“Well at least she’s prettier
than the last OT I had”

Around 12,000 years ago in a stone aged settlement in central Europe, a tribal elder made a decision that would change the course of civilization forever, and eek mankind one notch further on the evolutionary scale. This man decided to unleash the family goat from the nearby tree, and guide it to the warmth and protection of the hut. From that moment on, the history of animal domestication began. 10,500 years later, on the battle fields of the Crimea, Florence Nightingale reflected on this giant leap for mankind, and its potential benefits to the disabled; “a small pet is often an excellent companion for the sick, for long chronic cases especially”. For maximum pleasure Ms. Nightingale suggested a small “caged bird”. Decades earlier the Moral Managers of the York retreat in England envisioned that animals could become an important part of psychiatric treatment, helping lessen the need for medication and restraint. Since then animals have consistently been used in health care from guide dogs to helper monkeys. Can animals continue to play a role in the 21st century healthcare system, or should they be consigned to the history books? ”¦And what’s it all got to do with OT anyway?

Over the last decade, a wealth of studies have emerged to support the widely held anecdotal views that animals can be ”˜therapeutic’. A large proportion of these have looked at the benefits of animal assisted therapy (AAT) or therapy involving a trained (furry) animal and its owner, as opposed to a ”˜service animal’ such as a guide dog. A common finding between the studies is that animals have an intrinsically therapeutic effect on patients. Studying the benefits of a companion dog for patients with schizophrenia, for example, Barker, and Dawson (1998) found that the caring human-canine relationship helped ground the patient in reality. In another study Arnold discovered that for patients with dissociative disorders, a dog was a calming influence, which not only relaxed the patient but also gave the patient confidence to interact more with the healthcare professionals. Similarly, Holcomb and Meacham (1989) found that AAT was most effective in engaging patients who were most isolated on the ward. The conclusion made by Arnold (1995) is that interacting with the dog posed fewer demands than other traditional therapy groups that may have otherwise caused states of increased anxiety.

Although this evidence clearly expounds the comforting qualities of AAT, some critics have suggested that there needs to be more task-focused research in order to make it more clinically relevant for professions such as OT’s.

A study by Oakley and Bardin (1998) highlights the measurable effects of AAT on children recovering from traumatic brain injury. In treatment sessions at St Mary’s hospital for children in New York, the OT’s incorporate a dog into therapy sessions in order to satisfy specified goals. If, for example, a child has difficulty dressing and grooming due to decreased function on one arm, the therapist will get the child to reach out with the affected arm and stroke the dog. The child then becomes motivated and excited to participate in the task, and eventually attains the goals quicker than anticipated without the dog. According to Davies (1998) this is not only a fun activity for the child on a psychological level, but one that operates on a biological level too. Tests show that when stroking dogs, the blood pressure of children, and adults, decreases, even when performing an unpleasant task simultaneously.

The potential benefits of AAT to peoples physical health has more resonant implications for older adults. Recent studies have confirmed that pet owners experience greater longevity than their non-pet owning counterparts. A recent Australian study, for example, involving 5,741 participants found that pet owners had significantly lower blood pressure and triglyceride levels compared with non-pet owners (Anderson, Reed, Jennings, 1992). These findings could not be explained by other influencing factors such as smoking, alcohol consumption and social status. The exact causal link between animals and good health however is still unclear, ranging from the intrinsic anxiety reducing qualities of animals to, simply, the benefits of dog walking.

How can these findings relate to OT practice? For a start many OT clients are pet owners, and each has or could have a responsibility of care for that animal. The demands of looking after that animal such as feeding, cleaning andexercising the animal all rely on complex co-ordinated movements, exercise tolerance and even social interaction. This will help embed a structured routine into the client’s day. So, next time you are on a home visit, don’t just step over the dog or pat it on the head, think how the animal can be incorporated into an achievable and measurable goal for the client in his or her rehabilitation. Dr Albert Schweitzer, a leading expert of animal therapy, believes that animals have an important role to play in the future of health care “as we except animals as potential healers and major contributors to our health, wellness and vitality”¦we need a new wiser concept of animals’. In order for this vision to be fully realised, however, more evidence is needed that looks at specific, task related, AAT interventions and outcomes.

If OT’s fail to keep on top of the developments in the world of AAT then we are potentially leaving the door wide open for helper monkeys to take over our jobs. This monkey (above) is already working as a Senior I in Basingstoke ICT.

References

Anderson WP, Reid CM, Jennings GL: Pet ownership and risk factors for cardiovascular disease. Medical Journal of Australia 157:298-301, 1992 [Medline]

Arnold JC: Therapy dogs and the dissociative patient: preliminary observations. Dissociation 8:247-252, 1995

Barker S, Dawson K: The effects of animal assisted therapy on anxiety ratings of hospitalized psychiatric patients Psychiatric Services 49:797-801, June 1998

Beck A, Katcher A: A new look at animal-assisted therapy. Journal of the American Veterinary Medical Association 184:414-421, 1984 [Medline]

Davis JH: Animal-facilitated therapy in stress mediation. Holistic Nursing Practice 2:75-83, 1988

Holcomb R, Meacham M: Effectiveness of an animal-assisted therapy program in an inpatient psychiatric unit. Anthrozoös 2:259-264, 1989

Oakley D, Bardin G: The potential benefits of animal assisted therapy for children with special needs, 1998 (www.kidneeds.com)

Im currently building a nice sortable table of basic grade rotations around the country - where, when they employ, how much and most importantly the posts in each rotation. Until I make it presentable if you have any details about rotations send them to me on links@metaot.com.

It will hopefully be useful - not only if your looking for a rotation round the country but also from a research point of view. There are some rumours circulating that there are fewer basic grade posts this year due to cut-backs. Such a list may put some light on the situation.

Until then if you are looking for band 5 rotations in the NHS click here.

PS: yes, I do intend to do the same list for other bands/grades :)

UPDATE (11/12/06): Due to cease and desist request from CAOT themselves I have had to sadly pull these images. Read here for more info.
OK, someone from Canada may well ask me to remove this but hey.. Find attached a rather snazzy adaption of the Canadian Model of Occupational Performance - It's in PNG format so you should be able to resize it without a huge loss in quality. Hope its useful.. Please, please, please just reference it back to me - something like "Schematic representation of CMOP, Adapted from Townsend (1997), MetaOT.com, 2005)" Then just reference the url (http://metaot.com/CMOP-Diagram) to this page as neccessary. That should do the trick. UPDATE: I have also reworked the OPPM: Occupational Performance Process Model (It's beyond me why they call this a model as well - more of a OT process diagram - handy even if your not using CMOP) into a nice diagram for reuse. Two versions this time - one with text - one without so you can modify around a particular client group/case. Reference as "Occupational Performance Model, Adapted from Fearing, Law & Clark (1997), p11, metaot.com" or something similar! Watch this space for a "Will's Bluffer's Guide to Model's" coming to a web-browser near you soon

As I sit and watch the cricket, and our possible win(?) Im posting a story that may really kick the Aussies in when they are down.

An article issued in the Public Agenda supplement of the Times titled "Councils caught out by visa law" discusses the work shortage that local councils may soon, if not already, be finding themselves having. The problem is that since February, Vias Laws that apply to Australia as well as all Commonwealth countries (e.g. New Zealand & S.Africa) have changed - from allowing people to have a working holiday from 2 years to 1 year. Local councils are reporting real problems in hiring & keeping essential staff. As a member of the public my first thought is "are there really no local people able to work in local government?" but then I start to wonder - what the heck is going to happen to the NHS?

I have failed to find any statistics as to how many Commonwealth workers are currently being hired by the NHS but from anecdotal reports and my own observations it's pretty high. I wouldn't be to surprised if its as large as 20% in London. Locum work is an already massive cost to the NHS - with a reduction of "working holidaymakers" what are the predicted costs to the NHS?

Of course, every other Aussie or South African I come across seems to be either married to a Brit or has a dual-passport already so it may not matter a jot. So never mind.. perhaps the aussies will have the last laugh after all :)