I had always known she has a lot of soul and wisdom, but it still amazed me. Emma was incredibly gentle - gently resting her head on knees and gazing up at faces. She is a dark yellow Labrador Retriever with deep brown eyes emphasized with smoky black eyerims. A couple of the patients who were able to communicate well mentioned how beautiful those eyes were. She gave gentle little licks to hands (and if faces were extended down - to chins and cheeks as well). She sat by knees and smiled up at the patients while they stroked her head, neck, and chest. Her tail was moving, but in a gentle wag, not her usual "caution: beware of tail" blur! And of course she did her repertoire of tricks - surefire crowd pleasers. I was just so proud of my girl. I feel blessed to have her in my life. Don't think she is always so well behaved though - she later stole something from the garbage at home!

The visit described above took place at a facility that specializes in the care of people who have different types of dementia (Alzheimer's, stroke, etc.). It was our first trip to this particular facility and Emma was her usual loving self. We are members of PPATT (Peninsula Pet Assisted Therapy Team), in the San Francisco bay area, and are certified under two national therapy organizations: Therapy Dogs Incorporated (TDInc.), and Delta Society. Emma and I have been making visits for over 2 years now, and we usually visit a hospital subacute care ward, or a nursing home. Members of PPATT are well-known for their contributions to the surrounding hospitals and nursing homes. Emma and I are relative newcomers in this circle of veterans. One member has founded a service dog and therapy visit program at the Sacramento Shriner's Hospital For Children. Several members are evaluators for both TDInc. and Delta, and keep abreast of new research by attending the latest conferences about this magical connection between people and animals.

What is animal-assisted therapy?

This activity has formally been with us in America since at least 1919 (as part of a mental health program at St. Elizabeth's Hospital in Wash., D.C.), and uses animals (dogs, horses, cats, birds, etc.) to facilitate healing (physical or emotional), education, and offer simple but essential companionship. The environment can range from medical (hospitals, nursing homes, developmental disability and rehabilitation facilities, and hospices) to schools, shelters, fostercare, prisons, and even courtrooms. The impact of nature (through animals) on us when we are under stress has been documented both by the measurable (such as a decrease in high heartrate and blood pressure) and by the qualitative (a "million dollar" smile from the patient). (Note: the "meet and greet" activity that Emma and I do is sometimes referred to as an Animal-Assisted Activity (AAA), while ongoing therapy (with specific goals, and under the supervison/direction of a therapist) with the same patient is Animal-Assisted Therapy (AAT). However, AAT is commonly used to refer to both of these activities.

In a nutshell, the visits I make usually consist of: arriving at a facility, checking in with our contact (a facility employee), obtaining any critical information such as which patients would like visits, and if there are any special requests. We then may split into small groups and begin our visits. Upon reaching the room, we doublecheck to make sure the patient does want a visit and that there are no medical restrictions. Each step of the visit is guided first by your dog's safety (and yours), AND the patient's wishes.

The patient may want to only talk and look at your dog, but not be approached by the dog. Or the patient may enjoy having the dog as close as possible - maybe with front paws on the bed. The patient has the right to make decisions such as these. The visit may range from simple stroking of the dog to the exhibition of those tricks you've been working so hard on! The magic of the stroke of a patient's hand on the soft warm hair of a dog and the response of the dog to that stroke is much greater than the sum of the parts.

We usually finish our series of patients' visits within an hour. Too much can be stressful for the dogs. Each dog has its own signs of stress - yawning, a change in body posture, response to distractions, etc. Visits at a nursing home are similar, but may differ in that patients can be gathered in one large room to visit with the dogs.

How does this sound to you? Difficult? Enjoyable? Stressful? Depressing? Uplifting? Rewarding? It can probably be all these things for different people in different environments. There is a great diversity of types of facilities in which you can practice AAT.

It hasn't been depressing for me, although very sad when a patient died after I'd gotten to know him. I will always remember him. He was in a hospital sub-acute ward with multiple problems, and mainly confined to bedrest. He always had a smile for us and the dogs, and always kept a bag of candies by his bed to give to us. Imagine, he went to that trouble for us!!! There wasn't much room for Emma because of the bedrails, monitors, and other equipment. She would put her head through the rail so as to be next to his hand. He was very weak but was able to stroke Emma's head. That soft warm head must have felt wonderful. We chatted about Emma mostly - her virtues and mischievous exploits. It was difficult for me when I came for a visit, and was told that he had died. But I wouldn't have wanted to miss getting to know him.

A visit seems so in the present, in the now. It is about that spark or bond that ignites when we come into the room. Then it is on to the next room - it all seems to go so fast.

I really appreciate the emphasis the therapy programs put on observing and caring for your dog. You are there for the patients, but your dog comes first. We are constantly observing our dogs for signs of stress or physical jeopardy.

In order to maximize the rewarding aspects of AAT, I think it is important to affiliate yourself with a responsible national organization with a stringent evaluation process. The evaluation process is designed to show if you and your dog (acting as a team) are ready for this activity. If not, maybe you need a little time and training before testing again. This will prepare you and your dog to feel confident and enjoy the visits. An extremely important reason to join such an organization is that you are safeguarding the practice of AAT for hopefully many generations to come. Your competency and your dog's appropriate behavior are critical to ensure that new and current facilities will keep their doors open to us. A third benefit to be gained from a recognized organization is liability insurance in case anything unforeseen should go wrong. There is an evaluation test cost, as well as an annual membership cost. The membership cost can range from $15.00 to $25.00 a year depending on the specific organization.

Sound like something you'd like to do?

Step One: Find Your Niche

Find a local group already certified by a national organization, or conversely contact a national organization to find the closest local group or evaluator. In addition to the internet, you might find a local group by asking at your local breed club, dog training club, hospital or nursing home, or veterinarian. I found my evaluator, Lyn Belingheri, by asking one of my dog's breeders, Diana Pintel of Mistypoint Labradors (both are GGLRC members).

Step Two: The Evaluation

Your dog must be a minimum of one year of age to be evaluated. Emma was put through three types of evaluations: health (vaccinations, veterinarian visit for overall health and temperament), obedience (the dog must be well-behaved, walk calmly on leash and respond to commands), and temperament (this was more intensive than a CGC test - the dog is purposely slightly stressed physically and emotionally. Reactions to crowding, a neutral dog, angry yelling, a staggering moaning person, etc., were all assessed.) The temperament test is very important, and is used to try to predict the dog's reaction to a unforeseen accident in the hospital. Suppose the patient's children all squeal and rush the dog? What if the patient yells in anger? Suppose a metal tray or bedpan falls, hits the ground with a resounding bang and then catches your dog's tail tip on the rebound? Will your dog respond with a growl, a howl, or a nip? On the other hand, a happy unflappable dog might do excellently on the temperament test, but have to be restrained from jumping on every bed he sees (and every person). Another critical assessment that is made concerns your dog's reaction to meeting new people. Is this an activity your dog will enjoy? A patient may feel rejected by a dog that would prefer to stay next to his owner. Another important question: is this an activity that you and your dog would enjoy as a team? The word "team" is the essential component to AAT. Handler and animal companion both have to enjoy the activity to be successful and find fulfillment in AAT visits.

Step Three: Monitored Visits

Next, Emma and I went on three "observation" visits with our evaluator for the purpose of determining if we were ready and comfortable to make visits. The observation is designed to detect any areas that need improvement, and to increase our comfort level. We were then free to continue to visit with one of the various groups (to any of the facilities) or to work on our own. I prefer group visits mainly because of the support and camaraderie I receive from the group. I usually go with a group of four to ten other owners and their dogs.

Our Labradors are natural "therapy dogs" with their highly social unflappable temperaments. However, there is a great variety of breeds in our PPATT group: mixed-breeds, German Shepherds, Dalmations, Shitzus, Shetland Sheepdogs, Golden Retrievers, even a rare Leonberger. Small dogs can offer a special advantage to the patient. These dogs can snuggle on beds or laps without causing any discomfort to the patient. A 70 lb Lab might cause quite a different scene!

The richness of the personalities and gifts of the therapy teams, and the diversity of the patient environments in which the "therapy" takes place, are pretty magical to me. I hope that some of you may also enjoy this activity.

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