ArticlePDF Available

Abstract and Figures

There is a lack of scientific studies using farm animals in animal-assisted therapy (AAT) for persons with mental disorders. This Norwegian study used video records to study the working abilities and behaviors of 35 severely ill psychiatric patients in interacting with farm animals during a three-month intervention. The patients showed higher intensity (difference score: 0.26 ± 0.05, p < 0.0001) and exactness (difference score: 0.31 ± 0.06, p < 0.0001) in their work at the end of the intervention, particularly patients with schizophrenia and personality disorders. The patients spent most relevant time in physical contact with the animals, feeding, cleaning, and milking cows. Among patients with affective disorders, increased intensity of work correlated significantly with increased generalized self-efficacy (rs = 0.82, p = 0.01) and decreased anxiety (rs = −0.7, p = 0.05). For the patients with schizophrenia and personality disorders no correlation was found between the behavioral parameters and the effect scores of psychiatric instruments. Occupational therapy with farm animals may be beneficial to some persons with mental disorders.
Content may be subject to copyright.
Full Terms & Conditions of access and use can be found at
http://www.tandfonline.com/action/journalInformation?journalCode=womh20
Download by: [NMBU] Date: 20 October 2015, At: 02:12
Occupational Therapy in Mental Health
ISSN: 0164-212X (Print) 1541-3101 (Online) Journal homepage: http://www.tandfonline.com/loi/womh20
Humans with Mental Disorders Working with Farm
Animals
Bente Berget , Ingvild Skarsaune MSc, Dr. Med , Øivind Ekeberg & Bjarne O.
Braastad Dr. Philos
To cite this article: Bente Berget , Ingvild Skarsaune MSc, Dr. Med , Øivind Ekeberg & Bjarne
O. Braastad Dr. Philos (2007) Humans with Mental Disorders Working with Farm Animals,
Occupational Therapy in Mental Health, 23:2, 101-117, DOI: 10.1300/J004v23n02_05
To link to this article: http://dx.doi.org/10.1300/J004v23n02_05
Published online: 08 Sep 2008.
Submit your article to this journal
Article views: 684
View related articles
Citing articles: 11 View citing articles
Humans with Mental Disorders
Working with Farm Animals:
A Behavioral Study
Bente Berget
Ingvild Skarsaune, MSc
Øivind Ekeberg, Dr. Med
Bjarne O. Braastad, Dr. Philos
ABSTRACT. There is a lack of scientific studies using farm animals in
animal-assisted therapy (AAT) for persons with mental disorders. This
Norwegian study used video records to study the working abilities and
behaviors of 35 severely ill psychiatric patients in interacting with farm
animals during a three-month intervention. The patients showed higher
intensity (difference score: 0.26 ± 0.05, p < 0.0001) and exactness (dif-
ference score: 0.31 ± 0.06, p < 0.0001) in their work at the end of the
intervention, particularly patients with schizophrenia and personality
disorders. The patients spent most relevant time in physical contact
with the animals, feeding, cleaning, and milking cows. Among patients
with affective disorders, increased intensity of work correlated signifi-
cantly with increased generalized self-efficacy (rs= 0.82, p = 0.01) and
Bente Berget, PhD student, is affiliated with the Department of Animal and
Aquacultural Sciences, Norwegian University of Life Sciences, PO Box 5003, NO-1432
Ås, Norway.
Ingvild Skarsaune, MSc, is affiliated with the Department of Animal and Aqua-
cultural Sciences, Norwegian University of Life Sciences, PO Box 5003, NO-1432 Ås,
Norway.
Øivind Ekeberg, Dr. Med, is Professor and Psychiatrist, affiliated with the Depart-
ment of Behavioral Sciences in Medicine, University of Oslo, PO Box 1111 Blindern,
NO-0317 Oslo, Norway.
Bjarne O. Braastad, is Professor, Dr. Philos and ethologist, affiliated with the De-
partment of Animal and Aquacultural Sciences, Norwegian University of Life Sci-
ences, PO Box 5003, NO-1432 Ås, Norway.
Address correspondence to Bente Berget at the above address.
Occupational Therapy in Mental Health, Vol. 23(2) 2007
Available online at http://otmh.haworthpress.com
2007 by The Haworth Press, Inc. All rights reserved.
doi:10.1300/J004v23n02_05 101
Downloaded by [NMBU] at 02:12 20 October 2015
decreased anxiety (rs=0.7, p = 0.05). For the patients with schizophre-
nia and personality disorders no correlation was found between the be-
havioral parameters and the effect scores of psychiatric instruments.
Occupational therapy with farm animals may be beneficial to some
persons with mental disorders. doi:10.1300/J004v23n02_05 [Article copies
available for a fee from The Haworth Document Delivery Service: 1-800-
HAWORTH. E-mail address: <docdelivery@haworthpress.com> Website:
<http://www.HaworthPress.com> 2007 by The Haworth Press, Inc. All rights
reserved.]
KEYWORDS. Farm animals, intervention, working abilities, behavior,
animal-assisted therapy
INTRODUCTION
Effects of human-animal interactions have been widely studied with
pets, but there is almost a complete lack of scientific studies of human-
animal interactions during interventions with farm animals in animal-
assisted therapy (AAT). Initial studies of interactions between peo-
ple and their pets showed that physiological responses measured as
blood pressure and heart rate decreased while interacting with the pet
(Katcher, Friedmann, Beck, & Lynch, 1983; Katcher, 1981; Wilson,
1987). The anxiety levels paralleled the physiological responses (Wil-
son, 1991). Explicitly looking at animals perceived as being safe, is as-
sociated with, for example,, decreased physiological arousal (Katcher
et al., 1983) or making people feel safer (Lockwood, 1983; Holocomb,
Jendro, Weber, & Nahan, 1997) and more interactive, sociable and
helpful with others (Bernstein, Friedmann, & Malaspina, 2000; Marr,
French, Thompson, Drum, Greening, Mormon, Henderson, & Hughes,
2000; Haughie, Milne, & Elliott, 1992). An animal merely being pres-
ent is associated with a decrease in depression and anxiety (Folse,
Minder, Aycock, & Santqana, 1994; Barker & Dawson, 1998; Antonioli
& Riveley, 2005). Since it has been shown that humans can form attach-
ments to pets (Levinson, 1978; Peretti, 1990; Zasloff & Kidd, 1994),
that positive health effects can be obtained even if it is not one’s own an-
imals (Friedmann, 2000), and that physical contact with the animals is
particularly rewarding (Neer, Dorn, & Grayson, 1987), it is worth in-
vestigating to what extent psychiatric patients will seek close contact
with farm animals as well. In AAT with farm animals, we suggest that
102 OCCUPATIONAL THERAPY IN MENTAL HEALTH
Downloaded by [NMBU] at 02:12 20 October 2015
the combined effect of both contact and work with the animals can
affect the patients positively, that is, by providing a source of physical
contact of a living “other” and increased coping ability and self-esteem
through daily routines that include feeding and caring for other living
creatures.
During the last decade, the utilization of agricultural farms as a basis
for promoting human mental and physical health in cooperation with
health authorities is growing in several countries in Europe and in the
United States of America. In some countries this is called “Green Care,”
a concept which is not restricted to the use of animals, but also includes
plants, gardens and forests (Hassink & van Dijk, 2006). A German sur-
vey of 167 care farms concluded that working with both animals and
plants are meaningful activities and an aid to engage in social interac-
tion (Lenhard, Moevius, & Dabbert, 1997). A study of AAT with horses
showed that riding a horse may lead to improved quality of life, higher
self-esteem, and better social skills (Fitzpatrick & Tebay, 1997). A study
of 80 children at Green Chimneys educational farm outside New York
showed that the children visited the animals to feel better, and they
learned about nutrition and how to care for the animals (Mallon, 1994).
Berget, Ekeberg, and Braastad (2004) reported positive effects on depres-
sion, anxiety, and self-esteem in a Norwegian pilot study of five com-
pleters of a total of 10 patients with severe psychiatric diagnoses who
had an intervention consisting of work in animal houses at farms.
The working abilities of people with psychiatric disorders during inter-
ventions with farm animals and the nature of the client-animal interaction
has not been investigated previously. This will be important when con-
sidering work with farm animals as a form of occupational therapy. In a
three-month intervention study mainly with dairy cattle, we wanted to
examine whether patients with long-lasting psychiatric symptoms were
able to enhance working abilities by the end of the intervention measured
by intensity and exactness of their work with the animals, and if there
were differences among the diagnostic categories. Furthermore, we
wanted to investigate whether the working abilities were correlated with
better self-esteem, coping ability, quality of life, or less depression or
anxiety. Finally, we wanted to examine the physical distance to the ani-
mals as an indicator of the level of fear of the animals, and to study if
more physical proximity to the animals was related to active work and
caring for the animals by the end of the intervention period.
Berget et al. 103
Downloaded by [NMBU] at 02:12 20 October 2015
METHODS
Subjects
We recruited a total of 90 psychiatric patients, 59 females and 31
males, in the study. The patients were randomly selected by computer-
generated random numbers to a 12-week intervention with farm ani-
mals or to a control group, with two-thirds (60 patients) to AAT and
one-third (30 patients) to the control. Because the aim of this study was
to examine the working abilities and physical distance to the animals,
the comparison with the control group was not the focus of this study.
Among the 41 completers in the AAT group, 35 (58.3 %) patients, 26
females and nine males, were videotaped both early and late during the
intervention period, and therefore were used in this report. More than
50% of the patients had been ill for more than five years, and 71% had
been treated at psychiatric health institutions for more than three years.
There were both inpatients (5.7%) and outpatients (94.3%) connected to
a psychiatric department or to the municipal psychiatric health care ser-
vices in six counties in Southern Norway. Some of the patients had
unstable phases. As a result, six patients were not present on the farm ei-
ther during the first or the second video session and were therefore not
included in the analyses. The mean age ( SD) was 35.7 ± 10.9 (range
18-58) years. The diagnoses were based on consensus between treating
and research psychiatrists using the ICD 10 criteria (WHO, 1992). The
patients had the following main diagnoses: 13 (37.1%) persons with
schizophrenia and schizotypal disorders (F20-29), eight (22.8%) affec-
tive disorders (F30-39), four persons (11.4%) with anxiety and stress-
related disorders (F40-49), and 10 (28.6%) persons with disorders of
adult personality and behavior (F60-69). One did not complete the
questionnaires, and is only included in the results related to the behav-
ioral observations. Exclusion criteria were: (1) less than 18 years of age,
(2) acute psychotic disorder, (3) mental retardation, (4) serious drug
addiction, and (5) having had a job during the six months prior to
the intervention. The study took part between September 1, 2003 and
January 1, 2006. Therapists asked candidate patients whether they would
like to participate in this study with farm animals and work with the
livestock under supervision of the farmer. Primary therapists of the
recruited patients were involved in the project, checked that patients
filled in the questionnaires, and communicated with the farmer about
the patients when necessary. We assumed that the therapists formed a
representative sample of clinical professionals. Psychiatric nurse was
104 OCCUPATIONAL THERAPY IN MENTAL HEALTH
Downloaded by [NMBU] at 02:12 20 October 2015
the predominating profession (45%). There were also psychiatrists,
psychologists, nurses of mentally subnormal, psychiatric nurses auxil-
iary, college-trained social workers, psychiatric child welfare workers,
occupational therapists, and environmental therapists. The patients re-
ceived written information on the work, and could get further informa-
tion if required. Informed written consent was thereafter obtained for
those who accepted to participate. The AAT group received standard
therapy (individual, group therapy, or another kind of therapy) and reg-
ular medical treatment in addition to the intervention. Eighty-three per-
cent of the 35 patients took daily medication, mainly anti-psychotics
(28%), antidepressants (30%), sedatives (17%), and mood stabilizers
(12%). The control group received treatment as usual. Because of quite
varied types of therapy in the control group, we found it inappropriate to
document their behavior.
The Farms and Farmers
Among the 15 recruited farmers, there were seven women and eight
men working with the patients. Twelve of the farmers were between 30
and 49 years of age, one was between 20 and 29 years, and two were
more than 50 years old. Only two farmers had earlier experience with
psychiatric patients. Nine of the farmers (60%) were employed full-
time outside the farm; the rest had part-time in addition to farm work.
The median size of the farm was 10 to 30 hectares (25 to 75 acres). The
main productions were dairy cows (n = 10 farms, mean 20 animals),
specialized meat production with cattle (n = 2, mean 22 animals), sheep
(n = 2, mean 30 animals), or horses (n = 1, 18 animals). All dairy farms
had meat production with cattle in addition. Some also had sheep or
horses. All farmers had small animals like rabbits, poultry, pigs, cats, or
dogs as a part of the milieu on the farm. No animals were slaughtered
during the intervention period.
Procedure
The patients visited the farm for three hours twice a week for 12
weeks to participate in ordinary work with farm animals. One or two
patients visited the farm at each time, and the work was mainly carried
out in the afternoon. The patients were only working with the animals,
performing ordinary stockman work under supervision of the farmer;
they were not allowed to do other kinds of farm work. The farmers were
told that the work should depend on the patient’s coping ability and
Berget et al. 105
Downloaded by [NMBU] at 02:12 20 October 2015
interest, and that patients should have opportunity for physical contact
with the animals. The video recordings were carried out once during
the first two weeks and once during the last two weeks of the interven-
tion period. The patients were told to do ordinary work tasks with the
animals during the video sessions.
Video Records
Video records were made with a Sony DVCAM 3CCD digital
hand held camera in normal speed, zooming in from some distance to
avoid disturbing the patient’s behavior. The duration of the recordings
varied in time (mean 29 minutes, range 6-70 minutes) because some of
the patients were mentally unstable and did not always manage to exe-
cute the tasks with the animals. It occurred by chance if the unstable
periods were at the first or the second video recording, and the duration
of the recordings did not affect the results systematically.
Assessment of Video Recordings
The videotapes were analyzed by instantaneous sampling at one-
minute intervals for the patient’s behavior, distance between the patient
and the animal, and intensity and exactness of the work with the ani-
mals. Samples were taken during ±5 seconds around every minute. All
video analyses were carried out by one of the authors (I.S.). She was
blinded to the patients’ diagnoses. During the analyses the video camera
was connected to a 28 JVC TV. The observed behavior categories are
shown in Table 1. Although the duration of the video records varied, the
behavior categories observed occurred in both video sessions for each
patient (see Table 1).
The distance between the patient and the animals was measured
on a 5-point scale; 1 = 0-0.5 meters; 2 = 0.5-1 meters; 3 = 1-2 meters;
4 = 2-5 meters, and 5 = >5 meters. The intensity and exactness of the
work had five response categories, with (1) “Very low,” (2) “Quite low,”
(3) “Average,” (4) “High,” and (5) “Very high.” Average intensity and
exactness was based on a normal stockperson’s work and care for the
animals. Intensity is a measure of the speed and effectiveness of a cer-
tain work task. Exactness is a measure of the quality and accuracy of the
work that was performed. Together these measures were intended to
reveal the functionality of the work with the animals. The average
scores of intensity and exactness were calculated for each individual.
To estimate an average distance to the animals, each observation was
106 OCCUPATIONAL THERAPY IN MENTAL HEALTH
Downloaded by [NMBU] at 02:12 20 October 2015
regarded as representing the midpoint within the observed distance cat-
egory, that is, score 2 denoting 0.75 m. Averages of these estimates
were then calculated for each patient.
Questionnaires
Five psychiatric questionnaires were used, and the participants
answered these questionnaires both before and at the end of the inter-
vention. These instruments are all tested for their validity and reliability
and are widely used in psychiatric research and clinical practice.
The Spielberger State Anxiety Inventory (STAI; Spielberger,
Gorsuch, & Lushene, 1970) measures anxiety at the present time.
The inventory consists of 20 items and the patient responded to a
4-point scale from 1 “Not at all” to 4 “Very much so,” with a score
range of 20-80.
Berget et al. 107
TABLE 1. Different Behaviors that Were Observed During the Interactions with
the Animals
Behavior Explanation
Physical contact with the animals Patting, brushing, washing, looking after,
nursing, saddling, or riding horses.
Communication Verbalization, visual contact.
Moving the animals Behaviors that include moving animals from
different places in the cowshed, and between
different pastures.
Feeding Feeding adult animals with concentrates and
forage, and milk feeding the small animals.
Go/stand/run and sit down The participants moved around in the
cowshed to bring tools and straw to clean the
boxes.
Cleaning Cleaning the cowshed or washing buckets
and bottles.
Milking All routines connected to the milking
procedure.
Receiving instructions Receiving instructions from the farmer.
Various Behaviors that occur rarely, like filming
the animals and taking still pictures of the
animals.
Threatening behavior from the
animals
Encountering threatening or aggressive
behavior from the animals.
Downloaded by [NMBU] at 02:12 20 October 2015
Depression was measured with the Beck Depression Inventory
(BDI; Beck, 1967). This questionnaire includes 21 items that cor-
respond to the cognitive, affective, motivational, and vegetative
characteristics of depression. For each item, one of four statements
is selected, ranked from 0-3, with 0 being least serious. The score
range is 0-63. For both the STAI and the BDI, low scores reflect
low anxiety and depression.
Self-esteem was measured with the Generalized Self-Efficacy
Scale (GSE; Schwarzer, 1993) assessing the strength of a person’s
belief in his/her ability to respond to novel or difficult situations.
The patient responds to a 4-point scale from 1 “Not at all true” to 4
“Exactly true.” The score range is 10-40.
Coping was measured using the Coping Strategies Scale of the Pres-
sure Management Indicator (Cooper, Sloan, & Williams, 1988;
Cooper, Luikkionen, & Cartwright, 1996), translated and adapted
for use in Norway (Håseth & Malde, 2001). The scale includes six
items measuring control and planning ability in daily life (control
coping) and four items measuring coping by means of social sup-
port. The patient responds to a 6-point scale from 1 “Never used by
me” to 6 “Very frequently used by me.” The score range is 10-60.
A Norwegian version of Quality of Life Scale (QOLS-N; Wahl,
Burckhardt, Wiklund, & Hanestad, 1998) was used comprising 16
items and reflecting relations to other humans, work, and leisure.
The patient responds to a 7-point scale with 1 “Very content” to 7
“Very discontent” with a score range of 16-112.
In the GSE, the Coping Strategies Scale and QOLS-N high scores
reflect a high degree of self-efficacy, coping, and quality of life. A
14-item questionnaire was developed to measure the reasons for drop-
ping out of the project, with a 7-point scale from 1 “Not at all” to 7
“Very much.”
Statistics
Differences in means between early and late in the intervention
period in intensity, exactness, distance from the animals, and the dif-
ferent behavior categories were analyzed by matched-paired t-tests.
The Spearman correlation analysis was used to evaluate the relationship
between the video recordings (intensity, exactness, and distance from the
animals) and the psychiatric instruments (quality of life, self-efficacy,
coping ability, depression, and anxiety). The strength of the health
108 OCCUPATIONAL THERAPY IN MENTAL HEALTH
Downloaded by [NMBU] at 02:12 20 October 2015
effects was measured by an effect score for the total group (ES), calcu-
lated as the difference between the after score (T2) and the before
score (T1) of intensity and exactness divided by the standard deviation
of the score before the intervention. The level of significance was set at
p < 0.05. Mean ± standard errors are presented unless otherwise stated.
All analyses were conducted with JMP version 6 (SAS, 2005).
RESULTS
The differences in intensity, exactness, and distance from the ani-
mals between the first and the second video recordings are presented
in Table 2.
The participants showed a significantly higher intensity (score differ-
ence: 0.26 ± 0.05) and exactness (0.31 ± 0.06) in their work with the
animals during the second video recording. These differences were
manifested among the patients with schizophrenia or schizotypal disor-
ders (F 20 group), the patients with disorders of adult personality and
behavior (F 60 group), and the patients with anxiety and stress-related
disorders (F 40-49). There were no significant differences related to the
distance from the animals between the two recordings for the cohort as a
whole or for the different diagnoses. The participants were close to the
animals during both recordings (on average less than 1.5 meters).
The main reasons for all the 19 drop-outs were (1) little interest in the
animal species at the farm (mean = 3.3 ± 0.69; 26.7% answering “Very
much”), (2) that the work was boring (mean = 3.5 ± 0.65, 20% answer-
ing “Very much”), and (3) private reasons (mean = 3.3 ± 0.69; 26.7%
answering “Very much”). As much as 66.7% (mean = 1.8 ± 0.43) an-
swered that the reason for dropping out was “not at all” connected to the
farmer’s behavior. The main difference between dropouts and complet-
ers was that dropouts significantly more often were inpatients (2=
13.01, p = 0.006).
The patients spent, on average, most time on behavior related to
physical contact with the animals, feeding them, cleaning the cowshed,
and milking cows (Figure 1).
Although there was no significant difference between the two time
points in the video observations, patients tended to reduce the frequen-
cies of physical contact per se and cleaning the cowshed late in the inter-
vention, while they instead tended to spend more time feeding and
milking the cows at this time. The participants diagnosed as schizo-
phrenic spent less time cleaning the cowshed during the second video
Berget et al. 109
Downloaded by [NMBU] at 02:12 20 October 2015
TABLE 2. Scores in Intensity, Exactness and Distance to the Animals Early and Late in the 12-Week Intervention
Period, for the Cohort and the Different Diagnoses Groups (Paired t-test, Mean SE)
ICD 10
Categories
Intensity Exactness Distance from animals
Early Late t p Early Late t p Early Late t p
F20-29 2.64 0.09 2.93 0.07 5.40 0.002 2.74 0.08 3.09 0.13 3.17 0.009 1.44 0.47 1.53 0.50 0.59 n.s.
F30-39 2.82 0.13 3.00 0.07 1.56 n.s. 2.96 0.12 3.18 0.12 1.84 n.s. 0.93 0.26 1.11 0.19 0.51 n.s.
F40-49 3.02 0.02 3.23 0.05 5.84 0.01 3.25 0.10 3.60 0.14 6.87 0.006 1.37 0.41 1.01 0.44 0.64 n.s.
F60-69 2.82 0.14 3.14 0.14 2.52 0.03 3.02 0.12 3.35 0.12 3.11 0.01 0.93 0.17 1.07 0.25 0.49 n.s.
Total group 2.78 0.06 3.04 0.05 5.34 0.0001 2.93 0.06 3.24 0.07 5.56 0.0001 1.16 0.19 1.23 0.20 0.52 n.s.
110
Downloaded by [NMBU] at 02:12 20 October 2015
recording (early: 25.64 ± 7.79 % late: 14.67 ± 8.34 %, Z = 6, p = 0.03).
They spent more time on behavior related to milking routines later in the
study than they did earlier, although it was not significant. The scores of
the participants on the different psychiatric instruments before the inter-
vention and by the end of it are presented in Table 3.
There were no significant correlations between effect scores of the
video recording parameters (differences in intensity, exactness, and dis-
tance from the animals) and the scores of any of the psychiatric instru-
ments for the total patient cohort (after minus before). Within the F-30
group (affective disorders), those participants who showed the highest
increase in intensity of work with the animals also showed the highest
increase in generalized self-efficacy (rs= 0.82, p = 0.01), and the high-
est decrease in anxiety (rs=0.7, p = 0.05). The analysis of clinical sig-
nificance by measures of effect size (ES) showed that for the total
cohort ES in intensity was 0.56, and ES in exactness was 0.86.
Berget et al. 111
35
30
25
20
15
10
5
012345678910
Behavior categories
Percentage of time
FIGURE 1. Percentage distribution in time spent of the different behavior cate-
gories (SE) for the patients (n = 35) in the first video registration (black col-
umns) and in the second registration (grey columns). Category 1 = Physical
contact with the animals, 2 = Communication with the animals, 3 = Moving the
animals, 4 = Feeding, 5 = Go/stand/run and sit down, 6 = Cleaning the cow-
shed, 7 = Milking, 8 = Receiving instructions, 9 = Rare behaviors, 10 = Threat-
ening behavior from the animals. None of the differences between the two time
points were statistically significant.
Downloaded by [NMBU] at 02:12 20 October 2015
TABLE 3. Scores Before and After the Intervention in Generalized Self-Efficacy Scale (GSE), Coping Strategies
Scale, Beck Depression Inventory (BDI), Spielberger State Anxiety Inventory (STAI), and Quality of Life Scale
(QOLS-N). N = 34, mean ± SE
GSE PMI BDI STAI QOLS-N
Before After Before After Before After Before After Before After
Total
cohort
23.38 0.95 24.03 1.15 31.59 1.52 33.21 1.55 20.44 1.96 16.91 1.95 51.91 2.33 50.5 2.35 64.38 2.50 67.18 2.92
F20-29 24.42 1.37 24.75 2.05 31.00 2.45 33.33 3.36 13.67 3.0 13.50 3.01 44.92 3.97 44.42 3.60 68.75 4.69 72.25 6.08
F30-39 22.63 2.13 24.63 2.23 33.38 4.00 34.00 3.22 27.13 4.42 19.75 3.57 52.88 4.88 52.00 4.88 59.00 6.06 65.88 4.36
F40-49 22.50 2.63 24.25 4.77 32.75 4.96 36.00 3.19 25.75 5.86 16.75 8.75 60.00 6.54 53.50 8.86 71.25 5.14 65.50 10.82
F60-69 23.10 2.14 22.60 1.97 30.40 2.46 31.30 2.17 21.10 2.57 18.80 3.65 56.30 3.52 55.40 4.09 60.70 3.24 62.80 4.30
112
Downloaded by [NMBU] at 02:12 20 October 2015
DISCUSSION
This is the first study examining the working abilities of psychiatric
patients in AAT interventions with farm animals. We found that psychi-
atric patients working with farm animals for a 12-week intervention
increased both the intensity and the exactness in their work with the ani-
mals. There were some differences between the diagnostic groups. Pa-
tients with schizophrenia, personality disorders, and anxiety disorders
showed the greatest increase in intensity and exactness during the inter-
vention. For patients with affective disorders, increased intensity in the
work with the animals from early to late observations was correlated
with lower anxiety and higher self-efficacy. These patients also showed
increased self-efficacy and quality of life compared with the control
groups, as measured six months after end of intervention (Berget, 2006).
Because of the small sample size (n = 8), it is premature to conclude that
AAT with farm animals will be beneficial for all affective disorders.
The results correspond with earlier studies of anxiety in relation to AAT
with pets (Barker & Dawson, 1998; Wilson, 1991; Antonioli & Riveley,
2005). The latter study showed, however, no significant reduction in
anxiety among depressive patients in the treatment or control groups af-
ter a two-week intervention with dolphins. Our results on self-efficacy
among patients with affective disorders paralleled studies of Barlow,
Williams, and Wright (1996) and Gramstad, Iversen, and Engelsen
(2001) that generalized self-efficacy is an important predictor of emo-
tional and psychosocial adjustment in patients with epilepsy, and is as-
sociated with greater psychological well-being among people with
arthritis. In our study there were no significant differences in increased
quality of life, coping ability or decreased depression from the first to
the second registration, but patients showed lower anxiety and higher
self-efficacy at follow-up registrations six months after the end of the
intervention (Berget, 2006). Most patients in our study had had their
symptoms for quite many years, and one should not expect a rapid and
great improvement in self-experienced mental health in such patients.
The lack of decrease in depression is in contrast to the study of Antonioli
and Riveley (2005) where the dolphin intervention resulted in a signifi-
cant decrease in Beck Depression Inventory scores despite the short in-
tervention period of two weeks. In our study, the patients only visited
the farm twice a week. A more intensive and longer intervention period
might have yielded significant results for the psychiatric instruments
also during intervention, especially because many of the patients in
our study had serious psychiatric diagnoses and symptoms, such as
Berget et al. 113
Downloaded by [NMBU] at 02:12 20 October 2015
schizophrenia and major depressions. Barak (2001) showed encouraged
mobility, interpersonal contact, and increased activities in daily life
during a 12-month intervention with a cat or dog compared with the
controls, whereas the study of Kovacs et al. (2004) documented im-
provement in the health and domestic activities after a nine-month inter-
vention with weekly sessions with a dog for only 50 minutes. The
patients with affective disorders had rather moderate levels of depres-
sion, and one should not expect a pronounced effect on depression for
the cohort as a whole. Antonioli and Rievely (2005) found, however, a
significant reduction in depression among people with mild and moder-
ate mood disorders during AAT with dolphins compared with the con-
trol group.
We did not obtain significant differences within the cohort nor the
different diagnostic groups in relation to their distance from the ani-
mals. The main explanation seems to be that the patients maintained
rather short distances from the animals on the first video recording (less
than 1.5 meters). The short distances in the beginning of the interven-
tion indicate that the patients generally showed little fear of the animals.
The behavioral registrations showed that the patients managed to do
active and useful work with the animals, and as seen in increased inten-
sity and exactness, this study documents improved work skills for those
with severe psychiatric diagnoses. Long term prospective studies of
people with schizophrenia (Mikulska-Meder, 1992) showed that a ma-
jority of the patients in this study continued working two years after
looking for a job, and that two-thirds had achieved their stated rehabili-
tation at the end of a 3-year follow-up study of outpatients (Reker &
Eikelman, 1997). In the latter study of work therapy, it was stated that
successful rehabilitation had an impact on re-hospitalization rates.
One of the reasons stated for dropping out of the intervention was the
animal species itself, and in a further study it may be better to survey the
participants’ animal preferences before an intervention to prevent too
many dropouts. Very few participants answered that the farmer was
the reason for dropping out of the intervention, but questions must also
be raised about whether the characteristics of the animals, the farmer,
the settings and the interaction among these variables may influence the
assessed outcomes.
The study is somewhat limited by the moderate number of patients in
the different diagnostic categories, and by the inherent inability to blind
the active treatment and the lack of blinding whether the video record-
ings were from early or late in the intervention. The health outcome
measures, however, were based on standardized instruments that have
114 OCCUPATIONAL THERAPY IN MENTAL HEALTH
Downloaded by [NMBU] at 02:12 20 October 2015
been shown to both measure consistently across time and construct of
interest. According to Wilson and Barker (2003), it is not only a ques-
tion of sample size but also whether there is clinical significance. Our
results showed that the effect sizes of both intensity and exactness for
the total cohort were reasonably good, and indicated that clinically the
intervention was significant. Using work with farm animals may there-
fore be a relevant kind of occupational therapy in areas with farm ani-
mal husbandry. Further studies might investigate the extent to which
these patient groups can reveal a long-term rehabilitative effect.
Finally there is a question about whether the total amount of video re-
cording is sufficient to document all the different behaviors taking place
in the interaction with the animals, although the different behaviors
occurred in both video sessions. Among the study strengths are the ran-
domized study design, the completeness of the assessments, and the
moderate drop out rate.
CONCLUSION
The relationships between people and animals are complex, deter-
mined by a number of complex causes, and changing. Through working
with farm animals numerous skills can be taught or enhanced. Exam-
ples documented in this article include abilities practiced when feeding,
milking or brushing the animals, manifested by increased intensity and
exactness of the work with the animals by the end of the intervention.
This may berelated to improved mental health exemplified by decreased
anxiety or increased self-efficacy. It is, however, too early to conclude
which psychiatric diagnoses have the best outcomes from farm-animal
assisted therapy.
REFERENCES
Antonioli, C., & Riveley, M.A. (2005). Randomised controlled trial of animal facili-
tated therapy with dolphins in the treatment of depression. British Medical Journal,
331, 1231-1234.
Barker, S.B., & Dawson, K.S. (1998). The effects of animal-assisted therapy on anxi-
ety ratings of hospitalized psychiatric patients. Psychiatric Services, 49, 797-801.
Barlow, J.H., Williams, B., & Wright, C. (1996). The generalized Self-Efficacy Scale
in people with arthritis. Arthritis Care Research, 9(3), 189-196.
Beck, A.T. (1967). Depression: Clinical experimental and theoretical aspects. New
York: Harper and Row.
Berget et al. 115
Downloaded by [NMBU] at 02:12 20 October 2015
Berget, B. (2006). Animal-assisted therapy: Effects on persons with psychiatric dis-
orders working with farm animals. Philosophiae Doctor Thesis 2006: 20. Ås: Nor-
wegian University of Life Sciences.
Berget, B., Ekeberg, Ø., & Braastad, B.O. (2004). Farm animals in therapy for humans
with mental disorders. In People and Animals:A Timeless Relationship, 10th
International Conference on Human-Animal Interactions, 45,D.C.Turner(Ed.),
Glasgow 7-9 October.
Bernstein, P.L., Friedmann, E., & Malaspina, A. (2000). Animal-assisted therapy
enhances resident social interaction and initiation in long-term care facilities.
Anthrozoös, 3, 213-224.
Cooper, C.L., Sloan, S.J., & Williams, S. (1988). Occupational stress indicator. Wind-
sor, England: NFER-Nelson.
Cooper, C.L., Luikkionen, P., & Cartwright, S. (1996). Stress preventions in the work-
place: Assessing the costs and benefits to organisations.Loughlinftown, Dublin:
European Foundation for the Improvement of Living and Working Conditions.
Fitzpatrick, J.C., & Tebay, J.M. (1997). Hippotherapy and therapeutic riding. In Com-
panion animals in human health, 41-58, C.C. Wilson and D.C. Turner (Eds.),
London: Sage Publications.
Folse, E.B., Minder, C.C., Aycock, M.J., & Santqana, R.T. (1994). Animal assisted
therapy and depression in adult college students. Anthrozoös, 7, 188-194.
Friedmann, E. (2000). The animal-human bond: Health and wellness. In Handbook
on animal-assisted therapy. Theoretical foundations and guidelines for practice,
Ch. 3, 41-58, A. Fine (Ed.), San Diego: Academic Press.
Gramstad, A., Iversen, E., & Engelsen, BA. (2001). The impact of affectivity disposi-
tions, self-efficacy and locus of control on psychosocial adjustment in patients with
epilepsy. Epilepsy Research, 46(1), 53-61.
Håseth, K. & Malde, B.K. (2001). Tentative manual for the pressure management
indicator. Manuscript. Oslo: Department of Psychology, University of Oslo.
Hassink, J., & van Dijk, M. (2006). Farming for health. Green care farming across -
Europe and the United States of America. Wageningen UR Frontis Series. Dordrecht,
The Netherlands: Springer.
Haughie, E., Milne, D., & Elliott, V. (1992). An evaluation of companion pets with
elderly psychiatric patients. Behavioral Psychotherapy, 20, 367-372.
Holocomb, R., Jendro, C.,Weber, B., & Nahan, U. (1997). Use of an aviary to relieve
depression in elderly males. Anthrozoös, 10, 32-36.
Katcher, A.H., Friedmann, E., Beck, A.M., & Lynch, J.J. (1983). Talking, looking, and
blood pressure: Physiological consequences of interaction with the living envi-
ronment. In New perspectives on our lives with animal companions, 351-359,
A.H. Katcher & A.M. Beck (Eds.), Philadelphia: University of Pennsylvania Press.
Katcher, A.H. (1981). Interactions between people and their pets: Form and function.
In Interrelationships between people and pets, 41-67, B. Fogle (Ed.), Springfield,
IL: Charles C. Thomas.
Lenhard, J., Moevius, R., & Dabbert, S. (1997). Struktur und Organisationsformen von
Therapie–und Betreuungseinrichtung in der Landwirtschaft–eine explorative Studie.
Berichte der Landwirtschaft, 75, 459-485.
116 OCCUPATIONAL THERAPY IN MENTAL HEALTH
Downloaded by [NMBU] at 02:12 20 October 2015
Levinson, B. (1978). Pets and personality development. Psychological Reports, 42,
1031-1038.
Lockwood, R. (1983). The influence of animals on social perception. In New perspec-
tives on our lives with animal companions, 54-71, A. H. Katcher, & A.M. Beck
(Eds.), Philadelphia, PA: University of Pennsylvania Press.
Mallon, G.P. (1994). Cow as co-therapist: Utilization of farm animals as therapeutic
aides with children in residential treatment. Child & Adolescent Social Work Jour-
nal, 11, 455-474.
Marr, C.A., French, L., Thompson, D., Drum, L., Greening, G., Mormon, J., Henderson,
I., & Hughes, C.W. (2000). Animal-assisted therapy in psychiatric rehabilitation.
Anthrozoös, 13, 43-47.
Mikulska-Meder, J. (1992). Clinical state of patients with schizophrenia who are
employed and unemployed. Psychiatria Polska, 26(1-2), 97-103.
Neer, C.A., Dorn, C.R., & Grayson, I. (1987). Dog interaction with persons receiving
institutional geriatric care. Journal of the American Veterinary Medical Associa-
tion, 191, 300-304.
Peretti, P. (1990.) Elderly animal friendship bonds. Social Behavior and Personality,
18, 151-156.
Reker, T. & Eikelmann, B. (1997). Work therapy for schizophrenic patients: Results
of a 3-year prospective study in Germany. European Archive of Psychiatry and
Clinical Neuroscience, 247(6), 314-319.
SAS Institute Inc., JMP (2005). Introductory Guide, Release 6. Cary, NC, USA.
Schwarzer, R. (1993). Measurement of perceived self-efficacy. Psychometric Scales
for Cross-cultural Research. Berlin: Freie Universität.
Spielberger, C.D., Gorsuch, R.I., & Lushene, R.E. (1970). Manual for the State-Trait
Anxiety Inventory. Palo Alto: California Consulting Psychologists Press.
Wahl, A., Burckhardt, C., Wiklund, I., & Hanestad, B.R. (1998). The Norwegian version
of the Quality of Life Scale (QOLS-N). A validation and reliability study in patients
suffering from psoriasis. Scandinavian Journal of Caring Science, 12, 215-222.
Wilson, C.C. (1987). Physiological responses of college students to a pet. Journal of
Nervous and Mental Disease, 175, 606-612.
Wilson, C.C. (1991). The pet as an anxiolytic intervention. Journal of Nervous and
Mental Disease, 179, 482-489.
Wilson, C.C. & Barker, S.B. (2003). Challenges in designing human-animal interac-
tion research. American Behavioral Scientist, 47(1), 16-28.
World Health Organization (1992). The ICD-10 Classification of Mental and Behav-
ioral Disorders. Clinical descriptions and diagnostic guidelines. Geneva: World
Health Organization.
Zasloff, R. L. & Kidd, A. H. (1994). Attachment to feline companions. Psychological
Reports, 74, 747-752.
doi:10.1300/J004v23n02_05
Berget et al. 117
Downloaded by [NMBU] at 02:12 20 October 2015
... The remaining approximately 64% (n = 27) described the perceived benefits of Green Care with animals programs by both users and providers. In detail, in six of these studies, Green Care with animals programs were compared to other approaches (with the same users' category) to highlight their benefits [25][26][27][28][29][30]. In three records, the main focus was the evaluation of the efficacy of the Green Care with animals programs, but experimental designs lack of control groups [31][32][33]. ...
... Only 40% of selected records specified that the users' category involved psychiatric patients [25,30,51], people with autism spectrum disorders [33,49], elderly people with dementia [12,15,16,26], non-clinical population [27,31], drug users [23,35], depressed people [28,40], detainees [19] and long term unemployed [46]. In the remaining records (60%) the characteristics of the users involved were not described in detail. ...
... Regarding users' age, it is not possible to identify a real distribution because in the 48% of the records there is not a unique category of users or the age is not even considered. For the remaining records (52%), users are defined generically as adults (n = 12) [18,19,23,25,28,30,32,33,[40][41][42]46], adolescents/young people (n = 4) [27,39,43,45], elderly (n = 4) [15,26,29,31] and children (n = 2) [34,48]. ...
Article
Full-text available
Green Care (GC) and Animal Assisted Interventions (AAI) are recognised practices useful to enhance the wellbeing of people through interaction with nature and animals. This study aims at understanding the interconnections between GC and AAI by analysing deeply which interaction with animals is conducted. Therefore, we carried out a literature search through Web of Science and Google Scholar that allowed retrieval of 993 records; after the PRISMA selection process, 42 were included. Relevant information was extracted: year of publication, geographical location, objectives, settings in agricultural environment, animal species, characteristics of users involved, type of human–animal interaction, coexistence of other activities without animals, animal health and welfare issues. From the review emerged that research on GC with animals is common in high-income countries and that the line between AAI and occupational therapy is often vague. Moreover, the most common setting for these interventions appears to be the farm, and frequently animals involved are not selected according to their ethological characteristics. Users in this context are extremely various and not only involved in activities with animals. Within the included studies, we noted a lack in the consideration of animal welfare that indicates the need for increased awareness among practitioners and a more ethical approach when animals are involved.
... To support learning disabled adults to learn practical farm and woodland skills Farming, animal care, animal feeding and handling, making our own pizza dough bases and topping; chick cleaning and holding, craft (making bird feeders and bird cake, decorating a flower pot and planting a sunflower); woodland den building; animal cleaning and feeding. Animal care, horticulture, woodland management, traditional skills, enterprise and conservation Charity funding with animals, depending on the abilities of the client (Berget et al., 2007). ...
... Blinding. Primary outcomes variables were not assessed blindly in both studies (Berget et al., 2007;Pedersen et al., 2012b). This was reported as a limitation in the discussion section of both studies. ...
Conference Paper
Full-text available
Care farming (also called social farming) is the therapeutic use of agricultural and farming practices. Service users and communities supported through care farming include people with learning disabilities, mental and physical health problems, substance misuse, adult offenders, disaffected youth, socially isolated older people and the long term unemployed. Care farming is growing in popularity, especially around Europe. This review aimed to understand the impact of care farming on quality of life, depression and anxiety, on a range of service user groups. It also aimed to explore and explain the way in which care farming might work for different groups. By reviewing interview studies we found that people valued, among other things, being in contact with each other, and feeling a sense of achievement, fulfilment and belonging. Some groups seemed to appreciate different things indicating that different groups may benefit in different ways but, it is unclear if this is due to a difference in the types of activities or the way in which people take different things from the same activity. We found no evidence that care farms improved people's quality of life and some evidence that they might improve depression and anxiety. Larger studies involving single service user groups and fully validated outcome measures are needed to prove more conclusive evidence about the benefits of care farming.
... Behavioural theory (Lewinsohn, 1974) Certain environmental changes and avoidant behaviours inhibit individuals from experiencing environmental reward and reinforcement and subsequently leads to the development of depressive symptoms. By encouraging individuals to take part in activities that create a sense of pleasure or mastery, avoidant behaviours can be reduced with animals, depending on the abilities of the client (Berget et al., 2007). ...
... Blinding. Primary outcomes variables were not assessed blindly in both studies (Berget et al., 2007;Pedersen et al., 2012b). This was reported as a limitation in the discussion section of both studies. ...
Article
Full-text available
Care farming (also called social farming) is the therapeutic use of agricultural and farming practices. Service users and communities supported through care farming include people with learning disabilities, mental and physical health problems, substance misuse, adult offenders, disaffected youth, socially isolated older people and the long term unemployed. Care farming is growing in popularity, especially around Europe. This review aimed to understand the impact of care farming on quality of life, depression and anxiety, on a range of service user groups. It also aimed to explore and explain the way in which care farming might work for different groups. By reviewing interview studies we found that people valued, among other things, being in contact with each other, and feeling a sense of achievement, fulfilment and belonging. Some groups seemed to appreciate different things indicating that different groups may benefit in different ways but, it is unclear if this is due to a difference in the types of activities or the way in which people take different things from the same activity. We found no evidence that care farms improved people's quality of life and some evidence that they might improve depression and anxiety. Larger studies involving single service user groups and fully validated outcome measures are needed to prove more conclusive evidence about the benefits of care farming.
... Pedersen et al. conducted a small RCT of 29 people with psychiatric illness and reported significant decreases in anxiety and depression ((Pederson et al., 2012). Several cross-sectional and qualitative studies have found that many participants benefit from the relationship with the farmer (and their family and other staff); being part of a social community; engaging in meaningful activities in a green environment; and for some, the possibility for work opportunities (Berget et al., 2007, Pederson et al., 2011, Pederson et al., 2012, Elings, 2012a. The fact that the farm provides an informal, non-care context which is close to the experience of everyday life, is also valued ( Hassink et al., 2007;Hassink et al., 2009;Bragg, 2013a). ...
... Reductions in anxiety and depression have been observed in people with mental health issues ( Pederson et al., 2012, Berget and Grepperud, 2011, Gonzalez et al., 2009, Bragg, 2013a) and those with psychiatric and addiction problems have also experienced improved social and work skills (Elings et al., 2011, Hassink et al., 2009, Bragg, 2013a, Berget et al., 2008, Berget et al., 2007, Leck, 2013. People with learning difficulties also appear to benefit, with increased life skills and improved social interaction (Leck, 2013). ...
... People also tend to feel calmer with animals, possibly because we assess safety of surroundings based on calmness exhibited by animals in close proximity (Lefkowitz, 2005). Touching an animal has been associated with decreases in blood pressure, heart rate, stress, anxiety, anger, and depression, and increases in cardiovascular health and psychological well-being (Berget, 2007;Brodie, 1999;Connor, 2000;Lefkowitz, 2005;Millhouse-Flourie, 2004;Parshall, 2003;Sable, 2012;Sockalingam, 2008). Contact with an animal also releases endorphins, natural pain suppressors, and oxytocin, which elicits feelings of pleasure (Millhouse-Flourie, 2004;Sable, 2012). ...
... Even people that merely receive visits from volunteers with animals report a positive change in mood (Lutwack-Bloom, 2005;Millhouse-Flourie, 2004;Sockalingam, 2008). Moreover, when animals are used therapeutically, people show improved cardiovascular health and psychological well-being with decreases in blood pressure, anxiety, anger, and depression, and increases in (Berget, 2007;Brodie, 1999;Connor, 2000;Lefkowitz, 2005;Millhouse-Flourie, 2004;Parshall, 2003;Sable, 2012;Sockalingam, 2008). These responses have also been linked to decreases in medication use, violence, suicide attempts, and other destructive behaviors (Connor, 2000;McConnell, 2002). ...
Article
This study examines the effects of equine-assisted psychotherapies in children with an autism spectrum disorder. The CARS-2 and Children’s Sleep Habits Questionnaire parent-report questionnaires were used for evaluation, as well open-ended questions. A single researcher contacted and visited many PATH-certified centers in the United States. Facilities that participated were all located in the Mid-Atlantic to Northeast region. There were 16 participants, from 11 different farms, that completed both the initial and follow-up questionnaires which were given 7 weeks apart. A $25 Amazon gift card was used as an incentive to increase participation. Participating facilities also completed a questionnaire. Overall, results do not show a definitive trend towards worsening or improving. There was a possible age effect in participants who had an autism diagnosis, with improvements being seen in children older than 9 years. More research is needed to validate this claim. Those that improved or worsened on both questionnaires varied by age, gender, farm, and duration of equine therapy experience. No conclusions regarding the efficacy of equine-assisted psychotherapy could be made from these results. Subjective responses in the questionnaires indicate that participants feel that equine assisted therapeutic activities were enjoyable and beneficial to their children. Results also indicate that participants feel that they received the benefits that they expected to receive. There were no reports of negative experiences in this study. It could be possible that those that did not perceive enjoyment or benefit from this therapy may have stopped participating and therefore dropped out. In the absence of any measured objective effects, it is not clear if the perceived benefits merely represent a placebo effect, or a valid treatment effect. It is possible that factors dealing with expectations and feelings are affecting growth and healing. This study addresses future directions in this field. Growing interest in equine-assisted activities and therapies requires larger sample sizes to determine epidemiologic trends. However, the best way forward may not be through a randomized, double-blinded, heavily controlled approach. Instead, studies based on information accumulated in large patient registries and databases may allow us to assess the effectiveness of these therapies in the settings where they are traditionally practiced.
... In addition to in-house pets and horses, AAT with farm animals has many benefits [23,[47][48][49][50]. For example, pigs are incredibly intelligent and sensitive animals, making them good candidates for AAT [51]. ...
Article
Full-text available
The aim of this study was to apply the FaceReader technique to select the animal species and breed for a personalized AAT based on the emotions (‘neutral’, ‘happy’, ‘sad’, ‘angry’, ‘surprised’, ‘scared’, ‘disgusted’, and ‘contempt’) induced in the persons (18–64 years old) by the images of different animal species and breeds. To implement the aim, the images of different animal species (Canis familiaris, Felis silvestris catus, Sus scrofa domesticus, Ovis aries, and Equus caballus) and their breeds (dogs: Australian shepherd, pug, Labrador retriever, Doberman, miniature schnauzer, beagle, three mixed-breed types, Yorkshire terrier, Cane Corso, Samoyed, and Chihuahua; cats: British shorthair, Himalayan cat, three mixed breed types, Siamese cat, Sphynx, and Bengal cat; horses: Norwegian Fjord, Exmoor pony, Andalusian, and Friesian; pigs: Vietnamese pot-bellied and Kunekune; sheep: Herdwick sheep and Suffolk sheep) were used. This study showed that the animal species is a significant factor in the intensity of the emotions ‘neutral’ and ‘happy’ as well as valence, and the animal breed is a significant factor for the emotion ‘happy’ intensity and valence. The obtained results could be used as a personalized strategy for improving AAT and helping the individuals to select a pet.
... These approaches have been associated with increased socialization, helpfulness, friendliness, and cooperativeness (Burgon, 2003;Corson, Corson & Gwynne, 1975;Marr et al., 2000); decreased anhedonia, or the inability to experience pleasure (Corson, Corson & Gwynne, 1975;Nathans-Barel, Feldman, Berger, Modai, & Silver, 2005); increased motivation (Burgon, 2003;Nathans-Barel et al., 2005); decreased psychological distress (Klontz, Bivens, Leinart, & Klontz, 2007); increased ability to focus on the present moment and awareness of one's inner experiences (Burgon, 2003;Klontz et al., 2007); less emotional lability and increased verbalization (Corson, Corson and Gwynne, 1975); decreased worrying and increased confidence, social stimulation, self-concept, motivation, feelings of achievement and competence from working with animals successfully (Burgon, 2003). Berget, Skarsaune, Ekeberg and Braastad (2007) found that psychiatric patients with various mental health diagnoses increased the intensity and exactness of their work with farm animals during an AAT intervention in occupational therapy, and that the individuals with mood disorders (such as depression and anxiety-related illnesses) also experienced greater self-efficacy and a decrease in anxiety. Using AAT/EAT/L has also been associated with improvement in aspects of nonverbal communication, such as use of space, movements and gestures (Kovacs, Bulucz, Kis & Simon, 2006), decreased use of pain medication and increased quality of life (Lust, Ryan-Haddard, Coover & Snell, 2007); and improvement in life skills and activities of daily living (Kovacs, Kis, Rozsa & Rozsa, 2004). ...
Thesis
Full-text available
Animal-assisted therapy (AAT) and equine-assisted therapy/learning (EAT/L) are innovative techniques in counselling, psychotherapy, mental health, coaching, and other personal growth interventions. Although this field has experienced tremendous growth in the United States, very little is known about its Canadian equivalent. The purpose of this study was therefore to examine the current state of AAT and EAT/L in Canada, by conducting a national, bilingual (English and French) survey of helping professionals who involve animals in their practices. A total of 131 questionnaires were retained for analysis. The results of this study suggest that the field is very diverse, with a multitude of confusing terms and expressions, varying levels of education and training, and disagreement on how different practices are defined, resulting in a fragmented, confusing and inconsistent appearance. Recommendations for the evolution of the field and suggestions for future research are provided.
... In the past 10 years , several qualitative and cross-sectional or panel studies have been published regarding care farming; these studies have focused on a range of client groups within different types of care farms. The results of these studies show that the participants have: benefitted from being part of a social community; established a good relationship with the farmer (and other farm staff); and engaged in the agricultural activities, exhibiting some possibility of work inclusion (Berget et al., 2007;Elings, 2012) Other studies pointed out the improvements in both mental wellbeing and social interactions Bragg et al., 2013Bragg et al., , 2014, the reduction in anxiety and depression in people with mental health issues (Pedersen et al., 2011;Gonzalez et al., 2010); and the increased cognitive functioning and well-being of those with dementia (Bruin et al., 2009). ...
Article
In recent years, an increasing number of social farming initiatives have involved adults with autism spectrum disorders, both to improve their life conditions and promote their work inclusion. Several studies have assessed these experiences, showing that the participants derive important benefits from being part of a social community, working in the countryside, and establishing a good relationship with the farmer. This paper aims to assess the ability of 9 adults with autism spectrum disorders – who attend an adult day care centre in the Umbria region of Italy – to carry out agricultural and animal husbandry activities. Results from panel data analysis show that the activity of olive grove, indoor cleaning, and tidying at the agritourism farms has a considerable positive effect on the performances of the adults with autism spectrum disorders. Moreover, the adults studied prefer the activities in a greenhouse over those occurring inside (e.g., agritourism farm or the warehouse) and outside (e.g., vegetable, olive, and grape production). Further, the higher the precision level required to perform an action, the lower is their observed performance. Generally, the tasks that receive the highest evaluations are those in which the autistic person can relate with other people and/or animals. These findings confirm the role of social farming in developing working and relational skills in adults with autism spectrum disorders.
Article
Full-text available
The objective of this review was to scope the literature on nature-based interventions that could be conducted in institutional settings where people reside full-time for care or rehabilitation purposes. Systematic searches were conducted across CINAHL, Medline, Criminal Justice Abstracts, PsycINFO, Scopus, Social Care Online and Cochrane CENTRAL. A total of 85 studies (reported in 86 articles) were included. Four intervention modalities were identified: Gardening/therapeutic horticulture; animal-assisted therapies; care farming and virtual reality-based simulations of natural environments. The interventions were conducted across a range of settings, including inpatient wards, care homes, prisons and women’s shelters. Generally, favourable impacts were seen across intervention types, although the reported effects varied widely. There is a growing body of literature on nature-based interventions that could be applied to a variety of institutional settings. Within most intervention types, there is sufficient research data available to perform full systematic reviews. Recommendations for future systematic reviews are offered.
Article
Full-text available
This article addresses challenges in designing Human-Animal Interaction (HAI) research. A summary of previous reviews of HAI research is presented, followed by a discussion of areas that present particular challenges to research in this field, specifically design issues, control of extraneous variables, sample selection, intervention development, and outcome measurement. Suggestions for addressing these areas also are presented.
Article
Objective . To examine the comprehensibility, reliability, and validity of a trait measure, the Generalized Self‐Efficacy Scale (GSES), among people with arthritis. The scale is designed to measure perceived coping ability across a wide range of demanding situations. Methods . Four studies were conducted. Study 1 tested the comprehensibility of the GSES. Studies 2, 3, and 4 tested the reliability and validity of the modified scale. Data were collected through self‐administered questionnaires. Reliability and structure of the GSES were examined using standard item analysis, internal consistency (Cronbach's alpha), test‐retest reliability, and factor analyses. Concurrent and predictive validity were examined in relation to demographic, physical, psychological, and social dimensions. Results . The GSES assessed a unitary concept. Higher generalized self‐efficacy was associated with greater psychological well‐being, both cross‐sectionally and longitudinally. The GSES was independent of age and physical health status. Conclusions . The GSES is a reliable and valid measure for use among community‐based samples of people with arthritis and may be a useful indicator of general adaptational outcomes.
Article
Objective. To examine the comprehensibility, reliability, and validity of a trait measure, the Generalized Self-Efficacy Scale (GSES), among people with arthritis. The scale is designed to measure perceived coping ability across a wide range of demanding situations. Methods. Four studies were conducted. Study 2 tested the comprehensibility of the GSES. Studies 2, 3, and 4 tested the reliability and validity of the modified scale. Data were collected through self-administered questionnaires. Reliability and structure of the GSES were examined using standard item analysis, internal consistency (Cronbach's alpha), test-retest reliability, and factor analyses. Concurrent and predictive validity were examined in relation to demographic, physical, psychological, and social dimensions. Results. The GSES assessed a unitary concept. Higher generalized self-efficacy was associated with greater psychological well-being, both cross-sectionally and longitudinally. The GSES was independent of age and physical health status. Conclusions. The GSES is a reliable and valid measure for use among community-based samples of people with arthritis and may be a useful indicator of general adaptational outcomes.
Article
Animals have direct positive and negative impact on some physical aspects of health. Animals contribute to basic human health needs by providing food and clothing, and by assisting people in their daily lives by acting as beasts of burden, working, and assistance animals. Animals also are used as human surrogates in the development of medical procedures and products, and as sources for medical and health care products. In contrast to the ways animals directly impact physical health, animals also have well-documented detrimental health effects including transmitting infectious diseases, causing allergies, and inflicting injuries such as bites and scratches. This chapter addresses the evidence for the positive impact of animals on human health. Evidence for long-term health benefits will be discussed first. Once long-term benefits for cardiovascular health were established, experimental and quasi-experimental studies were conducted to elucidate possible mechanisms for the long-term benefits already found and to extend the scope of the investigation to other types of health benefits. The evidence for short-term benefits of health from studies conducted using three categories of human-animal interaction is presented. This is followed by a summary of the research findings and a discussion of their implications for future research and for animal-assisted therapy.
Article
Man has had animal companions since prehistoric times, as reflected in folklore, legends, and literature. In an urban, technological society such as ours, closeness to animals can reduce alienation. Development over the life cycle can be favorably influenced by close association with an animal companion, particularly during middle childhood and old age. The development of empathy, self-esteem, self-control, and autonomy can be promoted in children through raising pets, while the loneliness of old age can be eased and deterioration warded off by nurturing an animal. Psychologists have not studied animal-human relationships to date, and such research is long overdue.
Article
A sample of 100 adult cat owners participated in a mail survey designed to investigate various aspects of attachment to feline companions. 54 respondents were members of a nationwide computer cat club and 46 were attenders at a cat show in Anaheim, California. 92% of respondents reported preferring cats to all other pets citing ease of care, affection and companionship, and personality as the main reasons. A mean self-rated attachment score of 9.3 on a 10-point scale was obtained. Positive characteristics of the cat were associated with attachment, and the presence of certain problem behaviors did not affect that attachment. Comparisons of the benefits of feline and human companionship showed that affection and unconditional love were the primary benefits of the human-cat relationship, and verbal communication was the primary benefit of the human-human relationship. The findings indicate that, although not a replacement for human contact, feline companions can be a very important source of pleasure and em...
Article
This study examines the effect on the depression levels of 38 elderly males (Mean age=76y) exposed to an aviary at a Veterans Administration Medical Center adult day health care program. The research design was A1B1A2B2, with each phase (A=no treatment, B=treatment) constituting two weeks. Initial analysis uncovered no significant difference on the group's Geriatric Depression Index (GDI) scores associated with presence or absence of the aviary. A subsequent analysis of covariance on the difference between treatment and no-treatment depression scores indicated that utilization of the aviary by the men was significantly associated with reduced depression (N=38; F=7.48; df=1,36; p<.01), with greater reduction in depression associated with greater utilization of the aviary. Results from this study suggest that introduction of an aviary into the physical environment of elderly male day care participants may produce a reduction in depression among some men, possibly due to increased social interaction stimulated by the presence of the aviary.
Article
Reviews of animal-assisted therapy (AAT) research suggest the need for better controlled and designed research studies to supplement the many case studies and anecdotal reports. This study reports the results of such an investigation where sixty-nine male and female psychiatric inpatients were randomized to either an AAT psychiatric rehabilitation group or a similarly conducted control group without AAT, to test if AAT can improve prosocial behaviors. The Social Behavior Scale was scored daily by an independent rater and patients were monitored for four weeks. A two-group by weeks repeated measure analysis of variance was conducted for each outcome measure. There were no baseline differences between the two groups on demographics or any of the measures, but by week four, patients in the AAT group were significantly more interactive with other patients, scored higher on measures of smiles and pleasure, were more sociable and helpful with others, and were more active and responsive to surroundings. These data suggest that AAT plays an important role in enhancing the benefits of conventional therapy, and demonstrates the benefit of including a non-AAT group for comparison. The study also demonstrates the importance of using longitudinal, repeated measure designs. Previous studies may have failed to find significant effects because they were restricted to shorter intervals for measuring outcomes.