The URJC and Vall d'Hebron collaborate on dog-assisted therapy for children with mental disorders.

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Since April, patients admitted to this unit have been receiving a new therapy that complements their usual treatment and incorporates contact with dogs to help them learn to identify and regulate emotions. In addition to reducing anxiety and improving self-esteem, interaction with dogs provides clinical information and helps break down the wall of mistrust that many patients experience.

The initiative is a joint project of the Chair of Animals and Society at the Rey Juan Carlos University, directed by Professor Nuria Máximo, and the Hospitalization Section of the Child and Adolescent Psychiatry Service at Vall d'Hebron Hospital, coordinated by Dr. Marc Ferrer. It is fully funded by the Dingonatura Foundation and has the collaboration of the organization Perruneando, which specializes in animal-assisted interventions, which has trained this canine team to accompany the patients.

According to the World Health Organization, one in seven young people between the ages of 10 and 19 suffers from a mental disorder. Depression, anxiety, and behavioral disorders are the leading causes of disability in this age group. At the Vall d'Hebron pediatric psychiatric hospitalization ward, which opened two years ago, the majority of cases treated—approximately seven out of ten—are related to self-harm and suicide attempts. "This is a growing trend that should concern us as a society," warns Dr. Marc Ferrer. While between 2005 and 2017, self-harm accounted for 20,4% of admissions to pediatric psychiatric emergency rooms, it currently ranges between 50% and 70%. Although self-harm is a mechanism for managing anger, frustration, or regulating emotional pain—especially among girls—it must be treated because it can be a prelude to suicidal behavior. Eating disorders (ED) and autism spectrum disorders (ASD) are the other most common causes of admission. “Each disorder has its own particularities: some present difficulties controlling impulses, others with communication, but they all have in common emotional dysregulation, a difficulty managing emotional responses. And that's precisely what we work on with dog-assisted therapy,” explains Dr. Ferrer.

As a complement to individualized clinical treatment, animal-assisted therapy helps reduce anxiety, improve self-esteem, and control frustration and impulsivity, four characteristics of emotional dysregulation.

Between the ages of 14 and 16, the peak of the identity crisis

Many adolescents enter the clinic withdrawn into themselves and struggle to trust adults. Most are between 14 and 16 years old, a stage in which they experience identity crises most intensely and relationship problems can arise. Professor Nuria Máximo explains that "the bond with animals helps us break the ice and facilitates the therapeutic work of professionals." The scientific basis for this connection is known as "biophilia" and is well documented. Scientific literature has shown that interaction with dogs releases oxytocin, facilitates emotional expression, and helps control anxiety and fear. It also reduces heart rate and blood pressure. But to measure the real impact of the therapy, a study coordinated by Dr. Marc Ferrer and Professor Nuria Máximo is underway. Patients complete questionnaires before and after each session to assess anxiety, mood, and other indicators. This is an interdisciplinary study involving the Chair of Animals and Society at the Rey Juan Carlos University and professionals from Nursing, Clinical Psychology, and Psychiatry. "The philosophy of the Psychiatry Department is to listen to patients and involve them in treatment, and this research helps us understand firsthand whether dog-assisted therapy is useful for them," says Dr. Ferrer.

Although the study will be published next year, the initial results are already palpable. The sessions are held once a week, on Fridays, in groups of two to four patients, and last one hour. “On Wednesdays, some boys and girls already ask about the dogs,” says Merche Rodríguez, Nursing Supervisor of the Psychiatry Department at Vall d'Hebron University Hospital. “And we've observed that their visits are also beneficial for the professionals,” she adds. Considering that admissions cannot be predicted and that the average patient stay is about ten days—since this is an acute care unit, the goal is for them to return to their environment as soon as possible—the sessions are not designed to be continuous over time. “It's a structured therapy designed to work on emotional dysregulation, social relationships, and mentalization skills in one session: understanding their emotional state and how they relate to others,” explains Dr. Ferrer. “Some patients will have two or three sessions, but most only one,” he adds.

The bond with dogs improves self-esteem and helps regulate emotions.

In each session, two dogs work together, accompanied by their handlers, who also serve as their caregivers. They arrive at 10:45 and always follow the same route so as not to disrupt the hospital routine. Before entering the ward, they meet with the clinical psychologist and the nursing team, who brief them on the patients they will be working with. “We combine boys and girls with different disorders to form groups that are as heterogeneous as possible in terms of characteristics and symptoms; this way, we achieve a balance that helps us avoid clinical decompensations during the sessions,” explains Bàrbara Citoler.

In addition to the guides and the dogs, each session always includes a nurse to gather information. The interventions are fun and guided. They begin with a presentation in which guides specializing in animal-assisted therapy, Andrea Galofré and Laia Portolés, explain how to communicate with the dogs, what they like and dislike. At first, the dogs walk, sniff, and explore, but soon petting begins, which relaxes them. "When they're calm, we work on emotions through the dogs," explains Andrea Galofré. "For example, if we organize a circuit and a dog doesn't understand you, isn't able to or doesn't want to play a game, we can talk about what happens when you feel misunderstood, when you don't feel like doing something, or when you can't do it," she explains. "We also do games with rewards or dynamics in which patients must prepare materials, which gives them an active role. They stop being just patients and become caregivers," she continues. “The guided sessions provide us with a lot of clinical information and allow us to observe the children as they are and how they feel,” he adds.

The bond between humans and dogs is very ancient. 6.000 years ago, Neolithic humans already buried their dogs with them. Today, this ancestral bond becomes a therapeutic tool. “For us, the session with the dogs is a small reflection of real life within the hospital setting,” shares one of the patients. According to Paco Camarasa, director of the Dingonatura Foundation, the bond between people and animals is much more than companionship: it can be a real therapeutic tool. “Helping these young people at such a delicate time in their lives is one of the best applications we can give to the relationship between humans and dogs,” he states.