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Article 76

Cultural Diversity Considerations in Animal Assisted Counseling

Hallie E. Sheade & Cynthia K. Chandler

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Paper based on a presentation at the 2012 Texas Counseling Association Conference, November 16, Galveston, TX.

Animal assisted counseling (AAC) is the incorporation of qualified therapy animals into the counseling process under the guidance of a professional counselor. AAC is a modality that strengthens the therapeutic alliance by facilitating the therapeutic relationship, enhancing the experience of a safe and comfortable atmosphere, and creating additional opportunities for therapeutic gains (Chandler, 2012). Such counselor-facilitated client-animal interactions provide an opportunity for increased self and other awareness as clients examine and practice attitudes and behaviors that facilitate positive social relationships—first with the therapy animal, then with the counselor, and finally with others in their lives.

It has been demonstrated that the therapeutic relationship contributes 30% to the likelihood of a positive psychotherapy outcome (Asay & Lambert, 1999; Lambert & Ogles, 2004). Thus, any element that may enhance the therapeutic relationship increases the chances for therapeutic progress. Interactions with therapy animals, such as petting and holding a dog and stroking and hugging a horse, contribute to the formation and strengthening of a therapeutic relationship; the client feels more accepted and engaged by the nurturing social interactions (Chandler, 2012). Therapy animals offer social support and act as a buffer to stress, thus decreasing clients’ anxiety and facilitating the relationship with human counselor and client (Fine & Beck, 2010; Odendaal & Meintjes, 2003). Clients reported feeling safer and calmer when a therapy animal was part of the counseling process, thereby enhancing the therapeutic atmosphere (Lange, Cox, Bernert, & Jenkins, 2007). Therapeutic relationship-building effects of AAC have been measured physiologically – positive, social interaction with a therapy animal, such as holding and petting a dog, stimulates the release of calming, wellness-enhancing, and social-bonding hormones while diminishing levels of stress and anxiety invoking hormones (Cole, Gawlinkski, Steers, & Kotlerman, 2007; Odendaal, 2000).

As in counseling, AAC is about relationship-building and an extension of social connectedness. And just as cultural differences between counselor and client may influence the therapeutic relationship, cultural differences regarding attitudes about animals and interaction with animals may influence the therapeutic relationship and thus, the course of therapy. Following is a presentation of multicultural and diversity considerations for AAC. Sensitivity to cultural differences regarding applications of AAC may increase the comfort and safety of clients and their trust in the counselor and the counseling process.

Multicultural Sensitivity

Animal assisted counseling and therapy has been utilized across a wide variety of ages, genders, and cultures (Chandler, 2012). It is important that practitioners explore multicultural and diversity considerations as culture can greatly influence health and effectiveness of treatments (Haubenhofer & Kirchengast, 2006). People may differ greatly in their perceptions, beliefs, and attitudes towards animals across racial groups, geographical regions, genders, socioeconomic status groups, and levels of education. Whereas some clients may see certain animals as pets, others may view them merely as sources of food or work resources (Thigpen, Ellis, & Smith, 2005). It is also important to consider individual clients’ past experiences with animals. Clients that have had previous experience with animals and are more attached to their companion animals may feel more comfortable working with a therapy animal. In contrast, clients who have had negative experiences with animals may experience anxiety and fear in working with a therapy animal (Matuszek, 2010).

Within the United States, animals hold a very special, positive place, for many people. In the U.S., animals often play a wide variety of roles including loved one, savior, threat, tool, or object of wonder, and are often assigned people-like characteristics (Herzog & Galvin, 1992). By emphasizing a therapy animal’s role as a loving being with nurturing capacity, counselors can facilitate the development of a powerful therapeutic relationship between client and therapy animal that also generalizes to the human therapist. Haubenhofer and Kirchengast (2006) urged practitioners to tailor animal assisted interventions to be specific to the needs of unique cultural groups. Very little has been written to address culturally-sensitive application of AAC. This paper addresses that void.

Race and Ethnicity

Attitudes toward animals can vary greatly by race and ethnicity. Additionally, attitudes toward animals can vary greatly within a particular race or ethnicity. A counselor must consider an individual’s comfort or discomfort with particular animal species before proceeding with therapy that incorporates the work of a qualified therapy animal.

Caucasian. Caucasians in general are more likely to have and value companion animals than most other cultural groups, considering them to be sources of emotional support, unconditional love, and viewing these animals as family members (Risley- Curtiss, Holley, & Wolf, 2006). Thus, Caucasians may be more likely to be accepting of AAC and to feel most comfortable with companion animal interaction. However, counselors must not erroneously assume that all Caucasians feel comfortable with companion animals. Some persons may have had little contact with certain species of companion animals or may have had a negative experience with a particular type of companion animal.

Asian. Some researchers have reported success utilizing animal assisted interventions with Asian populations. Yeh (2008) found that incorporating dogs into work with children with autism facilitated the development of social skills in Taiwan. Furthermore, in their investigation on Japanese patients with schizophrenia, Iwahashi, Waga, and Ohta (2007) found most patients wanted contact with animals and they liked animals with their favorite ones being dogs and cats.

Animals hold a powerful symbolic place in some Asian cultures, such as the Chinese emphasis on the animal associated with one’s birth year. But a symbolic reverence for animals does not always translate into personal comfort with a companion animal. Risley-Curtiss, Holley, and Wolf (2006) found Asian people to be the least likely to have companion animals. Many Asian persons may consider dogs and other animals to be unclean or a nuisance, thus providing a potential barrier to an Asian client’s ability to form a relationship with a therapy animal (Matuszek, 2010). Koreans may see some animals, such as dogs, as a source of food and not appropriate for working in a professional role (Chandler, 2012). Some clients may fear dogs having only experienced them as aggressive guard dogs (Chandler, 2012). Even in contemporary, modern Asian cultures, such as in Hong Kong and South Korea, many people do not have pets because historically animals were not kept as pets and because of a lack of space and finances to adequately care for pets (Chandler, 2012). Although AAC may potentially provide many benefits for Asian clients, counselors must consider an individual’s possible discomfort with animals or prior negative beliefs or experiences that may hinder the client’s ability to benefit from AAC.

Latino. Individuals in the Latino population are more likely to have companion animals than other minority groups, but are still less likely than Caucasians (Risley- Curtiss, Holley, & Wolf, 2006). However, members of this cultural group do tend to see their animals similarly to Caucasian clients in their view of them as sources of support and companionship, and as members of the family (Faver & Cavazos, 2008; Johnson & Meadows, 2002; Schoenfeld-Tacher, Kogan, & Wright, 2010). Members of the Latino culture form strong human-animal bonds and place a higher degree of emphasis on the animal’s ability to provide a sense of safety than Caucasian clients (Risley-Curtiss, Holley, & Wolf, 2006; Shoenfeld-Tacher, et al., 2010). Latino clients are much more likely to have dogs than other animals (Risley-Curtiss, Holley, & Wolf, 2006). Clients who have immigrated from Central and South America may see animals, especially dogs, differently than Latino clients who have lived in the United States or Europe (Best Friends Animal Society, n.d.). Central and South American clients are often not used to having private companion animals but may have formed relationships with free-roaming community dogs in the village. These animals were valued as pest control and working animals, who were often fed by many, but belonged to no one (Richard, 2004). In Peru, dogs may serve a more utilitarian purpose as herding and work animals (Walsh, 2009). Depending upon a client’s environment, some Latino clients may dislike and even fear dogs. Poss and Bader (2007) found that most residents of colonias saw the free-roaming dogs as a problem and feared going outside. Latino residents born in the U.S., as opposed to Mexico, reported less fear of dogs.

It is important for counselors to consider the unique context of one’s Latino client in determining the appropriateness of AAC. In a study on interpersonal violence, Schultz, Remick-Barlow, and Robbins (2007) found that in a mixed sample of Hispanic and Caucasian children, both groups received therapeutic benefits following animal assisted psychotherapy, indicating that members of this population can equally benefit from animal assisted interventions. Risley-Curtiss, Holley, and Wolf (2006) recommended specifically working with dogs as co-therapists with Latino clients.

Middle Eastern. Regarding Middle Eastern clients, the authors found very little literature regarding AAC with this population. Chandler (2012) indicated that some people from the Middle East fear dogs since free-roaming, wild dogs may be common in certain areas. Other Middle Eastern clients may view dogs and other animals as unclean or a nuisance, thus impeding their ability to be therapeutic (Matuszek, 2010). In contrast, other Middle Eastern clients may benefit from working with animals in therapy. In her study on animal assisted play therapy, Parish-Plass (2008) incorporated a variety of animals into her practice with Israeli children who suffered from attachment issues and intergenerational abuse and neglect. Parish-Plass found that through interactions with the animals, the children showed improvement and positive outcomes through therapy.

Native Americans, First Nations, and Indigenous Peoples. Native Americans, First Nations, and indigenous peoples may have some of the strongest human-animal relationships and are more likely to have companion animals than other ethnic groups (Risley-Curtiss, Holley, & Wolf, 2006; Robinson, 1999). These groups often focus on the equality and interdependence of all creatures and see opportunities for health and healing through relationships with animals (Kesner & Pritzker, 2008). Dell, Chalmers, Dell, Sauve, and MacKinnon (2008) created a culturally-sensitive model for building resiliency in First Nations youth struggling with solvent abuse by adding an equine-assisted learning component based on the horse’s profound sacredness to this tribe and the belief that the horse will lead one in the right direction.

Although incorporating animals into counseling can be very effective for Native American clients, practitioners must remember that each tribe has its own customs and traditions associated with animals and the human-animal relationship (Best Friends Animal Society, n.d.; Risley-Curtiss, Holley, Cruickshank, et al., 2006). On some Native American reservations, individuals do not own dogs and cats, but rather prefer to allow these animals to roam freely; personal pet ownership of dogs and cats is more common among Native Americans that live off of a reservation (Munro, 2004).

African American. There is scarce information regarding the African American population and the human-animal relationship. In comparing Caucasian and African American veterinary students, Brown (2002) found several differences between the two groups. Brown found African American students to hold more utilitarian and negative views towards animals and demonstrate less attachment to their companion animals than Caucasian students. Brown offered several hypotheses for this phenomenon, such as differences in values, socioeconomic status, and cultural norms.

In considering these differences, it is especially important for a counselor to thoroughly explore an African American client’s perceptions of and prior experiences with animals before introducing a therapy animal as these clients may be less receptive towards forming a therapeutic relationship with an animal. However, Brown (2002) reported that African American students acknowledged the health benefits of having a companion animal. Researchers have reported benefits such as feelings of acceptance and loyalty by animals in AAC with African American children (Greenwald, 2000; Mallon, 1994).

Religious Diversity

Many spiritual traditions honor the human-animal relationship; for example, various scriptures in Judaism, Christianity, and Islam indicate that the life of animals is valuable to God, not for food, but for instruction, joy, and companionship (Walsh, 2009). In addition, these scriptures have teachings to honor animals for their ability to teach humans about the world and God (Kesner & Pritzker, 2008; Skeen, 2011). Christian practitioners have incorporated equine-assisted interventions into Christian and Biblical counseling, using the human-horse relationship as a metaphor for the client’s struggles and belief system (Christian, 2005). Eastern religions, such as Hinduism and Buddhism, often emphasize the interdependence of all species. Hindu teachings encourage interaction with the universe in order to stay balanced (Kesner & Pritzker, 2008). However, interactions with animals may not always be welcomed in counseling. Despite Islamic teachings to honor and be kind to animals, followers of Islam may also consider dogs to be unclean and refrain from interacting with or keeping dogs as pets (Chandler, 2012). Certain Christian beliefs may place humans on a higher moral plane than animals in which animals do not have souls or go to heaven (Lawrence, 1995). Clients who hold these beliefs may have little faith in an animal’s ability to be therapeutic, and thus experience more difficulty in forming a relationship with an animal co-therapist.

Socioeconomic Class

Few researchers have attended to socioeconomic diversity in AAC. Historically, possession of animals often indicated high social status (Blazina, Boyraz, & Shen-Miller, 2011). In Asian countries, the wealthy often owned purebred dogs, and in Europe, lap dogs were seen as a status symbol (Walsh, 2009). Horses historically have been, and continue to be, a symbol of the wealthy (Robinson, 1999). There is a continuous trend for members of higher socioeconomic classes to be much more likely to report having companion animals (Pew Research Center, 2006). This phenomenon may be partly explained by Risley-Curtiss, Holley, and Wolf’s (2006) observation that people who live in a more stressful environment may be less inclined to have companion animals as caring for animals may result in added stress. As clients of lower socioeconomic classes may have had less exposure to and positive interactions with animals, these clients may be fearful or uncomfortable with a therapy animal. This fear may be especially pronounced for clients living in low income communities where the police may utilize dogs to intimidate or apprehend the residents (Walsh, 2009). In contrast, clients in higher socioeconomic classes may welcome an animal as part of the counseling process. As a prominent populace, middle-class cultural beliefs and attitudes towards animals may influence members of other cultural groups’ attitudes towards animals and AAC (Pew Research Center, 2006; Risley-Curtiss, Holley, & Wolf, 2006).

Gender

Gender is one of the most important demographic influences on attitudes towards animals (Kellert & Barry, 1987). Overall, females have demonstrated more humanistic and moralistic attitudes towards animals, whereas men often have a more utilitarian view of animals (Herzog, Betchart, & Pittman, 1991; Kellert & Berry, 1987). Therefore, AAC may be more effective with females than with males, as females may have a stronger tendency towards forming a therapeutic relationship with a therapy animal. Parshall (2003) recounted the observations of a grief counselor who witnessed that women tended to stroke and hold a therapy dog for comfort, whereas men often played more aggressively with the dog and used the animal as a diversion from pain.

Although women may show higher levels of positive behavior towards animals, they also may have more fear of them (Herzog, 2007; Kellert & Berry, 1987; Poss & Bader, 2007). In working with horses, female clients may feel intimidated resulting in nonassertive behavior and dangerous situations (Taylor, 2001). In contrast, men may have difficulty relinquishing control in work with horses and may also create dangerous situations while trying to aggressively assert themselves (Taylor, 2001). Finally, men may be more resistant to certain animal assisted interventions perceived as female activities, such as horseback riding (Robinson, 1999).

It is important that counselors consider a client’s unique experience with animals. Although some women may have an easier time forming a relationship with an animal, other women may experience a great amount of fear and anxiety (Kellert & Berry, 1987). Despite the potential challenges of conducting AAC with male clients, facilitating the development of a relationship between a male client and an animal can become very therapeutic and powerful. Through the relationship with the animal, a male client may be able to practice social and relational skills, as well as become more self-aware (Chandler, 2012).

Implications for Practice

As many AAC programs require increased costs for training, program maintenance, additional personnel, and animal care, the cost to clients may be higher than traditional counseling services (McConnell, 2010). Elevated financial costs of AAC for a client are more prevalent for therapeutic settings incorporating large animals such as horses, llamas, alpacas, large farm animals, and so forth; this is due to the additional cost of boarding and care of large therapy animals in contrast with smaller therapy animals. Counselors should be sensitive to variables that may influence client access to AAC services such as the cost of services and transportation to and from rural therapeutic settings such as farms and ranches. Additionally, some insurance companies may not reimburse for certain types of animal assisted counseling services, most especially those involving large animals, placing the burden of cost fully on the client. Clients of minority cultural identities and lower socioeconomic classes may struggle to be able to afford and participate in AAC programs (Cohen, 2011). Counselors should be cognizant of the physical and cultural placement of counseling centers in order to provide services that are accessible for clients of all cultural identities (Cohen, 2011). Counselors should be diligent in creating AAC programs and seeking external funding to make these services accessible for all clients.

There are many ways to incorporate a therapy animal into counseling sessions in a culturally sensitive manner. Decisions regarding if, when, and how a therapy animal should be incorporated into counseling with a particular client depends on (1) the client’s desire for AAC along with the appropriateness of the client for AAC, (2) the counselor’s creative capacity to design AAC interventions consistent with a client’s treatment goals, and (3) the therapy animal’s ability and desire to perform activities that assist a client toward treatment goals (Chandler, 2012). As therapy animals are inherently authentic, genuine, and nonjudgmental, clients of all cultural identities can feel valued and accepted by the animal as it will not judge based on cultural identity (Chandler, 2012; Cohen, 2011). Furthermore, cultural differences between the client and counselor may be less of a hindrance as the therapy animal can help facilitate the development of the client- counselor relationship by decreasing client anxiety and increasing trust in the counselor (Chandler, 2012). By sharing the therapy animal’s lineage, history, and past experiences, the counselor may provide opportunities for the client to connect with the animal and feel safe to share one’s own personal experiences (Chandler, 2012). Furthermore, counselors may utilize discussion of differences among animals, such as varying breeds of dogs or colors of horses, to facilitate client exploration about culture while processing issues of power, privilege, and oppression in order to gain increased understanding of others’ worldviews (Cohen, 2011). As spoken language will be inherently de-privileged in interactions with animals, clients will have the opportunity to connect with the therapy animal in ways outside of Westernized traditional talk therapy (Brandt, 2004). Finally, interaction with therapy animals enables clients to engage in touch and physical affection that may not be considered acceptable in Western forms of counseling (Yorke, Adams, & Coady, 2008). As engaging in touch with a therapy animal can be highly therapeutic with numerous physiological benefits, clients of diverse backgrounds who value touch and closeness may benefit from interacting with a therapy animal (Chandler, 2012).

With various cultures and types of diversity, counselors must be sensitive to the possibility that animals may evoke different responses from different people (Chandler, 2012). Prior to beginning the practice of AAC, it is imperative that the counselor explores one’s own worldview, beliefs, biases, and experiences with animals in order to gain self- awareness of one’s own worldview and how this view may differ from one’s client (Cole, 2009). Without this examination, the counselor may unintentionally project biases onto the client’s experience with the therapy animal. Finally, counselors should also consider how, for some clients, even having a therapy animal may place the counselor in a privileged position in comparison to the client. In considering AAC as an intervention in working with a client, counselors should obtain a thorough history and background of an individual client’s experience with animals of a similar species as the potential therapy animal. A client’s view and attitude toward an animal may be starkly different than the traditional views of their own culture based on that individual’s experience of positive or negative encounters with animals (Risley-Curtiss, Holley, & Wolf, 2006). When considering a client’s cultural background, counselors must be careful not to make large generalizations (Brown, 2002). A client’s level of familiarity and comfort with a particular type of animal will be based on the client’s own experiences and may have a profound impact on how the client views the therapy animal. Counselors should respect each client’s unique cultural identity and tailor AAC interventions to be culturally sensitive to each individual client.

Conclusion

In examining AAC as an intervention, human-animal social connectedness can be a very powerful therapeutic adjunct (Chandler, 2012). As depicted in this paper, the human-animal relationship has been documented across many cultures and diversity of people. In examining racial and ethnic groups, religious diversity, socioeconomic status, and gender, counselors should consider the unique qualities of each of these groups and how these qualities may help or hinder the animal assisted counseling process. As there is very little research on the topic of cultural considerations in AAC, the authors have had to rely greatly on research about owners and their pets. From these studies, the authors extrapolated multicultural considerations for AAC based on the ways in which people of different cultures are exposed to and interact with different animals. Given the importance of understanding each client’s unique cultural context, researchers should focus efforts on continuing to examine the effects of AAC across different cultural groups. By seeking to attain greater self and other awareness regarding cultural diversity considerations for AAC, counselors can more effectively and ethically implement this intervention with a variety of clients and utilize the power of human-animal social interaction to facilitate growth and healing.