ABSTRACT
Background: For relapse prevention in depression, conventional mindfulness programs such as the mindfulness-based cognitive therapy proved to be useful. However, early life trauma is a risk factor for having adverse experiences during meditation. Thus, for this patient group mindfulness skills are often difficult to learn and may be facilitated by using animals and a nature setting. Methods: The aim of the study was to evaluate the preventative efficacy of a nature- and animal assisted mindfulness program (NAM) over the course of 1 year in unstable or partially remitted depressed patients with a history of early life trauma. NAM included 8 group sessions of 150 min each over 8 weeks plus one booster session. Sixty-seven participants were randomized to either NAM combined with treatment-as-usual (TAU; guideline oriented treatment) or TAU alone. The primary outcome was depression diagnosis over the course of 12 months after end of treatment. Secondary outcomes included clinician- and self-rated depressive symptoms, quality of life, mindfulness skills, and rumination post, and 12 months after the intervention. In addition, we evaluated the participants' satisfaction with the program. Results: Analyses revealed significant differences in relapse rates and number of weeks depressed throughout the course in favor of NAM. Furthermore, global quality of life improved significantly more in the NAM group. There was no significant difference for other secondary outcomes. Satisfaction with the program was high with a low drop-out rate of 6%. The vast majority of the participants felt safe practicing mindfulness in nature and found sheep for assistance helpful and motivating. Conclusions: A nature- and animal assisted mindfulness program proved to be feasible, highly acceptable, and more effective than standard treatment in preventing relapses in recurrently depressed patients with childhood maltreatment. Nature and animals can facilitate the engagement in the treatment process for individuals with a history of early trauma. However, further evidence in multicenter trials is necessary.
ABSTRACT
BACKGROUND: There is empirical evidence that the presence of a companion animal can have a positive impact on performance. The available evidence can be viewed in terms of differing hypotheses that attempt to explain the mechanisms behind the positive effects. Little attention has been given to motivation as a potential mode of action with regards to human-animal interactions. First we give an overview of evidence that animals might promote motivation. Second we present a study to examine the effect of a therapy dog on exercise performance in children with obesity. METHODS: Twelve children, aged 8-12 years old, were randomly assigned to two groups in a crossover design: dog-group and human confederate group. Several types of physical activities via accelerometer and subjective ratings of wellbeing, satisfaction, and motivation were assessed. Data were analyzed using analysis of variance for repeated measures on one factor. RESULTS: The main effect of condition was significant for all performance variables. There was less passive behavior and more physical activity for all performance variables in the presence of the dog than in that of the human confederate. Between dog- and human- condition there was no difference in the subjective rating of motivation, wellbeing, or satisfaction. DISCUSSION: The results demonstrate that the presence of a therapy dog has the potential to increase physical activity in obese children. Task performance as a declarative measure was increased by the presence of the dog in comparison to a human confederate, but self-report measures of motivation, satisfaction or wellbeing did not differ between the two conditions. Therefore, it stands to reason that a dog could trigger implicit motives which enhance motivation for activity. The results of our study indicate the potentially beneficial effect of incorporating dogs into outpatient training for obese children.
