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Animal-assisted therapy with farm animals for persons with psychiatric disorders: Effects on self-efficacy, coping ability and quality of life, a randomized controlled trial


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The benefits of Animal-Assisted Therapy (AAT) for humans with mental disorders have been well-documented using cats and dogs, but there is a complete lack of controlled studies using farm animals as therapeutic agents for psychiatric patients. The study was developed in the context of Green care, a concept that involves the use of farm animals, plants, gardens, or the landscape in recreational or work-related interventions for different target groups of clients in cooperation with health authorities. The present study aimed at examining effects of a 12-week intervention with farm animals on self-efficacy, coping ability and quality of life among adult psychiatric patients with a variety of psychiatric diagnoses. The study was a randomized controlled trial and follow-up. Ninety patients (59 women and 31 men) with schizophrenia, affective disorders, anxiety, and personality disorders completed questionnaires to assess self-efficacy (Generalized Self-Efficacy Scale; GSE), coping ability (Coping Strategies Scale), and quality of life (Quality of Life Scale; QOLS-N) before, at the end of intervention, and at six months follow-up. Two-thirds of the patients (N = 60) were given interventions; the remaining served as controls. There was significant increase in self-efficacy in the treatment group but not in the control group from before intervention (SB) to six months follow-up (SSMA), (SSMA-SB; F1,55 = 4.20, p= 0.05) and from end of intervention (SA) to follow-up (SSMA-SA; F1,55 = 5.6, p= 0.02). There was significant increase in coping ability within the treatment group between before intervention and follow-up (SSMA-SB = 2.7, t = 2.31, p = 0.03), whereas no changes in quality of life was found. There were no significant changes in any of the variables during the intervention. AAT with farm animals may have positive influences on self-efficacy and coping ability among psychiatric patients with long lasting psychiatric symptoms.
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BioMed Central
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Clinical Practice and Epidemiology
in Mental Health
Open Access
Animal-assisted therapy with farm animals for persons with
psychiatric disorders: effects on self-efficacy, coping ability and
quality of life, a randomized controlled trial
Bente Berget*
, Øivind Ekeberg
and Bjarne O Braastad
Norwegian University of Life Sciences, Department of Animal and Aquacultural Sciences, P.O. Box 5003, NO-1432 Ås, Norway and
University of Oslo, Department of Behavioural Sciences in Medicine, P.O. Box 1111 Blindern, NO-0317, Oslo, Norway
Email: Bente Berget* -; Øivind Ekeberg -; Bjarne O Braastad -
* Corresponding author
Background: The benefits of Animal-Assisted Therapy (AAT) for humans with mental disorders
have been well-documented using cats and dogs, but there is a complete lack of controlled studies
using farm animals as therapeutic agents for psychiatric patients. The study was developed in the
context of Green care, a concept that involves the use of farm animals, plants, gardens, or the
landscape in recreational or work-related interventions for different target groups of clients in
cooperation with health authorities. The present study aimed at examining effects of a 12-week
intervention with farm animals on self-efficacy, coping ability and quality of life among adult
psychiatric patients with a variety of psychiatric diagnoses.
Methods: The study was a randomized controlled trial and follow-up. Ninety patients (59 women
and 31 men) with schizophrenia, affective disorders, anxiety, and personality disorders completed
questionnaires to assess self-efficacy (Generalized Self-Efficacy Scale; GSE), coping ability (Coping
Strategies Scale), and quality of life (Quality of Life Scale; QOLS-N) before, at the end of
intervention, and at six months follow-up. Two-thirds of the patients (N = 60) were given
interventions; the remaining served as controls.
Results: There was significant increase in self-efficacy in the treatment group but not in the control
group from before intervention (SB) to six months follow-up (SSMA), (SSMA-SB; F
= 4.20, p=
0.05) and from end of intervention (SA) to follow-up (SSMA-SA; F
= 5.6, p= 0.02). There was
significant increase in coping ability within the treatment group between before intervention and
follow-up (SSMA-SB = 2.7, t = 2.31, p = 0.03), whereas no changes in quality of life was found. There
were no significant changes in any of the variables during the intervention.
Conclusion: AAT with farm animals may have positive influences on self-efficacy and coping ability
among psychiatric patients with long lasting psychiatric symptoms.
The utilization of agricultural farms as a basis for promot-
ing human mental and physical health in cooperation
with health authorities is growing in several countries in
Published: 11 April 2008
Clinical Practice and Epidemiology in Mental Health 2008, 4:9 doi:10.1186/1745-0179-4-
Received: 26 October 2007
Accepted: 11 April 2008
This article is available from:
© 2008 Berget et al; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Clinical Practice and Epidemiology in Mental Health 2008, 4:9
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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, forests, and the landscape. Historically, Green
care farms were associated with hospitals, psychiatric
departments and other health institutions. Today, most
Green care projects involve community gardens, city
farms, allotment gardens and farms. Because many Green
care farms are rather small compared with traditional
farms, there is often a diversity of activities, with the pos-
sibility of meaningful work for different people and target
groups. Other positive experiences with Green care like
self-esteem, responsibility and sense of purpose are simi-
lar in the different countries [1]. During the last decade,
an increasing number of persons with mental disorders
work with farm animals as part of their therapy [2-5].
Although Animal-Assisted Therapy (AAT) for humans
with mental disorders has been well documented with
cats and dogs, there is a complete lack of controlled stud-
ies of farm animals as therapeutic agents for psychiatric
patients. Previous studies of AAT with companion ani-
mals have documented that human-animal interaction
may decrease stress levels [6-12], and is shown to improve
self-confidence, social competence and quality of life
[13,14]. As it is shown that different types of animals may
have different impact on people's health [15,16], it is
therefore worth investigating to what extent contact and
work with farm animals will contribute to self-efficacy,
coping ability and quality of life among psychiatric
In AAT with farm animals, we suggest that the combined
effect of both contact and work with the animals can affect
the patients positively; by providing a source of physical
contact with a living "other", and increased coping ability
and self-esteem through routines that include feeding,
milking, and caring for other living creatures. Green care
programs with farm animals can be important supple-
ments to a traditional psychiatric treatment in reaching
the goals of self-esteem and coping ability. An interven-
tion with farm animals will shift from care in an institu-
tional regime to increased social integration and
normalisation of care.
We have earlier reported increased intensity and exactness
of work by patients with psychiatric disorders in a 12-
week intervention with farm animals [17,18]. The
patients also showed significantly lower anxiety at the end
of the intervention and at follow-up six months after the
end of the intervention compared with baseline. No such
changes were found for the control group.
In the present paper based on the same sample we report
on effects on self-efficacy, coping ability and quality of life
of a 12-week intervention with farm animals for adult psy-
chiatric patients. The aims of the present study were as fol-
1) To examine whether animal-assisted therapy for psy-
chiatric patients was associated with higher self-efficacy,
coping ability and quality of life after treatment and at six
months follow-up.
2) To assess if there were different treatment responses in
the different diagnostic groups.
3) To investigate the relationship between changes in self-
efficacy, coping ability and quality of life and specific
questions related to the intervention.
For checklist of the randomized trial, see Additional file 1.
Therapists recruited the candidate patients, and informed
written consent was obtained. The Norwegian Data
Inspectorate and the Regional Committee for Medical
Research Ethics approved the project, and the study took
part between February 1, 2003 and January 1, 2006.
Ninety adult psychiatric patients with a variety of psychi-
atric diagnoses were requited, and there were 59 (65.6%)
women and 31 (34.4%) men [Additional file 2]. The
mean age (± SD) was 34.7 ± 10.7 (range 18–58) years. In
the patient group there were 14 inpatients (15.5 %) and
76 outpatients (84.5 %). Diagnoses were made by the
treating psychiatrists using the ICD 10 criteria [19], and
the main diagnoses were 34 (37.7 %) schizophrenia and
schizotypal disorders (F 20–29), 22 (24.4 %) affective dis-
orders (F 30–39), 10 (11.1 %) anxiety and stress-related
disorders (F 40–49), and 22 (24.4 %) disorders of adult
personality and behaviour (F 60–69). There was one
patient with eating disorders (F 50) in the treatment group
who dropped out, and one patient with behavioural dis-
orders due to psychoactive substance use (F11) in the con-
trol group who completed the project. This patient was
omitted when analysing for effects of diagnosis. For 15
randomly chosen patients, the diagnoses were checked for
consensus between treating and research psychiatrists
using the ICD 10 criteria [19] and all were found to
More than 50 % of the patients had been ill for more than
five years, and 72 % had been treated in psychiatric health
institutions for more than three years. As much as 83% of
the 90 included patients received daily medication,
mainly antipsychotics (53 %), antidepressants (50 %),
sedatives (35 %) and mood stabilizers (27 %). Exclusion
criteria were: (a) age less than 18 years, (b) acute psychotic
disorders, (c) mental retardation, (d) serious drug addic-
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tion, and (e) being in a job during the six last months
prior to start of intervention. No minimal levels of symp-
toms were required.
The patients were randomized by computerized random
numbers by BOB to intervention with farm animals or to
a control group. There was two-thirds (60 patients) to AAT
and one-third (30 patients) to control. The reason for this
division was that we expected more drop-outs in the treat-
ment than in the control group due to experience in a
pilot project. Diagnoses and other demographic variables
were unknown during the randomization process. The
patients were well informed of the possibilities of getting
into either of the two groups, and no one withdrew after
the results of the randomization.
The farms and farmers
Among the 15 recruited farmers there were seven women
and eight men. Only two farmers had earlier experience
with psychiatric patients. The main productions were
dairy cows (N = 10 farms, mean 20 animals), specialised
meat production with cattle (N = 2, mean 22 animals),
sheep (N = 2, mean 30 animals), or horses (N = 1, mean
18 animals). All farmers had small animals like rabbits,
poultry, pigs, cats or dogs as a part of the milieu on the
The treatment group received standard therapy (individ-
ual, group therapy or other kinds of therapy) and stable
medical treatment in addition to the intervention. The
control group got treatment as usual. No significant differ-
ences in standard therapy, medication, educational level
and outpatient/inpatient ratio at baseline were found
between the groups.
The patients visited a farm for three hours twice a week for
12 weeks to work with the farm animals. One or two
patients visited the farm at each time. The patients were
only working with the animals; 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 interest, and that patients should have the opportu-
nity of physical contact with the animals. The farmers
were always close to the patients during the work with the
animals to ensure that there were no risks related to the
contact with the animals. The patients were also trained in
the working routines during the first week of the interven-
tion. An overview over the most frequent behaviours in
the interaction with the animals is given in Table 1.
Outcome measures
Three different inventories were used. These instruments
are all tested for their validity and reliability and are com-
monly used in psychiatric research and clinical practice.
The patients' scores were obtained before the intervention
(SB), in the end of the intervention (after: SA), and six
months after the end of the intervention (SSMA). Self-effi-
cacy was measured with the Generalized Self-Efficacy
Scale (GSE) assessing the strength of an individual's belief
in his/her ability to respond to novel or difficult situations
[20]. The scale comprises ten items, and 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 meas-
ured using the Coping Strategies Scale of the Pressure
Management Indicator [21,22]. The scale comprises six
items measuring control coping and four items measuring
support coping and the patient responds to a 6-point scale
from 1 'never used by me' to 6 'very much used by me'.
The score range is 10–60. A Norwegian version of Quality
of Life Scale (QOLS-N) was used comprising 16 items and
reflecting relations to other humans, work, and leisure
[23]. The patient responds on a 7-point scale with 1 'very
content' to 7 'very discontent' with the score range of
16–112. High scores reflect high degree of self-efficacy,
coping and quality of life. Thirty of the patients complet-
ing the intervention answered a final questionnaire
Table 1: Different behaviours that were observed during the interactions with the animals
Behaviour Explanation
1. Physical contact with the animals Patting, brushing, washing, looking after=?, nursing, or saddling or riding horses.
2. Communication Verbalization, visual contact.
3. Moving the animals Behaviours that include moving animals between different places in the cowshed, and
between different pastures.
4. Feeding Feeding adult animals with concentrate or forage, or milk feeding the small animals.
5. Go/stand/run or sit down The participants moved around in the cowshed to bring tools and straw to clean the boxes,
or remained inactive.
6. Cleaning Cleaning the cowshed or washing buckets and bottles.
7. Milking All routines connected to the milking procedure.
8. Receiving instructions Receiving instructions from the farmer.
9. Various Behaviours that occur rarely, like filming the animals or taking pictures of the animals.
10. Threatening behaviour directed from the animals. Receiving threatening or aggressive behaviour or signals from the animals.
Clinical Practice and Epidemiology in Mental Health 2008, 4:9
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related to their experience with the intervention. The fol-
lowing questions were used: "To what extent has the con-
tact and work with the animals affected your coping
ability in daily life; – your mood; – your self-esteem; –
your working ability; – made you more extrovert and talk-
ative?" and "To what extent has the physical contact with
the animals been important to you as part of the work?".
The patients answered on a 5-point scale from 1 'much
worse/very little' to 5 'much better/very much', with point
3 'no change'.
Analysis of variance (ANOVA) was performed by standard
least square means with three difference scores (interven-
tion period: SA-SB; intervention + post-intervention:
SSMA-SB, and post-intervention: SSMA-SA) as the
dependent variables, patient group (treatment: T/control:
C) and diagnosis as the independent variables, and the
interaction between patient group and diagnosis.
Matched-paired t-tests were performed to examine differ-
ences in means between time points for each group (T or
C). Spearman correlation analyses were used to measure
correlations between self-efficacy and coping, and to
relate the difference in the patient's scores in the interven-
tion period (SA-SB) to their answers on the experience of
the intervention (treatment group only). Chi-square tests
analysed for differences between completers and drop-
outs. The level of significance was set at p < 0.05. All anal-
yses were conducted with SAS [24].
There were 41 completers (68 %) in the treatment group
and 28 (93 %) in the control group. The scores of the
completers on self-efficacy (GSE), coping strategy (Cop-
ing Strategies Scale), and quality of life (QOLS-N) at dif-
ferent times are presented in Table 2.
There were no significant baseline differences between the
groups in any of the inventories.
For the GSE scores, the ANOVA analysis revealed no effect
of treatment during intervention (SA-SB) compared with
the control group (Table 2). However, the difference in
scores between six months after intervention and before
(SSMA-SB) was significantly higher in the treatment than
in the control group, reflecting a larger increase in self-effi-
cacy for the treatment group. A similar effect was found in
the post-treatment period (SSMA-SA). Within the treat-
ment group there was no significant increase in self-effi-
cacy during the intervention. At six months follow-up the
GSE scores were significantly higher than the baseline
(SSMA-SB = 2.6, t = 3.68, p = 0.001) and higher than at the
end of intervention (SSMA-SA = 2.2, t = 4.38, p = 0.0001).
For the control group there were no significant differences
between any of the time points.
For the F30-group the ANOVA analysis of GSE scores
showed significance during the intervention (T
(24.8–22.6) = 2.2, C
(25.4–27.3) = -1.9, F = 5.01,
p = 0.03), and from before to six months after (T
(28.3–22.6) = 5.7, C
(27.3–27.3) = 0.0, F =
6.36, p = 0.01), reflecting an increased self-efficacy for the
affective patients in the treatment group. Within this
patient group, GSE showed nearly significant increase in
the intervention period for the treatment group (SA-SB =
24.8–22.6 = 2.2, t = 2.09, p = 0.066), and significant
increases between before and six months after (SSMA-SB
= 28.3–22.6 = 5.7, t = 3.56, p = 0.006) and during the
post-treatment period (SSMA-SA = 28.3–24.8 = 3.5, t =
2.54, p = 0.03). For the control group no such change was
found. There was no significant change in scores for any
of the other diagnoses.
Table 2: Scores in Self-efficacy (GSE), Quality of Life Scale (QOLS-N) and Coping Strategies Scale before the intervention, at the end
of the intervention, and six months after the end of the intervention for the treatment (N = 41) and control (N = 28) groups (mean ±
Variables Score before
Score after
P Score six months
after end of
Self-efficacy (GSE)
Treatment group 23.1 ± 5.12 23.5 ± 6.56 1,60 0.02 n.s. 25.7 ± 5.93 1,55 4.20 0.05 1,55 5.6 0.02
Control group 25.6 ± 6.40 25.3 ± 6.62 25.4 ± 5.92
Quality of Life
Scale (QOLS-N)
Treatment group 64.3 ± 14.93 64.3 ± 17.09 1,60 0.49 n.s. 66.7 ± 16.86 1,57 0.38 n.s 1,57 0.38 n.s
Control group 63.2 ± 14.06 64.4 ± 13.52 66.0 ± 15.25
Coping Strategies
Treatment group 31.6 ± 8.51 32.8 ± 8.67 1,60 0.01 n.s. 34.3 ± 8.10 1,57 0.79 n.s. 1,57 0.39 n.s
Control group 32.2 ± 7.38 31.4 ± 8.69 31.6 ± 8.02
Analysis of variance (ANOVA) is used to test the differences in means between registration times and groups.
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For the Quality of Life Scale (QOLS-N) there was no sig-
nificant difference in scores between or within the total
treatment or control groups for any periods. However, the
ANOVA analysis showed significant difference in the F30-
group between follow-up and before intervention
(71.9–58.5) = 13.4, C
= -2.8, F = 6.30, p = 0.01), reflecting an increase in QOLS-
N for the affective patients in the treatment group.
For the Coping Strategies Scale the ANOVA analysis
revealed no treatment effect for any of the periods (Table
2). However, there was significant positive change in
scores for the treatment group between before and six
months after (SSMA-SB = 2.7, t = 2.31, p = 0.03). For the
control group there were no significant differences
between any of the registration times. There were no sig-
nificant changes in scores in any of the different diag-
Patients with the largest increase in self-efficacy during the
intervention also showed the largest increase in coping (r
= 0.45, p = 0.0029). A similar effect was also found
between baseline and six months after (SSMA-SB, r
0.57, p = 0.0002), and in the post-treatment period
= 0.64, p < 0.0001). There were no such cor-
relations for the controls in any of the registration periods.
There were also significant correlations between the differ-
ence in GSE scores during the intervention (SA-SB) and
the patients' answers related to the intervention (treat-
ment group only). Patients with the largest increase in
GSE reported the largest increase in coping ability in daily
life (r
= 0.40, p = 0.03). Similarly, the patients with the
largest increase in coping strategy reported the largest
improvement in mood (r
= 0.42, p = 0.02), and they
favoured to a larger extent physical contact with the ani-
mals (r
= 0.40, p = 0.03).
The dropouts in the treatment and control group left the
project after a range of 1–6 weeks, and there were 31(75.6
%) women and 10 (24.4 %) men among the completers
in the treatment group, and 17 (60.7 %) women and 11
(39.3 %) men in the control group. The main reasons for
dropping out of the intervention was little interest in the
animal species on the farm (26.7 % answering 'very much
the reason'), that the work was boring (20 % answering
'very much'), and private reasons (26.7 % answering 'very
much'). Comparison between completers and the drop-
outs showed significant differences between the groups in
institutional connection, manifested as higher drop-out
among the hospitalised patients (χ
= 13.01 p = 0.006).
There was also a higher degree of patients using sleeping
medicine among the dropouts (χ
= 3.77 p = 0.05). There
were no other differences in medication.
During the six months follow-up period self-efficacy was
significantly better in the treatment group, but not in the
control group. According to Bandura, self-efficacy refers to
the expectation that one can effectively cope with and
master situations through one's own personal efforts
[25,26]. The finding that self-efficacy was higher during
the six months follow-up period in the treatment but not
in the control group, could be attributed to several expla-
nations. One is that the patients may have learned new
tasks during the intervention, and afterwards felt more
self-confident. Another potential explanation is effects of
the ordinary psychiatric treatment being improved by the
AAT intervention, i.e. the AAT serving as a catalyst for pos-
itive development in the patient. A third explanation is
that the contact with the animals may have produced a
pleasurably experienced social interaction that made the
patients less afraid of new situations, and that the effects
first appeared during the follow-up period. A similar pat-
tern was also found for coping strategy within the treat-
ment group in the period between before the intervention
and six months follow-up. A study of Ventura et al. [27]
concluded that psychotic patients who had greater feel-
ings of self-efficacy and problem-focused coping strate-
gies, appeared to be more likely to cope with day-to-day
stressors. Our study also showed that the patients in the
treatment group with the largest increase in self-efficacy
during both the intervention and the follow-up period,
showed the largest increase in coping strategy in the same
periods, whereas such effects were not found for the con-
trols. Similarly the patients with the largest increase in
GSE scores also reported the largest increase in coping
ability in daily life when relating the questions to the
intervention experience. Likewise, the patients with the
largest increase in coping also reported favouring physical
contact with the animals. Although there was no signifi-
cance during intervention, these findings indicate that
AAT with farm animals offer a combined effect of both
contact and work with the animals that have positive
influences on the development of self-efficacy and coping
There was no effect on quality of life at any of the registra-
tion periods for the total patient group. This is in contrast
to earlier controlled studies with pets [28,29]. We found
however, as for GSE, increased quality of life among per-
sons with affective disorders. These findings indicate that
patients in this diagnostic category profit most on the
treatment. This is in accordance with the study of Antoni-
oli and Revely [30] who found significant reduction in
depression during AAT with dolphins compared with the
control group.
It is a question whether the length of the intervention in
our study was too short, or the frequency of farm visits too
Clinical Practice and Epidemiology in Mental Health 2008, 4:9
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low to get significant differences between the groups dur-
ing the intervention. The delayed effect in GSE and Cop-
ing Strategy Scale could indicate this, but this very effect
also indicated that the intervention with farm animals did
have some effects additional to the usual treatments.
Even if the results on self-efficacy and coping are rather
moderate, they are positive based on the limited sample
size and the rather unspecific intervention. According to
Wilson and Barker [31], questions must be raised whether
the characteristics of the animals, the farmer, the settings
and the interaction among these variables may influence
the assessed outcomes. In addition, most of the patients
(72 %) had been treated in psychiatric health institutions
for more than three years, which makes it unlikely to
achieve a rapid and great improvement. We found a sig-
nificantly higher drop-out rate among the hospitalised
patients compared with the outpatients. This indicates
that some inpatients were in an unstable phase. In future
studies these might have to be excluded to minimize the
drop-out rate.
The strengths of this study are that it is the first rand-
omized controlled follow-up design with farm animals,
and that the logistics have contributed to increased coop-
eration between health institutions, therapists and farm-
ers, and made Green care more accepted among the health
professions in Norway. Further strengths were that the
health outcome measures were based on validated stand-
ardized instruments, the completeness of the assessments,
and the relatively moderate drop-out rate. Limitations
were the moderate number of patients in the different
diagnostic categories, and the inherent inability to blind
the active treatment.
The results of this study suggest that AAT with farm ani-
mals may be a useful addition to traditional psychiatric
treatment, particularly for patients with affective disor-
ders. Self-efficacy was higher at follow-up compared with
baseline and at the end of the intervention in the treat-
ment group but not in the control group. The patients
with the highest increase in self-efficacy during interven-
tion reported the largest increase in coping ability. Further
controlled studies are needed for confirmation and to
more accurately define the treatment parameters and the
psychiatric population with the greatest potential of ben-
efiting from an intervention with farm animals.
Competing interests
The author(s) declare that they have no competing inter-
Authors' contributions
BB has undertaken the conception and design of the
study, the data collection and analysis. She has also
drafted the manuscript. ØE and BB have contributed to
the design of the study and to the drafting and revision of
the manuscript. All authors read and approved the final
Additional material
The authors are grateful for the participation by patients, farmers and med-
ical staff. Statistical assistance from Ingeborg Pedersen is highly appreciated.
The project was funded by a grant from the Research Council of Norway,
grant no. 152747/I10.
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Additional file 1
CONSORT Statement 2001 – Checklist. Checklist describing where in
the article important aspects of the randomized controlled trial are found.
Click here for file
Additional file 2
The Consort E-Flowchart Aug. 2005. Flowchart of the research design.
Click here for file
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... Social farming stems from a wider movement towards "green care" initiatives for health, which includes a range of therapeutic interventions involving farming and farm animals, horticulture and other contacts with nature such as wilderness therapy (Artz and Bitler Davis, 2017;Berget et al., 2008). ...
Purpose This practice piece aims to review an occupational therapy led pilot programme – social farming as an intervention option in an adult community mental health setting in Ireland. It will also reflect on the practical implications of delivering the natural surroundings based programme through the COVID-19 pandemic and plans for the future development of such programmes in adult mental health services. Design/methodology/approach The Occupational Circumstances Assessment Interview Rating Scale (OCAIRS) was used to measure occupational participation (Forsyth, 2005). This was administered with participants’ pre and post their participation in the 10-week programme. An internal questionnaire was developed to further capture both the participant and farmer experiences of the social farming programme. Findings Whilst improvements were noted in a number of OCAIRS domains, it was difficult to identify small changes over a short period of time. The main domains of change were habits, roles, interests and personal causation. The success of the social farming placements was also reflected in the internal questionnaire. The pilot programme has resulted in the further development of the social farming programme and securing of funding for placements for five years. Originality/value It would be beneficial to consider other standardised assessments that assess quality of life and occupation for future placements. It is also beneficial to consider practical implications in delivering a social farming programme, particularly to those with barriers to transport. It is hoped this paper will contribute to the growing knowledge of social farming as a meaningful therapeutic intervention in mental health occupational therapy practice.
... I løbet af de 12 uger brugte patienterne mest tid på arbejdsopgaver, der bragte dem taet på dyrene, såsom malkning, fodring og udmugning (Berget, Skarsaune, Ekeberg & Brastad, 2007), og de havde ifølge spørgeskemaer en bedre mestringsevne end kontrolgruppen, der ikke arbejdede med dyr. Der blev dog ikke fundet forskel mellem behandlingsgrupperne på patienternes opfattelse af deres egen livskvalitet (Berget, Ekeberg & Braastad, 2008). ...
Artiklen giver et etologisk perspektiv på terapidyr, introducererde bagvedliggende teorier og giver information om brugen afterapidyr i Danmark.Dyreassisteret terapi er en målrettet intervention, hvor dyreter en fast integreret del.Den teoretiske baggrund baseres på 1) unikke egenskaberved selve dyret eller 2) dyrets funktion som interaktiv partner.Der findes undersøgelser af dyrs terapeutiske effekt, men genereltmangler der videnskabeligt grundlag for terapeutiskanvendelse af dyr.En uformel spørgeskemaundersøgelse i Danmark indikerer,at terapidyr bruges til flere problemstillinger, at udbyderne harmeget forskellig baggrund, og at de primært bruger interaktionermed dyr som det bærende element.En styrkelse af fremtidig forskning i dyreassisteret terapi kanopnås ved mere fokus på metodik, større forsøgspopulationerog bedre forsøgsdesign. Desuden bør der satses på at kvantificeredyr-menneske-interaktionerne i selve terapisituationen ogses på sammenhængen med traditionelle effektmål, så det blivermuligt at
... The animalhuman bond, attachment. and biophilia can account for the improved effectiveness of multidisciplinary therapies that include animals [8,9]. Additionally, interspecific interaction can induce changes in the levels of oxytocin, which could be related to the effectiveness of this tool [10,11]. ...
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Dog-assisted interventions (DAI) are those that include specially trained dogs in human health services. Often, the training methods employed to train animals for DAI are transmitted between trainers, so the latest scientific research on dog learning and cognition is not always taken into account. The present work aims to evaluate the impact that the main theories on the evolution of the dog have had both in promoting different training methods and in the relevance of behavior in the evolution of the skills of actual dogs. Then, an integrative method for the training of dogs is presented. This method takes into account the research on dog learning mechanisms and cognition processes, and effectively promotes the development of desirable behaviors for DAI during the dog’s ontogeny.
Veterans deployed to combat zones experience high rates of posttraumatic stress disorder (PTSD), depression, and traumatic brain injury. Given the symptoms of these disorders and the physical injuries incurred while serving their country, Veterans may experience significant barriers to successful reintegration into civilian life. They struggle with seeking help, partly due to the stigma associated with mental health treatment in the military. For those who do participate in traditional treatments, there is a reported 50% early dropout rate. Even for those who participate in established treatment methods such as exposure-based therapies, a significant number will still meet the diagnostic criteria for PTSD. Alternative and adjunctive treatments, such as equine-assisted therapy are needed to address these barriers.
Full-text available
There is a need for evidence-based interventions that can contribute to more positive treatment outcomes for substance use disorders. Animal-assisted therapy is a supplementary intervention in which certified animals are used in a structured and goal directed manner in the treatment of various health problems. This review aims to systematically investigate and evaluate the available literature and thus hopefully contribute to future research. The electronic searches were performed in the databases PsycInfo, Medline, and Web of Science. Searches of reference lists were also performed. As the research on this particular field is scarce, the inclusion criteria had to allow for a relatively great variation in methods, interventions, and populations. Still, only ten studies were included, of which three were quantitative, six were qualitative, and one was a mixed methods study. All of the included articles examined the effect of AAT in the treatment of substance use disorders. The populations investigated included both women and men aged 13 to 55 years undergoing treatment for substance use disorder. A segregated design was applied, where the quantitative results were pooled using narrative synthesis and the qualitative using metasummary, all of which were combined in a final configuration. Three of the quantitative studies found significant correlations, and the metasummary indicated several reoccurring themes across the qualitative studies. However, a general lack of systematic investigation and an excess of explorative research were identified, and the majority of the articles neglected to report information important for replication. More thorough and systematic investigations are needed. A tentative explanatory model, with a hypothesis generating aim, is presented, in which the qualitative findings function as moderators or mediators of the relationships indicated by the quantitative studies.
Full-text available
The definition and understanding of the social farming (social agriculture) concept varies from country to country, depending on the specific conditions for its development. The contribution provides a systematic literature review of its definition and context. Scientific publications (134), which deal with the topic of social agriculture in different contexts within different geographical areas, and with different intensity over time, have been analysed. Special attention was paid to case studies. Most of the case studies dealt with Italy, The Netherlands, The United Kingdom and Norway. More than a third of the outputs address the issue of health effects of social farming. Social benefits are the second most frequent topic. Moreover, educational, environmental and economic effects of social agriculture are discussed in the analysed publications with a similar intensity. Green care (social agriculture) farms are significant players in rural development, and work and social inclusion, and can instantly and innovatively react to the local needs.
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El Grupo Desarrollador de la Guía y los expertos nacionales consideran que la detección temprana, atención integral, seguimiento y rehabilitación de pacientes con diagnóstico de distrofia muscular se debe hacer por equipos interdisciplinarios conformados en clínicas de enfermedades neuromusculares en las principales ciudades del país con profesionales competentes en la atención de estos pacientes que logren acumular conocimiento y experiencias, estables en las instituciones, que se vinculen a instituciones formadoras de talento humano relacionado con estos problemas de salud.
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This book collects various experiences on Adult Education (EPA). They are a reflection of some tasks that are being carried out in several European countries in this field of education. All of them have been exposed and debated in the II International Congress of Adult Education (CyLaei 2022) This event was held face to face, and virtually, on June 30 and July 1, 2022. CyLAEI 2022 is part of the AEI Project Erasmus+ Project Ref. 2019-1-ES01- KA204-063815 “Teachers of adults implementing successful and innovative models of employment and social inclusion”. The AEi (Adults, Employment and Inclusion) Project tries to introduce innovative and proven practical methodologies. These activities are aimed at solving the problem of unemployment and the consequent social exclusion. And this can be done from the perspective of educational institutions, entities or companies... with other complementary training actions. From 2019 to 2022, the members of this project traveled to learn about real examples in each of these contexts. They will then implement those models in their environments. The University of Oviedo (Spain) leads this project and has 4 partners: the Education of Castilla y León Administration (Spain), the Provincial Center for Adult Education of Padua (Italy), Ignacy Mościcki University of Applied Sciences in Ciechanów (Poland) and the educational center Borgå (Finland). The contributions are as varied as adult education itself, and come from professionals, trainers, researchers and educational managers of Adult Education. The thematic lines try to regroup some areas of work: training for social inclusion, digital competence, educational methodologies, professional training, European dimension, future challenges and professional teaching qualification. On the other hand, we collect the written contributions derived from two round tables where these aspects have been debated, both from the Spanish perspective and from the perspective of other countries. Finally, six contributions are shown that follow the poster or infographic format, giving a more schematic and iconic view of the subject.
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Las intervenciones asistidas con animales (IAA), en sus diferentes formas, han mostrado beneficios en las personas a diferentes niveles. En España, profesionales de diferentes ámbitos llevan a cabo este tipo de intervenciones, destacando la ausencia de profesionales de las ciencias del deporte (CAFYD). Este artículo tiene como objetivo valorar la pertinencia del profesional de CAFYD en las IAA, y más concretamente, dentro de las actividades físicas en la naturaleza. La metodología se ha centrado en la realización de una revisión sistemática de la literatura científica sobre sus beneficios en la condición física. Posteriormente se realizado un análisis crítico sobre la relación entre las IAA y las CAFYD, para posteriormente desarrollar la posible inclusión de las IAA como actividades físicas en el medio natural, de acuerdo con las diferentes clasificaciones existentes y atendiendo a las características propias de este tipo de actividades. Los resultados de la revisión de revisiones mostraron que las IAA tienen numerosos beneficios a nivel físico (equilibrio, movilidad o marcha), lo cual estaría relacionado con el componente motriz de las IAA y justificaría la presencia de profesionales en CAFYD. Además, la interacción humano-animal podría relacionarse también con los beneficios descritos mediante el concepto de biofilia, presente en las actividades físicas en la naturaleza
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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.
Full-text available
The purpose of this study was to examine the psychotherapeutic effect of riding therapy (RT) on a group of adult users of a social services mental health team in South Devon. The benefits of animal-assisted therapy (AAT) and pet ownership on human health and well-being are well documented. However, whilst research has been conducted on the benefits of hippotherapy (the employment of horse riding as a physiotherapeutic aid) little has been undertaken on the psychotherapeutic benefits of riding therapy. Through case studies, the current study sought to explore whether the participants benefited in terms of confidence, increased self-esteem and social/interaction skills. A further objective was to find out whether these benefits, if identified, were transferable to other areas of the riders' lives. The study was conducted utilizing a case study, participant observational methodology following the progress of six women with various mental health problems receiving RT on a weekly basis. The sessions comprised of learning to look after the horses and carrying out stable management tasks, in addition to the riding; the chief instructor was aware that an important factor of the RT was building up a relationship and trust with the horses on the ground. Methods employed to record the sessions, apart from participant observation, included interviews and questionnaires. The prime objective of the study was for the riders' experience of the therapy to be expressed in their own words. It was found that the participants benefited in areas ranging from increased confidence and self-concept, and that the therapy aided social stimulation and led to transferable skills being acquired.
Full-text available
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.
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.
Addresses the centrality of the self-efficacy mechanism (SEM) in human agency. SEM precepts influence thought patterns, actions, and emotional arousal. In causal tests, the higher the level of induced self-efficacy, the higher the performance accomplishments and the lower the emotional arousal. The different lines of research reviewed show that the SEM may have wide explanatory power. Perceived self-efficacy helps to account for such diverse phenomena as changes in coping behavior produced by different modes of influence, level of physiological stress reactions, self-regulation of refractory behavior, resignation and despondency to failure experiences, self-debilitating effects of proxy control and illusory inefficaciousness, achievement strivings, growth of intrinsic interest, and career pursuits. The influential role of perceived collective efficacy in social change and the social conditions conducive to development of collective inefficacy are analyzed. (21/2 p ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1982 American Psychological Association.
Using a mixed methodological approach, this exploratory study investigates the experiences of children who are placed in a residential treatment center that utilizes farm animals as one of its treatment approaches. The findings indicate that the children utilized the farm animals, like one would utilize the services of a therapist. Respondents indicated that they spoke to the animals, without fear that what they said would be repeated; that they visited the animals to feel better when they felt sad or angry; and that they learned about nurturing and caring for other living things. This article highlights a unique and novel approach to treatment that has not, as yet, been fully explored by the child welfare profession.
The agricultural situation and the social protection system in Slovenia are discussed first. Then, four typical patterns of the use of agriculture for therapeutic purposes are described (activities within the institutions, decentralization of the institutions, initiatives within the representative clients' organizations, and individual farmers' initiatives). Based on the results of the feasibility study at the national level a provisional SWOT matrix of health/care farming is drafted. Modelling and implementation of health/care farming have to be carried out with professional correctness by a multidisciplinary team (agronomists, social workers, economists, defectologists etc.) and with a great deal of social prudence. Relevant criteria, economic viability and quality of life of all involved have to be met. Therefore, the implementation of social services as a supplementary on-farm activity should be gradual and backed by building up partnerships between the participants: clients and farmers, while the role of the state has to be orientated to arranging and determining the scope of and the conditions for health/care faming.
Animal-assisted therapy (AAT) with farm animals for humans with psychiatric disorders may reduce depression and state anxiety, and increase self-efficacy, in many participants. Social support by the farmer appears to be important. Positive effects are best documented for persons with affective disorders or clinical depression. Effects may sometimes take a long time to be detectable, but may occur earlier if the participants are encouraged to perform more complex working skills. Progress must however be individually adapted allowing for flexibility, also between days. Therapists involved with mental health show a pronounced belief in the effects of AAT with farm animals, variation being related to type of disorder, therapist's sex and his/her experience with AAT. Research is still scarce and further research is required to optimize and individually adapt the design of farm animal-assisted interventions.
The utilization of agricultural farms as a base for promoting human mental and physical health and social well-being is a new promising development. On farms, the animals, the plants, the garden, the forest and the landscape are used in recreational or work-related activities for psychiatric patients, people with learning disabilities, people with a drug history, problem youth, burnt-out and elderly people and social-service clients. If not pure therapy, such activities may have therapeutic value according to extensive experience. The numbers of such multifunctional farms offering Green Care services is increasing rapidly in many countries. The positive experiences seem to be similar in different countries: working on the farm contributes to self-esteem, social skills, rehabilitation, inclusion, responsibility, physical health and sense of purpose. Important recognized qualities of Green Care farms are the space, quietness, useful work, diverse activities, caring activities, the working with plants and animals, and the protective and caring environment of the farmers¿ family and social community. Social farming appears as an evolving, dynamic scenario, which is gaining increasing attention from multiple stakeholders. The first part of this book contains scientific papers dealing with different aspects of Farming for Health. The second part describes the situation in different countries