The Distinctiveness of Animal Assisted Play Therapy®

Animal Assisted Play Therapy® (AAPT) came into being much longer ago than many people realize. In our Maxwell Award-winning book, Animal Assisted Play Therapy (VanFleet & Faa-Thompson, 2017, Sarasota, FL: Professional Resource Press), Tracie Faa-Thompson and I explain our own roots that contributed to the AAPT model as we have been teaching it since 2004. The actual beginnings of this approach, however, date back to the 1970’s, and the influences that have shaped it go back even farther in time. AAPT represents a science-based approach to the involvement of animals in psychotherapy and wellness interventions with all ages, and it is fine-tuned and adapted to new scientific and therapeutic information as it is reported in the peer-reviewed literature. It is also an approach with a strong ethical basis that includes extensive attention to the welfare and well-being of the animals involved in it. With the current popularity of Animal Assisted Interventions (AAI), it is quite easy to become confused about the approaches, training, and credentialing that are available. This blogpost is a step toward clearing away that confusion when it comes to the professional practice of AAPT.

There are a number of other blog posts on our website here that explain more details about what AAPT is and the independent AAPT International Certification Board finalized in 2020 to continue the certification process for those clinicians who meet the requirements after developing their competencies from the growing number of independent and certified training and supervision programs throughout the world. The current blog highlights some of the features that define and distinguish AAPT as a unique multi-disciplinary field with its own identity.

There are similarities between AAPT and AAT, just as there are similarities between AAPT and play therapy. But AAPT goes beyond the reach of these two very valuable fields, perhaps because it incorporates, in depth, the contributions of several other fields as well. In the early days, both Tracie and I were puzzled when attendees at our training programs, and especially those who had been through other AAI training or credentialing programs, repeatedly told us that what we were doing was very different. While we knew we were blending assumptions, knowledge, skills, and research in unique ways, we didn’t realize just how unique it was! Through the years, and especially the 15 years that Tracie and I have collaborated to further integrate our perspectives and how we teach them, we have come to realize that AAPT is, indeed, different from other AAI approaches. We are not saying here that it is “better than,” only that it operates differently in distinct ways that distinguish it from other fields and programs under the AAI and play therapy umbrellas.

In 2007, I began writing the book pictured above, Play Therapy with Kids & Canines (2008, Sarasota, FL: Professional Resource Press), which outlined the principles and practices of Canine Assisted Play Therapy™. The ideas there have since been expanded, clarified, and applied in ways that further tie theory, research, and practice together. Prior to writing this book, I had spent 2 decades reading every book I could find on dogs, and most particularly the science of what we knew about dogs at that time (although fiction was also included). My credentials in animal behavior and ethology came later, although I had studied ethology out of pure interest as an elective in my doctoral program in the early 1980s. This book received the 2008 Dog Writers Association of America’s Planet Dog Foundation Sit. Speak. Act. Canine Service Award. It recognized the unique thinking behind this work and encouraged its further development, in recent years with the involvement of the UK’s Tracie Faa-Thompson as collaborator, colleague, and friend. While Tracie’s primary focus has been horses for her entire life, her way of thinking and being with them and my own ways of conceptualizing relationships between humans and animals were very similar, and our countless discussions and experiences since then have strengthened the field. In 2013, the Pennsylvania Psychological Association also recognized the uniqueness of Animal Assisted Play Therapy® by honoring me with the Distinguished Contributions to the Science and Profession of Psychology Award for work in developing AAPT and furthering the Guerneys’ Filial Therapy.

Our 2017 book, Animal Assisted Play Therapy, as well as our next book on relationships cover in greater depth the features of AAPT that make it unique, but several of the key factors that distinguish it are included below.

AAPT Is Theoretically Integrative

Having learned Filial Therapy from both of its co-creators, Drs. Bernard and Louise Guerney, and then having spent decades teaching it to others, I was well-versed in a multi-theoretical, integrative approach to thinking about and conducting interventions. (Filial Therapy is a form of family therapy in which therapists teach and supervise parents as they conduct special nondirective play sessions with their own children. Eventually the parents become competent and can continue the sessions on their own at home, while still meeting with the therapist to discuss play themes, child behaviors and emotions, their own parental reactions, and family dynamics. It has one of the most impressive research histories of any child and family therapeutic approach). My thinking was shaped by Bernard Guerney (also known for his Relationship Enhancement® family of therapies) as much as by Louise Guerney, and Filial Therapy and its outgrowth, Relationship Enhancement®, represent the finest form of theoretical integration in therapy I’ve ever encountered. (I actually met Tracie first during an Intensive Filial Therapy training program I was conducting in York, England, and Edinburgh, Scotland.)

Drs. Louise and Bernard Guerney 

This theoretically integrative approach shows in AAPT from its beginnings. Not only are all the different forms of play therapy incorporated, but so are different forms of family and systemic therapies. AAPT is designed to be conducted with virtually any form of play therapy or family therapy or psychotherapy, for that matter. It can be used for educational, wellness, and therapeutic purposes. It encompasses psychological theories and techniques such as psychodynamic, humanistic, interpersonal, behavioral, cognitive, developmental/attachment, and family/systems. The theoretical and procedural integration does not stop there, however. To do AAPT properly, one must also be conversant in many aspects of animal behavior, including ethology, cognitive ethology, behavior and learning, human-animal bond, affective neuroscience and  neurobiology, species-specific communication and behavior patterns, superb observational skills, a full understanding of accurate and cautious interpretation of animal behavior, fluency in recognizing and responding to stress signals, a commitment to maximizing animal agency, enhanced sensory skills (such as peripheral vision), animal handling and husbandry, and considerably more. This sounds like a great deal to learn, and it is! To learn AAPT well, it takes two years of intense training and supervision followed by a dedication to lifelong learning, not only in one’s primary professional field (such as play therapy or family therapy, or allied health or educational interventions) but also in animal- and environmental-related fields. The good news is that all of this material is fascinating, and once it is integrated into one’s way of working, therapy becomes enriched immeasurably, whether animals are involved in it or not.

The Focus Is Always Relationship

AAPT is based on relationship, especially since most therapeutic and learning situations depend on excellent relationships. It is one of the three researched predictors of success in psychotherapy (along with therapist competence and enthusiasm for the method they are using). Not only is the therapist-client relationship important, but so is the client-animal relationship. Less discussed in the AAI literature is the importance of the therapist-animal relationship (see Howie, 2015, and VanFleet & Faa-Thompson, 2017 for detailed descriptions of this important factor). Even harder to find are resources that actually define the nature of the relationships involved. In many cases, the involvement of animals in therapy is put in terms of the value to humans. Even the testing procedures for the animals tend to focus on the behaviors that humans want to see, and far less on what behaviors are natural for the animals themselves.

There are many who talk about how important relationship is, but when one reads further or watches videos of their work, the relationships are disappointingly one-sided: how the animals can make life better for the humans. While I believe that these programs or individuals sincerely want to be humane, what is displayed often shows a lack of awareness or comprehension of what that actually means in terms of their own human behaviors. It is unfortunate that it is so hard to find resources that place equal attention on how the animals benefit (or not), how to ensure their well-being at all times, and what the handler-animal relationship conveys to clients and students.

In AAPT, we view every single interaction in terms of its impact on the relationship. This means that every interaction between therapist/handler and their animal is conducted according to principles of reciprocity and mutual benefit. While there might be many who agree with these words, there are implications for human behavior with animals that are harder to incorporate. Are the animals truly free to participate or decline participation? Can they actually decline if they are on a leash or rope? To what extent do we build the animals’ preferences and freely-made choices into the therapeutic process? How does it work when the animal wants something other than what the client wants? Do we use touch in a manner that the animal seeks it out, or do we use it in our human-driven ways? How well do we negotiate space around animals? Do we always provide them with an exit route or do we surround them while unintentionally creating a “human fence” holding them in one location?

When relationship is defined as being reciprocal and mutually beneficial, it has many implications for how the work is done. Glancing through other AAI-related websites quickly shows the difference. In AAPT, we want every interaction between therapist/handler and the animal/s to serve as both model and metaphor for what the client or student can expect in their own relationships with us. This often means examining and altering our lifelong habitual behaviors so that they become more animal-friendly. This is no easy task, but one that not only benefits the animals, but all of the humans involved, too. (Patricia McConnell’s classic 2002 book, The Other End of the Leash, covers this area well.)

The author demonstrates an attentive relationship and loose leash handling with an AAPT workshop participant’s dog. Awareness and attention are key aspects of building strong human-animal relationships.

Animals Get Top Consideration When It Comes to Well-Being

Most AAI programs would certainly want to use humane treatment of the animals involved. Important organizations like the International Association of Human-Animal Intervention Organizations (IAHAIO, www.iahaio.org) or Animal Assisted Intervention International (AAII , www.aai-int.org) make it clear that animal welfare must be considered, respected, and ensured. Differences from one provider of AAI to the next can be found in the interpretation of what is “humane,” however. One must look carefully at the specific policies and practices to determine if the organization fully understands how to ensure that animals are truly giving their consent to participate and that they are being treated with respect and understanding. Too often, the photographs and videos shown on websites or social media pages from community, professional, and university programs show animals who are displaying significant stress signals or who are being crowded, handled in a manner that is likely aversive to the animal, encumbered by equipment that seriously limits their mobility or is painful, or chased by clients who wish to touch them. Some training programs require that horses never lower their heads to eat grass while working in AAI. Others place animals in highly stressful environments apparently without consideration of how that might feel to the animal.

Fortunately, this is not the case with all AAI programs, but it is far too easy to find examples like these. One might ask questions such as the following to think about welfare issues.

> What happens when animal well-being conflicts with what the client needs and wants?
> Is it okay to use pressure-and-release methods of training horses for therapy work?
> Do leashes pulled tightly really allow dogs to make choices to participate in the program?
> Is it ever acceptable to objectify an animal in order to benefit a human client?
> Have therapists/handlers had extensive hands-on training in animal behavior and welfare?

In AAPT training and practice, the animals’ needs come first. For all intents and purposes, we conscript the animals into our work, so it is our obligation to take all measures to ensure that they are comfortable and can freely make choices of their own whenever possible. This means that if the animal shows signs of stress or avoids a person or activity, the therapist listens to that, no questions asked. Even if the client is upset that the animal refuses to do what they want, the animal’s choice is honored. It is the job of the therapist to help clients with their emotional reactions or disappointments, as that is the essence of therapy anyway. The therapist never pushes the animal to do something, even briefly, that the animal communicates is not of interest. This means that the animal is never considered a “co-therapist” or capable of making therapeutic decisions. That remains solidly the responsibility of the therapist. The animal simply gets to be him/herself at all times. Furthermore, there must be a training and relationship history from which the animal feels free to refuse or avoid certain situations. And finally, animal welfare, in which basic needs are met, is not considered sufficient. In AAPT, emphasis is placed at all times on animal well-being, an enhancement of living and working conditions that are made on the animals’ terms for the enrichment of the animals’ daily lives and choices. AAPT wants the kinds of relationships where animals are eager to be involved, not resigned to it because their choices have been limited.

AAPT places heavy emphasis on mutually beneficial collaborations with animals. The focus is relationship, not excessive formal training or continually asking animals to do things for us.

Animal Agency Is Honored and Voluntary Participation Is a Must

In June 2020, I wrote a blog called, Do We Sell Them Short? Supporting “Agency” in Animals (click the title to read it, a finalist in the Dog Writers Association of America competition in 2021). I have also made several presentations at international conferences on this topic (contact me for more information about recordings). Agency refers to the capability of humans and animals to act within their environment, usually by choosing a set of behaviors that help accomplish a goal. In many ways, agency encourages and allows animals to make many of their own choices, solve their own problems when possible, and be themselves to the fullest extent possible. In AAPT we avoid over-training while still expecting to have animals who are under sufficient control to be safe (for their own sakes as well as for clients’). While there are some behaviors or tasks we need from them, such as our dogs keeping “four on the floor” instead of jumping up and scratching people, they are not trained to an extent that they lose their enthusiasm for life, nor are they ever expected to tolerate intrusions from people. While it is not always possible in other forms of AAI, in AAPT we keep use of equipment such as harnesses, leashes, and ropes to a minimum and prefer when animals can work off-lead and at liberty. When this has been a “way of life” for animals, they feel as free to make choices, move toward or away, attend to people or ignore them, and so on during therapy just as much as when they are not working. When the relationship with the therapist/handler has a strong foundation based on a history of reciprocity, humans listening to the animal’s voice, giving the animal choices, and obtaining animal consent whenever possible, it becomes more likely that the animal will approach and want to be involved with other people, knowing that people are associated with positive interactions and experiences.

Putting a premium on animal agency makes it more likely that we can ensure voluntary participation of animals in meeting and interacting with clients in a wide range of ways. While it’s possible to train animals to do many tricks and behaviors that might be of interest to clients, and add some equipment to ensure that they will join the clients, this is not the AAPT approach. When therapists and educators learn the intricacies of animal behavior and develop their own observation skills to notice stress in animals or clients,  equipment designed to control the animals becomes much less necessary. The animals have space to move away if they so choose. When the relationships are strong and reciprocal with considerable agency, the animals also feel free to approach clients and students, to show their curiosity, and to exhibit initiative in some of the activities. When animals clearly are with the clients because they want to be, it shows, and it adds immensely to the authenticity of the therapeutic experience for clients. AAPT takes safety very seriously, but it works from different premises than most other forms of AAI. It represents a paradigm shift in which broad and deep knowledge of animals and a collaborative relationship with the animals provides greater freedom, voice, and choice for the animals while actually strengthening the safety of all involved. This is not a model that can be conducted in all environments, but for AAPT, it is both powerful and empowering for the clients and the animals.

When animals freely approach people, the genuineness of their engagement is clear in their body language.

AAPT Is Uniquely Playful

The broad field of play therapy uses the therapeutic powers of play (Schaefer & Drewes, 2014) to help create safety, acceptance, and developmentally-friendly conditions to help children work through their concerns and difficulties. There are many forms of play therapy, each with characteristic principles and methods. Nondirective play therapy has humanistic roots and allows children to make most of the decisions about what to play with and how to play. There’s also a continuum of levels of structure along which a variety of play therapy interventions can be found. These more directive forms have increasing levels of input from the therapist. AAPT was designed from the start to fit with virtually all forms of play therapy. Play or playfulness are used to help create the emotional safety and expression needed to overcome problems. There are also family and group forms of play therapy. AAPT incorporates the use of play and humor to assist clients of all ages in creating healthy change. For clients of all ages, AAPT provides opportunities for play-based relationships with the animals and the therapist. VanFleet & Faa-Thompson (2017) provide extensive information about how AAPT works with the different forms of play therapy, and how different levels of structure match with client goals. Because AAPT is a process-oriented form of therapy, just as much of play therapy is, it fits nicely with this modality for change. Therapists learn how to capitalize on the playfulness of animals and/or to infuse the sessions with their own play-based interactions and interventions.

An AAPT workshop participant works with Josie Patches on a playful intervention designed to enhance self-efficacy.

AAPT Is Based on the Goodness of Fit Concept

The “goodness of fit” concept used in AAPT is drawn from the child development and mental health fields (Thomas & Chess, 1977; Lerner, 1983). VanFleet (2021) was the first to apply it to AAIs in 2004. Goodness of fit suggests that a child’s temperament interacts with the environment to influence development and behavior. A good fit between temperament/personality and the environment leads to the best adaptation, while a poor fit often results in maladaptation. The goodness of fit approach to AAPT first requires a valid and reliable measure of personality of the animal across different environments to identify the relatively stable features. Then, the animal’s personality is matched with the type/s of AAPT that are best suited for that animal. Instead of trying to fit the animal into a “job description,” the job of the animal is derived from the animal’s personality, preferences, and choices. In AAPT, this means that the therapist always keeps the animal’s interests and capabilities in mind when selecting the type of play therapy or psychotherapy method used, as well as when developing or choosing specific interactions or activities. This process honors who the animal is while presumably reducing the stress that can come from a mismatch. For example, if a dog likes to be in the middle of activities all the time, he or she might not be a good fit for a child who needs nondirective play therapy and who rarely chooses to include the dog in the play. Similarly, an energetic dog might work best with more directive, action-oriented therapeutic activities.

Part of being an AAPT therapist is to be flexible and creative. Animals and clients can be unpredictable, so therapists or educators must be prepared to think on their feet to revise their plans accordingly. At all times, if they keep the following factors in mind, they are likely to shift to a therapeutically viable approach that is also freely engages the animal.

1. The needs and goals of the client/s
2. The personality, preferences, interests, and choices of the animal
3. The skills and competencies of the therapist
4. The environment within which they are working at this moment

Goodness of fit starts with the animals’ personality features. Curiosity is a characteristic that is very helpful in AAPT.

Natural Behaviors and Environments

As an outgrowth of AAPT’s emphasis on animal well-being and the goodness of fit approach, there is a strong preference for AAPT to be conducted in natural environments whenever possible. This means that horses are not moved to new situations or indoors, but remain in their own fields. Dogs become well-acquainted first with the playrooms and offices where they will work before ever working with clients. Natural environments lead to natural behaviors, and AAPT works best with natural behaviors. While some behaviors are trained, shaped, captured, or “premacked” and learned tricks can be useful in a therapeutic context, AAPT emphasis is placed more heavily on natural behaviors. Part of the relationship modeling is to demonstrate acceptance–understanding the core of who the animal is and accepting that rather than trying to change it. While therapists sometimes need to help the animal (and the client) to alter behaviors, there are no attempts to change the core personality. That acceptance plays a large part in the healing process. This focus on natural behaviors in natural environments also displays for clients an awareness of where the animals feel most comfortable and the therapist’s commitment to the animals’ comfort. At a fundamental level, the acceptance communicates the type of respectful relationship that AAPT advocates between humans and animals, as well as between therapists/educators and their clients/students.

When animals are accepted as themselves in their natural world, they often engage in behaviors that require physical and emotional safety, such as play. AAPT sometimes entails observations of animals playing spontaneously and discussions with clients about the conditions under which that happens in both the animals’ as well as their own worlds. The goodness of fit concept is relevant here as well, as the play styles of the animals are matched with the types of interventions for which they are best suited.

These goats became very interested and much more engaged when AAPT workshop participants designed a therapeutic activity that was tailored to natural goat behaviors of exploration and browsing.

The Differences Are in the Details

It is the combination of all of these elements and considerations that create the distinctiveness of AAPT. These are all essential features, and one or two alone do not suggest that an intervention or program is truly Animal Assisted Play Therapy®. Furthermore, “the devil is in the detail” as Flaubert said. It is not in the words, but in the actions. It is in the ways that therapists handle the animals, relate to the animals, listen to the animals, and so much more. The AAPT certification process is based on demonstrated competencies. How the human responds to the animal on a routine basis shows in the work they do together. The features described here represent a way of life with the animal, not merely how the animal works with the person. The highly trained and supervised AAPT therapist understands his/her animals in intimate detail, and that understanding, combined with the multiple disciplines that comprise this field, has an impact on decisions, behaviors, and relationships. The details show when people observe sessions, as was apparent during the March 2021 Virtual AAPT Conference during which certified AAPT therapists showed videos of their work. Even the same activities in some of the presentations looked different because they involved different animals who were permitted to approach it in their own ways. The best therapies are not technique-oriented but are principle-driven. The AAPT principles provide the guidance to therapists trained in the approach on every level. They are not merely ideas that sound good. They represent behaviors and decisions at every moment of the therapy process.

AAPT Guiding Principles

The following excerpt is from the VanFleet and Faa-Thompson (2017) Animal Assisted Play Therapy book, pages 50-52.

“Whenever nonhuman animals are asked to perform tasks under human direction, their welfare needs to be considered. Too many therapy animals are exposed to debilitating levels of emotional stress or exhaustion without any recognition by their owners, a state of affairs that disregards the animal’s welfare and presents a very poor model of caring to therapy clients. Similarly, when therapists bring dogs into the playroom or office, or take clients out to work with horses, they must think about additional factors that impact the clients and the therapeutic process. To ensure the physical and emotional well-being of clients and animals as well as the quality of the therapy, the following principles guide the practice of AAPT.

Respect
To the greatest degree possible, AAPT ensures the equal and reciprocal respect of clients and animals. The needs of humans and nonhuman animals are considered equally important.

Safety
AAPT activities must be physically and emotionally safe for all involved. The therapist places a limit upon, or stops immediately, any activity that is not safe. The therapist is responsible for maintaining the safety of all participants in the session.

Enjoyment and Choices
AAPT sessions must be enjoyable and pleasant for the animals as well as the clients. Clients and animals have the option of nonparticipation (i.e., they may opt out of any activities they wish). Tired or bored dogs can lie down. Children may choose to play without the dog. Horses may walk away or graze. Adult clients may decide to discuss concerns without the animal present. Client and animal decisions are respected within the boundaries of safety. The therapist facilitates the session to ensure its therapeutic value regardless of these choices.

Acceptance
In AAPT, the therapist accepts the client and the animal for who they are. The therapist accepts and works with clients’ needs, feelings, and processes without pushing them in a different direction or at a faster pace. Similarly, the therapist does not expect the animals to become something they are not. For example, AAPT dogs are not expected to become so docile or controlled that their individual personalities and interests are denied. While therapists need to prepare their animals for the work and ensure that their behavior is under control, they do not overtrain or overprepare them to relinquish their essential animal and individual natures. Some dogs are more suited to nondirective AAPT while others are better candidates for directive AAPT, and therapists consider this and act accordingly. The same principle of acceptance also applies to other species involved in AAPT.

Training
Therapists train their therapy animals using positive reward-, play-, and relationship-based methods. Aversive equipment or procedures, physical corrections, or forced holding of the animal have no place in the training, the therapy sessions, or the lives of these animals. This principle serves the welfare of both animal and client.

Relationship
The AAPT process focuses on relationship, not control. Just as the animals are taught to behave politely and respectfully with clients, clients learn to treat the animals with tolerance and respect. The therapist helps clients learn to recognize and respond to the animals’ feelings while developing a healthy relationship with them. All interactions with the animals follow the same principles for the development of humane, empathic, healthy human relationships. The essential playful nature of interactions during AAPT permits this to happen readily.

Empowerment
AAPT is an empowerment model. It encourages growth and independence, and the building of competence and confidence. Therapists demonstrate this as they engage clients and seek their input at each step of the process. The client builds the knowledge and skills needed to reach their goals, all with the support of the therapist. The same is true of the animals who work in AAPT.

Process
AAPT is a process-oriented form of therapy. While sessions might focus on specific tasks or goals, such as teaching something new to the animal, the process of getting there is considered much more important than achieving any single outcome. The therapist knows how to facilitate and use the process to help clients overcome their difficulties or develop new skills. Unexpected events are woven into the texture of the session so that client and animal needs are met.

Foundations
AAPT is grounded in well-established theories and practices in terms of lifespan development, clinical intervention, play therapy, ethical practice, and humane animal treatment. Practitioners remain within the boundaries of their training and expertise, and seek supervision, case consultation, and professional guidance when needed. They consult research when it is available, and they contribute to research as they are able. The foundations of ethical, quality clinical practice are always coupled with the foundations of ethical, humane treatment of animals.

Adherence to these foundations and the other AAPT principles is designed to ensure a positive, relationship-oriented, best-practices approach to each client and each animal involved in the therapeutic process. These principles guide AAPT practitioners in their planning, implementation, and processing of every aspect of AAPT. When doubts arise, therapists refer to the principles for guidance.”

References

Howie, A.R. (2015). Teaming with your therapy dog: New directions in the human-animal bond. West Lafayette, IN: Purdue University Press.

Lerner, R. (Ed.). (1983). Developmental psychology: Historical and philosophical perspectives. Hillsdale: Erlbaum.

McConnell, P.B. (2002). The other end of the leash: Why we do what we do around dogs. New York, NY: Ballantine.

Schaefer, C.E., & Drewes, A.A. (Eds.). (2014). The therapeutic powers of play (2nd ed.). Hoboken, NJ: Wiley.

Thomas & Chess (1977). Temperament and development. New York: Brunner-Mazel.

VanFleet, R. (2008). Play therapy with kids & canines: Benefits for children’s developmental and psychosocial health. Sarasota, FL: Professional Resource Press.

VanFleet, R. (2021). The goodness of fit concept in AAPT. Presentation at the International Animal Assisted Play Therapy® Online Conference, March 9, 2021.

VanFleet, R., & Faa-Thompson, T. (2017). Animal Assisted Play Therapy. Sarasota, FL: Professional Resource Press.

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*Animal Assisted Play Therapy is a trademark of the Family Enhancement & Play Therapy Center, Inc. and its International Institute for Animal Assisted Play Therapy®.[/caption]