The Impact of Animal-Assisted Therapy on the Well-Being of

Individuals with Various Disorders

Yuansi Wu

Department of Psychological & Brain Sciences, University of California, Santa Barbara, Santa Barbara, 93106, U.S.A.

Keywords: Animal-Assisted Therapy, Well-Being, Mental Illness, Cognition.

Abstract: Well-being is closely linked to social belonging and psychological health. Psychotherapy and

pharmacological treatments targeting these components significantly improve well-being. The current review

aimed to understand how animal-assisted therapy (AAT) contributes to positive social and psychological

outcomes in individuals with mental illnesses, neurodevelopmental disorders, and cognitive impairments.

Given the varying treatment approaches required for these conditions, the review also explored how AAT

implementation differs based on age characteristics. Results indicated that AAT tasks were more physically

demanding for children compared to elderly participants. For elders, AAT focused on meeting unmet

emotional needs to improve well-being, while for children, the focus was on enhancing engagement and self-

regulation skills. Both age groups experienced improvements in positive moods, anxiety levels, and social

connections. However, no significant cognitive or mental health improvements were observed. Future

research should explore the long-term benefits of AAT, investigate its potential cognitive benefits for elderly

participants, and examine strategies to optimize the involvement of professionals during therapy sessions.

1 INTRODUCTION

The connection between humans and animal dates

back approximately 140,000 years, when animals

were integral to human survival, aiding in agriculture

and hunting (Beggs & Townsend, 2021). From

meeting basic life needs to supporting emotional

well-being, the profound power of the human-animal

bond in addressing both physical and emotional needs

is undeniable. Today, service animals are commonly

seen in public settings, assisting individuals with

disabilities and mental health challenges. Unlike

service animals, therapy animals provide emotional

support, guiding and motivating patients through

traditional psychotherapy or recovery plans such as

addiction treatment, motor skill training, and

emotional regulation. The use of therapy animals as

complementary tools in treatment has become

increasingly widespread. Numerous studies on AAT

have demonstrated positive outcomes for both

psychological and physical health. However, as AAT

has been applied across various settings and

populations, research has focused on understanding

the variables that influence its outcomes. For

example, investigating the time required to form

effective animal-human bonds is essential for

designing treatment sessions (Rodrigo-Claverol et al,

2023). Variables such as treatment settings, patient

age, accessibility to AAT, and knowledge about the

therapy contribute to differences in treatment

outcomes.

Well-being, a key focus of positive psychology,

encompasses social skills and mental health, as these

aspects emphasize social functioning and positive

emotions. AAT improves patients’ psychological and

social conditions through goal-oriented activities

involving interactions with animals (Beggs &

Townsend, 2021). The supportive and nonjudgmental

environment fostered in AAT provides a safe space

for patients to connect, build trust, and actively

participate in therapy, thereby enhancing the quality

of treatment. The effectiveness of AAT, however,

varies across age groups, depending on cognitive

levels, physical capacities, and treatment goals.

Understanding how age differences impact AAT

procedures require a more systematic and focused

analysis of past research. The current study aimed to

explore the positive outcomes observed in patients

with various disorders related to AAT. Additionally,

the research sought to identify the different

approaches used in AAT to accommodate the needs

of different age groups. The current review retrieved

and analyzed articles from the core collection of the

Wu, Y.

The Impact of Animal-Assisted Therapy on the Well-Being of Individuals with Various Disorders.

DOI: 10.5220/0014110900004942

Paper published under CC license (CC BY-NC-ND 4.0)

In Proceedings of the 2nd International Conference on Applied Psychology and Marketing Management (APMM 2025), pages 193-199

ISBN: 978-989-758-791-7

193

Web of Science database, using keywords such as

“animal-assisted therapy,” “age differences,” “well-

being,” “mental health,” and “social skills.” Studies

were filtered to exclude review articles, non-English

studies, and articles focusing on counseling

neurotypical or mentally healthy individuals,

improving academic performance, or anecdotal

information. The final analysis included five selected

articles after screening relevant abstracts and

excluding unrelated studies.

2 LITERATURE REVIEW

2.1 Animal-Assisted Therapy

AAT is a form of animal-assisted intervention that

emphasizes building human-animal bonds by

integrating animals into goal-oriented activities.

Archaeological research has provided evidence of the

benefits of human-animal interactions dating back

14,000 years, during the early stages of animal

domestication, farming, and agriculture (Beggs &

Townsend, 2021). Early in the evolution of

psychology, Freud observed that the presence of his

dog promoted positive outcomes in his therapy

sessions (Beggs & Townsend, 2021). Freud’s

observations led to systematic data collection on the

use of dogs, with subsequent physiological data

supporting a range of emotional, social, cognitive,

and psychological improvements when incorporating

dogs into the therapeutic process. Many studies have

highlighted the benefits of using therapy animals as a

complementary tool in various settings, including

educational institutions, clinical environments,

hospice care, and rehabilitation centers (Burr et al,

2023, Guzmán et al, 2022, Pichierri et al, 2011). AAT

offers patients a nonjudgmental, safe, comfortable,

and warm space. The unconditional companionship

provided by animals can alleviate patients’ stress,

improve emotional regulation in children with

emotional outbursts, and reduce motor dysfunction in

the elderly (Pichierri et al, 2011). The selection of

animal require a comprehensive assessment of the

animals’ temperament, behaviors, levels of training

and suitability with the environment.

2.2 Well-Being and Age Differences

Studies on wellbeing have conceptualized it as a

multidimensional evaluation, where a high level of

wellbeing indicates the absence of dysfunction and

the presence of positive emotions (Chutiyami et al,

2022). Mental, physical, and neurodevelopmental

disorders are often accompanied by a series of life

inconveniences, leading to decreased overall

wellbeing. AAT have been found to improve patients’

well-being by alleviating stress, strengthening motor

function, facilitating physical activity and improving

social interaction. Specifically, AAT can help

patients with addiction, behavioral problems, stress

management issues, and motor disabilities transition

into a more satisfying lifestyle, promoting self-

sufficiency. AAT can be implemented in various

settings after familiarizing the therapy animals to the

environment and to a wide range of age group to

promote well-being. However, age-specific

interventions and relevant characteristics of patients

from different age groups should be carefully

examined when incorporating AAT into therapeutic

settings.

Improvement in motor skills are correlated with

enhancing social communication and social

interaction, improving sense of belonging, reducing

loneliness and emotional distress, which are

important components of well-being (Holloway &

Long, 2019). One study found that patients regained

motor control by performing cognitive tasks, such as

reading and memorization, alongside physical

training (Pichierri et al, 2011). This study was

motivated by the understanding that elders require

more cognitive intervention for motor disability than

younger adults, who tend to rely on automatic

physical responses. Elders often need additional

cognitive effort to maintain motor function and

balance, particularly as many suffer from dementia,

Alzheimer’s disease, and other conditions that further

deteriorate cognitive functioning (Pichierri et al,

2011,Acevedo & Loewenstein, 2007, Rodrigo-

Claverol et al, 2020). For childhood motor

intervention, early childhood engagement in goal-

oriented physical activities may not yield long-term

motor benefits, but targeted motor interventions in

autistic preschool children have shown significant

improvements in body coordination and self-care

skills, implying the interdependency between motor

skills and social skills (Coppens et al, 2021, Jin et al,

2023). Early motor intervention for children with

motor difficulties can so reduce overweight and

motor deficits in later adulthood, which might reflect

an Ashley of long-term benefit for childhood motor

interventions. The discrepancies between motor

intervention of different age group might be reflected

in cognitive abilities in which elders required greater

attention of cognitive improvement to restore motor

function, thus it suggests that relevant interventions,

such as AAT, for elders should use therapy animals

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for improving cognitive engagement in the recovery

process.

Mental disorders such as PTSD, depression, and

anxiety can persist into adulthood, leading to long-

lasting negative impacts on individuals’ quality of

life. However, research on age-specific interventions

remains limited. Previous studies have highlighted

age as a significant variable influencing patients’

motivation and perception of mental health services.

For instance, Ford et al. investigated satisfaction

levels with mental health services across different age

groups and found that older patients tended to view

psychotherapy, mental health interventions and

treatment more positively than younger adults (Ford

et al, 2013). Younger adults, equipped with greater

knowledge and understanding of mental health, are

often better able to combat societal stigma and seek

assistance without feeling ashamed. This trend might

explain findings from a meta-analysis that revealed

significantly smaller effect sizes for therapies in

children and adolescents (Cuijpers et al, 2020).

Perceptions of mental illness, influenced by education

levels, can shape individuals’ motivation and

attitudes toward seeking mental health services.

Elders and adults typically have greater

understanding about mental illness than the youth.

This might suggest that older individuals have higher

mental health awareness thus feeling more positively

toward mental health services. For young adolescents

whose knowledge of mental illness might be limited,

their can develop resistance to mental health

programs. For instance, many adolescents report fears

of negative interactions with therapists, confronting

their emotions, and stigma, which hinder them from

accessing mental health services, leading to delays

and missed diagnoses (Pfeiffer & In-Albon, 2022).

Despite growing awareness of mental illness in

educational settings, negative social labels, such as

associating mental illness with being “crazy,” persist

among children, indicating a need for education

meaningful teaching on mental healthcare. Notably,

early detection of mental health issues in children and

timely intervention are crucial, as they yield the most

effective outcomes. A study comparing the

psychotherapy outcomes of patients from different

age groups show the most significant improvements

in emotional regulation, familial relationships,

networking, and attention spans among children

(Eadie et al, 2022). Early interventions can effectively

help individuals avoid long term psychotic disorders,

yet negative associations with mental illness among

children and young adolescents might hinder this

progress, thus mental health services target at

children should educate children about mental health

and foster acceptance , reducing their reluctance to

engage in therapy sessions (Beckman et al, 2023).

3 AAT’S CONTRIBUTION TO

SOCIAL SKILLS

The presence of animals creates human-animal

bonds, which are the primary source of support for the

benefits of incorporating animals into therapeutic

sessions. A study recruited 48 clinically diagnosed

children with ASD (4–5 years old) and compared

their social interaction and communication skills

between a group interacting with dolphins and a

control group. The interventions were carried out by

a therapist and a dolphin trainer, consisting of 45-

minute sessions three times per week for each group.

The control group received the same therapy sessions

and physical activities only the interaction with

dolphins was replaced by using a human therapist.

The researcher assessed participants social

communication and socialization skills by

interviewing caregivers or parents, completing verbal

language scales, and interacting with the autistic

child. The three assessments were carried both before

and after the interventions. The results showed a

significant improvement in social interaction,

particularly in vocalizations and gestures, among the

treatment group. This improvement could be

attributed to the frequent interaction and commands

required during the dolphin interaction. However, no

differences were observed in communication skills,

as the two types of therapy differed only in the

presence of the dolphin (Hernández-Espeso et al,

2021). Since all sessions involved novel

environmental factors and playful activities to engage

the children’s motivation, improvement in social

interaction might not be significant.

AAT involving dolphins are less common

compared to the use of domesticated animals, the cost

of using dolphins in AAT can reduce the community

accessibility, thus affordability should be noted when

deciding the types of animals and future research

comparing the effectiveness of different types of

animal use in AAT will also be important.

For older adults, a study included 50

institutionalized geriatric patients with moderate to

severe cognitive impairments (aged 65 and older) and

divided them into two groups (Rodrigo-Claverol et al,

2020). The experimental group participated in

sessions facilitated by a family doctor who managed

the dog-patient interaction with assistance from a

physiotherapist and an occupational therapist

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195

(Rodrigo-Claverol et al, 2020). These sessions were

conducted in the nursing center with groups of six

patients, consisting of one 60-minute session per

week for 12 weeks. The treatment group will receive

physiotherapy and social stimulation activities with

the engagement of the animal. The control group will

have the same procedure but they will not have the

animal involved. The communication levels were

measured by the Holden Communication Scale in

which 12 times were used to assess individuals’

knowledge of the environment, language use,

behavioral patterns. The research also measured

participants balance control, evaluating sitting and

standing balance. The results indicated that AAT for

older adults with moderate cognitive impairment

yielded greater improvements in mobility, social

communication, and interaction than severe cognitive

impaired individuals (Rodrigo-Claverol et al, 2020).

This suggests that AAT could serve as a non-

pharmacological approach to enhancing motor

control and social skills for elders, preventing risks of

falls and reducing loneliness, improving daily

functionings. In Richeson’s nine-week pilot study

using dogs in two nursing homes with 15 older adults

(aged 60 and above) diagnosed with agitation issues,

the researcher trained the therapeutic recreational

staff at the nursing homes and asked them to complete

AAT flow chart for each individual with dementia

and agitation issues on a daily basis (Richeson, 2003).

The AAT flow chart which measures levels of social

interaction with the therapy dogs and the handler

increased among the participants. However, no

significant differences were found in cognitive

function as measured by MMSE. Although this study

included few participants, it could suggest a

discrepancy between the two research, indicating

further attention on the cognitive targeted AAT for

elders. Pichierri et al pointed out the importance of

combing cognitive task with physical exercise to

enhance motor coordination, hence, future AAT can

consider using therapy animals to support elders

engaging in active physical tasks while integrating

memorization tasks.

Notably, in these two studies, both results showed

a significant improvement in social interaction,

especially in improving verbal interaction and

physical engagement (Hernández-Espeso et al, 2021,

Richeson, 2003). Actions such as giving command,

feeding, grooming, hugging involved during the AAT

might contribute to these outcomes seen in both

children and elder with neurodevelopment disorders.

Importantly, differences in age contribute to different

outcomes of the interventions with particular

differences observed in the applied procedures. For

example, in autistic children’s study using dolphins,

the settings are playful and novel to children who

need greater motivation and focus to take part.

Whereas for elders in nursing centers, the settings are

uniform and involve fewer physical activities which

is reasonable considering the physical competency.

Moreover, benefits of AAT can be influenced by self-

selected effect. For example, elders selected are likely

to express affections for animals and this can enhance

the effectiveness of treatment. For children, the

selection criteria are likely to based on allergy,

diagnosis, and parental consent. Importantly,

discrepancies between autism and dementia are not

discussed in this review, which might explain why

communication benefits are seen in elders with

dementia as opposed to autistic children who have

experience more prominent social challenges,

including repetitive behaviors and narrowed

attention. These can significantly hinder the

effectiveness of AAT in improving the autistic

children’s motor ability and subsequently contribute

to decreased social connections.

4 AAT’S CONTRIBUTION TO

MENTAL HEALTH

Interaction with therapy animals can ease emotional

stress and anxiety by forming positive bonds between

patients and the dogs, as well as with the therapist.

The unconditional supportive environment generated

through AAT contributes to an enhanced emotional

state and reduced mental health symptoms for

patients across various settings.

An exploratory study recruited ten elders with

Alzheimer’s disease and conducted a repeated

measures experiment to evaluate pre- and post-

intervention outcomes. The experiment was divided

into three periods: the first two weeks involved

regular treatment, the following three weeks included

the use of plush dogs, and the last three weeks

involved animal-assisted activities (AAA). For the

AAA sessions, activities were tailored to each

patient’s cognitive capacity (Mossello et al, 2011).

Social communication, agitation, cognitive abilities,

and motor and behavioral patterns were measured for

comparison before and after the plush dog and AAA

interventions. After the 8-week experiment, cognitive

and neuropsychiatric outcomes remained unchanged,

and no significant differences were observed in

agitation levels. However, the emotional state of the

participants improved significantly, as indicated by

reduced anxiety and sadness, and increased positive

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mood. Additionally, an increase in general alertness

suggested greater interest in the external

environment. Traditional pharmacological approach

dedicated to the psychological well-being of elders

have indicated to have contribute to a wide range of

negative side effects despite achieving similar

outcomes. The presence of animals has shown to

increase positive moods of elders who continue

taking pharmacological treatments. It could mediate

the negative effects of drugs while enhancing

physical and emotional well-being. Despite these

emotional improvements, AAT did not reduce

depressive symptoms, although a single-time analysis

of the neuropsychiatric scale revealed reduced

anxiety levels after the sessions. Therefore,

researchers should distinguish between emotional

improvements and mental health disorders when

evaluating the effects of AAT on mental well-being.

Furthermore, Mossello et al.’s results did not show a

significant improvement in cognitive function,

highlighting an important area for further

enhancement in future AAT implementations. At the

same time, the finding also suggested that AAT needs

to collaborate with other types of treatments, such as

reading, cooking, drawing, medication, and other

psychosocial therapy in order to enhance elders’

physical and psychological health.

In pediatric mental health services, AAT has also

demonstrated improvements in mental health and

emotional regulation among children with various

mental health disorders. Guillen Guzmán et al.

conducted a two-year-long study on dog-assisted

therapy in a children’s day hospital. All participants

were under 13 years old, and their emotional and

behavioral outbursts, as well as attendance rates, were

assessed before and after the intervention (Guzmán et

al, 2022). The researchers conducted qualitative

interviews with healthcare professionals and

measured emotional and behavioral data, and rate of

engagement in quantitative form using the Social

Responsiveness Scale-2 (SRS-2) and the Self-Control

Rating Scale (SCRS). During the dog-assisted

therapy sessions, a dog handler and a staff member

from the day hospital facilitated the sessions, with a

research team member tracking progress.

Quantitative results showed a significantly higher

attendance rate on days when dog-assisted therapy

was conducted. Additionally, emotional and

behavioral outbursts were significantly lower after

the therapy sessions (Guzmán et al, 2022). Qualitative

interviews revealed that professionals found dog-

assisted therapy helpful for approaching children with

high levels of anxiety and for building therapeutic

connections. Children who received dog-assisted

therapy appeared calmer and more motivated to

participate in therapy sessions. However, according

to parental interviews, no significant behavioral

differences were observed outside the therapy setting.

Similar to Mossello’s study, a reduction in anxiety

levels was noted in children at the day hospital.

Reports from professionals suggest that AAT

improves motivation and engagement while fostering

trust during therapeutic sessions. However, these

positive behavioral changes did not extend beyond

the day hospital setting. Moreover, it remains unclear

whether the positive changes last over the long term,

as the effects were measured shortly after the

interventions.

In children’s treatment involving therapy animals,

as illustrated by Guillen Guzmán et al., the focus is

on encouraging motivation and fostering connections

with the therapist among children with

neurodevelopmental and mental disorders (Guzmán

et al, 2022). The goal of AAT is to improve mental

well-being through human-animal interactions.

Although the ultimate goal is the same across age

group, AAT approaches patients differently based on

individual needs and age differences. For elders, who

often struggle with mental health problems,

emotional distress, and agitation, these issues are

often related to unmet needs instead of the disorder

itself (Richeson, 2003). For instance, dementia and

Alzheimer’s disease, which are common in elders,

can lead to motor and cognitive dysfunction as well

as adverse effects on mood regulation. These

symptoms of aging are often linked to unmet physical

and psychological needs, which can be moderated by

manipulating the environment, such as providing

emotional comfort and support through AAT. By

fulfilling elders’ emotional needs with the

companionship of therapy animals, psychological

stress can be reduced. For children, AAT focuses

more on fostering a proactive attitude toward mental

health services. Building this mindset in children

encourages trust in their therapist and facilitates

connections, which contributes to more effective

intervention outcomes, such as reduced emotional

outbursts and anxiety attacks. Unlike elders, whose

mental health issues are typically related to natural

aging, children receiving AAT often experience

neurodevelopmental deficits, such as ASD and

ADHD, which can persist into adulthood. Early

intervention for children at mental health risk can

prevent the exacerbation of symptoms and reduce

treatment difficulties in adulthood. The goal of

treatment is to encourage children to actively engage

in therapy, aiding in self-regulation and emotional

management so that, in later years, they will have the

The Impact of Animal-Assisted Therapy on the Well-Being of Individuals with Various Disorders

197

cognitive and social capacity to support themselves

and the willingness to seek professional help when

needed.

5 DISCUSSION

The current review sought to understand the

differences in AAT procedures when accounting for

age variations and how AAT enhances the social

functioning and psychological health of individuals

with mental health, cognitive, or neurodevelopmental

disorders, such as dementia, depression, and ASD.

The researcher noted three unresolved questions after

analyzing the selected articles. The first issue is the

lack of cognitive improvement among cognitively

impaired elders with dementia and Alzheimer’s.

Although implementing AAT resulted in positive

mood and motor improvements, the results in

cognitive improvement were not significant, which

can hinder the effectiveness of treatments for elders

who tend to suffer from cognitive dysfunction

(Rodrigo-Claverol et al, 2020). Cognitive impairment

can be reflected in brain activities, including memory

retention, attention span, processing speed, and

orientation. The relationship between brain areas and

cognitive impairments is worthwhile to study as it

offers insight into the specific brain areas stimulated

during engagement with therapy animals. Therefore,

based on previous research, future studies could

measure the brain functionality of older adults while

performing cognitive tasks, such as the Stroop Task,

and interacting with therapy animals to develop a

clearer understanding of the benefits of AAT in

enhancing cognitive abilities.”

The second issue is the lack of long-term

investigation into the benefits of AAT on the well-

being of individuals, especially among children. The

main purpose of conducting early interventions for

children with risky behaviors and emotional

regulation issues is to prevent persisting symptoms

and reduce recurring issues in adulthood. However,

many studies do not indicate the long-term benefits of

AAT, possibly due to the approaches taken in

measurement and the cost of hiring handlers and

caring for therapy animals. While children

participating in AAT demonstrate immediate social

and emotional improvements, these effects do not

extend beyond therapy settings, let alone persist

throughout their lifespan (Guzmán et al, 2022). The

length of time required for AAT to solidify positive

outcomes in children with ASD or other mental health

issues should be explored further. Specificity, when

conducting longitude studies the researcher should

carefully control the variables to minimize the

influence of third variables on the outcomes.

The last issue is the involvement of healthcare

professionals in the treatment process. Since AAT

can be applied in various settings, therapists must

educate other healthcare professionals in these

institutions to ensure an effective process.

Additionally, therapists without certified animal-

assisted therapy licenses may have to work

simultaneously with handlers. The involvement of

different professionals in the treatment process can

interfere with the formation of animal-human bonds.

Patients might struggle to form in-depth connections

with the therapy animal or engage effectively with the

therapist due to the presence of multiple staff

members. Future research could explore whether the

number of people present influences the bond-

forming process between the animal and the patient

by assessing patient satisfaction levels, memorization

of the external environment, or using brain imaging

techniques to compare variations in brain activity

when interacting with a therapist alone versus with

multiple healthcare staff.

6 CONCLUSION

The second issue is AAT has significantly advanced

the fields of medicine and psychology. When

integrated with traditional treatment methods, AAT

enhances the well-being of individuals with various

disorders. The current review explored the

differences in applying AAT across age groups,

including children, adolescents, adults, and elders.

Furthermore, it examined how AAT improves the

well-being of these groups by analyzing

psychological and social outcomes following therapy

sessions. Improvements in anxiety levels, positive

emotions, and reductions in negative social behaviors

were observed across all age groups. However, the

focus of AAT differs based on age. For younger

children and adolescents, who often have limited

awareness of mental health and reduced social

interaction skills due to challenges with self-

regulation, AAT primarily targets motivation and the

development of self-regulation skills. In contrast, for

elders, AAT focuses more on addressing unmet

emotional needs to enhance their well-being. The

types of tasks also vary by age. Elders typically

engage in calmer activities with therapy animals,

while children often participate in more physically

demanding tasks. Despite these benefits, the research

and application of AAT, such as insufficient

professional presence during sessions, a lack of long-

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term research methodologies, and limited cognitive

emphasis in both studies and applications. These

findings highlight the need for more multidisciplinary

research to optimize and expand the scope of AAT.

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