Johnson et al.

Human-Animal Interactions (2024) 12:1

https://doi.org/10.1079/hai.2024.0003

RESEARCH

Recommendations for uniform terminology

in animal-assisted services (AAS)
Amy Johnson Binder1*, Nancy Parish-Plass2, Meg Kirby3, Melissa Winkle4, Daniela Plesa Skwerer5, Laura Ackerman6,
Cindy Brosig7, Wendy Coombe8, Esther Delisle9, Marie-Jose Enders-Slegers10, Jo-Ann Fowler10, Laura Hey11, Tiffani Howell12,
Michael Kaufmann13, Mariana Kienast14, Miyako Kinoshita13, Debbie Ngai15 and Brigitte Wijnen16

Abstract
Through the years, the range of services involving animals benefiting people, often described as “animal-assisted interventions” (AAIs),
has been plagued with confusing and inconsistent taxonomy, terminology, and definitions. This has caused difficulties for the delineation
of roles of service providers, for the recipients of services, as well as for the preparation, training, and expectations of the animals that
work in different roles. It can be argued that these difficulties have compromised the development of the field in terms of establishing
agreed standards of practice, qualifications, and competencies and adopting good animal welfare practices. It has also likely limited
the base of evidence, as search terms used to access studies are not consistent, and study protocols are difficult to compare, lacking
uniformity in terminology. Additionally, the current terminology cannot accommodate the expansion and diversification of programs in
recent years, which is likely to continue as the field evolves. Establishing internationally agreed upon uniform taxonomy, terminology, and
definitions is crucial to more accurately reflect the key features of different approaches, to define the scope and competencies for different
service providers and their animals, to provide transparency about services for recipients, and to ensure the appropriate preparation,
training, and support of the animals that work with them.
The recommendations in this article are the result of an international work group that convened over the course of two years. The umbrella
term animal-assisted services (AAS) is proposed, defined as services that are facilitated, guided or mediated by a health or human service
provider or educator, who works with and maintains the welfare of a specially alongside a specially qualifying animal to provide therapeutic,
educational, supportive and/or ameliorative processes aimed at enhancing the well-being of humans. AAS are further categorized into three
main areas: treatment, education, and support programs. A recommendation for provider-specific terminology is also suggested. The aim of
these proposals is to set clear expectations and boundaries for each specialty of practice, without compromising the richness and diversity
of each approach. The adoption of this new umbrella term and its categories is intended to improve clarity for all involved in the receipt and
delivery of services, as well as for those who study their effects.

Keywords: animal-assisted interventions, animal-assisted services, animal-assisted therapy, animal-assisted activities, animal-
assisted treatment, animal-assisted education, animal-assisted support program, pet therapy, therapy animals, therapy dog

providers, handlers, animals, and recipients of the services. While

Introduction equally important, there are significant differences in the services
that teams provide which are largely based on the handler’s formal
In recent decades, the breadth of initiatives where animals benefit
education and training, qualifications and credentials, and scope
people has expanded and diversified to include crisis response,
of practice. It follows that the description and skills of the animals
coaching, vocational programs, education, initiatives in healthcare
involved, also vary.
settings and more. Common to all is the promotion, facilitation,
and support of human well-being. However, the diversity and Many volunteer visiting teams belong to organizations that have a
specialization of human-animal teams have implications for the rich history of educating, evaluating, and registering human-animal

Affiliations: 1Animal Assisted Intervention International, Brooks College of Health, University of North Florida, USA; 2IAAAP – The Israeli Association
of Animal-Assisted Psychotherapy, Tel-Hai College, Israel; 3The Equine Psychotherapy Institute & Animal-Assisted Psychotherapy International,
Australia; 4Animal Assisted Intervention International, Dogwood Therapy Services, University of North Florida; 5Boston University/Center for
Autism Research, USA; 6Denver Pet Partners, USA; 7Operation H.E.E.L., LLC, USA; 8Animal Therapies Ltd, Australia; 9The Canadian Institute of
Animal-Assisted Interventions, Canada; 10International Association of Human Animal Interaction Organizations, USA; 11Health Heelers, Inc. &
Animal Behavior Carroll University, USA; 12School of Psychology and Public Health, La Trobe University, Bendigo, Victoria, Australia; 13Green
Chimneys Farm and Wildlife Center/Sam and Myra Ross Institute, USA; 14Veterinary Science, University of La Plata, Argentina; 15Hong Kong
Animal-Assisted Therapy Association, Hong Kong; 16Donkey Therapy Farm Hans & Gretel, The Netherlands
*Corresponding Author: Amy Johnson Binder. Email: [email protected]
Submitted: 13 November 2023. Accepted: 17 January 2024. Published: 14 February 2024
© The Authors 2024. Open Access. This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits use, sharing, adaptation, distribution
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Johnson et al. Human-Animal Interactions (2024) 12:1 https://doi.org/10.1079/hai.2024.00032

teams for very specific criteria for informal visits with humans. • suggest ways in which practitioners in the field, researchers
They may visit a site two times a week and stay for duration of and individuals, organizations and educational providers who
up to 2 hours. During that block of time, they may have several have a special interest in human-animal interactions (HAI)
brief interactions with recipients, each lasting a few minutes. and AAS in any capacity, may contribute to implementing
The handler is solely responsible for tending to the animal and these changes.
maintaining good welfare practices, including ending an interaction
if the animal shows signs of distress or discomfort. In contrast, a
licensed/credentialed/registered healthcare provider-animal team WHY IS UNIFORM TERMINOLOGY IMPORTANT?
may provide very different services. Clients may be seen with more Specialized knowledge requires consistent terminology for the
frequency, for a longer duration per session, and for a specific representation, communication, and teaching of concepts to
treatment plan that was based on a physical, cognitive or mental professionals (Cabré, 2002). Every profession has its industry-
health evaluation. The animal handler may also be the healthcare specific lexicon (Cabré, 2002) to help readers grasp the technical
provider who juggles the responsibilities of client, the treatment contexts and interactions between concepts. Professionals
plan, equipment, and the animal. in a field or industry must speak the same language, develop
evidence-based literature, and layout competency guidelines to
Currently and historically, the most widely used terminology
ensure consistency and understanding among them, as well as
is oriented around animal-assisted interventions (AAI) as the
to enhance interprofessional collaboration. Within the field of what
umbrella term, covering several categories of services that have
has heretofore been referred to as AAI, fully accepted vernacular
been subsumed under the names: animal-assisted therapy (AAT),
does not exist.
animal-assisted education (AAE), and animal-assisted activities
(AAA). Descriptions and definitions of these terms have been For the field to be seen as a credible, research-driven area of
published by the International Association of Human Animal practice with potential for growth, a consistent language must
Interaction Organizations (IAHAIO, 2018) and Animal-Assisted be adopted. The processes involved in various areas of the field
Intervention International (2022). cannot be understood in the absence of consistent language
specifying how services are set up or delivered. Scholars must start
However, inconsistencies remain in how these services are described,
from similar conceptualizations and definitions of core constructs
practiced, and reported upon in professional literature and in the
in order to draw scientifically valid conclusions about the internal
media. Without uniform terminology and definitions, standards of
validity and efficacy of this work.
practice have been difficult to define and monitor, the quality and
appropriateness of the interactions may be negatively impacted,
and quality research may be difficult to conduct (Parish-Plass, 2014; PROBLEMS WITH CURRENT TERMINOLOGY FOR
Trevathan-Minnis et al., 2021). Leaders in the field, researchers PROFESSIONALS, RECIPIENTS AND GENERAL
and providers, have increasingly expressed concerns about prolific, PUBLIC
inconsistent terminology used over recent years. They have repeatedly
The field of practices of AAIs has developed and evolved
called for the adoption of uniform and optimal terms and definitions to
dramatically over the last 50 years. Terms such as AAT, or
provide more conceptual clarity in the field (Beck and Katcher, 2003;
historically, “pet therapy,” are widely used as umbrella terms to
Kruger and Serpell, 2010; Parish-Plass, 2014; Fine et al., 2019; Fine
describe a wide spectrum of interactions, including those whose
and Andersen, 2021). For example, in 2021, a consensus document
context or process does not involve therapy. The term “intervention”
was published to recommend optimal uniform terminology for services
has been particularly problematic and the cause of much debate
that incorporate equines to benefit people (Wood et al., 2021). The
in the field and among those within this workgroup. For some, the
stated benefits of such an approach included advancing future
term “intervention” itself may be commonly used as a synonym for
scientific development and reliable measurement of effectiveness,
treatment or for human service. For others, and for much of the
mitigating future terminology-related problems, protecting consumers,
public, the term is defined as attempting to remove undesirable
removing reimbursement obstacles, and helping physicians and
behaviors (Loss, 2008) in a forcefully interfering manner such as
insurance carriers embrace, recommend, and fund some of these
the act of “intervention” within the substance abuse field.
services. More recently, an international study of terminology in
human-equine interactions (Mattila-Rautiainen et al., 2023) highlighted Likewise, the terms “therapy horse” or “therapy dog” are commonly
the need for clarification of terms to address cultural and methodical used to describe an animal that participates in recreational,
differences. The authors of the study suggested creating a matrix educational, and support activities or services. These are not
of terms that would include descriptions of the services provided, always within the context of therapy, mental health treatment,
leading to a clearer understanding by practitioners and clients of these or other types of professional treatment1 and they imply that the
services, as well as allowing for improved cross-cultural, work-related animal is somehow the therapist, with an inherent ability to be
exchange and research. The authors of this article have reviewed therapeutic or “deliver” therapy. The problems arising from this lack
these documents and support the terms recommended, but there of clarity and proposed alternatives are addressed in Howell et al.
remains a need to provide clear, operational definitions for terms used (2022) and are not addressed in this article.1
in initiatives beyond the equine context.
This lack of consistent and clear terminology has complicated
In this article, we: the setting of relevant, widely-accepted standards in the field,
defining crucial provider competencies, credentialing of both
• explain, using examples, why the continuing use of the humans and the animals who accompany them, and thus
inconsistent, unclear terminology is particularly detrimental to confused governing bodies. For example, a program may have
the acceptance and recognition of the field as an evidence- therapeutic effects and provide many benefits, yet not belong to
based, scientifically grounded set of practices; a recognized field of therapy. A practice can only be considered
• propose terminology and definitions that should provide more to be therapy when a licensed, credentialed, and/or accredited
clarity and guide the understanding of the scope and therapist is involved in the therapy process and the intervention
requirements of the different practices that include animals to involves therapeutic goals, appropriate therapy techniques, and
benefit humans. The recommended terms that are proposed measurable outcomes. The authors emphasize that in order
are: animal-assisted services (AAS) as the umbrella term and to work with animals in practice ethically, providers must work
animal-assisted treatment (AATx), animal-assisted education within their boundaries of knowledge, skills, and competence.
(AAE), and animal-assisted support programs (AASP) as Incorrectly categorizing one’s work as therapy, when the provider
subcategories. Recommendations for provider-specific is not professionally credentialed, licensed, and registered, harms
terminology are also proposed; the reputation and perceived efficacy of the services. Clients in
Johnson et al. Human-Animal Interactions (2024) 12:1 https://doi.org/10.1079/hai.2024.00033

need of therapy may be inadvertently harmed by providers who organizations and educational institutions that engage in animal-
profess to do therapy, yet do not have the education and licensure, assisted interactions. As a first step toward this goal, four core
credentials, or registration to conduct therapy. Programs should members, Melissa Winkle and Amy Johnson Binder (representing
state their specific preparation, goals, scope, methods, techniques, AAII) and Marie-Jose Enders-Slegers and Jo-Ann Fowler
processes, and projected outcomes. (representing IAHAIO) collaborated for over a year and a half to
frame projects and review literature.
PROBLEMS WITH CURRENT TERMINOLOGY FOR
RESEARCH AND PUBLICATION TIMELINE OF EVENTS
The lack of specificity or clear operationalization of the methods For the next step, they prepared and presented a half-day
and standards of practice used under current terminology also workshop for the International Society for Anthrozoology, reviewing
confuses researchers and theoreticians, making it challenging to previous and current terms and definitions from the literature
evaluate and compare the results of research investigating the and the official documents of AAI and Human-Animal Interaction
effects of any given practice (Fine, 2010; Griffin et al., 2011; Fine organizations. Brief presentations were made, followed by semi-
and Beck, 2015). Non-standardized terminology use makes the structured discussion groups among attendees and facilitators.
publication of a scientific study of animal-assisted interactions and Workshop discussions were focused on the clarity of the
services difficult because it impedes the possibility of comparing terms and implications of terminology, identification of more
studies, severely limiting the ability of researchers to conduct transparent terms and recommendation of terms as outlined in
meta-analyses that would allow them to start drawing conclusions this article.
about important questions such as dosage, duration, and overall
Following this process, through a live and recorded invitation
efficacy across populations. Reviewers may not have knowledge
presented at the ISAZ 2020 conference session, the IAHAIO 2021
about uncommon or inconsistent language that is used, or even
conference session, and the AAII 2021 Members Forum, together
understand that there are various ways to include animals and the
with an international open invitation via email and social media,
differences between them. For instance, many studies included
potential members were sought to join the IC-AAI task-force to
in various meta-analyses erroneously refer to AAT despite
identify terminology problems and make recommendations to
investigating the effect of the presence of an animal in non-therapy
address these.
situations. It is impossible to have a consensus of whether an
approach can be shown to be effective if we do not accurately Three personal invitations were extended to well-respected
define the environment, provider qualifications, methodology and specialists in mental/physical health and veterinary medicine who
content of the intervention investigated by the research study with are known for their contributions in AAIs. Their purpose was to
consistent terms. periodically monitor and review the group’s outcomes. A total of
91 people joined the IC-AAI general workgroup, which consisted
In summary, the adoption of uniform terminology is expected to
of the four original IC-AAI chairs, two dozen university faculty,
provide a clear pathway for enhancing the quality of the service
researchers, volunteer dog handlers, dog trainers, and providers
for the recipient and for determining appropriate training and
from a variety of disciplines, working with different populations,
qualifications for providers. Additionally, more explicit practice
in more than 13 countries. Members of the general workgroup
standards and competencies would lead to greater scientific and
were invited to join any of four topic-specific work groups: (1)
public confidence and credibility in the field.
AAI terminology, (2) therapy animal terminology, (3) government
regulations for AAI, and (4) qualifications and continuing education
Methods for AAI. Individuals were placed in at least one of their top two
working group choices. The intensive input of the members of
these groups spanned 2 years.
AAII AND IAHAIO COLLABORATION
The consensus-building process began in 2020 with working Twenty-seven individual members with AAS experience from
group collaboration between the Animal-Assisted Intervention various disciplines and practices from around the globe signed
International (AAII) and the International Association of Human- up for the AAI terminology group, which culminated in this article.
Animal Interaction Organizations (IAHAIO). AAII was founded in This work group was charged with reviewing and recommending
2012 and is a member-driven (including both organizations and unified and optimal terminology for those incorporating animals
individual providers) non-profit organization that has expanded into their services. The work group was facilitated by Amy Johnson
standards of practice, competencies, accreditation, and continuing and Nancy Parish-Plass. The workgroup met virtually on Zoom
education for AAS providers, including animal trainers who work for eight meetings, from January 2022 until August 2022, as well
with people and their dogs who conduct animal-assisted services as continuously worked via emails and shared documents until
(Animal-Assisted Intervention International, 2020). One of AAII’s September 2023. The four original chairs met regularly during the
core goals has been to facilitate international collaborations with same period to discuss progress and make recommendations. The
other organizations for professionalizing AAS practices. AAII is list of members is noted in the authorship list of the article. This
supported by 112 individual and organization members across six article reports the results from the AAI terminology group. There
continents. was no financial support for this work group (Table 1).

In 1992, the IAHAIO was founded as a global association of

organizations that engage in practice, research and/or education Results
in animal-assisted human services, human-animal interactions
and service animal training (IAHAIO, 2018). There are over 110 ANIMAL-ASSISTED SERVICES
member organizations within IAHAIO, across 30 different countries.
We propose that the term animal-assisted service (AAS) replace
One of IAHAIO’s strategic directions is to establish international
AAI as the umbrella term for the full spectrum of practices in
task forces to address pressing issues in the field, for example,
which animals are included in various roles for the benefit of
the international task force for standards in AAI best practice and
humans. AAS are defined as the mediated, guided or facilitator-led
animal welfare (Strategy 7). It provides international guidelines on
practices, programs and human services that incorporate specially
many aspects of AAS, position statements, and declarations.
qualified animals into therapeutic, educational, supportive and/
The AAII and IAHAIO leadership decided to form the International or ameliorative processes aimed at enhancing the well-being of
Consortium of Animal-Assisted Interactions (IC-AAI), an humans while ensuring the welfare of the animals involved in these
international task force made up of experienced individuals, practices. There are three categories of AAS: animal-assisted
Johnson et al. Human-Animal Interactions (2024) 12:1 https://doi.org/10.1079/hai.2024.00034

Table 1. Timeline of events.

April 2020 IAHAIO/AAII joined forces to professionalize AAS practices beginning with uniform terminology

June 2020 IAHAIO/AAII conducted a half-day workshop at the ISAZ conference; formed the International Consortium of
Animal-Assisted Interventions

September 2021 IAHAIO/AAII presented the results of the work progress at the IAHAIO conference, and AAII monthly forum.

January 2022 Working groups were formed that included AAS terminology, therapy animal terminology, government regulations
in AAS, and continuing education in AASI; AAS terminology workgroup chairs were confirmed

September 2022 Outcomes and recommendations were presented at the IAHAIO and AAII conferences

September 2022–June 2023 The International Terminology task force met monthly to begin assembling the article of recommendations

June 2023 Rough draft of the article sent to members of AAII and IAHAIO and to Nancy Gee, Aubrey Fine, and Zenithson
Ng for peer review

July 2023 Edits that were suggested from the review process above were discussed amongst the task force and AAII/
IAHAIO core members and implemented as applicable; that version was sent to the larger international
consortium (IC-AAI) for review.

August 2023 Edits from that review process were discussed among the task force and implemented as applicable.

October 2023 Paper submitted to the Human Animal Interaction journal (CABI) for peer review and publication

treatment (AATx), animal-assisted education (AAE), and animal- and discipline, as well as to the type and level of professional/
assisted support programs (AASP) (see Figs. 1 and 2). academic training and competencies that are required for
licensure and/or accreditation for the particular profession in the
AAS are a distinct category of human-animal interactions, where
country in which the service takes place. Importantly, while AATx
human-animal interactions are described as “any manner of
can be construed as an adjunct to another treatment approach
relationship or behavior between people and animal(s). These
(e.g., a therapist might use an evidence-based therapy such as
interactions can vary widely and be positive, negative, or neutral
cognitive behavioral therapy while interacting with the animal,
for either party. They can occur in individual, community, or societal
referring broadly to this practice as AATx), AATx can be integrated
contexts” (AVMA, 1998) Appendix A (examples of HAIs that are
as the primary treatment approach chosen with a clear clinical
not AASs) provides further clarity on the distinction between HAI
rationale (e.g., humanistic animal-assisted psychotherapy. AATx
and AAS.
professionals must practice within the scope of their profession
In AAS, the human-animal bond (defined as a mutually beneficial (e.g., occupational therapy, counseling, etc.) and with the accepted
and dynamic relationship between people and animals that is target population of that profession, according to the standards,
influenced by behaviors considered essential to the health and well- competencies, and ethics of professional practice conforming to
being of both, AVMA, 1998) may or may not develop, depending those of the country in which it is practiced. It is imperative to note
on the specialized process being facilitated and the subjective that different countries define the scope of various professions in
experience of the professional, recipient and animal(s). Some different ways. For instance, in some countries, psychotherapy
AASs intentionally develop the (potential for) human-animal bond may be conducted within the scope of clinical psychology,
to facilitate change in the client. Other AASs include interactions counseling and social work, while in other countries practitioners
with animals where the human-animal bond may not develop, in any or all of these professions must obtain further training to
however, other mechanisms involving animals and supporting become a licensed psychotherapist.
change are involved (such as observing a group of horses to
A competent and ethical AATx professional should be trained and
project and reflect on a client’s family dynamics). Firmly embedded
supervised first in their licensed/credentialed profession (e.g.,
in the definition of AAS is an emphasis on the need for proper
counseling, occupational therapy) and then in the specialized area
animal welfare practices across all categories. This is covered in
of treatment being provided (e.g., animal-assisted psychotherapy,
further detail in Section “Animal welfare and well-being”. Figures
animal-assisted occupational therapy, animal-assisted speech
1 and 2 provide a graphic illustration of the three main categories
therapy). The additional education and training would include studying
under the umbrella term, AAS.
the human-animal bond, animal studies, animal welfare, and ethical
considerations, as well as the specific discipline-based AATx theory and
ANIMAL-ASSISTED TREATMENT (AATx) practice methodology they are utilizing, if such courses are available
Animal-assisted treatment (AATx) replaces animal-assisted in their country. Most professional codes of ethics state that the onus
therapy (AAT). In the simplest of terms, AATx is treatment focused. is on the professional to take the necessary steps to find education
AATx refers to a class of mental or physical health professional and training before including specialty modality in their practice (see,
treatment modalities for which the integration of animals, directly e.g., Available at: https://www.apa.org/ethics/code, accessed 10
or indirectly, is a critical component of the treatment approach September 2023). A separate workgroup formed through the IC-AAI
of the professional. Tx was chosen as it is a common medical is currently working on establishing best practices for the education
abbreviation for the term treatment and is recognized in accepted and training of providers wanting to include animals in a treatment,
medical sources such as The American Heritage Stedman’s educational or service program capacity. Depending on the technique
Medical Dictionary (Stedman, 2004) (e.g., Tx for treatment, Dx for of the particular AATx, the professional may work collaboratively with
diagnosis, Hx for history, etc.). an animal handler or animal/equine specialist in order to further the
goals of the treatment. It is recommended that the handler/specialist
The term treatment is more inclusive of professions that employ a
has attended coursework related to the particular field of AATx.
variety of treatments by mental and physical health professionals
that are not necessarily therapy but are part of the scope of their The AATx practice may take place in a traditional setting (such as
profession. Each AATx provider subscribes to the goals and a clinic, private practice rooms, hospital, etc.) or in a non-traditional
techniques defined and accepted in the particular profession setting, such as a zoo, private stable, animal rehabilitation center,
Johnson et al. Human-Animal Interactions (2024) 12:1 https://doi.org/10.1079/hai.2024.00035

Fig. 1. Examples of human animal interactions that are not considered animal-assisted services.

Fig. 2. Examples of animal-assisted services that includes area of focus and distinctions.
Johnson et al. Human-Animal Interactions (2024) 12:1 https://doi.org/10.1079/hai.2024.00036

natural habitat, prison, etc. The following is a list of how AATx ANIMAL-ASSISTED SUPPORT PROGRAMS
professionals might identify their work: Intended to replace the term “Animal-Assisted Activities,” the
new category proposed here, animal-assisted support programs
• Animal-Assisted Occupational Therapy (AASP), includes only programs in which animals are engaged,
• Animal-Assisted Physical/Physiotherapy directly or indirectly, in activities aimed at supporting and
• Animal-Assisted Speech Therapy enhancing the well-being of humans. These programs may have
• Animal-Assisted Clinical Nursing** aims that include increased motivation, prevention of loneliness
• **This may apply to a psychiatric nurse practitioner or an and isolation, reduction of tension and anxiety, distraction from
advanced practice nurse who has been credentialed to difficult situations, or emotional comfort. In the case of animal
conduct therapy visitation services, the human service providers and animal
• Animal-Assisted Psychotherapy** specialists may be volunteer handlers with related knowledge in
• **Psychotherapy practice; providers still need to operate animal behavior and training at the species, breed, and individual
under their scope of profession levels. The activities may or may not be documented, depending
• Animal-Assisted Psychology on the goals and demands of the specific AASP being carried out.
• Animal-Assisted Counseling Other examples of these AASPs include courthouse facility dog
• Animal-Assisted Social Work programs, formal crisis interventions, victim advocacy, prison or
detention visiting programs, support services and dog training
programs for human rehabilitation. An AASP may be an adjunct to
ANIMAL-ASSISTED EDUCATION (AAE) AATx or AAE.
The workgroup has retained the category name of animal-assisted These programs can be delivered in three different ways,
education (AAE), used historically, but modified the definition depending on the background of the provider:
that was published in the 2018 IAHAIO white paper. In this new
definition, AAE refers to any educational program in which animals • by professionals with licensure/degree who also have
are integrated, directly or indirectly, as a critical component of an specialized training in this type of AASP in the circumstance/
ongoing educational process. Depending on the degree and type of environment specific to the program (e.g., life skills coach);
training of the AAE provider, the nature of the goals of AAE programs • by professionals with licensure/degree or equivalent, working
may be academic, social-emotional, psychoeducational, cognitive, together with an assistant who is a trained, qualified animal
vocational, and/or personal or organizational development, and handler;
may focus on emotional regulation, coping strategies, prosocial • by volunteers (see provider-specific terms below) who have
skills, and/or empathy development. One example would be education, skills and/or experience in delivering this specific
programs that include reading to dogs. A program set up in a type of support activity (e.g., visitation animal team),
classroom, where students read daily or weekly to a dog and the interaction or intervention in the specific circumstance,
process is overseen by a teacher or paraprofessional with the goal environment, or target population.
of increasing reading levels, would fall under the classification
of AAE. However, if conducted by a volunteer in a library setting The term “support programs” is likely to help support service
during monthly visits, it would be classified as an animal-assisted providers feel that their work is important for making a difference in
support program (formerly activity or AAA). the life of the recipient, more so than simply “running an activity.”
AAE may take place in a variety of locations, such as schools This work is of equal importance to that of a therapist, but is different
providing education, prisons, stables, and private centers. in nature (goals, methods, training of service provider, etc.).
Programs with animals specializing in humane education goals
may include those operated by animal welfare groups, museum PROVIDER-SPECIFIC TERMS
education, nature and environmental centers. Programs in AAE Historically, terms used to describe the human’s participation in
may include equine- and canine-assisted learning, requiring conducting AASPs have been somewhat unclear. The terms used
relevant training and knowledge of the animals present in the by individuals to describe themselves have often also been unclear
program. An AAE psychoeducation program may involve working and inconsistent. For example, individuals who are volunteering with
with prisoners or at-risk youth, teaching social skills with the goal their registered visiting dogs on hospital visits may have referred to
of helping the recipient feel a sense of self-worth or self-esteem, themselves as animal-assisted therapists. However, this would not
acquire positive self-control skills, internalize limits and positive be accurate because no “therapy” is being conducted. The authors
limit-setting skills. The AAE provider may work with facility-owned of this article recommend the following terms to best represent
animals, collaboratively with an assistant or may work with their the work being done within specific categories: Degreed and non-
personal animal. In all cases, it is recommended to have knowledge degreed professionals, paraprofessional, volunteer (Fig. 3).
of animal behavior and communication to protect the health and
well-being of the animal and everyone else involved in the process. This decision tree can help the provider determine their role and
category of AAS being conducted.
Providers of AAE programs fall into two categories, which are
differentiated by the degree of training undertaken by those carrying Professional – AATx-P
out the program: (1) AAE professionals are required to have an
The professional provider of treatment (AATx-P) is the individual
academic degree or certificate in education, depending on the
providing treatment with an academic or professional degree, related
country where the program is taking place. (2) AAE non-degreed
licensure or registration as a health or human service provider (e.g.,
professionals are required to have training or coursework relevant
occupational therapist, physical therapist, psychologist, licensed
to the program they provide. The process of programs runs by any
professional counselor, registered psychotherapist, social worker,
provider of AAE includes structured or semi-structured sessions,
or psychiatric nurse). The service would be defined as AATx if the
evaluation, and documentation of the sessions. Depending on the
professional provider is overseeing or directing the interaction
goals of the program, professional AAE programs may sometimes
with set outcomes for the client in a clinical setting on a consistent
be carried out by non-degreed professional AAE providers who are
schedule. The service would not be AATx if that same professional
actively overseen and directed by a mental health or educational
provider were visiting a hospital setting with their dog outside of
professional.
their work schedule or professional role. That professional provider
Animal dissection, animal experiments, or animal collection for would be a volunteer in that scenario, potentially providing animal-
research are not considered AAE. assisted support.
Johnson et al. Human-Animal Interactions (2024) 12:1 https://doi.org/10.1079/hai.2024.00037

Fig. 3. Determinants of provider-specific term: professional.

The next consideration involves desired outcomes. What goals or handler bringing a dog into the school setting to visit with students
outcomes are the individuals looking to achieve with their clients? or allow students to read to the dog.
Goals and outcomes should have value for the therapy process
that helps with short-term and long-term goal attainment related
to the particular profession. If the goal is to provide comfort, while
Discussion
considered therapeutic, it would fall outside of the professional
COMPETENCE AND QUALIFICATIONS
scope of AATx-P.
One of the main criteria differentiating the types of AAS is the
And finally, the frequency of the interactions needs to be taken qualification and expertise of the provider (and those who offer
into account. Treatment is conducted over a period of time rather training and continuing education to providers). Every person
than a one-time interaction. Meeting weekly or bi-weekly to work delivering any type of AAS needs to be a competent provider.
toward achieving a therapy outcome with the inclusion of an animal However, depending on the technique or approach involved in
in sessions with a therapy professional best meets the criteria of delivering the AAS, each type of service will require a particular set
treatment. of skills needed for the provider to reach competence, skills that
are developed through training and the awarding of qualifications
Paraprofessional – AATx-PP as well as continuing education or professional development.
A paraprofessional is “a person to whom a particular aspect of a Although there are published standards and guidelines for
professional task is delegated but who is not licensed to practice including animals in services (IAHAIO, 2018; AAII, 2014,
as a fully qualified professional”. This definition describes the work 2020, 2022) as well as competencies (ISAAT/ESAAT; IAAAP –
of a volunteer (paid or unpaid) who works under the supervision or Israeli Association of Animal-Assisted Psychotherapy, 2015;
direction of a professional. American Counseling Association, 2020; Chandler, 2017; VanFleet
and Faa-Thompson, 2017; AAII, 2020); and ethics endorsed
Volunteer – AATx-V, AAE-V, AASP-V by national professional organizations (American Counseling
Association, 2020; IAAAP – Israeli Association of Animal-Assisted
The abbreviation would be, based on the context of the interaction,
Psychotherapy, 2016; American Psychological Association Human-
animal-assisted treatment volunteer (AATx-V), animal-assisted
Animal Interactions Section 13, 2020), there remains the challenge
education volunteer (AAE-V), or animal-assisted support program
to reach consensus on specific training and qualifications that
volunteer (AASP-V). The difference between a paraprofessional
accommodate regional, national, and international differences in
role and a volunteer role would be whether the handler is a part of
definitions (e.g., specialists) and qualifications.
the interdisciplinary team or providing one’s animal in a visitation
capacity. The role of the volunteer in this context is animal handling. Currently, there are wide variations in course content and what
This could be a visiting dog team in a hospital setting or an animal qualifications and job titles represent. In trying to reach consensus
Johnson et al. Human-Animal Interactions (2024) 12:1 https://doi.org/10.1079/hai.2024.00038

in terminologies in AAS, we need to also be clear about what is knowledge of laws, regulations, outcomes and techniques related to
meant by terms such as “professional,” “licensed,” “qualified,” their roles working with the degreed professional. In different parts of
“evaluated,” “certified,” “registered.” the world, the term paraprofessional is not widely used and instead,
reference is made to “handlers” or “specialists” who meet these
While all animals should be screened for suitability to the AAS they
same or very similar criteria.
are participating in, some animals will require additional education,
training, and evaluation for their specialized role, including A third example is the term “counselor.” Depending upon the region,
animal registration (e.g., a dog trained and included in a speech a counselor may be formally educated, degreed, and certified or
therapy room-based session). The type and degree of training licensed to diagnose and develop treatment plans. Other regions
and evaluation depend on the goals, process involved, population have counselors without training to diagnose or write treatment
served, setting, and type of animal. Other AASs may not require plans, but have been certified to provide social support services
such training, but rather the animals may be chosen for their to students/clients. Further debate and discussion is needed to
temperament or personality. Comprehensive training, supervision provide more clarity but for now it would seem that the onus is on
and registration of the specialized AAS provider will serve to the professional to understand how their governing bodies classify
promote animal and recipient safety, limit risk and liability to the them within their region.
provider, and contribute to the overall efficacy and professionalism
of each of the specialized branches of AAS’s (within the AATx, CONCLUSION
AAE, and AASP specialties).
This internationally represented workgroup has sought to describe
The maturing field of AAS, with its increasing and diversifying the problems with the current ambiguity in the range of services
range of services, will demand the growth of more specialized and that have been commonly referred to as AAI (pursuant of the
comprehensive education, training and registration pathways and term AAS), to provide clarity on definitions and terminologies, and
opportunities for future service providers from within each AATx, to specify criteria for differentiating between them. The overall
AAE, and AASP specializations. This maturation involves moving umbrella term AAS is recommended, which encompasses three
away from the more popularized, generalized, information-based major categories. AATx refers to the integration of animals into
AAS courses (former AAI virtual courses) and “one size fits all” the practice of mental and physical health professional practice,
animal registration or certification trends towards more service- in which the professional practices according to the scope, goals,
specific, in-depth academic and practice-based training and techniques of that profession. AAE refers to an educational service
education available at graduate and postgraduate equivalent with academic, instructive, cognitive, social-emotional learning, and
levels (when appropriate for licensure), as well as a more well- psychoeducational goals, practiced by credentialed and informal
developed understanding of evaluation for the animal for the role educators. A new category proposed is AASP which includes
that they have in the service. previously existing services (e.g., animal visitation activities), as
well as those that have evolved and have been developed over the
As noted earlier in this article, there is a separate workgroup, past 10 years (e.g., courthouse facility dog programs). AASP, which
part of the IC-AAI, working on provider and animal qualifications, may be motivational and social in nature, or provide emotional
education, and training primer to align with the work presented in comfort, involves programs aimed at supporting and enhancing
this article on terminologies, that should be ready in 2024. human well-being with the aid of animals. Providers may or may
not be credentialed but must have some training in their service
ANIMAL WELFARE AND WELL-BEING program. Provider-specific terms are also proposed to clarify the
As the range of services of AAS has grown, so too has the roles of providers of different services.
awareness of the central importance of animal welfare and
All service providers must have education and training in the
well-being and ensuring health and safety of both humans and
specialty AAS area they are providing, including appropriate
animals engaging in AAS (Haubenhofer and Kirchengast, 2006;
knowledge and skills related to the integration of animals into the
Grandgeorge and Hausberger, 2011; Glenk et al., 2014; Glenk,
service (e.g., animal studies, animal care, animal welfare, ethics).
2017; Enders-Slegers and Hediger, 2019; Fine et al., 2019; Winkle
A separate work group in the International Consortium of Animal-
et al., 2020; Wijnen and Martens, 2022). Additionally, it is crucial
Assisted Interactions will detail outcomes for provider education in
that the animals included in AAS are not only suitable for their roles,
a different paper.
but they willingly participate and/or thrive in the AAS environment.
Further inspection of terminologies should also consider these Animal well-being, sometimes overlooked in AAS services focusing
issues, making the participating animal’s suitability and welfare on human benefits, is included as a crucial part of each service’s
needs an integral part of the process. scope and responsibility, firmly embedded in the definition of
AAS. A reconsideration of the misleading term “therapy animal” is
REGIONAL AND NATIONAL DIFFERENCES IN also put forward but has been rigorously addressed by another
LANGUAGE AND MEANING work group as part of the IC-AAI as well as another large group
of collaborators comprising researchers, practitioners, and end
Reaching consensus in AAS terminologies requires sensitivity
beneficiaries (Howell et al., 2022).
to regional differences in terms of how the language and terms
translate across different regions, and how various training and We have presented a typology that sets clear expectations for
qualifications compare in different parts of the world. For example, each AAS, with clear distinctions between them. We encourage
our description of the training and qualifications required by all providers of AASs to identify and describe their work using
someone delivering AATx, that is, a degreed, licensed professional the three main categories proposed. Dialogue may then develop
in human health or human services, may in many countries describe between various AAS about issues concerning all, such as ethics
a “therapist.” In other countries, the term “therapist” may have a and possibilities for cooperation, leading to improvements in
broader application and include people with specialist training but practice, research, and policy decisions.
without degrees or a license to practice in a specific field.
Individuals, organizations, and educational providers, who have a
Another example is the use of the term “paraprofessional.” Within special interest in HAI and AAS in any capacity, can help to make
several disciplines in the United States, individuals who do not have this change by being part of the movement to professionalize the
clinical or educational degrees, but who collaborate with health or services in these areas. They may do so by participating in the
human service professionals who do, are called paraprofessionals. If activities listed below:
acting as a paraprofessional within the AAS context, these individuals
should have extensive knowledge of their animal at a species, breed, • review updated terminology and the rationale for the changes
and individual levels, of their skill and preference sets, as well as (such as this article or any following tools) with boards of
Johnson et al. Human-Animal Interactions (2024) 12:1 https://doi.org/10.1079/hai.2024.00039

directors, other decision makers, members of organizations, guidance. The first five authors contributed to more than a dozen
and students; iterations of this manuscript and the additional authors participated
• publish terminology changes on websites, social media, intra- in the monthly meetings to discuss the content and reviewed the
and interdisciplinary groups; article and offered their insight.
• contact journal editors that publish content about HAI or AAS
with a summary of these updated terms as well as enforce FUNDING STATEMENT
this terminology with journal reviewers;
This research received no external funding.
• write and publish summary commentaries about the changes
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• submit this article or summaries to professional organizations References
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