Animal-Assisted Psychotherapy for Pediatric Chronic Pain: Case Series of an Open Pilot Study to Test Initial Feasibility and Potential Efficacy

Abstract

Objective

Chronic pain is a common complaint in children and adolescents, placing an enormous burden on individuals, their families, and the healthcare system. New innovative approaches for the treatment of pediatric chronic pain (PCP) are clearly warranted, as drop-out rates in intervention studies are high and it can be difficult to engage patients with PCP in therapy. Here, animal-assisted interventions (AAIs) might be promising, since there is preliminary evidence for the approach in adults with chronic pain, and AAIs are generally known to foster the therapeutic motivation of patients. To date, however, AAIs have not been examined in pediatric chronic pain.

Methods

The aim of this open pilot study was to examine the initial feasibility of recruitment and potential efficacy of an animal-assisted group psychotherapy (including horses, rabbits, chickens, goats, and a dog), providing case reports of three children with chronic pain. We applied a mixed-methods approach, including the conductance of semi-structured interviews and assessment of quantitative pre-post data with a focus on pain severity, avoidance behavior, pain acceptance, and ability to defocus from the pain.

Results

The three participating girls (age: 9–12 years) reported chronic pain in the head and abdomen. The process of recruitment turned out to be challenging. All three children reported reduced pain-related disability and pain-related distress, as well as an increased ability to accept pain and to defocus from the pain. The qualitative data revealed that patients and their parents had a positive attitude towards AAIs.

Conclusion

Our initial open pilot study is the first to investigate AAIs in the context of pediatric chronic pain. Notably, we had difficulties in the recruitment procedure, mostly due to the Covid-19 situation. Based on three case reports, we found some first indication that AAI approaches might be associated with symptom changes. Future randomized-control studies with larger sample sizes are clearly warranted.

Clinicaltrials.gov Identifier

NCT04171336.

Keywords:

• children and adolescents
• chronic pain
• animal-assisted psychotherapy
• group-based

Data Sharing Statement

Data can be made available upon request to the corresponding author.

Acknowledgments

The authors would like to thank Jorinde Straub, Paula Muser, and Silea Häusermann for their support with study procedures.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This study was supported by a grant from the “Stiftung für psychosomatische, ganzheitliche Medizin” given to Dr. Cosima Locher, Dr. Helen Koechlin and Mrs. Milena Petignat. At the time of manuscript submission, Dr. Koechlin was further supported by a grant of the Swiss National Science Foundation (SNSF; P5R5PS_203064), as were Dr. Locher (PZ00P1_201972) and Dr. Hediger (PCEFP1_194591).