Intended for healthcare professionals

Editorials Christmas 2019: Shiny Happy People

Elephant in the room: animal assisted interventions

BMJ 2019; 367 doi: (Published 18 December 2019) Cite this as: BMJ 2019;367:l6260
  1. Elena Ratschen, associate professor in health services research,
  2. Trevor A Sheldon, professor in health services research and policy
  1. Department of Health Sciences, University of York, York, UK
  1. Correspondence to: Elena Ratschen elena.ratschen{at}

A growing industry that urgently needs better supporting evidence

Healthcare settings as diverse as acute inpatient wards, rehabilitation and psychiatric units, hospices, and dementia care homes open their doors to animals and their handlers every day, aiming to improve patient wellbeing. Most of the animals are dogs, although cats, rabbits, guinea pigs, and other species can also be encountered. Most handlers are pet owners volunteering for charities, but some NHS trusts now employ their own “dog therapy teams.”12 Health and social care generally uses an evidence based approach to interventions. Animal assisted interventions are a notable and, arguably puzzling, exception.

The idea that interactions and relationships between animals and humans can affect health and wellbeing as part of the human-animal bond is ancient.3 Sigmund Freud used his dog Jofi in therapy sessions to improve rapport and reduce patient anxiety.4 However, the emergence of using animals therapeutically is usually linked to the work of US child psychologist Boris Levinson and his dog Jingles, in the 1960s.5

From dogs to dolphins

Animal assisted interventions “intentionally include or incorporate animals as …

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