∗ , Samuel B. Ross Jr. † , Steve Klee † , Lisa Ross ‡
∗Hunter College School of Social Work
†Green Chimneys Children’s Services
‡Touro University
8.1 Introduction
Although health and mental health systems continually examine fresh and original approaches to serve their client constituents, new proposals are seldom greeted with enthusiasm within organizational structures (Bolman and Terrance, 1991; Brager and Holloway, 1978; Dutton, 1992; Kets de Vries and Miller, 1984; Morgan, 1986; Moss-Kanter, 1982, 1988). One relatively new approach that utilizes a variety of animals including companion animals, farm animals, and injured wildlife as adjuncts in the treatment of various populations, has, or soon may receive, greater acceptance and consideration by health or mental health organizations (Brooks, 2001; Hanselman, 2001; Mallon, 1994a,b, 1999). Utilizing animals in health and mental health organizations is a proposal that has engendered both the regard and the ire of administrators.
The emerging breadth of its applications and the involvement of skilled professionals from diverse disciplines have made animal-assisted therapy (AAT) more than a “therapeutic” intervention. Although AAT is beginning to be recognized as a treatment modality much like dance, music, art, and poetry therapy (Beck and Katcher, 1984), it is also important to note that the main difference between AAT and other adjunctive therapies is that the central “tools” in this intervention are living, breathing, interacting creatures. This is an important element because when animals are introduced into a health or mental health delivery system, unique organizational issues must be considered.
Utilizing a predominantly social work and psychological approach to organizational administration, this chapter contains advice to help organizations discern whether or not to utilize AAT and to aid implementation. What can be considered are equine experiential learning, equine facilitated psychotherapy and therapeutic riding as part of a program offering. In addition, horticultural activities should be considered as part of the introduction of the activities. Clarity as to whether the program is to provide therapy or psychotherapy must be part of any planning. Today, dog training by students, school gardens, mini-zoos, visiting animals and handler and nature therapy combine elements which are seen in animal-assisted therapy and activity programs. With Green Chimneys Children’s Services (see Ross, 1999) as our organizational model of choice, the authors, who are among the principal administrators of this program, focus on rules and principles that guide program development.
8.2 Animal-assisted therapy
Boris M. Levinson (1962) was the first professionally trained clinician to formally introduce and document the way in which companion animals could hasten the development of a rapport between therapist and patient and increase patient motivation (Mallon, 1994c). First termed pet therapy by Levinson, this approach is now known as animal-assisted therapy. Originally ridiculed by his colleagues for presenting such a “preposterous” technique, Levinson continued to research, write, and speak about the efficacy of this novel intervention throughout his life.
Levinson initially advocated utilizing animals with children in residential treatment and wrote extensively about it (Levinson, 1968, 1969, 1970, 1971, 1972; Levinson and Mallon, 1996). In an attempt to gather data on the utilization of animals in organizations, Levinson conducted the first survey documenting the use of pets in residential schools (Levinson, 1968). With a sample of 160 residential and day schools identified from the Directory for Exceptional Children, a response rate of 75.6% (n = 121) was obtained. Levinson found that 40.7% did not permit pets in the schools. State regulations, fear of diseases, the labor-intensive nature of caring for pets, and potential mistreatment by the children were all cited as reasons for barring animals in organizational settings. In the 1970s, the American Humane Education Society commissioned a survey to determine how many institutions in the country were using animals in facilitating the treatment of clients. The survey indicated results (48%) similar to those found earlier by Levinson. Several of the institutions surveyed reported disadvantages as well as advantages (Arkow, 1982). In many cases, these programs were developed in a surge of enthusiasm, by well-meaning, but overzealous and inexperienced individuals (Daniel et al., 1984).
By the 1980s, then, the necessity of careful program design became clear. Although many other AAT programs are rapidly emerging both in this country and abroad, one organization that has thoughtfully and carefully crafted an animal-assisted program for children is Green Chimneys Children’s Services, located in Brewster, New York, 60 miles outside of New York City.
8.3 The Green Chimneys model
The main campus of Green Chimneys Children’s Services is a year round residential treatment center and special education program for children and youth with special needs. Green Chimneys serves 102 children and adolescents in residence and 96 in the day program. The students share the rural environs of the campus with barnyard animals, domestic companion animals, and wildlife. But the healing power of human/animal interactions has been an active component in this organizational therapeutic milieu for more than 60 years.
This former dairy farm was purchased in 1947 by the Ross family, and the organization was originally designed as an independent boarding school for very young children. Operating as Green Chimneys School for Little Folk, the educationally based facility incorporated the dairy farm into the children’s daily lives. Initially, the staff did not know or appreciate the therapeutic part of this alliance. The staff saw the animals as merely providing companionship, socialization, pleasure, and education for the students. They soon realized, however, that they were providing much more.
In the early 1970s, the school evolved into a residential treatment center that specialized in the care of children with emotional and behavioral needs. Children came with histories of severe neglect; sexual, physical, and emotional abuse; homelessness; family substance abuse; and behavioral and educational difficulties. Many had learning disabilities and had experienced very limited success in school. Most were hospitalized for aggressive behaviors, suicide attempts, or chronic depression. The majority lived in poverty. Most had experienced significant psychosocial stressors at home, in school, and in their communities.
Although many changes occurred as the organization changed its program to meet the needs of a new population, the human/animal interactions component remained intact. The staff realized that these special children and youth, mostly from urban environments, could truly benefit from interactions with animals.
As part of the program, students are involved in a client focused survey so that it is clear what experiences the student has had with animals before entering the program. Green Chimneys Longitudinal Assessment Scales (GLAS) were developed by Myra Ross for use in the program; measurable treatment outcomes are monitored by clinical program staff and are maintained in the case record. Non-licensed personnel deliver animal-assisted activities so that their work is distinguished from licensed professionals who are licensed as therapists and as such provide animal-assisted therapy.
There has been a tremendous growth in programming at Green Chimneys with environmental education clearly in mind. New initiatives include: work in animal welfare; youth enrichment; Wildlife activities—Green Chimneys was issued a permanent license from the US Fish and Wildlife in 2009; training of assistance dogs—students are involved in training assistance dogs; and opportunities for Green Chimneys’ staff to bring their own companion animals to the workplace provided that the dog has a role in the program and is approved after a test of behavior.
Many youth whom we serve have been turned off by their families and their communities and Green Chimney’s goal is to reintroduce them to the world around them. The animals cannot speak for themselves so students have to anticipate their needs. Since they cannot protect themselves, the students protect them. Peer relationships develop as a result. Staff trust students to do their very best and students rise to the occasion. Everything we do has a value to humans and animals. In a real sense we all learn from “daily” happenings.
Being that Green Chimneys is in the New York City watershed area, careful control of manure, food waste, water run-off and trash storage and removal including whatever is recycled must be planned for. Learning to assume responsibility for one’s living space both indoors and out is extremely important for the health and welfare of humans and animals. As we move into the twenty-first century, Green Chimneys maintains its focus on growing “green” and going “green.”
8.4 Organizational issues
The eventual success or failure of a proposed organizational innovation is a consequence of the interplay of power and politics at numerous levels—individual, intraorganizational, interorganizational, and societal (Frost and Egri, 1991). The Performance Improvement Committee, which is a board and staff committee, meets monthly. The Executive Council of Green Chimneys, which consists of the agency’s executive director, the organization’s founder, the clinical director, the clinical coordinator, the director of treatment, the chief fiscal officer, director of education, and the director of fund development, meets on a weekly basis to monitor/review agency practices and procedures and to ensure that all parts of the organization are functioning at optimal efficiency. This council provides leadership and direction, and acts as a sounding board on major organizational issues, including the utilization of animals in the treatment programs.
Other health and mental health organizations that wish to implement an animal-assisted program component must consider the level of support that the innovation can amass on multiple levels. The following questions represent areas that the Green Chimneys’ Executive Council recommends as important considerations to be discerned by other organizational administrators who wish to implement an AAT program:
Is there administrative support for the idea?
Does the idea have board support and will it need board approval?
Does the innovation have staff that will support the idea?
Will new staff have to be trained and hired?
Has anyone asked the clients if they think this is a good idea?
How will the innovation be funded, and what costs will be incurred throughout the process?
What are the salient issues with respect to infection control?
What are the issues with respect to safety and humane treatment of animals?
What liability issues need to be considered?
Is there family support for the program?
Do the clinical staff accept and support the program?
And, in the age of managed care:
Are there measurable outcomes that will enable the organization to document and evaluate the program’s effectiveness?
How can this intervention be monitored for continuous quality improvements?
8.5 Program design issues
8.5.1 Staff issues
Because animals have always been a part of the Green Chimneys approach to working with children and families, we have always enjoyed the support of our organization’s board of directors and agency administrators. But as the agency has grown, we have often had to find ways to ensure that our animal focus is maintained.
Knowledgeable, experienced, and enthusiastic personnel greatly influence a program and ensure programmatic longevity. A consistent group of core staff make management easier. After a great deal of experimentation and trial and error logic, Green Chimneys has found that an animal-assisted program can be staffed by licensed and credentialed personnel (social workers, nurses, psychologists, physicians, occupational therapists, physical therapists, vocational therapists, teachers, certified therapeutic riding instructors, licensed wildlife rehabilitation staff) and other staff (child care workers, school personnel, recreation workers, nurses aides, therapy aides); and volunteers can provide animal-assisted activities (AAAs). It has been an ongoing challenge for our organization to determine which staff positions or responsibilities should be filled by professionals, which should be staffed by trained personnel, and which are suited for volunteers. Over the years we found that many of the staff currently employed by the agency came forward to fill roles in working with both children and animals. Staff may bring animals to work if there is a therapeutic purpose. Two key factors were their desire to incorporate animals into their work with people and their commitment to designing innovative approaches to working with people in need. An additional essential element was whether or not they had the support of their supervisors in this endeavor. Green Chimneys has historically recognized that those helping professionals who work with both people and animals need to be flexible, but there is also a need for structure, consistency, and limits. Many different philosophies are represented by those who are interested in developing approaches to working with animals and humans. Before any new program can be developed, it will need to be approved by the organization’s board of directors and administrative staff. The first question that most boards of directors and administrators will want an answer to is this: How does this project relate to the organization’s mission, vision, values, goals, and needs? On a secondary level, both bodies will want to know about costs, about maintaining the program, about agency personnel and client support, and about liability. At Green Chimneys, we receive many calls and e-mails asking about insurance coverage and names of agents and carriers. When interviewing for positions, administrative staff must seek out the candidate’s specific beliefs and personal stance. Know where the candidate stands on issues that may come up in the workplace. Staff surveys may be another important step that can permit their voices to be heard when considering a new intervention.
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