Essential Skills for OT's partnering with animals.

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Welcome to animals and aquatics I'm Gina, your host. And I'm an occupational therapist, a sleep deprived, mom of three, and a lover of all things nature based. Today, we're going to discuss some important skills when incorporating animals into your occupational therapy sessions. And how to gain these skills, a little bit about me or my background. I'm an occupational therapist working in a nature based private practice, incorporating animals and aquatics into my practice. I've worked with many animals in occupational therapy, including horses, alpacas, goats, chickens, and a bearded dragon named Suki. For many sessions, I have horse handlers or horse handlers that are assisting me, but I've also been the handler who is working directly with the animal and with the client. And it's important to be familiar with the animals that we're working with and the team members that have knowledge of the animals. I've worked in a nonprofit, early intervention settings, outpatient pediatrics, and currently I teach as an adjunct occupational therapy professor in an OTA program for pediatrics and mental health. Why did I think we needed to record this episode? My fieldwork student actually asked about getting started. And how did I kind of find my way? I thought that was a really important story to share. And I thought it was important to look at some of the key skills. And I've been reviewing the animal assisted intervention specialist certification, and in the certification, it gives a pretty good guideline or outline of some of the key skills that an occupational therapist who's going to partner with animals should have. So I thought this would be an excellent opportunity to review those skills, different ways to gain those skills and how you could start to gear your experience as a student or as a new practitioner towards working with animals, with your clients and what do you need to know? So in some of the core skills that you should have, one of them is understanding animal behavior. And it's really important that you're familiar with the animal or the animal species that you're going to work with. So each species is a little bit different that you are going to work with. Alpacas, goats and horses are all herd animals. They're all prey animals. But the handling requirements and they way that they react to things are all very different. So understanding what stress behaviors look like in an alpaca is definitely different than understanding what stress behaviors look like in a horse. So when we're thinking about what those stress behaviors look like in a horse, I might see tail switching; I might see uh, pinning of the ears, reluctance to move forward. In an alpaca, it could be something like Cushing. So when a alpaca cushes, that means they lied down. So sometimes that's a stress response. And an alpaca that as frightened, they may vocalize. So knowing what those stress responses look like is an important skill to have. Knowing what active participation of the animal is, is a key skill. And so an animal that is interested in working with you in your occupational therapy session is key. And our goats love to be active participants in our therapy sessions. They're very inquisitive and interactive. They're going to approach the client. So those types of behaviors are things that I'm looking for, especially when selecting and working with the animal. But then also during the session, you know, sometimes animals have bad days too. And I'm looking for some of those behaviors that show me that the, goat or the chicken wants to be there and wants to be part of this interaction. The occupational therapy provider needs to be able to recognize animal stress and fatigue. During the interaction. So if the animal is getting tired of the interaction, tired of the therapy session, tired of the way that the client is interacting, we need to be able to step in and intervene. So that is a key skill that our occupational therapy providers we're going to partner with animals, needs to have, and then the risk factors. So each animal species that we work with has different risk factors, involve horses are big and strong and powerful, and there are significant risk factors. Goats are smaller and our goats are de-horned so disbudded. They don't have horns. So that limits one risk factor. And we said one of my fears with goats, if they do have their horns, 'cause we had some that had horns that were extremely social and would have made good therapy, goat counterparts, but with their horns I was always afraid of some person bending over to pet them and the goat, bringing their head up suddenly like, oh, what's that? And catching someone with their horns. Like not even intentionally. Doing anything with the horns, but just that, that would be a risk factor. Alpacas have soft toes. So if they were to kick, they have soft toes. They don't have upper teeth. So they can't bite in the same way that a dog could bite. So knowing what each animal's risk factors are. Are a component of knowing those animal behaviors. Now. That's the animal part, but then when we put the animal and the client together, there's an interaction piece. Right. So how do you screen the clients that are going to be part of your occupational therapy session, where you are incorporating animals, knowing what factors to screen for and how you're going to look at that partnership between the client and the animal. Like when is it going to be a good fit? When is it really therapeutically beneficial for an animal to be part of the occupational therapy session? When is it going to help that client move towards more more quickly or help them accomplish more skills or help them feel safe. So screening the clients is a key skill that we need to develop and having a system in place is really important because it allows us as occupational therapy providers to be fair with who is having the interactions. If we have a larger caseload or we work in a bigger practice uh deciding who is going to be involved at the stable and be using hippotherapy or who is going to be part of a group where the therapy goats are coming. That's really important that there are some set criteria in a way that we screen clients. But we also want to make sure it's a benefit to the client. That it's just not something else that we're throwing into the session or something that is kind of a requirement for every session, because in some sessions it may not be beneficial or it may not help us move towards our occupational therapy goals. So we're looking at what is that risk? What is the benefit and how is it going to help the client move along? How has this interaction with the animal going to help the client move along towards their goal. As the leading therapist or occupational therapy assistant, who's leading the OT session, we need to be able to manage the roles that the client and the animal play. And if you are the handler for the animal, you are really managing dual roles. You're needing to be there as a support person for the animal you're needing to manage the animals behaviors, but then you also need to be there for the client and helping the client feel safe and be sensory regulated and gain the skills that they need to reach their goals. And sometimes there can be a bit of a conflict between where the animal is at and where the client is at. So being able to manage both of those roles is really a key skill. And then communication. Communication to the animal, to the client and to the handler. So often when I'm teaching others about hippotherapy, I say it's really like being dual or trilingual lingual, because we need to be able to speak horse language to our horse handlers. We need to be able to communicate to the client in a way that is client centered. So if I'm working with children, it has to be child-friendly. And then I may need to either communicate to the parent or to other people on the team member in a more clinical way or a parent friendly way. So being able to switch between all those dialects is really important. But when we're communicating directly to the animal, if we need to give the animal a command. So if I want a goat to jump up, right, I need to be able to give them the command to come up. And I want them to know that that's an expectation for them, which is different than what I'm communicating to the client. So when we're thinking about incorporating animals into our sessions, we're looking at that functional outcome and basing our knowledge and our skills of those functional outcomes and then translating the interaction with the animal or the bio-psychosocial response from input, from a movement experience, from an animal like a horse into that functional outcome. That is a key component of clinical reasoning. For an occupational therapy provider to have, when you're thinking of partnering with animals is understanding what the client is going to get from that interaction and then being able to translate it into how does that get that client closer to the goals. So you're adapting the interaction or the input from the animal to the needs of the client. And as a pediatric OT, there are many ways to address ADL's, education, play through these interactions with animals. And then additionally, from a mental health perspective, we can incorporate animals as an important component to addressing our client's mental health. So as OTs are really good at addressing health and wellness, this partnering with animals really can be a very good fit. Another key area for skills the occupational therapy providers should have before they decided to partner with animals is understanding the health and safety component. So what are potential risks to the client? So with horses, we know that there could be a risk of being kicked. Being bitten being stepped on. If the client is on the horse and experiencing the movement of the horse, there's a risk of a fall. So for each animal species that we work with, we need to know what those risks are to the client. And we need to decide if those risks can be mitigated and in which ways can they be mitigated? And the component with that then is then what is the benefit? What are the risks to the animal? Based on the type of interaction that we're going to partner between the animal and the client, what are the risks to the animals? So we, I mentioned stress a little bit, but there are other risks. Some of the clientele that I work with are prone to having outbursts and that can be psychologically stressful for the animal, but it also could be physically stressful for the animal. We can think about things that children just don't know any better. And although we're very close, in supervising and, being there for the client and the animal there is just that like momentary thing where a client is like, Ooh, let me touch the eyeball. And that is a risk to the animal, is as an adult and we wouldn't go up and we wouldn't touch or poke an animal in the eye, but a child may do that and they may not even do it to be hurtful. They may just be curious and not understand the effect that's going to have. On animals that are more fragile, like chickens and rabbits, children can be rough and that's one of the things that we're really cautious about when we have interactions with the bearded dragon, he's very easy to handle and the children very much like to be able to hold him or put them put him on their shoulder, but if the child were to become frightened because the bearded dragon moved or if they are just done with holding him and they're unable to communicate that and they drop him, that would be a risk to him. So being able to mitigate those risks as much as possible. The occupational therapy provider should be aware either in charge of, or able to oversee care and grooming of the animal. So you may not be responsible for all of the functions of caring for, and grooming the animal, but you should be aware of what it takes to do so. What is correct what that animal should look like when they are in good health and well groomed. And what needs to be done if that's not happening. So who on the therapy team needs to be in charge of that. Who do you need to speak with? Do you need to speak with an equine or a barn manager? Do you need to speak with the handler that's volunteering and bringing that animal to your session is the animal having some sort of health issue in which they shouldn't be participating in your occupational therapy sessions until that issue is resolved? And that kind of leads us to the next component of health and safety, which are zoonotic infections and knowing what can be transmitted from an animal to a client is super important for any occupational therapy provider. That's going to partner with animals. It's an absolute must skill. You must know what could potentially be transmitted from the animal to a client and how to prevent it. And we just want to give an example from goats. So with goats, they get something called orf, O R F, it's a viral infection and it causes like blistering and lesions around the face and the mouth. It's really yucky. And it can be transmitted to humans. So we always say don't ever kiss your goats because if they were to get orf, you could get it and you will get the same blisters around your face and mouth. It is not pretty. And you do not want orf. So that's something that can be transmitted from goat to human. When we know it as a ringworm and it's a fungal skin infection, it's fairly common. It's in animals. You can see it in, in goats and horses, and it's made in a round shape, which is why it's called ringworm and, but it's actually fungal and it can be transmitted from the animal to the human. Again, it's transmitted both by direct contact. So both orf and ringworm are transmitted from direct contact with an infected animal. And so again, that's why it's so important for the health and safety of our clients and our animals. That if we are partnering with animals, we have a good understanding of those health and safety aspects. Another key area is animal training and management. So again, this might be an area that we might not be 100% responsible for. We may not be doing all of the animal training. We may not be overseeing all of the animal management, but we do need a certain level of awareness. We need to have a certain level of comfort and being able to speak up and advocate for the animal if they're going to be part of our sessions. So one, will you be the one training and handling the animal in your occupational therapy session? Because if you are, then you need to have a skill level in order to teach the animal what they need to know, be able to translate what you need in your session, over into the animal behavior side of things. And if not, then you're going to have a handler on your team. And when you have a horse handler on your team, a goat handler and any animal, right that has a handler. We need to be able to communicate our needs to the handler. There needs to be mutual respect between us and the handler and being able to have that communication between the handler saying my animal can do this, my animal can't do this. My animal is struggling with this. And as the occupational therapy provider, we need to respect that. Or opposite wise is this is not really working for my client. Now I need the dog to back up, or I need this client to really be focused right now. So maybe I need the animal to leave this room or our classroom, our space for a little while. We need to understand the behavior or the movement that we want to support our occupational therapy goals. So if I'm using hippotherapy I need a particular movement to help my client reach a state of regulation or to engage their extensor muscles or to practice feed forward and feedback and I need a horse that can deliver that. And I need a horse handler that understands my needs. I also need to understand the animal's behavior and link that to what my occupational therapy goals are. So if I have some social goals involving reading body language I can help my clients start to decode some of the animal's body language before we work on human body language. So we want to recognize that the animal has an opportunity to choose how it's going to participate in our sessions. And whenever an animal is forced into an interaction- that is a safety risk. So part of that skill set is recognizing that choice or option is key to safety and safety is the number one priority. There always has to be an out or a choice for that animal a way for them to say no. I don't want to do this. I can't do this. I don't like the way that this is happening and we need to be able to decode that. We need to be able to decode it and translate it. Our handlers need to be able to communicate with us if that is happening. We want to respond to the body language cues from the animal as part of that safety plan. So again, that's a key component. Is that we're reading the signals that the animal may be giving us and recognizing that we need to respond, we need the client to respond, or we need to remove the animal from that situation. We want to look at ways that balance the needs of the animal and needs of the client in the session and figuring out when to introduce the animal and how to get closure as the animal is going to be leaving the interaction is important. Sometimes the animal is done and the client is not done, and so we need to have multiple strategies in place to go ahead and have that opportunity to close out the interaction where the animal is still in a good state. They're, regulated and they're feeling comfortable. And allow the client also to have that ability to end that interaction. In some cases if, if they've had enough of the animal. We need the animal to be able to back down. And sometimes we can think of that with dogs, but also with goats sometimes because they're very much interested in having this interaction or if there was food introduced in the session, then that animal may be seeking food and then the client may need a break from that. So figuring out when the animal should be part of the session and when it is time for that animal to leave. When we have had the interaction that we see as beneficial towards meeting our goals. That's a component of that. And then recognizing when we're bringing an animal into our session, we're more incorporating them and it changes the dynamic. So. If we have a horse handler or another handler for the animal. Then it's you, as the clinician, the handler of the animal, the animal and the client. So there's four systems. If we're going from a dynamic systems, there there's four systems that are interacting. And a change in one system will produce a change in the other systems. So thinking about it becomes quickly, very quickly infinitely more complex when we're dealing with all these different systems. And if the client becomes dysregulated, and that has an impact on the animal, and the animal becomes stressed and the handler then is going to be protective of the animal. And then you've got to manage the handler stress protecting the animal, the stressed out animal and the client who's dysregulated. That's why the level of skill that we need to have when we're thinking about partnering with animals is more complex and is higher. Because there's these, components that when we think from that dynamic systems perspective, right, become much more complex, much more quickly. And we need to be able to intervene much more quickly because we know that there are some risks. We need to find a way to be able to direct the animal or the handler. Through voice or hand signals or gestures. A pat and a verbal cue for up for a go, if I want them to come up and be beside the client, that's a way that I can direct the animal. That's part of the animals training and behavior. And then finding ways to identify how I'm going to support the animal in a changing environment or changing situations with clients. That's another component of behavior and management for the animal. If a child is becoming more active or more dysregulated, finding that way to work on that and from a training and behavior perspective is important. We're still working on skills and this one is a big one documentation. So when we think about documentation the animal interaction part of our session is never the only tool or treatment strategy or intervention that's being used to support progress towards OT goals. And the goals are going to be assessed after each session, the results are communicated to the parent, to the school, to the payer, whoever that needs to be communicated to. And when we're documenting, we're focused on documenting the progress towards our OT goals. We may not necessarily be focused on documenting the tools or strategies that we've been using to get there, because again, the animal interaction is only one strategy that we're using. And we have other things that we're using in our sessions. So thinking about am I documenting all of the tools and all of the strategies that I'm using and the animal interaction is one of those. How is that communicated to the stakeholders that that needs to be communicated to? If we're communicating to parents, the communication with parents is really important because we need them to carry over the skills and the other interventions that we're using that support the client's progress. That is all part of that communication to the parent. So when we talk about documentation, it's really helpful, I think ,for new clinicians who are interested in partnering with animals to be able to see documentation. What does it look like when a therapy goat is involved? What does it look like when it's a social skills group with a bearded dragon? So story time with Suki is a social skills group that involves a bearded dragon. And so what does that look like? The focus is not on the bearded dragon. The focus is on the social skills that the clients are gaining with that. And how do you document that? So it's really important as occupational therapy providers that we're documenting to avoid fraud. We don't want anything to be hidden in what we're doing, but we also want our documentation to be goal and goal oriented goal, outcome oriented. So after going through all of those skills, You might be wondering how do I gain the skills that are needed to begin with animal assisted interventions as an occupational therapist? And I think I can share a little bit of my journey in how I've gained skills in partnering with animals and the different animals that I've partnered with. And part of that, I would say Is experience in the handling the animals, the animal husbandry piece. I think is been really helpful. And just since I was very young, I've had a variety of different animals ,from goats and rabbits and ducks and Guinea pigs. We had a little bit of everything. I think I probably convinced my parents to let me have just about every pet that there was at some point in my childhood. And so I got a real hands-on experience for a lot of that, but then I also did have more formal education. And so my bachelor degree is in equine studies. So at that point I had a lot more formalized education in caring for horses in basic veterinary or emergency care that horses might need. In theory of teaching riding, in a lot of components of nutrition and conditioning for horses. And anything that is pre-veterinary medicine, animal studies, things like that can really be helpful in acquiring those kinds of basic animal husbandry skills. But if you don't have that or haven't gone that way, certainly, mentoring can be a huge component. Volunteering can be really good observation of someone who is having animals as part of their occupational therapy sessions or practice. And being able to observe, and then come in and ask questions that can also be part of interning or a formal academic experience, like a field work placement. All of those can be a component. And then there are exams like the hippotherapy clinical specialist exam or the animal assisted intervention specialist exam. Those exams can also give you a feeling of kind of your level of competence. But I think a lot of people's comfort level in incorporating animals into their occupational therapy sessions is going to come from mentoring from another occupational therapy provider in practice. And a lot of session debriefs talking about how you're planning on incorporating that animal and having someone walk you through some of the potential risks or pitfalls or things that maybe you haven't thought of. So having that relationship or a networking or a mastermind group of people who are incorporating animals into their sessions, where you can really start to learn from people. Who've had the experience and I have had that opportunity. So when people say like I'm really interested in incorporating animals as an occupational therapy, like how can I get started? If you have an opportunity to have a field work rotation. That's great. That's a wonderful way to really get that hands-on experience. Mentorship, pairing up with others who are, already partnering with animals is great. Observing and volunteering. If you're interested in horses in the hippotherapy side of things, taking riding lessons is good, but there's nothing that's going to replace just the day in and day out time caring for the animal that you would like to work with. So I think there's the animal husbandry piece that cannot be replaced. I can go out and just look at the goats and no. If I need to change something or somebody is feeling a little off and that just comes from doing it day in and day out. And so that makes me very tuned into to them. But then there's the clinical piece and you need to have another clinician for that. So, we do hope to offer a mentoring community, to help students and therapists who want to work with animals in their practice really get the clinical piece and the clinical support that is going to help you be successful when you want to partner with animals. So to wrap up for today, there are definitely specific skills for occupational therapy providers who want to use animals in their practice? We covered a whole chunk of them today and they're essential for safe and effective practice. Finding a mentorship or field work opportunity to gain these skills is a continual area of development in the field of OT. In this discussion, I was hoping to introduce you to some of the skills needed as an occupational therapy provider or a student that's hoping to gain those skills. And I'd really love to hear from you. If you are an OT working with animals in your practice, or if this is an area of interest for you. Thanks for listening.