From The Straits Times    |
animal-assisted therapy in Singapore

Credit: Her World

From taking an alligator on a walk to bringing a peacock on the plane, emotional support animals have been making international headlines. Their owners’ unusual choice of pets is certainly attention-grabbing, but it’s opened up conversations about how animals can become a mental and emotional crutch.

Animals – alligators not withstanding – have been found to help their owners create better human-to-human friendships. A 2015 study by the University of Western Australia, Harvard University and the Waltham Petcare Science Institute showed that among the 2,700 participants surveyed, 60 per cent of these were pet owners who are more likely to get to know people in their neighbourhoods than those without pets.

In March this year, volunteers from a local community pet Whatsapp group organised Pets in the Park, a casual get-together of pet owners and animal lovers living in Yishun.

Nearly 200 residents showed up with their animals in tow – dog owners mingled with attendees carrying cats, terrapins, rabbits and hamsters, while proud owners of parrots encouraged curious onlookers to let the friendly birds perch on them.

Volunteer Ho Shu Huang, who led the event, says the goal of this ground-up event was to “get people together and out of the house”.

“We were brainstorming different types of wellness activities to organise that would be broadly appealing to the community. Several volunteers mentioned animals, being in nature and social interaction with neighbours. So we thought we’d have a simple event where residents could bring their pets out to a park and get to know each other,” he says.

The idea that pet ownership is associated with the health benefits of their owners is dubbed the “pet effect”, said to help reduce stress and anxiety, and promote feelings of safety. But this so-called “effect”, says Dr Tiffani Howell of La Trobe University’s School of Psychology and Public Health, is hard to quantify due to conflicting results and insufficient research.

While more studies are required, the senior research fellow, whose work includes examining human-animal relationships, acknowledges that with proper care and management, animals can serve as positive conduits, such as during animal-assisted activities.

“Some studies do indeed find that pet ownership is associated with improved mental and physical health outcomes, as well as increased social interactions with other people in the community,” she says.

Young with her dog Diplo, an eight-year-old Singapore Special, at Pets in the Park, a get-together for pet owners in Yishun.
Nee Soon South MP Carrie Tan poses with an Amazon parrot at the event.

Tapping on the “pet effect”

These benefits are some of the reasons why Adele Lau founded home-grown social enterprise Animal-Assisted Interactions SG (AAISG) in February 2022. The goal? To offer beneficiaries “temporary respite from life’s troubles” through positive animal interactions. One of its programmes is an animal-assisted social initiative for retired people.

She shares an example of an elderly participant who overcame her social isolation through AAISG’s Sunshine Canines Programme. Mdm Sim (not her real name) had suffered from depression, and her social workers initially had trouble convincing her to sign up for activities. However, they knew she loved dogs, and managed to convince her to try the programme.

“Mdm Sim appeared slightly withdrawn in her first session with us, but as the sessions progressed, we were astounded by how far she opened up to us and our ‘Caring Canines’ – from sitting in the corner of the pavilion and silently observing activities, to holding our hands with a dog on her lap and happily chatting.

“It’s been about eight months, and Mdm Sim continues to show up at our sessions. Now that she has formed such a strong emotional bond with our dogs, we see her becoming increasingly comfortable interacting with the other seniors in the group. Through our dogs as catalysts of interaction, Mdm Sim now has a wider network of social support,” says Adele.

AAISG is run by founder Adele Lau (right), and programme manager Sarah Chin (left).

The real impact of animal-assisted interactions on mental health

It can be easy to confuse animal-assisted activities with animal-assisted therapy, since both tap on the benefits of the “pet effect”. The main difference between the two is that animal-assisted therapy involves treatment conducted by trained mental health professionals like a psychologist or therapist.

One of the few places to integrate animals in professional therapy here is Pawsibility, a psychological counselling practice founded 10 years ago by Maureen Huang. Trained in animal-assisted therapy in Colorado, she has more than 16 years of experience in the field. The team at Pawsibility consists of psychologists, psychotherapists and therapy dogs.

“While trained therapy animals are present in these sessions as a source of comfort and joy, the focus of the sessions is similar to traditional talk therapy, which helps individuals process their emotions, see things from different perspectives, and equip them with coping strategies to better manage challenges,” she explains.

“In a therapy session, clients often feel less anxious and more relaxed in the presence of a therapy dog [while discussing their issues with their therapist], making it easier to talk about and work through challenges in their lives.”

Pawsibility’s Maureen Huang with therapy dogs Telly, a Labrador Retriever, Hope, a Golden Retriever, and Riley, a Miniature Schnauzer.

Another form of interaction that can offer therapeutic benefits is animal-assisted intervention, which local charity Equal specialises in. Located in central Singapore, the 2,000 sq m space houses a horse stable and a large ring where learning activities involving equines are conducted. These horses include rescued and retired breeds ranging from former race and equestrian horses, to miniatures that are sponsored by a donor.

Here, programmes that integrate equine-assisted learning range from interactive games to horse riding and horse care, and are facilitated by professional special needs therapists who guide beneficiaries by encouraging the use of observation, emotional scaffolding, and introspection.

“For youths and children, this interaction can help build social emotional skills,” shares Sandra Leong, CEO of Equal.

A stronger sense of responsibility, and increased empathy in children with developmental disorders are some positive outcomes that have been observed through participating in small group activities that require them to work as a team, such as leading a horse from one point to another.

Additionally, a study conducted with the charity from 2013 to 2014 showed that equine-assisted intervention led to progressive improvements in character skills in 192 Secondary 1 students from a special needs school over the semester. Equal also conducts “meet and greet” sessions for nursing home residents, where they are given the opportunity to perform simple acts of care, such as grooming a miniature horse with a brush.

“This switches the role of the resident from one who receives care, to one that provides care, as they would have during their younger days. It returns to them a sense of purpose, which may be difficult to attain during a person’s senior years,” says Sandra.

Equal is a charity organisation that offers equine-assisted intervention to individuals, families, and children with special needs.
Therapy horses at Equal include rescued and retired breeds ranging from former race and equestrian horses, to miniatures.

Despite the many positive examples cited, there is also research showing no effect, or that people with pets or emotional support animals sometimes have worse health outcomes.

“In many cases, this may be because the studies are usually looking at associations between pet ownership and health, rather than showing cause-and-effect. There may be other factors determining a pet owner’s health, beyond merely owning a pet.

“A recent study found that a very strong bond with a pet is associated with poorer mental health, but only in people who do have so-called ‘anxious attachment’ relationships with other humans (those who find it hard to trust others due to a fear of abandonment),” says La Trobe University’s Dr Howell.

She adds that there are other possible reasons for the mixed results, because these studies are almost always correlational. She explains: “For instance, in the research showing that dog owners get more exercise, is it that they get more exercise because they have a dog, or do they get a dog because they are active people and a dog fits well into their existing lifestyle?”

Dr Ellen Jongman, a senior research fellow at University of Melbourne’s Animal Welfare Science Centre, shares a similar sentiment about the actual efficacy of animal-assisted activities.

She says: “There are no standardised rules on how animals are to be incorporated and what activities to be are included. Some animal-assisted activities are also often presented as therapy, even though little actual therapy is provided (other than animal interaction) – they really should be incorporated in existing therapy with a clear goal in mind.”

While this may be so, Dr Jongman adds that such interactions are still associated with moderate effect in improving outcomes in autism-spectrum symptoms, medical difficulties like mobility issues, behavioural problems, and emotional well-being.

Attendees at Pets in the Park with their animal companion, Mysty, a 13-year-old Labrador and Basset Hound Cross.
Tinku, a seven-year-old Shih Tzu at Pets in the Park.

A helping paw for trauma survivors

Perhaps one of the biggest potentials of the human-animal bond is exploring how service animals, such as dogs, can be trained in providing support for those with psychiatric conditions.

Unlike emotional support animals that mostly provide companionship, psychiatric service dogs are trained to perform specific tasks related to the needs of their owners. Dr Howell led an assistance dog programme for 20 veterans with post traumatic stress disorder (PTSD) in Australia, which ran from 2018 to 2022.

The study, which functioned as an adjunct to traditional psychiatric therapy, was a collaboration with Evolution Research, the Department of Veterans’ Affairs, and the Centre for Service and Therapy Dogs Australia (CSTA). The veterans were paired with young adult dogs trained to assist them with their specific needs after a year-long acclimation process with temporary psychiatric assistance dogs. This helps the veterans learn how to work and live with the canines.

“It means that the veteran has to cede control to the dog and learn that sometimes, the dog needs to be in charge. The veteran learns, okay, I can trust this dog, this dog will always look after me,” explains Dr Howell.

It’s an intensive process, but one that resulted in a high success rate. Three out of 20 veterans dropped out early in the programme for various reasons, but not because of an unsuitable pairing.

“We did see improvements in quality of life and a reduction in PTSD symptoms for the veterans. However, it was a mixed bag for the carers of the veterans. Some reported that their care burden was reduced. For others, the dogs were an additional responsibility,” reveals Dr Howell.

Still, the trial served as a promising example of how assistance animals can help individuals with mental health conditions integrate back into their communities. Dr Howell hopes to be able to do further research on the project to track the impact of a psychiatric assistance dog on its owner, especially when the canine is no longer able to work for them.

“There’s not a lot of research that’s been done [on the full impact of emotional support or assistance animals], although it’s picking up now. But that doesn’t mean that animals aren’t helpful for people – I’ve spoken to people and I’ve heard their stories.

“The evidence base hasn’t quite caught up with what’s happening on the ground yet, but I think it’s just a matter of time before the scientific evidence for assistance animals is solid,” she says.

PHOTOGRAPHY Nur Athirah Annissa & Phyllicia Wang