**3.4. Animals, social support, and relaxation**

indirectly learns from the innate, unfavorable characteristics of children by using children's behavior to take care and control real animals [16]. Compassion and anxiety for the health of animals became one of the didactic themes of children's literature that lived in the eighteenth and nineteenth centuries; the main aim was to inspire the morality of the good and sex, respectively, especially in boys [17–19]. In the late eighteenth century, theories about the social effects on animal care were initiated in the treatment of mental illnesses. The bestdocumented studies took place in The York Retreat in England. The York Retreat used more innovative methods than the mental treatment methods used at that time. In this study, prisoners were encouraged to do handwriting, writing and reading books, and they were also allowed walking freely around the courtyards and gardens of the Retreat, where small pets were also part of the Retreat and prisoners could interact with them. In his description of the Retreat (1813, p. 96), Samuel Tuke, the founder's grandson, described how the internal courtyards of the Retreat were supplied "with a number of animals; such as rabbits, sea-gulls, hawks, and poultry. These creatures are generally very familiar with the patients: and it is believed they are not only the means of innocent pleasure; but that the interaction with the sometimes tends to awaken the social and benevolent feelings." In the nineteenth century, pets became an increasingly popular feature in the psychiatric departments of hospitals in the UK. For example, in a highly critical report on terrible conditions for patients in Bethlem Hospital in the 1830s, British Charity Commissioners proposed that the shelter of people with a mental problem is provided support for treatment of sheep, rabbits, apes or other domestic pets, they have also been described as social animals. Such recommendations are clearly taken seriously. According to a paper published in Illustrated London News of 1860, the regulations at Bethlem Hospital have been redesigned according to the stimulus [20]. It has been observed that animal companions have beneficial and therapeutic effects in the treatment of physical disorders. Florence Nightingale, for example, observed and wrote in Notes on Nursing (1880) that "a small pet is a particularly good friend, especially for the patient, long chronic cases"

94 Occupational Therapy - Therapeutic and Creative Use of Activity

Despite the success of animal-supported institutional care in scientific studies during the nineteenth century, with the development of evidence-based medicine in the early twentieth century, the use of animals in hospitals has declined dramatically [20]. For the next 50 years, animals were used in the context of zootomic illnesses, public health concerns, or psychoanalytic theories of the origin of mental illnesses. Sigmund Freud's ideas concerning the origins of neurosis tended to reiterate the Hobbesian idea of mankind's inherently beast-like nature [16]. According to Freud, infants and young children are in fact similar to animals, as long as they are governed by instinctual desires or could be influenced by organized basic biological functions such as nutrition, defecation, sexuality, and self-protection. Freud describes this basic and animal-like instinct of human nature as "identity." As children mature, their parents' behaviors will either cause too much impulsive behavior by reacting to the child's inner aggression or induce their sense of fear, guilt, and socialization. The suppression of these children under the consciousness of children ensures that their behavior in their daily lives is healthy. But they are like animals in their 30s. Freud refers to this as a bottled animal chart. It results in explosive situations where the individual cannot go out on regular outings [22]. Freud interpreted the

[21].

**3.3. Psychotherapy and animals**

There has been considerable development in the theoretical substructure of animal-assisted approaches during the last 20 years and, at least in part, in response to the skepticism shown toward blood-based medicine. This substructure offers the basis for demonstration as a psycho-mental mediator by providing relief from relatively metaphysical-based thoughts about animals [24]. The primary catalyst for this change of emphasis was a single, groundbreaking study of 92 outpatients from a cardiac care unit who, statistically speaking, were found to live longer if they were pet owners [28]. This finding prompted a whole series of other healthrelated studies as well as stimulating a lot of discussion concerning the possible mechanism(s) responsible for the apparent salutary effects of pet ownership. Of these, at least two have stood the test of time. According to the first, animals are able to induce an immediate, physiologically de-arousing state of relaxation simply by attracting and holding our attention. According to the second, companion animals are capable of providing people with a form of stress-reducing or stress-buffering social support [29, 30]. Although the de-arousing effects of animal contact have been demonstrated by a considerable number of recent studies, little evidence exists at present that these effects are responsible for more than transient or short-term improvements in physiological parameters, such as heart rate and blood pressure. On the other hand, pets serving as a source of social support seem to provide a relatively high level of evidence for the longer-term benefits of animal companionship [31].Cobb has defined social support as "relationships that direct, to emphasize and give importance to, to describe that it is the pattern of mutual obligations." However, the newer authors have expressed it as "perceived social support" and "social networking" characteristics. The first represents a qualitative definition of the degree of satisfaction from the support that one receives from certain social relations; the second is a more quantitative measure involving the number, frequency, and propensity of the person's general social interactions [32]. However, the importance of social support to human well-being, which we wanted to describe, has been regarded as one of the top-down issues throughout history. Loneliness—lack of social support—has always been seen as a painful and distasteful phenomenon; since ancient times, societies have used single-cell imprisonment, exile, and social mobilization as methods of punishment. This, in fact, shows that loneliness is actually the basic punishment method. In addition, religious themes explain in detail the psychological effects of autobiographical, social isolation that homeland traitors and prisoners of war wrote. Many of them describe physical torture in a way that will emotionally, often sharply, up to the apex of gradual descent. This decrease in pain is associated with the onset of a serious indifference and hopelessness, which usually requires catatonic deprivation [29]. In the last 10–15 years, a comprehensive medical literature has emerged confirming that there is a strong and positive link between social support and improved human health and survival [33–35]. There is a great deal of social support in reducing the adverse effects of stress, which chronic life has brought. With the controversy still underestimating these effects, many authorities now accept the judgment that the main benefits arise from the buffering or healing capacities of long-term effects of supporting social relations [36]. Theoretically, this beneficial effect of social support should be applied to any positive social association. It has been observed that positive behaviors are exhibited within the two parties in relation to which one is loved or respected. Despite the increasing evidence for anthro-zoological research in the recent past, the idea that animal attendants contribute socially to human health, however, received very limited medical attention [8].

autism spectrum disorders, sensory processing disorders, degenerative neurological and muscle disorders that mainly focus on control of muscle tonus, mobility, and balance [40]. When the elderly and adult population rehabilitation applications are examined, it is seen that animal-assisted approaches are preferred in the treatment of diseases such as multiple sclerosis, head trauma, post-traumatic neurological conditions, Alzheimer Disease, dementia, anxiety, and depression [41–43]. These diseases can cause a reduction in postural symmetry and control, and deterioration in cognitive skills like attention, memory, and executive func-

Animal-Assisted Therapy in Occupational Therapy http://dx.doi.org/10.5772/intechopen.76468 97

All of these patients with diseases, whether young or old, were psychologically affected, and their motivation decreased during rehabilitation. It is known that sensory, emotional, and physical characteristics of animals can be utilized to increase the level of motivation in rehabilitation. In fact, in most developed countries today, health-care providers employ animal-assisted therapy in a wide range of settings, including rehabilitation centers, acute care, psychiatric centers, and outpatient clinics. For example, doctors' consulting rooms have fish tanks in their waiting rooms to promote a sense of calm [44]. It is now well known that the presence of animals can induce relaxation, increase positive emotions, reduce resistance to

Awareness of the advantages and disadvantages of the animals and species used by the professional practitioner team in rehabilitation practices involving many health disciplines involved in this area positively affect the effectiveness of rehabilitation [6]. At the same time, it also emphasizes the importance of knowing the animal's unique structure and instincts in these studies [6, 37]. Most studies and programs in AAT utilize animals such as livestocks, dolphins, dogs, cats, birds, hamsters, or horses [45]. All animals have certain advantages and disadvantages within themselves, so that the practitioner can make arrangements according

It is mentioned in the literature that all farm animals can be easily included in treatment approaches as long as they are checked by the veterinarian for good health and reliability. The benefits and difficulties of incorporating livestock into therapy approaches may vary according to the therapist's rehabilitation goal. These animals are preferred by the occupational therapists (OTs) in rehabilitation applications, in particular for those individuals who have difficulty in independent daily living skills, in terms of a large living space, and special need for care. There are also studies showing that AAT with livestock affects individuals' motor and cognitive functions positively [46, 47]. They are preferred by OTs because they can help improve their equilibrium, hand-eye coordination, executive function, and hand skills

AAT in individuals with both physical and cognitive impairment is a useful method for facilitating human interaction, stress reduction, relieving depression, and increasing

tions [37].

treatment, and put patients' minds at ease.

to the individual and individual's needs.

*4.1.1. Therapy with livestock*

of individual.

*4.1.2. Therapy with dolphin*
