Counselling With a Therapy Animal
Patricia Nitkin, PhD, CCC, is a clinical professor and the Clinic Director of the SFU Surrey Counselling Centre in the Master’s program in counselling psychology at Simon Fraser University in British Columbia, Canada. She also runs a part-time private practice offering individual and group work with her therapy dog assistant George. Patricia offers relational and existential-humanistic therapies with the adjunctive approaches of Mindful Self Compassion, animal-assisted therapy and music therapy.
I named my companion-animal George Harrison after my favourite Beatle, because George is a remarkably present, peaceful, loving and deep rescuedog. He accompanies me in my psychotherapy practice where I work with individuals, couples and families struggling with relational challenges, grief, trauma and/or mental-health issues. As many dogs do, George reads each person who enters the office and responds uniquely to the way they are in that moment. It marks the beginning of what will hopefully be a healing experience.
Early in my life and career, it became clear to me that companion-animals often provide extraordinary support to the humans in their world. I worked in palliative care and psychosocial-oncology, witnessing firsthand how patients, family members and staff relied on their companion-animals, speaking of them in profoundly grateful and loving ways. Many of them longed to be near their animal-companions and suffered when building or organizational regulations prohibited this. I experienced this myself through multiple painful losses. So after 20 years, I decided to pursue my Ph.D. in counselling psychology' and study the human-animal bond (Nitkin & Buchanan, 2020).
In 2012 with the backing of research and some additional training, George joined me in his first session with a client who requested his presence. That was eight years ago, and George has been a partner in my counselling practice ever since. On a typical day George lays on the floor by the feet of the client or on the couch beside them during the session. He is on the couch strictly by the client’s invitation and jumps down when either of them wishes. Some clients lay their heads on him as they weep. Others pet him rhythmically as they disclose painful life experiences, or they laugh when he yawns or snores. George gazes at them lovingly, at other times looks away knowingly, often falling asleep on their lap or by their feet. It is moving to witness, and clients share that his presence significantly contributes to a safe and healing environment.
George’s interactions with clients offer relational exchanges that can be profoundly therapeutic and healing. However, incorporating George into my practice has required serious ethical and clinical consideration. Bringing another sentient being into the counselling experience is complex. What follows are some of the considerations I believe are critical to including a therapy animal (TA) in clinical counselling.
Clinical and Ethical Considerations
- • It is essential that any TA be professionally trained for the work, and unfortunately, this training remains limited in availability. While we may adore them, our companion-animals may be unwelcome or dangerous to some. All clients must be informed of and given the choice ahead of time to have a TA’s presence in session. As such, you may need additional space in your office where your TA can be comfortable and safe during sessions where they are not of benefit.
- • It is essential that you include your TA in any and all legal and ethical considerations of your practice including professional liability insurance, client consent forms, rental contracts and building permits. Many office buildings only permit service-animals. If you share an office with other practitioners, they and their clients must be informed in case of allergies, fears or phobias.
- • Psychotherapy is challenging work. Endeavouring to assist another person who is suffering and seeking your help requires skill, depth and full presence. With a TA, you now have another creature for which you are responsible. Will this distract you from your focus on the client?
- • Counselling is emotionally charged and energetically dynamic. Its important to ensure that your TA is comfortable physically and emotionally during sessions. Are they overburdened by the energetic exchanges? I take George out for air after every second session and a run in an open space after each workday. Water, treats and food must be readily available, and the temperature in the room must consider their comfort as well as your clients’ and your own.
- • You likely love your TA and will watch for the way your clients treat them. What would you do if they held the animal so tightly that they yelped? How might this impact the therapeutic alliance? And how would you deal with your TA if they became frightened, upset or needy during a client session?
- • As George gets older, both my clients and I are aware he won’t live forever. Another impending loss can cause additional emotional suffering for a client, in particular those struggling to cope with grief.
- • There is also the matter of touch. The majority of my clients welcome George s warm physical proximity. Your TA may want to be touched and given attention by clients; this can be rich therapeutic work, however, it may also be unsettling or too much of a focus in session. Additionally, clients who have experienced unwanted touch or sexual assault may experience a TA’s bids for touch as unsafe.
- • Finally, George and I became a popular duo for clients with dog phobias as well as those experiencing pet bereavement. As such I pursued further training in exposure therapy as well as companion-animal grief. Be prepared to expand your training to serve new presenting issues and needs in an ethical and clinically sound manner.
These are a few of the considerations I urge mental-health professionals to contemplate. I do so with the knowledge that the benefits of Georges presence far outweigh any challenges I have faced. The richness of working with people who are struggling is an honour, and George s presence is a gift. Having a TA as a counselling-assistant, however, involves real emotional, legal and physical risks as well as a myriad of benefits and relational magic.
*Therapy animal: Currently the field of animal-assisted therapy is rapidly evolving and there is little to no standardization regarding the definition or certification of a therapy animal. I use this term with a descriptive stance.
Nitkin, P., & Buchanan, M. (2020). Relationships between people with cancer and their companion animals: What helps and hinders. Anthrozoos, 35(2), 243-259. https://doi. org/10.1080/08927936.2020.1719764