The status of a person’s mental health is related to how the person copes with and responds to stressful situations, and occupational therapy is an integral component in the development of coping strategies that enhance abilities to effectively manage stress. Research on resilience to stress shows that social support through quality relationships is integral to maintaining optimal physical and mental health, such that “positive social support of high quality can enhance resilience to stress, help protect against developing trauma-related psychopathology, decrease the functional consequences of trauma-induced disorders, such as post-traumatic stress disorder (PTSD), and reduce medical morbidity and mortality” (Ozbay, Johnson, Dimoulas, Morgan III, Charnay, & Southwick, 2007, p.35). For example, a study involving Vietnam veterans found that individuals with high levels of social support were 180% less likely to develop PTSD than individuals with low levels of social support, and another study discovered that patients with acute and chronic cardiac illness displayed decreased depression when they utilized active coping mechanisms, which were preceded by high levels of social support (Ozbay et al., 2007). Research on the perspectives of adults labeled with serious mental illness has also revealed that participation in valued social roles provides individuals with a sense of meaning and purpose and is associated with increased self-esteem and decreased symptoms and hospitalizations (Deegan, 2005).
On a neurophysiological level, the neurotransmitter oxytocin has been investigated as a component in the regulation of social attachment and promotion of positive social interactions, and findings conclude that oxytocin is associated with reductions in anxiety and reduced secretion of stress-related hormones (Ozbay et al., 2007). Therefore, increased levels of oxytocin may contribute to increased positive social interactions and subsequently increased development of quality social support systems.
Occupational therapy interventions that promote the development of quality social support systems may be more effective when incorporating components that facilitate increased secretion of oxytocin. One way to facilitate this may be through animal-assisted interventions, specifically interventions that incorporate dogs. Physical interaction with dogs has been found to result in increased release of oxytocin in both humans and dogs (Beetz, Uvnas-Moberg, Julius, & Kotrschal, 2012). Not only can petting a dog promote the development of the ideal internal environment necessary to prime individuals for social interaction, but that same dog can establish an external environment in which other people are drawn to interact socially with the person who is next to the dog. Studies on the benefits of human-canine interaction have found that the presence of a service dog was associated with increased friendly social attention, smiles, and conversation from others for persons who use wheelchairs (Beetz et al., 2012), dogs provided a safe topic of conversation among dog owners who frequented a local park in the UK (Robins, Sanders, & Cahill, 1991), and in a study in Western Australia, 83.3% of owners who walked their dogs reported talking with other pet owners during those walks (Wood, Giles-Corti, & Bulsara, 2005). This presents an opportunity for occupational therapy interventions for adults labeled with mental illness, specifically when goals include boosting resilience to stress through the development of increased social participation and establishment of social support networks. However, this area of intervention has only been minimally studied and rarely implemented.
In a study involving adults labeled with mental illness who live in a Canadian community, pet-owners demonstrated higher frequency of social interaction with neighbors than non-pet owners; however, of the participants in this study only 18.6% were pet owners, which is a considerable amount lower than the 53% of the general Canadian population who own a pet (Zimolag & Krupa, 2009). When looking at the numbers of dog-owners specifically, 15% of pet owners in the study by Zimolag and Krupa (2009) lived with one dog; again, this is significantly less than the number of Americans who live with a dog, which is calculated to be 36.5% of the general population (AVMA, 2018). Of the non-pet owners in this study, 63.2% reported a desire to live with a pet due to hopes of experiencing companionship; and the three most frequently reported motivations for living with a pet in the pet-owner group were companionship, someone to love, and stress relief (Zimolag & Krupa, 2009). There appears to be a wealth of opportunity to facilitate increased resilience to stress in adults labeled with mental illness by establishing increased social support networks through supporting companionship with dogs.
Occupational therapy facilitates resilience in the population of adults labeled with mental illness through the development of coping strategies to effectively manage stress, stress is managed more effectively when individuals have higher secretion of oxytocin and increased access to positive social support systems, and companionship with dogs is associated with increased secretion of oxytocin and positive social interaction with others. A substantial proportion of adults labeled with mental illness who live in the community may desire the companionship of a dog, and supporting companionship of dogs through occupational therapy interventions presents an opportunity to increase the frequency and quality of social interactions experienced by adults labeled with mental illness, such that they can establish increased positive social support networks, increased resilience to stressful situations, and ultimately increased overall well-being.
Sharon Vincuilla, OTR/L
Occupational Therapy Doctoral Resident
American Veterinary Medical Association (AVMA). (2018). U.S. Pet ownership statistics [2012 U.S. Pet Ownership & Demographics Sourcebook]. Retrieved from https://www.avma.org/KB/Resources/Statistics/Pages/Market-research-statistics-US-pet-ownership.aspx
Beetz, A., Uvnas-Moberg, K., Julius, H., & Kotrschal, K. (2012). Psychosocial and psychophysiological effects of human-animal interactions: The possible role of oxytocin. Frontiers in Psychology, 3(234): 1-15.
Deegan, P. (2005). The importance of personal medicine: A qualitative study of resilience in people with psychiatric disabilities. Scandinavian Journal of Public Health, 33(Suppl): 29-35. doi: 10.1080/14034950510033345
Ozbay, F., Johnson, D.C., Dimoulas, E., Morgan III, C.A., Charnay, D., & Southwick, S. (2007). Social support and resilience to stress: From neurobiology to clinical practice. Psychiatry, 35-40.
Robins, D.M., Sanders, C.R., & Cahill, S.E. (1991). Dogs and their people: Pet-facilitated interaction in a public setting. Journal of Contemporary Ethnography, 20(1):3-25.
Wood, L., Giles-Corti, B., & Bulsara, M. (2005). The pet connection: Pets as a conduit for social capital? Social Science & Medicine, 61, 1159-1173.
Zimolag, U., & Krupa, T. (2009). Pet ownership as a meaningful community occupation for people with serious mental illness. American Journal of Occupational Therapy, 63, 126-137.