Animal-assisted therapy
Animal Assisted Therapy (AAT) is a powerful way to bring connection and comfort into the therapy room. By intentionally incorporating animals into treatment, therapists can help clients reduce anxiety, build trust, and engage more fully in the healing process.
Whether it’s a dog, horse, or even a small therapy animal, AAT can strengthen the therapeutic relationship and open new paths for progress. In this post, we’ll look at how Animal Assisted Therapy works, its benefits, and tips for integrating it into your clinical practice.
Summary
- Animal Assisted Therapy (AAT) is a structured clinical intervention—not just casual pet interaction shown to reduce anxiety, depression, and physiological stress markers like heart rate and cortisol levels.
- It’s used across counseling, occupational therapy, speech therapy, and physical rehabilitation, enhancing rapport, motivation, and emotional regulation.
- Practitioners can obtain specialized certification through organizations like Pet Partners, EAGALA, or the Animal Behavior Institute, and can document AAT sessions within HIPAA-compliant EHRs such as TheraPlatform.
- Using EHR systems, such as TheraPlatform can help therapists significantly streamline tasks like scheduling, billing, client communication, and documentation, while helping to expand their animal assisted therapy practices.
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Trained professionals intentionally use human-animal interactions as part of a clinical plan, unlike casual interactions with pets. In AAT, the therapist collaborates with an animal, such as a dog, horse, or even a small mammal, to facilitate engagement, reduce anxiety, and foster connection.
AAT can take place in various settings, including hospitals, mental health clinics, schools, and residential treatment centers. It is grounded in the therapeutic relationship between the client, therapist, and animal, often referred to as the "triad."
The presence of an animal in therapy can lower physiological stress markers such as blood pressure and heart rate, while also helping clients feel safe enough to explore difficult emotions or traumatic experiences.
Brief history of animal assisted therapy
The use of animals for healing dates back centuries, but modern AAT emerged in the mid-20th century.
In the 1940s, Dr. Boris Levinson, a child psychologist, noticed that his dog, Jingles, facilitated communication with a withdrawn child client. He coined the term "pet therapy" and published his observations, sparking interest in animal-based therapeutic interventions.
Throughout the 1970s and 1980s, structured programs began appearing in hospitals and rehabilitation centers. Organizations like Delta Society (now Pet Partners) formalized training and ethical guidelines for therapy animals.
Today, AAT is recognized by the American Psychological Association (APA) and American Counseling Association (ACA) as a legitimate adjunctive therapy that can enhance traditional modalities such as cognitive-behavioral therapy (CBT), trauma-focused therapy, and occupational therapy.
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Common techniques in animal-assisted Therapy
Animal-assisted therapy employs a wide range of techniques, each designed to engage clients in goal-directed interactions that enhance emotional regulation, communication, or physical rehabilitation.
One commonly used approach is guided interaction, in which a therapist facilitates structured contact between the client and the animal, such as brushing, feeding, or walking the animal to build mindfulness, patience, and trust. This simple engagement often encourages emotional expression and groundedness.
In projective or metaphor-based techniques, clients interpret the animal's behavior or emotional state as a reflection of their own, fostering insight and empathy.
For example, a therapist might ask, "What do you think the dog is feeling right now?" to help clients externalize and process their own emotions.
Behavioral modeling is another strategy, particularly in children's therapy. Animals often model self-regulation and responsiveness; observing or mimicking these patterns can promote adaptive behavior.
In rehabilitation or physical therapy, structured movement activities involving animals, such as grooming or riding horses, can improve motor skills, coordination, and balance.
Across all methods, the therapist maintains responsibility for ensuring that interactions remain safe, ethical, and purposeful. The animal's welfare is equally central, reflecting the growing movement toward mutual benefit and compassion-centered practice.
What conditions can AAT help with?
Animal Assisted Therapy is applied across a broad range of psychological, emotional, and physical health conditions.
AAT helps reduce symptoms of anxiety, depression, post-traumatic stress disorder (PTSD), and social withdrawal. In children with autism spectrum disorder (ASD), structured sessions with animals can enhance sensory regulation and social communication.
In trauma treatment, animals help create a sense of safety and nonjudgmental presence. Clients who have difficulty trusting humans may find it easier to connect with an animal first, using that relationship as a bridge toward deeper therapeutic work.
Similarly, individuals experiencing grief or loneliness often find comfort and attachment in the therapeutic animal relationship.
Animal Assisted Therapy is also integrated into medical and rehabilitation settings. Patients recovering from surgery, stroke, or chronic illness may benefit from reduced pain perception, lowered blood pressure, and improved motivation to participate in treatment.
The calming presence of an animal can also aid individuals with dementia or Alzheimer's disease, stimulating memory and reducing agitation.
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How effective is animal-assisted therapy?
A growing body of research supports the efficacy of Animal Assisted Therapy as a complementary treatment. According to a meta-analysis published in Frontiers in Psychology (2022), AAT interventions were associated with moderate to large effect sizes in reducing anxiety and depression symptoms across diverse populations.
Another review by the American Psychological Association (APA) found that human-animal interaction can significantly decrease cortisol levels and heart rate, indicating a measurable physiological reduction in stress.
AAT also shows promise for trauma and attachment-related conditions. For example, equine-assisted psychotherapy (EAP) has demonstrated positive outcomes in improving emotional regulation and reducing hyperarousal in clients with PTSD.
Studies in pediatric populations reveal that therapy dogs can enhance children's engagement and cooperation during medical or dental procedures, reducing fear and pain perception.
While Animal Assisted Therapy is not intended to replace established psychotherapies, evidence increasingly suggests that it strengthens treatment adherence, builds rapport faster, and supports clients who might otherwise resist or disengage from therapy.
Downsides and considerations of animal assisted therapy
Despite its many benefits, Animal Assisted Therapy comes with unique challenges and ethical considerations.
Therapists must ensure the safety and welfare of both clients and animals. Not all clients are appropriate candidates for AAT; those with allergies, severe phobias, or a history of animal trauma may require alternative interventions.
Liability and insurance coverage also vary by jurisdiction and the therapist's professional license. Ethical practice requires informed consent that outlines potential risks, boundaries, and the animal's role in therapy.
Additionally, therapists must monitor the animal's wellbeing to prevent fatigue, stress, or overstimulation.
Another consideration involves public perception and professional boundaries. Therapists should maintain clear distinctions between therapy animals and emotional support or service animals, as each serves different legal and clinical functions.
Insurance billing for animal assisted therapy
Billing for Animal assisted therapy can be complex, as most insurance providers do not yet have a specific CPT code for animal-assisted interventions.
Instead, sessions are typically billed under standard psychotherapy or occupational therapy codes, with documentation indicating that AAT was an adjunctive method.
Therapists should maintain clear clinical notes that describe therapeutic goals, animal involvement, and outcomes to ensure compliance with insurance and ethical standards. It's important to verify coverage in advance and explain to clients that out-of-pocket costs may apply.
Some organizations, including Pet Partners and the International Association of Human-Animal Interaction Organizations (IAHAIO), provide billing and ethical guidelines for practitioners navigating these issues.
Animal assisted certification for therapists
To practice AAT ethically and effectively, therapists must complete specialized training that covers both clinical and animal-handling skills.
Programs typically address behavioral cues, infection control, safety, and species-specific welfare. Certification is available through organizations such as Pet Partners, the Equine Assisted Growth and Learning Association (EAGALA), and the Animal Behavior Institute.
Therapists integrating AAT should also have a background in their professional discipline (e.g., counseling, psychology, social work) and ensure that animal-assisted techniques align with their scope of practice.
Continuing education courses offered by the American Counseling Association (ACA) and the American Psychological Association (APA) often include modules on integrating AAT into evidence-based care.
Most common animals used in therapy
While dogs are by far the most common therapy animals due to their trainability and social nature, other species also play important roles.
Horses are frequently used in equine-assisted psychotherapy, particularly for trauma and emotional regulation work. Cats, rabbits, guinea pigs, and even miniature pigs or birds can be incorporated in specialized contexts, particularly with children, older adults, or individuals with sensory needs.
Each animal species offers unique therapeutic benefits. Horses, for example, provide powerful feedback through mirroring body language and energy, while small mammals can evoke nurturing instincts and promote calm.
The key factor is not the species itself but the individual animal's temperament, training, and compatibility with the therapy setting.
Equine therapy (Hippotherapy, EAP)
Equine-based therapies encompass several approaches. Hippotherapy involves using the horse's movement as part of physical, occupational, or speech therapy to improve posture, strength, and coordination.
Equine-Assisted Psychotherapy (EAP), on the other hand, focuses on emotional and psychological growth through activities such as grooming, leading, and observing horses.
EAP can enhance self-awareness, boundary-setting, and emotional regulation. Because horses are prey animals, they are highly sensitive to human emotion and nonverbal cues, offering immediate feedback to clients. This dynamic often leads to breakthroughs in clients who have difficulty verbalizing or accessing their feelings.
How therapists choose animals
Choosing the right animal for therapy involves both science and intuition. Therapists consider factors such as the animal's temperament, training, health status, and the client population they serve. Animals used in therapy must be calm, responsive, and well-socialized to tolerate varied environments.
Therapists also take into account the goals of therapy. Dogs might be used for emotional support and social skill-building. At the same time, therapists may choose horses or body-based or trauma recovery work.
Regular veterinary care and ethical treatment are essential components of responsible practice. Matching the right animal to the right client is as much an art as it is a clinical decision.
Resources to learn and get certified
Therapists interested in expanding their practice through AAT can explore reputable training and certification programs such as:
- Pet partners: One of the oldest and most respected therapy animal organizations, offering handler and team certification.
- Equine Assisted Growth and Learning Association (EAGALA): Specializes in equine-assisted psychotherapy training.
- Animal Behavior Institute: Provides online certifications in animal-assisted interventions.
- University-based programs: Institutions such as the University of Denver's Institute for Human-Animal Connection and the University of North Texas offer graduate certificates and research initiatives focused on human-animal interaction.
These programs emphasize both clinical competence and animal welfare, ensuring that AAT is practiced safely, ethically, and effectively.
Animal-assisted therapy is far more than a comforting presence; it's a science-backed, relationship-centered approach that taps into the deep bond between humans and animals.
As research continues to demonstrate the measurable physiological and emotional benefits of AAT, more therapists are integrating it into trauma recovery, emotional regulation, and even medical rehabilitation.
For clinicians, the challenge lies in balancing compassion with professionalism, ensuring that animal welfare, client safety, and therapeutic intent remain central.
With ongoing advances in research, training, and technology, AAT stands poised to become an increasingly recognized and respected modality in holistic, client-centered care.
Documenting animal assisted therapy
An essential component of animal assisted therapy (and indeed nearly all therapeutic work) is accurate, timely documentation. One common structure is the SOAP format:
- S (Subjective): What the clients report — emotional state, concerns, events since last session.
- O (Objective): What the therapist observes — interaction patterns, tone, nonverbal cues.
- A (Assessment): Therapist’s clinical interpretation — what the subjective and objective data suggest in terms of attachment needs, emotional blocks, and relational dynamics.
- P (Plan): What will be done going forward — interventions, new homework, focus for next session.
Sample SOAP Note for Animal-Assisted Therapy (AAT)
- Client: Sophie M.
- Date: 10/27/2025
- Therapist: Dr. K. Alvarez, LPC, AAT-Certified
- Animal: “Buddy” (Certified Therapy Dog, Golden Retriever)
S – Subjective
Client reported increased anxiety related to the upcoming school transition. She expressed excitement to “see Buddy” and stated that interacting with him “makes it easier to talk.”
O – Objective
Client initiated gentle petting of Buddy without prompting. Demonstrated appropriate social boundaries and calm tone. Noted visible relaxation (slowed breathing, reduced fidgeting). Engaged in guided activity (brushing Buddy) for 10 minutes, then completed grounding exercise.
A – Assessment
AAT facilitated emotional regulation and engagement. Client demonstrated decreased physiological signs of anxiety and improved verbal expression. Continued positive therapeutic rapport observed through sustained eye contact and spontaneous communication.
P – Plan
Continue AAT sessions once weekly with focus on emotional regulation and confidence-building. Next session will introduce “mindful walking” activity with Buddy. Document AAT as adjunctive intervention under psychotherapy CPT code 90837.
Watch this video to learn how to save time on therapy notes
How EHRs can help with documentation
Modern EHR/practice management platforms (such as TheraPlatform) assist greatly with documentation by providing HIPAA‑compliant, integrated systems for note entry, storage, scheduling, and billing.
They allow therapists to:
- Use templates (e.g. SOAP, DAP, others) to speed note writing and ensure completeness.
- Link notes to treatment plans, goals, and session history so that therapeutic progress is more easily tracked.
- Securely access and share documents (with clients or other providers, where appropriate) and maintain confidentiality.
Meanwhile, AI‑assisted note tools are emerging which can further help clinicians by:
- Automatically transcribing session audio (if permitted) and highlighting key moments (e.g. emotional shifts, major themes).
- Suggesting draft notes or filling in objective or assessment sections based on observed data, freeing up clinicians’ time.
- Supporting consistency and reducing missing components in notes, which helps from both clinical, legal, and insurance perspectives.
Together, structured SOAP ‑ type notes plus good EHR platforms and smart AI tools support better therapeutic outcomes, more efficient workflows, and stronger accountability.
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References
American Counseling Association. (2023). Animal-assisted therapy in mental health counseling. https://www.counseling.org
American Psychological Association. (2023). The healing power of the human-animal bond.
Bargigli, G. et al (2025) Evidence of Physiological Co-Modulation During Human-Animal Interactions: A systemic review. https://arxiv.org/pdf/2510.10559
Beetz, A., Uvnäs-Moberg, K., Julius, H., & Kotrschal, K. (2021). Psychosocial and psychophysiological effects of human-animal interactions: The possible role of oxytocin. Frontiers in Psychology, 12, 637512.
Bert F, Gualano MR, Camussi E, Pieve G, Voglino G, Siliquini R. Animal assisted intervention: A systematic review of benefits and risks. Eur J Integr Med. 2016 Oct;8(5):695-706. doi: 10.1016/j.eujim.2016.05.005. Epub 2016 May 20. PMID: 32362955; PMCID: PMC7185850.
Chandler, C. K. (2022). Animal assisted therapy in counseling (3rd ed.). Routledge. https://pmc.ncbi.nlm.nih.gov/articles/PMC7185850/
Liu H, Lin J, Lin W. Cognitive mechanisms and neurological foundations of companion animals' role in enhancing human psychological well-being. Front Psychol. 2024 Apr 24;15:1354220. doi: 10.3389/fpsyg.2024.1354220. PMID: 38721326; PMCID: PMC11076790. https://pmc.ncbi.nlm.nih.gov/articles/PMC11076790/
Pendry, P., & Vandagriff, J. L. (2022). Animal-assisted interventions in trauma-informed care: Outcomes and considerations. Frontiers in Psychology, 13, 923861.
Pet Partners. (2024). Standards of practice for therapy animal teams. https://petpartners.org
University of Denver, Institute for Human-Animal Connection. (2024). Graduate certificate in human-animal-environment interactions. https://socialwork.du.edu
FAQs about Animal Assisted Therapy
What types of animals are commonly used in animal assisted therapy?
Dogs and horses are most common, but cats, rabbits, guinea pigs, and birds can also be used depending on the client’s needs and therapeutic goals.
Is Animal-Assisted Therapy covered by insurance?
Not directly—there’s no specific CPT code for AAT. Most clinicians bill under standard psychotherapy or OT codes, noting AAT as an adjunctive method.
What training do therapists need to provide AAT?
Therapists should complete a specialized certification from accredited programs (e.g., Pet Partners, EAGALA, or Animal Behavior Institute) and stay within their licensed scope of practice.
