Animal-Assisted Therapy for Social Anxiety Disorder

Top Reasons to Take Part in AAT for SAD

Animals are sometimes part of therapy for mental illness.
Animals can help in therapy for social anxiety disorder.. Getty / Tom Ervin

Animal-assisted therapy (AAT) is sometimes used in the treatment of social anxiety disorder (SAD). Animals may be uniquely suited to help individuals with SAD, as they offer nonjudgmental support and a chance to learn about interactions with others. 

History of AAT

AAT dates back to the 1940s, when an army corporal brought his Yorkshire Terrier to a hospital to cheer up wounded soldiers. It began in earnest in the early 1990s; however, it is still a relatively new field.

AAT uses trained animals to enhance the physical, emotional, and social well-being of clients.

What Is AAT?

AAT is defined by the American Humane Association as "a goal-directed intervention in which an animal is incorporated as an integral part of the clinical health-care treatment process. AAT is delivered or directed by a professional health or human service provider who demonstrates skill and expertise regarding the clinical applications of human-animal interaction." 

How Animals Are Used in Therapy for SAD

Animal-assisted therapy does not follow one specific mode of treatment. For example, animals are included in everything from cognitive-behavioral therapy (CBT) to psychodynamic treatment. The animal is there to assist in the therapeutic process, not to drive the process of therapy. 

Animals used in therapy can be of all different types. Dogs and horses are the ones most people think of when they picture therapy animals, but even more exotic animals can serve in the therapy process.

What role do animals play in therapy? There are several specific aspects of therapy for SAD that animals can help with:

  • Animals can help you improve your self-esteem, develop social skills, and reduce symptoms of anxiety.
  • In group therapy for SAD, animals may help to increase interactions between group members. Indeed, it is easy to imagine that a socially anxious group accompanied by a cute furry friend would be more likely to open up and talk to one another.
  • In one-on-one therapy, an animal may help you to feel safer  and build rapport with your therapist. 
  • Animals such as horses and dogs pick up on cues in social relationships. Your therapist can use these reactions to guide therapy sessions. For example, your therapist may show you how your behavior (friendly or standoffish) will affect how the animal responds to you. This is a simple way to see how your behavior affects those around you.
  • Research has also demonstrated that animals have a calming effect, reducing blood pressure and anxiety. Having an animal in your therapy sessions will help you to feel relaxed.
  • Animals in therapy provide the opportunity to give affection and to receive it. This may be particularly helpful for children and teenagers struggling to find connections among family or peers.
  • Animals in therapy may help to reduce depression and isolation. Among children, they may help in social expression. 

  • Finally, having an animal in your therapy sessions means that the focus is not all on you—something that those with SAD may find overwhelming in the early stages.

    Where Do Therapy Animals Work?

    Animals used in therapy may work in any of the following settings:

    • nursing homes
    • hospitals
    • schools
    • libraries
    • correctional facilities
    • rehabilitation centers

    Difference Between Therapy Animals and Psychiatric Service Animals for SAD

    Animals who assist with therapy are not the same as psychiatric service animals. Service animals live with individuals with psychological disorders and other disabilities to help them with activities of daily living, such as remembering to take medication or learning to identify the signs of an impending anxiety attack. Service animals fall under the protection of the American Disabilities Act (ADA) in this regard.

    Evidence Supporting Animal-Assisted Therapy

    There is a plethora of anecdotal information and case studies in support of animal-assisted therapy, but not much long-term controlled research has been conducted.

    A 1998 study published in the journal "Psychiatric Services" examined whether a single session of animal-assisted therapy reduced anxiety levels in 230 hospitalized psychiatric patients and whether these were related to their diagnoses. The results of the study showed that animal-assisted therapy was associated with reduced anxiety in hospitalized patients with a variety of psychiatric diagnoses.

    A 2007 meta-analysis of 49 studies found AAT to be associated with moderate effect sizes in improvements in four areas: autism-spectrum symptoms, medical problems, behavioral problems, and emotional well-being. Surprisingly, aspects of the participants and studies did not show different outcomes.

    Overall, the research on AAT shows that it has promise when used alongside traditional treatments for some problems that may be related to SAD, such as anxiety and emotional well-being. However, more rigorous controlled studies are needed to determine the best methods for applying AAT for maximum benefit.

    How Does AAT Improve on Traditional Therapy for SAD?

    The use of animals during therapy for SAD may offer several advantages:

    • Increased oxytocin levels leading to lowered blood pressure and heart rate. Oxytocin is a social hormone that is positively affected by human-animal interactions.
    • Children and teenagers can touch the animals—something that they may be missing in their lives—whereas touch during traditional therapy would be inappropriate. 
    • Animals are nonjudgmental. They don't know your history or situation or details that others can sometimes judge you for, like being out of work or single. They accept you for who you are, flaws and all. They are forgiving and happy to see you and are consistently happy. While therapists can hope to achieve the ideal of neutrality, animals are naturals at it.
    • For children with selective mutism, a condition in which a child fails to speak in one or more situations because of severe anxiety, animals can make therapy less threatening and help them to stay in treatment longer.

    Who Should Not Receive AAT

    For most people with SAD, there should be no reason that AAT would not be suitable. However, if any of the following applies in your situation, then AAT may not be advisable.

    • You have a strong fear of animals. You will need to work through this fear first, and even then AAT may not be helpful for you.
    • You are allergic to certain types of animals (others may still be suitable—even dolphins do AAT!)
    • You have reduced immunity due to HIV/AIDS, chemotherapy or radiation for cancer, or any immune-suppressive medications. Contact your doctor if any of these situations applies.

    How Are AAT Practitioners Governed?

    There is currently no governing body that oversees AAT. However, organizations such as Pet Partners offer training of both animals and therapists.

    Dogs registered with Therapy Dogs International must have yearly screenings by a veterinarian in order to participate in AAT. 

    In general, animals participating in AAT should be up-to-date on vaccinations and in good health.

    Training in Animal-Assisted Therapy

    Are you a counsellor, therapist, or social worker interested in becoming trained in animal-assisted therapy? The University of North Texas offers training in AAT, including a distance education course.

    AAT Example

    What better way to illustrate how AAT works than with an excerpt from a case study? In this short excerpt republished from an article, licensed social worker Stephen Quinlan describes what it was like to use AAT with a child with selective mutism. 

    We made use of a tennis ball that I have in my office, and had Layla first “sit” then “wait” while Charlie threw the ball. I then released Layla with an “OK.” She charged after the ball and returned it and I told her to “drop.” Charlie watched all of my doing this and then pointed to himself. I asked him if he would like to try. He nodded. To this point in treatment, Charlie had not uttered a single word to anyone. He was able to laugh and make sounds, but completely unable to speak. “Si-t” was the first word that Charlie sounded out in a choppy fashion. “Wuh-ait,” he continued, “OO-KUH!” he bellowed loudly. Layla again charged after the ball and Charlie screamed with delight. “Duh-Ruh-op,” said Charlie upon Layla’s return."

    In summarizing his experience, Quinlan notes that "Layla had both set the bar for Charlie’s being verbal in session and given him a comfortable place to go back to when his anxiety was particularly high."

    Where to Find Animal-Assisted Therapy

    There are several options to try and find an AAT therapist in your area. Note that you may need to travel to the site where the animals work rather than having the animal come to you.


    Barker SB, Dawson KS. The effects of animal-assisted therapy on anxiety ratings of hospitalized psychiatric patients. Psychiatr Serv. 1998;49(6):797-801. doi:10.1176/ps.49.6.797.

    Dr. Weil’s Wellness Therapies. Animal Assisted Therapy. Accessed May 29, 2016.

    Ontario Centre of Excellence for Child and Youth Mental Health. Evidence in-sight: Animal-assisted therapy. Accessed May 29, 2016.

    Quinlan S. Animal Assisted therapy: Therapeutic interventions in working with children who have a diagnosis of selective mutism and autism spectrum disorder. Accessed May 29, 2016.

    Nimer J, Lundahl B. Animal-assisted therapy: A meta-analysis. Anthrozoos: A Multidisciplinary Journal of the Interactions of People & Animals. 2007;20(3):225-238.

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