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Integrating Animal-Assisted Therapy into Trauma-Focused CBT for Maltreated Youth: A Randomized Feasibility Trial

Thu, March 21, 9:30 to 11:00am, Hilton Baltimore, Floor: Level 2, Key 9

Integrative Statement

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based treatment for trauma-exposed children experiencing posttraumatic stress and associated symptomatology (Cohen, Mannarino, & Deblinger, 2006). A key component of the intervention involves gradual exposure to the memories and cognitive processing of one's traumatic experiences. However, youth report that discussing their traumatic experiences is often difficult, and that the process can be aided by empathic clinicians and learning to effectively cope with stress (Dittmann & Jensen, 2014). Two of the more prominent hypotheses regarding how animal-assisted therapy (AAT) may impact treatment are that it (1) enhances the development of clinician-patient rapport and (2) serves an anxiolytic effect (Brooks, 2006; Reichert et al., 2016). As such, the integration of AAT into TF-CBT may enhance the patient's experience and the process of TF-CBT, and potentially improve outcomes. This session will present the preliminary results of a randomized controlled clinical trial examining the efficacy and feasibility of integrating AAT into TF-CBT for a sample of approximately 60 maltreated youth receiving a qualifying score on the UCLA PTSD Reaction Index. Using a block randomization procedure to account for gender and age, youth between the ages of 6 and 17 are assigned to receive TF-CBT or TF-CBT with AAT integrated into each session. In the TF-CBT+AAT condition, a trained and certified service dog is present during sessions. Clinicians were trained by handlers in basic commands and the specific functions which the dogs may serve in session, and the handler observes sessions from an adjoining room. Child and caregiver-report measures are used to track progress of posttraumatic stress symptoms, as well as broader internalizing and externalizing symptoms, emotion regulation, and therapeutic rapport. Respiratory sinus arrhythmia (RSA) is being measured in session at defined increments to determine whether AAT improves in-session physiological regulation. Given the paucity of research on AAT, particularly with trauma-exposed youth, a primary goal of the study is to examine the impact and integration of the animals into treatment sessions, with metrics including canine in-session heart rate, canine salivary cortisol, and observations of behavioral signs of canine distress. Caregiver and child satisfaction also is being assessed as is clinician perceptions of the role of the animals and treatment disrupting events attributable to the presence of the animals. Initial analyses show evidence of significant improvement in posttraumatic stress across both conditions and that therapeutic rapport is strong regardless of the presence of dogs, though clients in the TF-CBT+AAT condition report enjoying the presence of the dogs. Clinicians suggest that the impact of AAT may be idiosyncratic as those youth who choose to involve the dog in treatment appear to benefit from their presence, while those youth less interested in the dogs do not seem to evidence such benefit. The impact of participation on the dog also appears idiosyncratic, with some dogs showing a particular aptitude to participating in trauma-focused treatment sessions.

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