July 30, 2012

Dogged Determination


When Rebecca Phillips, OTR, CHT, first read Jacob "Jake" Tinney’s resume, the administrative director of pediatric rehabilitation services for Martin Health System in Stuart, Fla., thought Tinney’s experience and education seemed a little unusual. When she reached the section marked "rufferences," she realized she was reading the credentials of a weimaraner.


The dog’s owner, Donna Tinney, a physical therapist assistant with Martin Health, used the clever gimmick to broach the subject of starting pet-assisted therapy. She had already worked with Jake on the requisite obedience training and certification through Therapy Dogs Inc. The next step was building support among MHS administration and staff.


Three years later, Tinney’s idea became a reality. She and Phillips ironed out policies and procedures, marketed the program within the facility, and garnered funding from the Jensen Beach, Fla., Women in Philanthropy.


"The hospital has many things to be concerned about: risk management regarding infection control; the way the animal is taken care of before and after any interaction with children; all the hoops and loops we had to go through; all the different precautions, just to make sure the parents were in agreement, [that] the physician recommended it, [and] that the child was not allergic to [the] dog — there are just many details," Phillips said. 


During 5-year-old Jake’s first 10 months, he logged about 120 visits at MHS, or about 12 per month. Preliminary satisfaction surveys — and smiles on patients’ faces — indicated the program has been a huge success. "The [surveys] are coming back very favorably," Phillips said.

What’s a dog to do?
Jake works with pediatric patients with a variety of diagnoses, but he primarily sees children with cerebral palsy, since they make up the majority of the department’s patients. During sessions, a child might be working with a PT, an OT, or a speech therapist, as well as with Jake and Tinney. "Jake is used as a motivator to have the child try to follow him," Phillips said. "So he’s used for ambulation training, for encouragement for the child to participate a little longer, a little bit further or a little bit harder. Also [for] trying to reach for him with their extremities that may be limited in the range of motion. [And] coordination activities — they often dress the dog [and] brush the dog." 


Tinney said: "It was easier as a physical therapist assistant to think of things that Jacob could do with PT. But then I started getting some good ideas for OT with the therapist. Both of us together. That grew." 


The program in speech is starting to blossom as well. "I’ll work with [Jake] on the days that he’s not here to teach him little tricks that I think the kids would enjoy seeing," Tinney said. Children who are rarely verbal often speak when Jake is around.


"Jake is really used as a tool, a modality to encourage the therapeutic exercise," Phillips said. That is why insurance is not billed for pet therapy, but for activities of daily living, or gait training, or whatever the overarching therapeutic activity is that the therapist is working on with the child. Tinney’s salary for the time she spends in the clinic with Jake is paid for through the philanthropic donation.


"We happen to have the magic formula," Phillips said. "The pet owner [Tinney] is also a clinician, a therapist. We have a double benefit."


Other programs have volunteer teams of owners and pets, keeping costs down for running an animal-assisted therapy program, said Bill Kueser, vice president of marketing for Pet Partners (formerly Delta Society), one of three national organizations that registers therapy animals.


Pet Partners has registered over 11,000 pets nationwide. Their training program, Kueser said, focuses on the human end of the leash. "We actually train people," he said. "Our therapy animal program trains people to visit with their pets in specialized environments."


This includes basic obedience, as well the team’s response to typical situations in therapeutic environments. "How does the team react to loud and unexpected noises?" Kueser said. "Would the animal in the team react to medical equipment? Walkers, wheelchairs — can they maneuver around them? Is the animal stressed by them?" 


He recommended that facilities interested in starting an animal-assisted therapy program research information at one of the three registering organizations. "We provide an 'Introducing a Visiting Animal Program’ kit that has the basis for policies and procedures," he said.


Pet Partners also provides liability insurance for therapy animal teams provided the handlers are volunteers and that the animal is on a leash at all times. Since animals might be off leash in a rehabilitation environment, facilities would need to get their own liability coverage.


Those benefits and concerns of pet therapy programs were the focus of a seminar that occupational therapy student Abigail McNair presented in March at Towson (Md.) University entitled "Animal-assisted Therapy within the Scope of Occupational and Physical Therapy." 


The event touched on topics such as managing risks and liabilities, as well as basic research supporting the practice. "One of the great things that you first notice about animal-assisted therapy has to do with motivation," McNair said. "All of a sudden your client or your patient is interested in what they’re going to be doing because they are no longer just moving laundry or walking down the hallway. There is this nice, furry dog next to them wagging its tail." 


In addition to being a powerful adjunct to therapeutic activities to improve physical deficits in such areas as strength, endurance and coordination, animal-assisted therapy can have psychological benefits as well. "A lot of times it reduces blood pressure; heart rate levels come down; people are a lot more relaxed," McNair said. "It’s a treatment that can be simple, but it’s got complex benefits."

(Source: news.todayinot.com)

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