the study and an associate at the University of Saskatchewan’s School of Public Health, tells Inverse .

What’s new — The researchers found that spending just ten minutes with therapy dogs improved hospital patients’ overall well-being. Compared to patients who hadn’t spent time with therapy dogs, those who did reported significantly lower levels of anxiety and depression following the visit.

Patients who experienced the therapy dog visits also reported increased well-being compared to those who did not, as well as significantly lower pain ratings.

“These findings suggest that the therapy dog intervention had a positive effect on reducing participant pain,” the researchers write.

This study “offers a clearer understanding of the potential value of therapy dogs in the emergency department,” Dell says.

Doctors have utilized therapy dogs informally for years, but there have been few clinical trials conducted on the health benefits of these visits.

Why it matters — Patients commonly visit the emergency room to manage pain, and mental health concerns like anxiety often make the pain worse.

“People attend the Emergency Department primarily for pain, and associated anxiety can make it worse because of environmental stressors, such as bright lights and long wait times,” Dell says.

Therefore, understanding how one method of care — therapy dogs — impacts pain and mental health will be enormously valuable in improving patients’ well-being in these situations.

“Interacting with a therapy dog can make the ER visit a little calmer and help the patient and family realize that all the members of the ER staff are there to help and support them,” James Stempien , a co-author on the study and the provisional head of emergency medicine at the University of Saskatchewan in Canada, tells Inverse .

There’s also a timely reason for this study, the paper notes. As concern over the mounting opioid epidemic grows, clinicians are seeking alternative pain relief methods for their patients.

“There is a prior study that found involving therapy dogs in patient care plans following joint replacement surgery improved patient pain scores,” Dell says.

Another study found that the distraction therapy dogs provided did not reduce the patients’ source of pain but it did affect their perception of pain according to Dell. In a sense, doctors have been informally “ prescribing” people’s own pets to help them with depression and chronic pain, Dell explains.

“Many hospitals, care homes, jails, university campuses...are constantly asking that therapy dogs attend because they can assist people in numerous ways,” Dell says.

But Dell also stresses we need more research before therapy dogs can serve as a catch-all treatment for pain in emergency departments or other settings. After all, dogs are also “sentient beings” and not medications we can simply dole out, Dell says.

Therapy dogs can help ease pain and reduce anxiety for emergency department patients, the study finds.

How they made the discovery — Researchers recruited hundreds of patients at the Royal University Hospital Emergency Department to participate in their trial; the hospital has a longstanding therapy dog program.

Ultimately, 97 patients were selected to receive therapy dog visits, while 101 patients participated in the control group that did not receive such therapy. Researchers measured the patients’ pain severity, anxiety, depression, and general well-being on a rating scale according to the Edmonton Symptom Assessment System. Higher ratings indicated worse patient outcomes.

On average, therapy dogs spent ten minutes with each patient. The researchers conducted follow-up visits and used a quantitative data analysis program to determine the differences in patients’ scores before and after therapy dog visits. Finally, researchers also reviewed any pain medications patients were taking to ensure they were accurately measuring the effects of the therapy dogs and not other factors.

What’s next — While these findings are significant, the researchers are also quick to point out there are considerable limitations in their study. For one thing, the sample size of participants is small.

The researchers write that “a larger sample would be needed to examine the interaction of multiple key demographic independent variables,” such as the therapy dog’s experience levels and patient backgrounds such as ethnicity or age.

Other factors, like the potential impact of the dogs’ human handlers on therapeutic benefits, will require further study in future research to “even more precisely isolate what is happening for the patient,” Dell says.

For now, though, the new work provides tangible proof of a treatment for pain that doctors and patients have long known works.

This article was originally published on March 13, 2022

Photo Essay: Therapy Dogs Provide Support At Airport

Paws 4 Passengers is a non-profit organization that uses nationally registered therapy dogs to comfort the traveling public and employees at the Reno-Tahoe International Airport in Reno. They will be volunteering often during the busy holiday season as the airport will be packed with busy and anxious visitors.

"This program is important because it has a calming effect on people. The children are happy. They're not calm. They are excited when they see our dogs, but it has a calming effect on the general public and unfortunately, in today's world, people aren't calm when they come to the airports," said Debbie Harvey, the founder and board chairman for Paws 4 Passengers. 

Our reporter, Alexis Harris, spend some time with four volunteer therapy dogs and their owners, while taking photos of them at work.

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The Dogs Helping the Covenant Children Find Their Way Back

To heal after a mass shooting, the Covenant School families have turned to therapy, faith, one another — and a lot of dogs.

Monroe Joyce, 10, runs with one of two dachshunds taken in by her family. She is one of several children who now have a dog after surviving the Covenant School shooting. Credit...

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By Emily Cochrane

Photographs by Erin Schaff

Emily Cochrane and Erin Schaff spoke with more than a dozen Covenant School parents, students, staff and their dogs.

• March 24, 2024

Two of April Manning’s children, Mac and Lilah, had just survived the mass shooting at the Covenant School in Nashville. They needed stability and time to grieve.

So she did everything she could to keep the family dog, Owen, their sweet but ailing 15-year-old golden retriever, with them for as long as possible. She pushed back his final trip to the vet, keeping him comfortable as he slowly moved around the house.

Getting another dog was the furthest thing from her mind. But a few weeks after the shooting, her children sat her down for an important presentation.

Prepared with a script and a PowerPoint — “Why We Should Get (Another) Dog” — they rattled through research showing the mental health benefits of having one. It could limit their chances of developing PTSD and help them feel safe. Playing together would get them outside and boost their happiness.

Ms. Manning and her husband considered. Maybe a second dog was possible.

First came Chip, a Cavalier King Charles spaniel. Then, after Owen succumbed to old age, came Birdie, a miniature poodle and Bernese Mountain dog mix. And in taking them in, the Mannings were far from alone.

In the year since Tennessee’s worst school shooting, in which three third-graders and three staff members were killed by a former student, more than 40 dogs have been taken in by families at Covenant, a small Christian school of about 120 families.

“I really only expected them to help in a cuddly kind of way, like just to snuggle the kids when they’re upset ,” Ms. Manning said. “But I wasn’t really expecting all the other benefits from them.”

To spend time with the Covenant families is to understand how they have relied on one another, traditional psychological treatments and mental health counseling, and their Christian faith to hold them together.

But it is also to see how often what they needed — a distraction, a protector, a friend who could listen, something untouched by darkness — came from a dog.

An Immediate Response

Dogs greeted the surviving children at Sandy Hook Elementary School as they returned to a refurbished middle school in 2013. A dozen golden retrievers were on hand in Orlando to provide comfort after the deadly attack at a L.G.B.T.Q. nightclub in 2016. The therapy dogs who tended to the surviving students in Parkland, Fla., made the school yearbook .

“Over this period of sort of, 35,000 years, dogs have become incredibly adept at socializing with humans, so they’re sensitive to our emotional state,” said Dr. Nancy Gee, who oversees the Center for Human-Animal Interaction at Virginia Commonwealth University.

Even brief, minute-long interactions with dogs and other animals can reduce cortisol, the body’s stress hormone, research by Dr. Gee and others has shown, providing a possible lifeline for veterans struggling with PTSD and others recovering from trauma.

And on the day of the Covenant shooting, dogs were immediately there to help. Covey, the headmaster’s dog, was at a nearby firehouse, where dozens of staff members and students were evacuated. Squid, a retriever mix, was at the children’s hospital at Vanderbilt University Medical Center, helping to comfort the staff if needed.

When the students who survived were put on a school bus to be reunited with their anguished parents, Sgt. Bo, a police dog, was sitting at their side.

Officer Faye Okert, the dog’s handler with the Metro Nashville Police, handed out a baseball card of dog facts to distract and comfort the children.

“The focus was on him,” said Officer Okert. “You had smiles after what they had been through.”

After families reunited, counselors offered clear advice: To help your child, get a dog. Or borrow a neighbor’s.

That led several parents to connect with Comfort Connections, a nonprofit comfort dog organization. Jeanene Hupy, the group’s founder, had seen firsthand how therapy dogs had helped the Sandy Hook students and started her own organization once she moved to Nashville.

The group, which oversees a menagerie of golden retrievers, a gentle pit bull and a massive English mastiff, began its work by visiting individual homes in the days after the shooting. Then, when students returned to class weeks later, the dogs were once again there.

They were something to look forward to, in the moments when walking through the school doors felt overwhelming. And when there were painful reminders — a water bottle clattering to the floor, an unsettling history lesson on war or the absence of a friend — a child could slip away and cuddle a dog.

As Ms. Hupy put it, something special happens “when you bring in something that loves you more than it loves itself, which is these guys.”

A Reassuring Presence

First it was a joke, then a reality: Everyone was getting a dog.

Fueled by community donations and her own money, Ms. Hupy began connecting several parents and puppies. Even for families who could easily afford a new dog, Ms. Hupy and her trainers dramatically eased the logistical hurdles by finding and training puppies that seemed perfect fits to each family.

The Anderson girls shrieked and cried with joy when they learned they were getting a dog, and have now taught Leo how to flaunt sunglasses and do tricks. The Hobbs children constantly scoop up Lady Diana Spencer, often fashionably dressed in a string of pearls or sweaters.

The dogs are also there in the harder moments, too, like when an ambulance or police car drives by blaring its siren or when the memorial ribbons in their neighborhood remind them of what was lost.

“Sometimes it’s just nice to have a giant soft pillow that doesn’t need to talk to you and just cuddle it,” said Evangeline Anderson, now 11.

And if the dogs chew on a shoe or make a mess on a rug, Ms. Manning said, it is a lesson in how to deal with conflicting emotions.

“We still love them and we’re so glad we have them — both things can be true,” she said. “Just like we can be really nervous about going back to school and still also be excited to do it.”

And maybe, the parents realized, it was not just for the children.

Rachel and Ben Gatlin were driving back from vacation on the day of the shooting. That has meant grappling with the heaviness of survival and knowing that Mr. Gatlin, a history teacher who carried a pistol on his ankle for personal protection, could have run toward the shooter that day.

And while their new dog, Buddy, has adapted to the bossiness of their young children and has developed a penchant for sock consumption, he has also kept the adults’ thoughts focused in the moment. Tending to his needs has served as a reminder of their own.

“When you see it working, you’re in total comfort,” Ms. Gatlin said.

Even the school’s chaplain, Matthew Sullivan, found that the stories of new puppies being shared each day in chapel were “wearing me down in a good way.”

“I kind of wanted to enter into the experience of all these families firsthand,” he said.

Now Hank, a slightly anxious, floppy-eared Scooby-Doo doppelgänger, has been adopted into his home, which had been a little empty without his grown children.

The Alternatives

Not everyone got a dog.

For the McLeans, the solution was two rabbits.

“It’s an incredible distraction to their reality,” Abby McLean said of her children, cupping her hands to mimic cradling a rabbit on her shoulder. “I find myself occasionally doing it as well.”

Another family added Ginny, a tortoise with a possible seven-decade life span, to the mix of animals already in their house.

“For having lost people early in life — there was something that equated to me in that, that there was a longevity to it, to a tortoise,” said Phil Shay, who picked out the tortoise with his 12-year-old daughter, Ever.

Still, the dogs far outnumber the other pets. And every day they can make a little difference.

The first night that George, Jude and Amos Bolton had tried to sleep alone without their parents after the shooting, the slightest grumble from the ice machine or the dryer had been too much. Their mother, Rachel, who had maintained that she liked dogs, just not in her house, soon agreed to take in Hudson, a miniature Goldendoodle puppy with doe-like eyes and wild curls.

“We didn’t realize the dogs could create comfort for people,” Jude, now 10, said, his hands ruffling Hudson’s ears. And when Hudson came home, he added, “he’s just been comforting us ever since.”

It is now easier to sleep through the night, safe with the knowledge that Hudson is there.

“All my friends joke, they’re like, ‘I can’t believe you’re a dog person now,’” Ms. Bolton said. But this dog, she added, “has healed this family.”

Emily Cochrane is a national reporter for The Times covering the American South, based in Nashville. More about Emily Cochrane

Erin Schaff is a photojournalist for The Times, covering stories across the country. More about Erin Schaff

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Paws for Thought: A Controlled Study Investigating the Benefits of Interacting with a House-Trained Dog on University Students Mood and Anxiety

Simple summary.

This study investigates whether interacting with a dog would have a positive effect on university students’ mood and anxiety. Students were assigned to either watch videos of a dog or interact directly with a dog. Several measures were collected both before and after their assigned conditions to evaluate their mood and anxiety levels and to assess for possible changes. The results indicated that participants in both conditions experienced a reduction in their anxiety and an improvement in their mood across time, however those who directly interacted with a dog experienced a greater decline in anxiety and improved mood scores.

University students have been found to have higher rates of psychological distress than that of the general population, which reportedly rises significantly upon starting university and does not return to pre-university levels throughout their time in university. It is therefore highly important to find ways to improve student health and well-being. One way that may help is by interacting with animals. Therefore, the purpose of this study was to determine whether interacting with a dog would have a positive effect on university students’ mood and anxiety. This study assigned 82 university students to either the experimental condition (dog interaction, n = 41) or to the control condition (dog video, n = 41). The students completed the Positive and Negative Affect Schedule-Expanded Form (PANAS-X), State-Trait Anxiety Inventory (STAI) and the Pet Attitude Scale before their assigned conditions, to evaluate their mood and anxiety levels and attitudes to animals. The participants again completed the STAI and PANAS-X Form after their condition, to assess for possible changes in anxiety and mood. The findings of the study indicated that all participants, regardless of condition, experienced a reduction in their anxiety and an improvement in their mood across time. However, directly interacting with a dog resulted in greater declines in anxiety and improved mood scores, more so than watching a video. Consequently, it appears there are psychological benefits to be gained by students from interacting with dogs and it is hoped this study will help to inform future best practices in designing student dog interventions.

1. Background

University can be a very stressful time for students, especially when they are faced with a new environment as well as the social, academic and emotional challenges that are part of university life. The transition from late adolescence into emerging adulthood is a key developmental period marked by new challenges, changing roles and increased responsibilities [ 1 ].

For many students, moving to university is their first time being away from home and they may therefore experience homesickness or have trouble settling while away from friends and family. In particular, first year students are more prone to coping with difficulties when adjusting and learning to handle their new responsibilities. These new challenges may be even more difficult for those individuals who are suffering from psychological issues, such as anxiety and depression. University students have been found to have higher rates of psychological distress than that of the general population [ 2 ]. Furthermore, students’ levels of psychological distress have been reported to rise significantly upon initially starting university and do not return to their pre-university levels throughout their time in university [ 1 , 3 ].

Brougham et al. [ 4 ] examined the stresses that come from transitioning into university life, the sources of stress and students’ coping strategies. The sources of stress include financial, academic, social, family and daily hassles (e.g., being late). Avoidance, self-punishment and self-help were just some of the coping strategies reported.

According to the American College Health Association, [ 5 , 6 ]) stress is the most commonly reported barrier to students’ academic success. The American College Health Association’s National Assessment was used to survey American university students with students reporting that within the past year, 58.4% felt overwhelming anxiety, 59% felt very lonely, 65% felt very sad, 37% felt so depressed that they found it difficult to function and 9.8% seriously considered suicide [ 5 , 6 ]. Furthermore, according to the Centre for Collegiate Mental Health 2017 Annual Report [ 7 ], 161,014 students at the 147 universities and colleges contributing to the report sought counselling during the academic year, 2016–2017. The three most common psychological issues faced by these students were anxiety (62.2%), depression (49.7%), stress (45.5%). The report also indicated that anxiety and depression are the most common presenting concerns (as assessed by clinicians) and are the only presenting concerns that have demonstrated a clear growth trend over the last four years whilst other concerns appear to be stable. The report also stated that, for the seventh year in a row, the lifetime prevalence rates of threat-to-self characteristics (serious suicidal ideation, non-suicidal self-injury and suicide attempts) increased among students seeking treatment.

In another study, Beiter et al. [ 8 ] studied stress, anxiety, and depression among college students. The researchers found that 15% experienced anxiety, 11% struggled with depression and 11% of students reported dealing with stress. The Institute of Public Policy Research [ 9 ] analysis suggests that, in the United Kingdom, between the years 2015–2016, 15,395 UK-domiciled first-year students disclosed a mental health condition which is almost five times the number reported in 2006–2007. Furthermore, the report states that between 2007 and 2015, the number of student suicides increased by 79% (from 75 to 134). The number of students who dropped out of university due to experiencing mental health problems had increased by 210% in the years 2014–2015 when compared to 2009–2010 figures. The universities themselves have also reported experiencing significant increases in demand for counselling services over the past five years, with 61% of those universities reporting that the demand has increased by over 25%.

Given these figures, it is clear that the transition into university can be incredibly stressful, and as a result, this population is particularly vulnerable to developing or exacerbating depressive symptoms [ 10 ]. With this in mind, and the impact that these issues may have on students’ academic success, there is a clear need to find ways to reduce stress and improve student health and well-being.

One way that may help is interacting with animals. It is commonly reported in the media that owning a pet can have a positive impact on our physical health and wellbeing, such as increased physical activity, increased social interactions and reduced blood pressure [ 11 ]. Studies have also indicated that there are some psychological benefits to be gained from pet ownership. Over the years, research has shown that pet owners, and particularly dog owners, have greater life satisfaction, enhanced self-esteem, reduced levels of loneliness and anxiety, more ambition and more positive moods [ 12 , 13 , 14 ].

Animal assisted therapy (AAT) has been shown to improve mood in children and adults with physical or mental health problems [ 15 , 16 , 17 ]). There are also a number of studies demonstrating various effects of animals on self-reported anxiety in humans. However, the effects of pets on anxiety are mixed, with some studies finding significant effects and others finding no statistically significant difference [ 18 , 19 , 20 , 21 , 22 , 23 , 24 ].

Occasionally reported by the media, are the studies which have shown in some cases a negative effect. Gilbey, McNicholas and Collis [ 25 ] administered the UCLA–Loneliness scale to 59 participants living in England who were interested in owning a pet. They then retested the participants 6 months later and found that those individuals who had acquired a pet (35 of the 59) were just as lonely as they had been before getting their pets. Moreover, they were no happier than the participants who had not gotten a pet. Additionally, another study into 117 older adults indicated that those who were considered extremely attached to their dogs tended have higher levels of depression than the participants who did not have as deep an attachment to their dogs [ 26 ].

Bao and Schreer [ 27 ] sought to explore overall life satisfaction, negative emotions, and positive emotions through two questions and two hypotheses. Firstly, is there a direct correlation with the happiness of the owner whether they owned a pet or not; secondly, whether there was a difference in happiness when comparing dog owners to cat owners [ 27 ]. There were 263 participants between the ages of 19–68 who completed numerous questionnaires and the researchers found that there were no significant differences in measured happiness between those with pets and those without. The same analysis was conducted for those people who identified themselves as either a cat person or a dog person and the results showed that there were no differences in positive emotions or overall life satisfaction. However, those individuals who identified as a cat person displayed significantly higher negative emotions than those who identified as a dog person [ 27 ]. Therefore, dog visits do not always have a therapeutic effect and there is a need for further research in this area before the benefits can be substantiated. However, whilst previous studies appear to have mixed findings, they do suggest that there may be numerous benefits from AAT programs, including decreased depression and anxiety and it is clear that there is still much to uncover.

Despite the mixed findings of effectiveness, AAT programmes are starting to become increasingly popular on university campuses as they appear to offer an effective option for students struggling with anxiety and stress [ 28 ]. The popularity is likely due to the low cost. Most university pet therapy programs are free for students and universities as most of the dog handlers are volunteers [ 29 ]). These programmes involve bringing animals and their handlers onto the campus to interact with students. A common format for University AAT programmes involves a large group of students interacting with animals during a single drop-in session [ 30 , 31 ]. The advantage to this format is that a far larger number of students can participate over a shorter period than other format types which require a longer period of time [ 32 ] and are more resource-intensive which have been found to have positive effects on students’ mental health and well-being. However, the shorter sessions held in a group format could dilute the immediate as well as the longer lasting benefits of such interventions.

It is only recently that empirical evidence has begun to emerge surrounding the effects of the single drop-in therapy dog session format. Thus far, studies have indicated that a single drop-in group therapy dog session can increase students’ feelings of connection to their campus, temporarily relieve homesickness and stress [ 33 ], improve mood and well-being, and decrease anxiety [ 34 ]. However, it would appear as though the effects are relatively short-lived as despite an initial recording of effects immediately following the therapy dog session, there were no effects detected two weeks after the sessions took place [ 33 ]. Nonetheless there is some qualitative evidence to suggest that the students believe that therapy dog sessions provided them with lasting benefits when asked three months after the sessions [ 35 ].

In the United States, 96% of college freshmen were in favour of having a pet therapy programme on campus [ 36 ]. It was also recently reported that 62% of surveyed universities in the United States reported having such programmes, many of these exclusively involved dogs [ 37 ]. Katcher and Beck [ 38 ] revealed that interacting with dogs can reduce physiological indicators of stress, depression, and loneliness. Interacting with dogs has also been shown to encourage fostering social connections with new people [ 39 ] as well as reduce anxiety and increase positive affect [ 40 ].

A large number of university students suffer from homesickness, whilst for some this is only a minor issue, for others the homesickness can become so severe that they seek out counselling [ 41 ]. The usefulness of AAT as a treatment for homesick first-year university students was investigated in a recent study, where a treatment group participated in an 8-week program with trained therapy dogs and their handlers [ 32 ]. The students were assigned a 45-min session on the Friday of each week. During these sessions, the student would interact with an assigned dog for 30 min before being allowed to interact with any dog present for the remaining 15 min. A non-treatment control group was informed that they were on a waiting list and never received the treatment. The findings indicated that the intervention was successful in increasing satisfaction with life and decreasing homesickness.

Pets might compliment whatever family support an individual is already receiving or otherwise provide support which is not being provided by a missing family member [ 42 ]. One other study found that pets provided social support even for those individuals who are already receiving support from others, and that just thinking about their pets was shown to alleviate the effects of social rejection [ 43 ]. Furthermore, Adamle, Riley, and Carlson [ 36 ] found that first year students said that their pets provided comfort and support during stressful times. Reduced levels of perceived stress have been observed to be associated with increased happiness and researchers have suggested that finding ways to lower stress may facilitate interventions aimed at reducing depression [ 44 ].

The impact pets can have in reducing stress has been well-documented. First year students who were asked to view a presentation about pet therapy before being asked to interact with a therapy dog [ 36 ]. The vast majority of the participants said that they missed their pets, that their pets had stayed at home, and that they thought it would be advantageous for therapy dogs to visit campus and help with stress. The researchers also suggested that the students may be helped to form new social connections with others by having access to therapy dogs. Therefore, therapy dogs might also lessen homesickness in students and perhaps enable the students to make new friends and not only reduce stress. This in turn could lead to an overall more enjoyable university experience. Indeed, simply interacting with a dog in pet therapy programmes has also been shown to positively influence college students’ emotional well-being in addition to reducing stress and helping to establish new relationships among the students [ 45 ].

Polheber and Matchock [ 46 ] investigated various types of social support and its influence on stress reactivity among university students. The participants were randomly assigned to one of three conditions: a novel dog, a friend, or no social support during the experimental procedure. The participants were able to interact with their friend or with the dog before the Trier Social Stress Test (TSST) began—this test contains an arithmetic and speech task. During the Trier stress test, either the friend or dog stayed nearby, or in the case of the no social support group were instructed to sit and relax. The participants’ cortisol levels and heart rates were measured throughout the study. The study found that the participants in the dog condition experienced reduced heart rate and reduced cortisol levels during the TSST in comparison with the other two groups who were not in the presence of a dog. In fact, those who were not in the presence of a dog proved to have higher cortisol levels after the induced stress. The researchers reasoned that this finding was because other humans have the ability to perceive and judge their own friends, whereas dogs can provide a non-judgmental support system for humans [ 46 ].

McDonald et al. [ 47 ] sought to find a similar result to Polheber and Matchock [ 46 ] by examining the effects of a novel dog on University students stress prior to exams. The researchers measured the students’ blood pressure levels both before and after the experiment in two different groups, 15 min prior to a mid-term exam. The first group was instructed that they could do any quiet activity of their choice, whilst the second group was allowed to play with a novel dog. The researchers found that the participants in the group that interacted with a novel dog had significantly lower blood pressure levels after finishing the experiment in comparison to the control group. Interestingly, the control group’s blood pressure was actually found to have increased despite being able to do any quiet activity that they wanted. McDonald et al. [ 47 ] determined that exposure to any dog, whether it be trained or untrained, has the potential to reduce blood pressure levels, which can therefore lead to decreased stress in students [ 47 ].

Animals have also been shown to have noticeable effects on measurable physiological correlates of stress. Recent research conducted by Somerville et al. [ 48 ] examined the effects of physical contact with a dog and a cat on blood pressure and pulse among 62 university students (28 males and 34 females). The participants who held a dog or cat experienced an immediate decrease in diastolic blood pressure. However, this reduction in blood pressure did not occur during the contact with an animal and instead only occurred after the contact had taken place. There were no significant gender differences found, however females did have lower blood pressure than males [ 48 ]. Interacting with a dog has also been shown to decrease cortisol levels, and therefore indicate a reduction in stress levels in university students, who themselves did not own a pet. However, this effect was not found for those students who were pet owners [ 49 ]. Furthermore, the immunoglobulin IgA, which is another biomarker for stress, was not shown to be affected in either group of participants after interacting with a dog.

Wilson [ 50 ] examined the effect of a pet on psychological consequences of stress (i.e., state and trait anxiety levels) of undergraduate students comparing three test conditions (i.e., reading quietly, reading aloud and interacting with a dog). The findings of the study were that reading quietly and interacting with the dog both effected anxiety levels. However, there was more effect seen by reading quietly than by interacting with a dog. There were no significant differences found when examining the interactions among the variables. Whilst a decrease in anxiety level was found after interacting with a pet, pet owners did not report using their pet as a social support significantly more than those who were previously pet owners. Furthermore, whilst the results did indicate that the participants experienced lower physiological and psychological response levels after interacting with a pet, a similar effect was also seen by reading quietly.

In addition to reducing stress, therapy dogs have also been shown in recent research to reduce anxiety levels in university students. Shearer et al. [ 51 ] compared the effects that interacting with a therapy dog and mindfulness meditation had on the stress and anxiety levels of students. Whilst interacting with a therapy dog was proven to lower anxiety and stress levels, the mindfulness meditation therapy lowered the students’ anxiety levels more than the sessions with the therapy dog.

However, potentially the biggest disadvantage of owning a pet and therefore of longer-term pet interventions, is the possibility for the animals used to cause distraction from studies, work and other important tasks. Torres et al. [ 52 ] found that in their study, the participants were distracted by even just pictures of animals when answering questions on a math exam. Likewise, Foreman et al. [ 53 ] in her review of the research saw the potential for these animals to potentially increase unsolicited social attention or cause a distraction from work tasks. However, these studies have both suggested that the occurrence of a distraction could decrease as the novelty of the dog wears off, although more research is needed to show whether this would be the case [ 52 , 53 ]. The other disadvantage to using pets is the impact on the owner or client through the loss and grief experienced after the pet dies. The loss of a pet can be a tremendously emotional event and as a university student, this could cause a distraction from studies and social activities. Furthermore, Eckerd et al. [ 54 ] report that many bereaved pet owners experience symptoms of feeling depressed, numbness, crying, feeling guilt, disbelief, or experiencing a sense of loneliness. Given the multitude of different feelings that can be experienced, in addition to the already stressful situations at university, students can be easily distracted from their priorities. This would also be counter intuitive given that the purpose of this type of therapy is to reduce feelings of stress, anxiety and depression.

As outlined, the previous literature on whether pets can have a positive effect on human wellbeing is divided. Even less is known about the effect of owning pets on anxiety and depression in university students and adolescences, as a substantial portion of existing research has focused on the effects of pets on stress in university students or have otherwise focused on mental health in patients and the elderly. However, increasingly high numbers of adolescents are affected by mental health issues and the incidence of mental health issues increases during adolescence, peaking during early adulthood [ 55 ].

2. The Present Study

Most of the previous research which has investigated the role that dogs may play in the mental health and wellbeing of humans has involved the elderly and children [ 15 , 24 ], with a few studies also looking at the university demographic. However, previous studies that have looked at this demographic have primarily focused on stress as an outcome variable and whilst correlations between stress, anxiety and depression might be drawn, there is little conclusive research surrounding the impact of pets on the latter two within this demographic. This study therefore aims to extend the parameters of this by looking at mood and anxiety.

Furthermore, most of the previous studies have focused on those individuals who are either critically ill or have behavioural disabilities [ 56 , 57 , 58 ]. Additionally, whilst there are a considerable number of studies that have examined the impact of certified therapy dogs on humans, there is very little research on the benefits of a novel dog on those populations. A novel dog is a typical house-trained dog that is not purposefully trained like therapy dogs to know how to react in response to human emotions, instead working off their own instinct, and are unfamiliar to the participant [ 47 ]. This gap in the research was discovered in both studies by Polheber and Matchock [ 46 ] and McDonald et al. [ 47 ]. Lastly, there are only a few studies which allow participants to have individual sessions, with many studies and AAT sessions operating single drop-in sessions [ 30 , 31 ].

As such, the purpose of the proposed study is to extend research into the effect of pet and human interactions, while also hoping to address some of the limitations. Furthermore, despite the growing body of research on the interaction between humans and animals, the notion that pets have a positive impact on human health and well-being still remains a hypothesis which needs confirmation rather than being an established fact.

This study involved university students interacting with a house-trained 2-year-old female Golden Retriever of which they were unfamiliar. This specific breed of dog was chosen for this study because it is a popular standard breed in the UK and is not considered to be an intimidating or dangerous breed. Retrievers have also been shown to elicit more smiles and verbal responses than other breeds, such as Rottweilers [ 59 ]. Additionally, a house-trained dog should provide the most realistic results as possible. Those students who may have a dog at their family homes are more likely to own a typical house-trained dog rather than a therapy dog or will have otherwise come across more house-trained dogs in their lives than therapy dogs.

The question to be addressed is whether interacting with a pet improves mood and reduces anxiety levels. This question is interesting because it would suggest that pets have a positive impact on a person’s physiological state and thus, have potential important health implications for university students through the translation into appropriate interventions concerning pet ownership. At the core, this research aims to ask, “Can students’ mood and anxiety be enhanced from spending time with a pet dog brought to campus?”.

To examine whether interaction with a dog might impact college students’ mood and anxiety levels, a quasi-experimental two group pre/post design study was conducted. It was hypothesised that there would be a significant positive effect on those university students’ mood and anxiety levels that had experienced physical interaction with a dog, compared to the control group that watched a video montage of Golden Retriever clips.

On an exploratory basis, possible gender differences were additionally examined. It has been shown that female students benefit more from therapy dog sessions than male students [ 35 ], therefore suggesting the need for research into gender differences.

3.1. Ethical Considerations

It is important to consider ethics when dealing with studies that involve humans and animals. It is important to keep in mind what the dog is being subjected to and if the activities are fair, as well as if it is a fair environment for the dog. Ethical considerations when conducting research with human subjects are equally important. When testing for aversive or stressful situations or asking questions that could be potentially distressing, it is essential to ensure it is not damaging or harmful to the person [ 52 ].

Therefore, ethical approval was sought from the University of Warwick in March 2018 and was approved in May 2018. Additionally, approval was sought and granted by the Animal Welfare and Ethical Review Body (AWERB.48/17-18) as well as the University’s Health and Safety department. Third party insurance was also obtained for the dog participating in the study and the documentation was provided to the insurance office.

For the duration of the study, it was always ensured that a first aider was present during the testing times. The room cleaning team were always made aware that the room needed to be cleaned after every testing session and on one occasion being asked to return to ensure a thorough removal of hair. The dog was checked not to have a history of biting people and that this was not considered a dangerous breed.

The dog in this experiment was granted the ethical approval to spend 10 min with each of 3 participants before receiving a minimum of a 30 min break where it had access to water and was allowed to urinate or defecate as required (totally a time period of 90 min). These 90-min sittings were to be repeated no more than three times per day. The dog would perform these for a maximum of 4 days in a row before being given a minimum 2 days break.

The dog’s usual daily routine was maintained during the testing periods. The dog was constantly monitored for signs of distress by its owner both during and after the sessions and did not display any concerns. If the dog had displayed signs of distress, the study would have stopped until the dog was well enough to resume or otherwise, a replacement would have been found.

3.2. Participants

The participants in this study were 82 students who were attending the University of Warwick. Of those 82 students, 42 identified themselves as male, 40 as female, 0 as other (please describe if you wish) and 0 chose the option prefer not to say. Their age range was from 18 to 23 years old. The students were studying a range of subjects and were a mix of first year ( n = 44), second year ( n = 12), third year ( n = 10) and post graduate ( n = 16). The students were recruited through a posting on the participant recruitment website Sona and did not receive any form of reward for participating in the study. The participants were screened on the sign-up page as well as via a follow up email from the researcher for allergies towards dogs.

3.3. Measures

Demographic survey. The participants were requested to provide some demographic information that consisted of nine questions including age, gender, ethnicity, what year of study they were in, if they have a pet dog, how frequently they interact with a dog and if they consider themselves as a dog person or a cat person.

Pet Attitude Scale (PAS). This measure included 18 statements rated on a 7-point Likert scale from 1 (strongly disagree) to 7 (strongly agree) [ 60 ]. The participants were asked to rate certain statements such as “I love pets” or “I spend time every day playing with my pet (or I would if I had one).” The current study had a Cronbach’s alpha of 0.702.

State-Trait Anxiety Inventory (STAI). This measure included six statements that were rated on a 1 (not at all) to 4 (very much) Likert Scale [ 61 ]. The participants reported how they felt in the moment, involving statements such as “I feel tense” or “I feel content”. The current study had a Cronbach’s alpha of 0.816.

Positive and Negative Affect Schedule-Expanded Form (PANAS-X). This measure involved 60 words and phrases that described different feelings and emotions on a 1 (very slightly or not at all) to 5 (extremely) Likert Scale [ 62 ]. The participants indicated how much they felt certain emotions, such as how happy, upset or nervous they felt in the moment. Negative affect had a Cronbach’s alpha of 0.902, Sadness scores had a Cronbach’s alpha of 0.868. Positive affect had a Cronbach’s alpha of 0.929 and joviality scores had a Cronbach’s alpha of 0.920.

3.4. Procedure

The participants were assigned to one of two groups, the experimental or control. The assignment was based upon which timeslot the participants chose, since each of the two conditions were held on different days unbeknownst to the participants. Seven days were dedicated to the participants coming in spread out over the course of a three-week time period. The first week of the experiment was dedicated to the experimental group and the second week was dedicated to the control group. During the third week, the allocation of the group was dependent on the dogs previously allocated breaks and daily routine. Those participants who had selected a timeslot which coincided with the dog’s arranged break would participate in the control variable. When all participants arrived for their selected timeslot, they were asked to read an information sheet, with the appropriate adjustments to reflect the activity in which these participants were going to engage and were given their own unique identification code. The participants were informed of their right to withdraw at any given point in the study. They would then be asked to fill out the consent form, demographic questionnaire, PAS, STAI and PANAS-X before the experiment was conducted.

Experimental group: Those participants in the experimental group ( n = 41) played with the dog for ten minutes. The time was recorded on an iPhone stop watch to ensure the time for all participants was consistent. Before introducing the participants to the dog, the participants were asked to verbally confirm that they were happy to be in a room with and to interact with a dog. The participants were also asked to verbally confirm once again that they had no allergies to dogs. Only upon this confirmation were the participants allowed to enter the room. The dog that participated in the experiment was a 2-year-old female Golden Retriever. The dog was consistently energetic and eager to meet each new participant and play. The participants were informed they could freely play with the dog, including sitting with her, petting her, throwing toys which squeaked for her, talking to her, and cuddling her. Some participants would be more enthusiastic in their free play than others and would more actively engage with her, whilst others preferred to remain in one place and fuss her quietly.

Control group: Those in the control group ( n = 41) watched a ten-minute-long video montage which was created by the researcher. This video featured multiple amusing or cute clips of Golden Retrievers, the majority of which were of the retriever used in the study, the others were acquired from YouTube. The video was always played on a HP Spectre x360 laptop and the screen brightness was the same for each participant.

After the participants in each condition had finished their dog-related activity, they were requested to complete the post-test surveys (PANAS-X and STAI) to determine if there were any changes to their mood and anxiety scores when compared to their pre-test survey scores. Upon completion of the surveys, a debriefing statement was issued for the participants to read and take with them. Each session lasted approximately forty minutes, including the time to complete the established measures.

The data was analysed to investigate the study’s hypothesis that there would be a significant positive effect on those university students’ mood and anxiety levels in those students that had experienced physical interaction with a dog, compared to the control group that watched a video montage of Golden Retriever clips. Both groups’ pet attitude analyses scores were firstly examined to ensure that the participants’ attitudes toward pets did not differ between groups, as well as age, gender and whether they consider themselves to be a cat or dog person, or neither. Following this, the mood and anxiety scores were explored as a function of group and time (before exposure to dogs and after).

4.1. Preliminary Analyses

Age: An independent t -test was run to explore whether or not the participants’ ages were significantly different for the experimental condition compared with the control condition. No statistically significant difference was found between conditions for the participants’ ages (experimental group M = 19.66; control group M = 19.76), t (80) = −0.366, p = 0.716. Therefore, each of the conditions contained participants of a similar age.

Gender: A chi-square test was run to explore whether or not the participants’ genders were significantly different for the experimental condition compared with the control condition. No statistically significant difference was found between conditions for the participants’ genders χ(1) = 0.195, p = 0.659. The control group consisted of 19 females and 22 males, the experimental group consisted of 21 females and 20 males. Therefore, each of the conditions contained an overall equal split of genders.

Dog or Cat person: A chi-square test was run to explore whether or not the split between dog and cat people was significantly different for the experimental condition compared with the control condition. No statistically significant difference was found between the conditions for whether the participants considered themselves a cat or a dog person χ(2) = 0.157, p = 0.925. There was a total of 4 participants who considered themselves a cat person (experimental = 2, control = 2), 71 dog people (experimental = 35, control = 36) and 7 participants who considered themselves neither (experimental = 4, control = 3). Therefore, each of the conditions contained an overall equal split of cat and dog people.

Pet attitude scores: An independent t -test was run to explore whether or not the participants’ pet attitude scores were significantly different for the experimental condition compared with the control condition. No statistically significant difference was found between the conditions for the pet attitude scores (experimental group M= 57.46; control group M = 55.56), t(80) = 5.48, p = 0.135. Therefore, each group of participants had similar attitudes towards pets overall.

4.2. Main Analyses

4.2.1. stai anxiety scores.

A 2 condition (control and dog) × 2 time (Time 1 and Time 2) repeated measures ANOVA conducted on anxiety scores was also performed. The post hoc comparisons using the Bonferroni correction indicated that there was a main effect for condition (F (1,80) =6.01, p =0.016). Specifically, the participants in the experimental condition (Before M =39.76, After M=29.02) reported having lower anxiety scores than the control group (Before M = 41.46, After M = 39.35). There was also a main effect for time (F (1,80) = 43.14, p = 0.000). Particularly, the participants reported having lower anxiety scores in the post survey (time 2) (M = 34.19) than at Time 1 (M = 40.60), see Table 1 . Furthermore, there was a significant interaction between condition and time (F (1,80) = 19.42, p =.000) d = 0.985. As can be seen in Figure 1 , the participants in this study experienced a decrease in their anxiety scores following their exposure to dogs, whether they directly interacted with a dog or simply observed dogs on a video. However, this was significantly greater in the experimental condition than the control.

The mean State-Trait Anxiety Inventory (STAI) anxiety scores are plotted for the participants in the control condition and the participants in the experimental (dog) condition before their interaction and after their interaction with 95%-confidence-interval error bars.

Descriptive Statistics: Anxiety.

4.2.2. PANAS-X Negative Affect Scores

A 2 condition (control and dog) × 2 time (Time 1 and Time 2) ANOVA conducted on the general negative effect was performed. The post hoc comparisons using the Bonferroni correction indicated that there was no main effect for condition found (F (1,80) = 0.078, p = 0.780). Specifically, the participants in the dog condition (Before M = 15.12, After M=12.15) did not report having a lower general negative affect than the control group (Before M = 14.24, After M = 13.54). However, there was a main effect for time (F (1,80) = 27.48, p = 0.000). Particularly, the participants reported having a lower general negative affect in the post survey (M = 12.84) than at the pre survey (M = 14.68), see Table 2 . There was also a significant interaction between condition and time (F (1,80) = 10.42, p = 0.002) d = 0.722.

Descriptive Statistics: Negative Affect.

As can be seen in Figure 2 , the participants in this study experienced a decrease in their general negative scores following their exposure to dogs, whether they directly interacted with a dog or simply observed dogs on a video.

The mean general negative affect scores are plotted for the participants in the control condition and the participants in the experimental (dog) condition before their interaction and after their interaction with 95%-confidence-interval error bars.

4.2.3. PANAS-X Sadness Scores

A 2 condition (control and dog) × 2 time (Time 1 and Time 2) repeated-measures ANOVA conducted on sadness scores was also performed. A main effect for condition was found (F (1,80) = 4.24, p = 0.043). Specifically, the participants in the experimental condition (Before M = 10.68, After M = 6.95) reported lower sadness scores than the control group (Before M = 11.12, After M = 10.34). There was also a main effect for time (F (1,80) = 43.30, p = 0.000). Particularly, the participants reported having lower sadness scores in the post survey (M =8.65) than at the pre survey (M = 10.90), see Table 3 . Furthermore, there was a significant interaction between condition and time (F (1,80) = 18.53, p = 0.000) d = 0.963. As can be seen in Figure 3 , the participants in this study experienced a decrease in their sadness scores following their exposure to dogs, whether they directly interacted with a dog or simply observed dogs on a video. However, this was significantly greater in the experimental condition than the control.

The mean sadness scores are plotted for the participants in the control condition and the participants in the experimental (dog) condition before their interaction and after their interaction with 95%-confidence-interval error bars.

Descriptive Statistics: Sadness.

4.2.4. PANAS-X General Positive Affect Scores

A 2 condition (control and dog) × 2 time (Time 1 and Time 2) repeated-measures ANOVA conducted on general positive affect was performed. The post hoc comparisons using the Bonferroni correction indicated that there was no main effect for condition found (F (1,80) = 16.76, p = 0.725). Specifically, the participants in the experimental condition (Before M = 26.71, After M = 30.37) did not report having a higher general positive affect than the control group (Before M = 27.98, After M = 28.07). There was however a main effect for time (F (1,80) = 16.76, p = 0.000). The participants reported having a higher general positive affect in the post survey (M = 29.22) than before the survey (M = 27.34), see Table 4 . There was also a significant interaction between condition and time (F (1,80) = 15.06, p = 0.000) d = 0.868. Therefore, the participants in the experimental condition and the control condition did not experience a significant increase in their positive affect scores following their interactions.

Descriptive Statistics: General Positive Affect.

As can be seen in Figure 4 , the participants in this study experienced an increase in the general positive affect scores following their exposure to dogs, whether they directly interacted with a dog or simply observed dogs on a video.

The mean for general positive affect is plotted for the participants in the control condition and the participants in the experimental (dog) condition before their interaction and after their interaction with 95%-confidence-interval error bars.

4.2.5. PANAS-X Joviality Scores

A 2 condition (control and dog) × 2 time (Time 1 and Time 2) repeated-measures ANOVA conducted on joviality scores was also performed. The post hoc comparisons using the Bonferroni correction indicated that there was a main effect for condition (F (1,80) = 60.23, p = 0.000). Specifically, the participants in the experimental condition (Before M = 23.15, After M = 29.29) reported having higher joviality scores than the control group (Before M = 23.22, After M = 24.05). There was also a main effect for time (F (1,80) = 34.99, p = 0.000). Particularly, the participants reported having higher joviality scores in the post survey (M = 26.67) than at the pre survey (M = 23.18), see Table 5 . Furthermore, there was a significant interaction between condition and time (F (1,80) = 4.16, p = 0.045) d = 0.456.

Descriptive Statistics: Joviality.

As can be seen in Figure 5 , the participants in this study experienced an increase in their joviality scores following their exposure to dogs, whether they directly interacted with a dog or simply observed dogs on a video. However, this was significantly greater in the experimental condition than the control.

The mean joviality scores are plotted for the participants in the control condition and the participants in the experimental (dog) condition before their interaction and after their interaction with 95%-confidence-interval error bars.

4.3. Exploring Gender

4.3.1. stai anxiety.

Anxiety scores: A 2 gender (male and female) × 2 condition (control and dog) X 2 time (Time 1 and Time 2) repeated-measures ANOVA conducted on anxiety scores was also performed. There was no significant effect found for gender (F (1,78) = 0.004, p = 0.951), meaning there were no significant differences between the two genders. Specifically, the female participants’ scores (Before M = 39.92, After M = 41.05) were not significantly different from the male participants’ scores (Before M = 41.27, After M = 33.97), see Table 6 . There was also no interaction found for time and gender (F (1,78) = 1.28, p = 0.261) nor was an interaction found between gender and group (F (1,78) = 0.893, p = 0.348). There also was no significant interaction between time, gender and group (F (1,78) = 0.016, p = 0.900).

Descriptive Statistics: Anxiety and Gender.

4.3.2. Negative Affect Scores

A 2 gender (male and female) × 2 condition (control and dog) × 2 time (Time 1 and Time 2) repeated-measures ANOVA conducted on general negative scores was also performed. There was no significant effect found for gender (F (1,78) = 0.078, p = 0.780), meaning there were no significant differences between the two genders. Specifically, the female participants’ scores (Before M = 14.93, After M = 12.88) were not significantly different from the male participants’ scores (Before M = 14.45, After M = 12.81), see Table 7 . There was also no interaction found for time and gender (F (1,78) = 0.535, p = 0.467) nor was an interaction found between time, gender and group (F (1,78) = 0.445, p = 0.507). There was however a significant interaction between group and gender (F (1,78) = 0.078, p = 0.041). Specifically, the males in the control condition had a much lower negative affect scoring before the intervention (M = 12.90) than those males placed in the dog condition (M = 15.86), but those in the dog condition had the greater decline in their negative affect scores after the intervention took place (M = 12.91) than the control (M = 12.70).

Descriptive Statistics: Negative Affect and Gender.

4.3.3. Sadness Scores

A 2 gender (male and female) × 2 condition (control and dog) × 2 time (Time 1 and Time 2) repeated-measures ANOVA conducted on sadness scores was performed. There was no significant effect found for gender (F (1,78) = 0.694, p = 0.407), meaning there were no significant differences between the two genders. Specifically, the female participants’ scores (Before M = 10.50, After M = 8.35) were not significantly different from the male participants’ scores (Before M = 11.29, After M = 8.93), see Table 8 . There was also no interaction found for time and gender (F (1,78) = 0.008, p = 0.927) nor was an interaction found between group and gender (F (1,78) = 0.552, p = 0.460. There was also no a statistically significant three-way interaction between time, gender and group (F (1,78) = 0.211, p = 0.648).

Descriptive Statistics: Sadness and Gender.

4.3.4. Positive Affect Scores

A 2 gender (male and female) × 2 condition (control and dog) × 2 time (Time 1 and Time 2) repeated-measures ANOVA conducted on positive affect scores was performed. There was no significant effect found for gender (F (1,78) = 0.498, p = 0.483), meaning there were no significant differences between the two genders. Specifically, the female participants’ scores (Before M = 27.95, After M = 29.63) were not significantly different from the male participants’ scores (Before M = 26.76, After M = 28.83), see Table 9 . There was also no interaction found for time and gender (F (1,78) = 0.058, p = 0.811) nor was an interaction found between group and gender (F (1,78) = 1.81, p = 0.182. There was also no significant interaction found between time, gender and group (F (1,78) = 0.055, p = 0.815).

Descriptive Statistics: Positive Affect and Gender.

4.3.5. Joviality Scores

A 2 gender (male and female) × 2 condition (control and dog) × 2 time (Time 1 and Time 2) repeated-measures ANOVA conducted on joviality scores was performed. There was no significant effect found for gender (F (1,78) = 0.737, p = 0.393) meaning there were no significant differences between the two genders. Specifically, the female participants scores (Before M = 23.75, After M = 27.08) were not significantly different from the male participants scores (Before M = 22.64, After M = 26.29), see Table 10 . There was also no significant interaction found for time and gender (F (1,78) = 0.004, p = 0.949) as well as for group and gender (F (1,78) = 2.38, p = 0.127). Nor was there a statistically significant three-way interaction between time, gender and group (F (1,78) = 0.055, p = 0.815).

Descriptive Statistics: Joviality and Gender.

5. Discussion

The purpose of the present study was to determine whether there would be a positive effect on university students’ mood and anxiety scores after interacting with a dog. Consistent with past research, the results of this study do provide evidence that interacting with a dog does have a positive effect on the students’ emotional well-being. This study found considerable increases in happiness and reductions in both anxiety and sadness scores immediately after the students interacted with a dog.

The findings of this study are in line with previous research indicating there are short-term psychological benefits of interacting with a dog [ 33 , 34 , 38 , 40 , 47 ]. However, this study fills a research gap as unlike much previous research on this topic which uses a typical single drop-in group therapy dog session [ 30 , 31 ], this study was designed to allow the students to interact with the dog on an individual basis. As past research has primarily focused on children and the elderly or otherwise the impact on stress in students, there has been limited research conducted on the university population specifically with regards to the role of dogs influencing anxiety and depression. Therefore, this study aimed to fill this research gap.

5.1. Anxiety

It was hypothesised that there would be a significant positive effect on those university students’ anxiety levels that had experienced physical interaction with a dog, compared to the control group who watched a video montage of Golden Retriever clips. In the present study, this hypothesis was supported because a main effect for condition was found and the participants in the dog condition reported having lower anxiety scores than in the control group who watched a video. Thus, it appears that the treatment did have a positive effect on the anxiety levels of the university students. This result supports the previous research findings of Cole et al. [ 21 ], in which it was found that hospital patients experienced the greatest decrease from baseline in state anxiety scores after interacting with a dog when compared with the other groups. A main effect of time was also found for anxiety, with participants reporting lower levels of anxiety in the post survey for both conditions. As there was also a significant interaction between condition and time, it can be concluded that the participants in this study experienced a decrease in their anxiety scores following their exposure to dogs, whether they directly interacted with a dog or simply observed dogs on a video. However, given the main effect of condition, this was significantly greater in the experimental condition than the control.

5.2. Negative Mood

Negative mood was looked at in two ways. Firstly, general negative affect was examined which totalled the scoring for responses of feeling afraid, scared, nervous, jittery, guilty, ashamed, irritable, hostile, upset, distressed. Secondly, sadness was examined which included responses of feeling sad, blue, downhearted, alone, lonely. It was hypothesised that that there would be a significant positive effect on those university students’ mood levels that had experienced physical interaction with a dog, compared to the control group who watched a video montage of Golden Retriever clips.

Negative affect: With regards to negative affect scores, there was no main effect for condition found. However, a significant interaction between condition and time was found. Specifically, the participants in both the dog condition and control condition did experience a significant decrease in general negative affect following their interactions. The participants also reported having lower general negative affect in the post survey than at the point of the pre-survey, regardless of group. This would appear to be in line with the likes of Wilson [ 50 ] where there was shown to be a positive impact found on participants from a dog interaction condition, however, a parallel effect was also seen by reading quietly.

Sadness scores: With regards to sadness scores, the hypothesis was supported as a main effect for condition was found and the participants in the experimental condition reported having lower sadness scores than the control group. Thus, it appears that the treatment did have a positive effect on the sadness scores of the university students. There was also a main effect for time and a significant interaction between condition and time. Therefore, the participants in this study experienced a decrease in their sadness scores following their exposure to dogs, whether they directly interacted with a dog or simply observed dogs on a video. However, this was significantly greater in the experimental condition than the control. This result supports the previous research findings of Orlandi et al. [ 14 ] who compared two groups of patients receiving chemotherapy, with one group serving as a control and the other group assigned to receiving a visit by a therapy dog during the chemotherapy session. The results of their study indicated that depression levels only showed improvement in the dog visit group and not in the control group.

5.3. Positive Mood

Positive mood was also looked at in two ways. Firstly, general positive affect was examined which totalled the scoring for responses of feeling active, alert, attentive, enthusiastic, excited, inspired, interested, proud, strong, determined. Secondly, joviality was examined which included responses of feeling cheerful, happy, joyful, delighted, enthusiastic, excited, lively, energetic. It was hypothesised that that there would be a significant positive effect on those university students’ mood levels that had experienced physical interaction with a dog, compared to the control group.

Positive affect: With regards to positive affect scores, there was no main effect for condition, however there was a main effect of time as well as a significant interaction between condition and time. Therefore, the participants in the experimental condition and control condition experienced a significant increase in their positive affect scores, regardless of which interaction group they were placed. This would appear to support research conducted by Bao and Schreer [ 27 ] who explored overall life satisfaction, negative emotions, and positive emotions. The researchers found that there were no significant differences in measured happiness or overall life satisfaction between those with pets and those without.

Joviality scores: However, upon analysis of the joviality scores, the hypothesis was supported as a main effect for condition was found and the participants in the experimental condition reported having higher joviality scores than the control group. Thus, it appears that the treatment did have a positive effect on the joviality scores of the university students. There was also a main effect for time and a significant interaction between condition and time. Therefore, the participants in this study experienced an increase in their joviality scores following their exposure to dogs, whether they directly interacted with a dog or simply observed dogs on a video. However, this was shown to be significantly greater in the experimental condition than the control. This result also supports the previous research findings of Orlandi et al. [ 14 ] in addition to El-Alayli et al. [ 12 ], Nathans-Barel et al. [ 16 ] and Kaminski et al. [ 15 ] who reported significantly greater positive moods after participants were involved with dog therapy in comparison with control groups.

5.4. Gender Differences

There were no statistically significant results found between genders for any of the variables in this study, apart from the variable of negative affect. There was a statistically significant effect found between group and gender within this variable with males placed in the dog condition reporting a higher initial negative affect score before the intervention took place and experiencing a greater drop after the intervention. This contradicts previous research which suggests that female students benefit more from therapy dog interventions than males [ 35 ]. However, overall there were minimal differences between genders.

5.5. Strengths and Limitations

One strength of this study was its participant size. There were 82 students who participated in this study, ranging between all study years. Whilst the majority of students who took part were white ( n = 48), this study also included multiple other ethnicities including Chinese ( n = 5), Asian or Asian British—Indian ( n = 13), Asian or Asian British—Pakistani ( n = 2), other Asian ( n = 3), other (n = 7), Black British (n = 3) and other White background ( n = 1). However, as the sample of students consisted solely of students studying at the University of Warwick, the findings may not be generalised to other universities. That being said, as mentioned above, there was a diverse range of participants in the present study which may help the generalisability.

However, as with all research, there are several limitations with the present study. Firstly, one of the biggest limitations with this study was that those individuals who took part were largely those who considered themselves as a dog person ( n = 71) and as such may have experienced the greatest benefit from spending time in the dog interaction condition. People who do not like dogs did not appear to be as likely to sign up to these types of studies and so therefore, the effect sizes may be overestimated. Furthermore, the large number of participants who consider themselves a dog person suggests that there could be a self-selection bias. Perhaps, one of the biggest limitations to most of these studies is that great portions of the subjects were already shown to either have an interest in or a general like for dogs. Numerous previous studies have also used a pet attitude scale to determine if the participants either have a strong liking for dogs or otherwise, a dislike of dogs prior to beginning the study [ 46 ]. This can be a strength as there is a better chance that the study will be more successful if the participants in the study are already proven to be fond of spending time with a dog. Regrettably, having a larger number of participants who consider themselves as dog people also decreases the generalisability of the study, given that it is only applicable to the part of the population who either like dogs or are not afraid of them. Furthermore, reviews of animal-human relationship studies have also found that typically, these studies rarely display the effects of other pets on humans and generally only account for mainly dogs, and less frequently cats [ 27 ]. Secondly, a potential limitation of this study was that it was a controlled and not a completely random study. Whilst the participants selected which times and days they were available, some people with particular traits may have only been able to make it in the first week while others in the second week and therefore, this might add bias to the current study by not having randomisation. Finally, the demographic data collected in this study did not include sexual orientation, social factors or disability which are known to affect mental health [ 63 , 64 , 65 , 66 ].

5.6. Future Research

It should be noted that not all people like dogs. Some people may have a phobia of dogs, may be allergic to dogs, or may simply just not want to interact with a dog [ 67 ]. Therefore, future research could include more of those individuals who rate themselves as “neither” and “cat people” to examine the differences in the effects, as those who do not like dogs may find the experience unpleasant and may instead experience an increase in anxiety levels and negative mood. Additionally, future research should also include other house-trained pet types in order to examine the effects on parts of the population who prefer other animals over dogs.

The researchers also believe that it may have been more beneficial for the study and sessions to take place during particularly stressful periods of the study year, for instance it would have been preferable for the study to take place at the start of the year when university life is new, particularly for undergraduates, and students are transitioning to university life as this is considered to be a stressful time, and as a result this population is particularly vulnerable to developing or exacerbating depressive symptoms [ 10 ]. Other stressful periods of time could be during exam periods, or even for dogs to be present while students complete assignments. This is something to consider with regards to future research. However, this study took place just after the end of year exams while students were waiting for their results which might also considered to be a stressful point of their year. The directions for future research could include the research taking place from the beginning of the year through to the end at regular intervals to compare times of elevated stress, especially for first-year students, and should go beyond the temporary relief offered by one-off sessions and incorporate longitudinal measures into the design to examine if there is a long-term benefit of interacting with a dog for students. Do the effects dissipate over time? How short-lived are the effects? Future studies could incorporate several measurement points. Moreover, is there an association between university students’ productivity throughout the year and interacting with a pet regularly? Whilst there is research to suggest an association between reduced stress, anxiety and depression and dog therapy sessions, it is not yet known whether this reduction has an impact on university students’ productivity and academic success. Might the quality and amount of work accomplished be higher due to the psychological benefits provided by owning a pet, or could they in fact be lower as a result of added responsibility and distractions? Generally, with all populations, there are limited longitudinal studies that have examined the impact of pets, therefore to investigate what exactly are the lasting impacts that dogs have on humans, it would be very beneficial to utilize such designs [ 53 ].

It is also important to consider cultural differences with regards to using pets in therapy sessions, as not all cultures feel the same way about domestic pets, such as dogs. Not everyone shares the same perception or love for animals or see them as a positive influence on their life [ 53 ]. It is therefore vital to bear in mind that the concept of animals as a therapeutic intervention is not universally accepted as some people might have cultural or religious reasons for why they do not want to interact with animals [ 68 ]. This could open avenues for future research to ensure that animal interventions are culturally suitable and beneficial, as not much is known about how cultural or religious views impact therapeutic outcomes in animal interventions [ 69 ]. Though researchers and animal volunteers should mitigate such risks by asking beforehand whether the potential individual is happy to interact with the animal in question. Equally, it is important to bear in mind that these interventions involve living, breathing animals and there are risks to the participating therapy dogs themselves [ 67 ]. Therefore, it is mandatory that those in charge of organising and running such interventions should ensure the therapy dogs’ health, safety, welfare, and that its daily routine is maintained.

With this is mind and given that the number of animal interaction studies are increasing, future research should consider investigating the impact such interventions on the therapy dogs themselves as at present, the research in this area is lacking [ 70 ]). There are only a few animal intervention studies that incorporated measures to investigate how participating therapy animals are affected by these studies [ 71 ]. Therefore, in order to be considered humane and effective methods of treatment, animal interventions should be beneficial to both the participating therapy animals and the potential clients [ 70 ] and researchers should investigate the effects of these interventions on both parties given the current lack of clarity.

Future research should also consider exploring which of the specific aspects of university dog sessions lead to better lasting positive effects, for instance, explore what the optimal number of sessions is for long-term benefits or what the optimal length of time is for students to remain engaged with the session. In addition to using self-report measures, future research could also include the use of physiological measures, such as heart rate, galvanic skin response, cortisol levels and blood pressure to assess changes. Given that students’ levels of psychological distress have been reported to rise significantly upon initially starting university and do not return to their pre-university levels throughout their time in university [ 1 , 3 ], it is of high importance that students have accessible interventions to reduce anxiety and depression.

6. Conclusions

To the best of the researcher’s knowledge, this present study helps to fill a research gap and provides further support that allowing students to interact with dogs on campus has positive psychological benefits to students. Whilst no significant results were found between the groups for negative or positive affect, the researchers argue that the items that comprised the sadness and joviality scales were more relevant to mood and feelings, while affect is more the experience of their emotions. This would however appear to be in line with previous research that has suggested that animals do not necessarily even need to be present and simply images alone of pets can improve psychological wellbeing [ 52 ]. This study found that there were positive effects on anxiety, joviality and sadness in the case of the control variable as with the experimental, though the benefits of the experimental condition were significantly greater, and there were positive effects on general positive affect and general negative affect regardless of condition. Ultimately, the use of dogs whether they have been trained specifically for therapy or are general house-trained dogs, or even just the use of videos, can be a highly beneficial tool for universities to implement to help reduce depression and anxiety in students. The positive benefits associated with students being allowed to interact with dogs in university appears to be a suitable, relatively low-cost and effective way to enhance and sustain student psychological well-being.

To conclude, the results of this study indicate that interacting with a pet dog considerably reduces anxiety and feelings of sadness and improves happiness scores. There are several limitations with the current study which leave a gap for future studies to fill. Further controlled studies are required for confirmation and to accurately define the population who will receive the greatest benefit from such treatments, as well as the optimum duration. It is hoped that this study will help to inform future best practices in designing student dog interventions, which will in turn, facilitate improved psychological well-being in university students.

Acknowledgments

I would like to thank my supervisor Dr. Sakari Lemola, an associate professor in the psychology department at Warwick University, for his expertise and assistance throughout all aspects of this study and for his help in writing the manuscript.

This research received no external funding.

Conflicts of Interest

The authors declare no conflict of interest.

10 Reasons Pitbulls Make Great Therapy Dogs

Posted: February 24, 2024 | Last updated: February 24, 2024

Affectionate Nature

Intuitive to Emotions

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Eager to Please

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National Puppy Day: See how Ohio stacks up in dog statistics

by Trinity Langbein

CHIME IN -- Look at Sherry Lemos's adorable pup Girly Girl. Taken on Valentines Day, 2024 in Cardington, Ohio.

COLUMBUS, Ohio (WSYX) — Ohio's furry friends appear to follow a few trends, based on the preferences of their owners.

Did you know that one breed is a fan favorite of the Heart of America? That breed is the German Shepard, according to a 2023 survey by Forbes.

The survey stated that the German Shepard was also the number two national favorite, upstaged by only the Australian Shepherd.

Although there was some variation among states on what type of dog ranked supreme, the majority of American dog owners... [showed] that Americans are unbiased when it comes to selecting their loyal companions," Forbes shared regarding national rankings for favorite dog breeds in 2023.

ALSO | Nationwide Children's Hospital expands therapy dog program

According to Camp Bow Wow , the top 5 dog names in Ohio are:

The top breeds with the name Luna were Labrador Retriever, Goldendoodle, German Shepherd, Australian Shepherd and Siberian Husky. [The name] Luna ruled in 27 states, mainly on the East and West Coasts and in the Southwest and northern Midwest," Camp Bow Wow shared in a statement .

Cincinnati ranked number 5 out of the top 25 best cities for pet owners , according to these 2023 metrics by Forbes:

• 10th best in both dog and cat veterinary costs.
• Cincinnati dog and cat owners pay the 10th lowest amounts for vet office visits, vaccinations, spay or neuter surgeries and professional dental cleanings.
• Cincinnati has the 13th highest concentration of pet stores per 10,000 businesses.

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Ohio ranks 43 out of the states with the "most spoiled" dogs , with 25% of dog owners regularly throwing birthday parties or other celebrations for their dogs. The survey by Forbes also recorded that 44.5% of Ohio dogs owners spend more money on their dog's health and grooming than they do on their own self-care.

And finally, to top off the slew of fun Ohio dog facts, the top three pet peeves of Ohio dog owners are:

• Having to find a dog sitter when they are going out of town
• Excessive shedding
• Excessive barking

Do you have a furry friend? Send us your photos via Chime In , and those photos may be shared on television or online!