Improving Engagement in Behavioral and Mental Health Services Through Animal-Assisted Interventions: A Scoping Review.

Objective: Client engagement in behavioral and mental health services has been strongly linked to improved outcomes and treatment completion. Animal-assisted interventions (AAIs) are increasingly used to improve client engagement, for example, by involving a dog in therapy to support a client's sense of safety. Although existing research suggests that human-animal interactions may promote engagement, further research is needed to understand the underlying mechanisms, identify procedures needed for treatment fidelity, and determine the populations in which this intervention would be most effective. The aim was to identify the existing knowledge base to inform future research and practice in these areas.

Methods: A review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines to answer three questions: What research has been completed regarding the use of animals to affect client engagement, including measurement of potential processes of change? How have interventions that use animals been structured and protocolized? How is engagement operationally defined by these studies?

Results: Ten studies were identified for review. Preliminary evidence indicates that AAIs may support client engagement in behavioral and mental health services. A wide range of conceptualizations in which populations and settings could benefit from AAIs were identified, but it remains unclear who would benefit most. The review did not substantively address the efficacy of AAIs for increasing engagement or factors that may drive engagement.

Conclusions: Further research is needed to quantify the impact of AAIs on service engagement and to identify mechanisms of change.