Yesterday (19 December 2018), the Centre for Mental Health published a new report evaluating the impact of therapy dogs in a prison environment. “Restoring something lost: The mental health impact of therapy dogs in prison” is authored by Graham Durcan and makes for a fascinating and encouraging read.
The report describes the evaluation of a therapy dog scheme introduced to three prisons in England’s North East by Rethink Mental Illness to pilot, develop and test initiatives which may reduce the risk of self-harm or self-inflicted death in prison. Rethink therapy dogs worked with women and men (including young men). The mental health benefits of therapy dogs have been demonstrated widely across health care settings. In the light of increasing rates of self-harm and suicide in prisons, the Centre for Mental Health explored whether these benefits could be replicated amongst people in prisons.
Evaluating the work of Rethink Mental Illness in three prison sites, Dr Durcan found that the therapy dogs had a calming influence on prisoners, helped increase coping skills and strategies, and provided a safe space for them to explore ways of expressing and processing emotions.
The pilot scheme
The pilot scheme involved the introduction of two therapy dogs handled by Rethink practitioners, who were experienced in working in prisons and with people with mental health problems, and who were also experts in dog handling and agility. The intervention was simple and could involve no more than one of the scheme’s
participants either sitting and petting one of the therapy dogs or throwing a ball, playing the simple games one might see replicated in any park. Simple as the intervention was, it appeared to have a marked positive impact on participants’ wellbeing, by their own accounts, from the evaluators’ and other stakeholders’ observations, and through gauging this change using validated measures.
The impact of the therapy dogs on prisoner’s wellbeing was tested both quantitatively and qualitatively.
Participants completed a Short Warwick-Edinburgh Mental Well-Being Scale SWEMWBS at every session. Follow up data was available for 87 participants (i.e. 87 participants had both an initial rating and a final rating on completion of the intervention). The SWEMWBS has seven items or statements; the results of each item can be tested individually, as can the total score. For each test, the result was that the SWEMWBS self-reports showed a statistically significant improvement at the end of the intervention compared with the start the intervention. So, whilst one must be cautious in attributing causality, at the very least it can be concluded that the period over which the therapy dog intervention took place was associated with statistically significant self-reported improvement in wellbeing.
The qualitative evaluation revealed positive outcomes in eight different domains, described briefly below with some quotes from the prisoners involved.
1: Calming influence
An example of the calming effect of the therapy dogs was a prisoner who described why he felt the way he did and gave an account of his early life. He had experienced several adverse and traumatic events in his early years and whilst giving his account, he became visibly increasingly distressed and agitated. At this point, the therapy dog approached him, licked his face and lay across the man’s lap. The man began stroking the animal, and whilst continuing to describe traumatic life events, calmed and became less agitated; for example his speech slowed, and he was able to complete sentences.
2: Supporting engagement
Several prison staff interviewed for the evaluation said they were better able to relate and hold conversations
with some participants.
“…I have spoken to her when the dog was there…there is a dramatic difference…I’d have the dog there all the time…but generally now, it is easier to get through to her…”
3: Increasing coping skills
Staff and some participants felt that the therapy dog sessions coincided with and influenced changes in behaviour, and in how some participants addressed issues/problems.
“…I think [participant] is quite changed as a part of this, he seems less volatile…we are more able to explore things now and I can challenge his thinking on some things without him getting cross…” [Mental health practitioner]
“…I don’t know if I am calmer…but I do know I don’t react in the same way, I don’t ‘fly straight off the handle’ now…I think I consider things a bit more now…I don’t know why…” [Participant]
4: A safe place – a safe relationship
The relationship formed with the dog was believed by some participants and other stakeholders to help participants feel safe, secure, and to manage their emotions. The relationship with the dog allowed participants to discuss difficult and potentially distressing things that in other circumstances they might have been unable to.
Many people who come into prison have or have had pets, and commonly pet dogs in the community. Like
anyone else these pet dogs have often been experienced as important ‘family members’. But unlike actual family or friends, visits from a dog or any other pet are usually not possible. Coming into prison can mean not seeing a pet for very long periods and, given the shorter life span of animals, possibly never again. This can be all the more important for people who struggle with relating to other people, including for example some people with Autistic Spectrum Disorders. A female participant described this:
“…my dogs are really important to me…I don’t understand people and I don’t get on with people…but I get on great with animals and find I understand them and they understand me better…not seeing them is really hard…quite distressing…”
Another prominent theme emerging from the evaluation was the “unconditional positive regard” and “non-judgemental” nature of the relationship.
“…unlike a lot of people here – staff and inmates – Cooper doesn’t have a hidden agenda and he doesn’t judge me…I can’t tell you just how different that is in this place…”
7: A special bond
Related to the perceived non-judgemental nature of the therapy dogs, was a “special” relationship with the dog that was described by several participants.
“…he knows me…there’s a special understanding…”
“…I have only seen Cooper 3 or 4 times and so it might seem silly, but I feel like there is a special bond…”
“… we seem to ‘pick up’ where we left off each time…”
‘Confidence’ was another theme, particularly in the conversations with men, both younger and older. Related to this the young adults we spoke to enjoyed being with the dogs, but some acknowledged that a more “acceptable” way to have contact was through gym sessions where they worked on agility training with the therapy dog. Some young adults were very sensitive to teasing for having therapy dog sessions, but the gym-based sessions were less prone to this. A bonus of the agility training was the sense of satisfaction, achievement and confidence in successfully training a therapy dog to perform a trick or task. Some older men also enjoyed agility training and did this in their one-to-one sessions.
“…it seems really simple, but if you can get Cooper to walk backwards or whatever it’s really satisfying…”
Dr Durcan concludes the evaluation:
No ‘therapy’ can be a panacea for all ills, and such an intervention will not be appropriate for everyone, due to cultural reasons, allergic reactions to animals and those who simply do not feel comfortable near animals. However, the therapy dog intervention has a great deal to offer many high-risk individuals in prisons, both
as a therapy in its own right and in conjunction with others.
He recommends that more prisons should consider making therapy dogs available and that more comprehensive research should be undertaken.