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  • Created 06 Mar 2012

About that word "interventions..."

  1. Pamela Pitlanish

    I'm stuck (and wonder whether I should be posting this in the "sticky stuff" forum) with my final project in the AAT Certificate Program I'm in. I decided to develop a guide/manual of interventions for use with families of infants & toddlers using a canine co-therapist in private practice, based on attachment theory. The reason I went in this direction is because one of the first assignments was to design lesson plans for working with whichever population we chose, so that we were aware of the intent behind what we were doing. Below is an example (this is what I created). The reason I'm stuck is because the way I do psychotherapy is in the moment with clients. I'm wondering whether anyone doing AAT uses any sort of pre-planned activity to assist clients toward their goals, or whether it's best to conduct AAT in the same manner in which one usually does therapy.

    OBJECTIVE:  Child will understand basic concepts of resiliency as evidenced by 

    1. Participation in exercise with dog and answering questions related to resiliency theory 
    2. Parental report of child's improved behavior, verbalizations, or mood  at 1-week follow-up session 
    3. Child's ability to recall at least 3 behaviors indicative of resilience as a positive mechanism to cope with stressful situations at 2-week post-intervention session.  

    BACKGROUND & POPULATION : Child's symptoms displayed at beginning of treatment included anger, verbal abuse toward mother and MGM (maternal grandmother), not completing homework, defiance, and conflicting description of family functioning and level of conflict by the daughter. I will be using my own dog for this intervention, a 9-year-old male, neutered Border Collie named Buddy, who has years of experience in bouncing to catch balls and Frisbees, and who is currently finishing a therapy-dog training program.  

    MATERIALS: 

    1. Hand-out for mother, "Bouncing Back: Teaching children resilience skills" (Palomares)
    2. Hand-out for daughter, adapted version of the above, showing images of Buddy 
    3. Set of 10 questions  to be read to client, depicting responses which indicate resiliency choices or non-resilient beliefs 
    4. Tennis ball  
    5. Water bowl 
    6. Leash 
    7. Lawn of my office building  

    PROCEDURE: 

    • Therapist to ensure that Buddy is well-rested, clean, and not in poor physical health the day of the session. 
    • Therapist will provide mother with a description of the session's activities, as well as a copy of the parent's handouts.  
    • Therapist will see client in office to review abbreviated handouts, discuss these with her, and explain that "Buddy is excited to help her understand the importance of bouncing back." 
    • Once outside, client will be informed of Buddy's rules, in the interest of client's safety: 
      1. "The ball is mine until I set it down," and 
      2. "If I'm holding the ball, I'm not ready for you to take it." 
    • Therapist will read each of 10 questions, which client is to think about and answer honestly (to be stressed, as substance-use and its partner, dishonesty, go hand-in-hand, and also because the handout for mother points out that modeling honesty is a way to build a child's resiliency). When she has provided an answer, she is to throw the ball for Buddy if she believes her answer does not display resiliency, or to bounce the ball as high as she can if she thinks her answer does show a component of resiliency. The following questions were adapted from Resilience Self Test (Scott) on About.com, and from Resilience - Don't let things get you down (Kids' Health - Resilience), from Child and Youth  Health on the Women and Children's Health Network website.
    1. When I set a goal for myself: 
      1. I usually achieve it through hard work and sticking to my goal 
      2. Things don't usually work out for me or my family. 
    2. When I'm faced with a tough or stressful situation, I: 
      1. Know that even though I can't always choose what happens to me, I can choose how I react to my situation, and that can make all the difference! 
      2. Usually get really mad, because life's just NOT FAIR, and besides that, I often feel scared when not in control. 
    3. When I'm bothered by something, I: 
      1. Have some friends who like me, but nobody I can really talk to about my deep feelings. 
      2. Have lots of people I can talk to about my feelings and problems. 
      3. Have no one; my friends aren't really true friends, and my family doesn't really care. 
    4. When things or people in my life have crazy stuff going on, I: 
      1. Try to adapt, but I can become pretty stuck thinking of ‘how things used to be.'  
      2. Can be flexible & bounce back. Change is a part of life! 
    5. When faced with something tough I have to do, I first think: 
      1. “I know I can get through this, and I’ll probably be stronger because of it in the end.” 
      2. “Why is this happening to ME?” 
      3. “I can't do this.”  
    6. In my family there are rules. What I think about rules is: 
      1. "We don't need any rules; life is easier when no one tells you what to do." 
      2. "Rules let me know what to expect from other people, and are important at home, in school, and in my city, state, & country." 
    7. Some kids have said mean things to me. I think: 
      1. They're probably right.  
      2. I'm a good person, by the way I take care of myself, and by how I treat others. 
    8. Exercising my body is just as important as exercising my brain. 
      1. Yes 
      2. No 
    9. Do you have faith in a higher power, a greater good, or something outside of yourself that can give you strength? 

                    a. No 

                    b. Yes 

    1. Sometimes I hear myself saying negative things about me. But for every negative thing I say to myself, I can think of _____ positive things!
      • 1-5 
      • 5-10 
      • 10-20 
      • 100 

    At mother's weekly follow up session, therapist will inquire as to any changes in child's behavior, verbalizations, or mood, and if so, in what way. At child's follow-up session 2-weeks post-intervention, she will be asked to state 3 attributes of a person who shows resiliency to life's stresses.  

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  2. Nancy Parish-Plass

    Actually, Pam, I think this is a good place for your post. I have a lot to say but hope that others may jump in first. However, I think this is an appropriate time a place to mention a translation of an article I recently wrote in the Hebrew "Animals and Society" journal dealing with the question of the confusion between the various animal-assisted interventions. It is titled: Order out of Chaos: A Call for Clear and Agreed-Upon Definitions Differentiating between Animal-Assisted Interventions.  I am attaching it to this post and I have placed it in the Resources section of this group. 

     Everyone - what are your reactions to Pam's questions and deliberations?

    What are your reactions to my article, which I admit was my way of saying: "Hey, guys, stop trying to blur boundaries. Respect yourselves and what you do, and respect me and what I do. It's NOT the same thing!" It was my attempt to protect AAP from being watered-down and misunderstood.

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  3. Pamela Pitlanish

    Thank you for the article. It speaks to all of the confusion in my head, even after studying AAT in a University program. I was pleased when I began reading Animal Assisted Psychotherapy:Theory, Issues and Practice (2013), simply to hear the words "animal-assisted psychotherapy." There is so much confusion about AAI vs AAT (and now AAP), that, like any field, I think, 'the more you know, the more you know you don't know." Which is good. My example in the first post above is clearly a animal-assisted intervention, but processed with the client via psychotherapeutic methods, and based on that particular cl's tx goals, in order to meet your definition from the "Order Out of Chaos" article posted above: "Therapy is a controlled process involving the setting of therapy goals, the use of techniques appropriate to specific therapy field being employed, and constant evaluation and reevaluation of change" (p. 7).

    My dog is the medium, much like a tray of sand and objects, which assists the client in the realization of insight and therefore, healing.

    So, Nancy, tell me your thoughts about whether I'm pointing myself in the wrong direction (poring over others' writings is never a waste of time, unless there's a due date!) with deciding to draw up specific interventions for use with families of young children. Also: is citing your paper--in process of publication--permitted?

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  4. Melanie Jones

    I want to read this again and respond in more depth - however I empathise with the question - how does one manualse the minute by minute relationship that we use to create change?!

     

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  5. Pamela Pitlanish

    Thanks, Melanie. What I've decided to do is to write up in a more general way (than with specific interventions) the basic model for how I use AAP with IMH (infant mental health) and attachment theory in working with families having young children. So I've got the basic--who the client is (the family unit, & more specifically the relationship between parent/child), a hypothesis about AAP w/ IMH families, safety of child and tx animal, awareness of parties involved in "the dance," inc. dog, development of alternate stories for families (Zilcha-Mano 2013), and then a process for documenting the interventions & family responses as I go along in my practice. This, then, might be able to provide something useful about this work, and Lord knows, maybe others will want to look at it?

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  6. Melanie Jones

    http://www.tandfonline.com/doi/full/10.1080/19411243.2015.1026017#.VW5Ydlzkbdk

    article on mother infant attachment and EAI

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