REVIEW OF THE LITERATURE AND METHODOLOGY PAPER
formulation is the first step in the process of social work research. This assignment will help guide you through a
basic approach to formulating a research topic and developing a methodology to conduct
your research. This assignment should
not exceed 10 pages (1″ margin, 12 point typeface), excluding
references. This is not meant to be a
lengthy paper, nor should it be. Please
edit your paper carefully so that it covers all salient points in a flowing,
interesting manner. Use headings to make
for a well-organized and concise paper.
Papers must be double-spaced according to APA. Ideally you will build upon the paper and
implement the described project as part of your second semester assignment.
BACKGROUND and SIGNIFICANCE (3-4 pages)
assisted therapy improve depression in dementia patients?
The integration of animals into the
therapy setting by treatment providers has been a growing trend. Psychological
problems treated include emotional and behavioral problems, attachment issues,
trauma, and developmental disorders.
This research paper will focus on whether Animal Assisted Therapy (AAT)
is an effective treatment for relieving signs of depression in dementia
patients. For the purposes of this study
the animal used will be dogs. AAT therapy often serves in conjunction with traditional work done
by a licensed psychotherapist, social worker, or other mental health–care
provider. Dogs are usually the primary animals used, although various
animal-assisted programs offer different animals for people with different physical
and emotional needs.
AAT typically involves a scheduled encounter with a certified therapy
team consisting of an animal and its handler for the purpose of supporting or
improving patients’ social, emotional, physical, or cognitive functioning. In terms of specific mental health benefits,
studies in the last few years have shown that AAT may improve outcomes and
reduce various symptoms for people with depression, anxiety, dementia, loneliness and more. It has been found to be effective across multiple
settings and demographics, including autistic children in the classroom,
adolescents in a residential care home and older adults in nursing homes.
AAT is recognized by the National
Institute of Mental Health as a type of psychotherapy for treating depression and other mood
disorders. Being around pets appears to “feed the soul”, promoting a sense of
emotional connectedness and overall well-being.
Animals can provide a sense of calm,
comfort, or safety and divert attention away from a stressful situation and
toward one that provides pleasure. Advocates of AAT say that developing a bond
with an animal can help people develop a better sense of self-worth and
trust, stabilize their emotions, and improve their communication, self-regulation, and
Importance of AAT to Social Work
social work profession utilizes the bio-psycho-social-spiritual approach to
inform various stages of practice. Social workers should stay informed about
all available treatments due to their commitment to clients and their ethical
obligation of competence. If social workers fail to provide interventions that
contain all areas of the bio-psycho-social-spiritual model they limit the
holistic success of their clients. The National Association of Social Work
states that the primary responsibility of social workers is the wellbeing of
their client (Code of Ethics, 2008). Social workers support clients’ right for
self-determination except in specific situations where there is a safety risk
toward the individual client or others. The Code of Ethics (2008) continues by
stating that social workers should remain current in professional practice and
literature by critically examining topics and knowledge that relate to social
work in addition to continuing education requirements.
teachers, and other individuals that care for children with mental health
diagnoses often feel hopeless and helpless. According to Ogilvie, Morant, and
Goodwin (2005) caregiving for people with schizophrenia, dementia, or unipolar
depression significantly impacts multiple areas of the caregiver’s life. The
caregiver’s beliefs of the disease in addition to previous exposure to the
mental health system strongly impact caregiver burden. Caregiver burden often
leads to increased levels of stress, negatively impacts the caregiver’s health,
and causes more worry (Murphy, Christian, Caplin, & Young, 2006; Ogilvie et
behavior of adult with mental health disorders can become disruptive,
overwhelming, and stressful. After an extended period of time caregivers and
other supportive adults sometimes feel that all options have diminished. Staff at long-term care and specialized care
centers do not have the time or ability to work with every patient for the
amount of time needed to help make a difference with these client’s
treatment. A lack of professionally qualified social workers in
nursing homes is one of several factors that potentially contribute to
inadequate and inconsistent mental health and psychosocial care in nursing
homes. Numerous studies document the extent of nursing home resident mental
health needs as well as significant gaps in provision of mental health
History of Animal Assisted Therapy Theory
Although the term AAT is relatively
new, the use of animals to help people overcome illness and/or mental disorders
is not a new idea. The earliest use of pet animals for therapeutic use was in
Belgium in the middle ages, where pets and people were rehabilitated together,
with pets providing a part of the natural therapy for the humans. Following
this practice, The York Retreat in Germany and Bethel for the mentally ill and
the homeless included animals, as a part of the therapeutic milieu reaping the
benefits. Later, the Human Animal Bond was conceptualized by a Psychologist,
Boris Levinson and Konrad Lorenz, an Austrian Nobel laureate in Physiology.
This bond is explained as an essential need in humans to bond with nature,
especially in the background of their chaotic lives. The modern movement of
using companion animals as a means of therapy had a multidisciplinary origin,
involving the fields of veterinary medicine, psychology, sociology, psychiatry
funded by pet food industry (Chandramouleeswaran & Russell, 2014).
There are references to the fact that the early Greeks
used horses to lift severely ill people’s spirits. In the 17th century,
physicians reportedly began using horses as treatments to improve both physical
and mental health issues in their patients. In the 1940s, the American Red
Cross and the Army Air Corps established a farm where recuperating veterans
could interact with and take care of animals while they were healing from war
injuries and illness. Working with the animals was thought to comfort the
recovering veterans, help them forget about the war, and focus on recovery
An unlikely champion of AAT was Dr. Sigmund Freud, who
used Jo-Fi, his dog, in his clinical practice. Freud believed that Jo-Fi could
judge a person’s character accurately. Freud also believed that having Jo-Fi
present during his therapy sessions had a calming influence on his patients,
particularly children (Coren and Walker, 1997).
However, the first formal therapeutic work and research
was done by Dr. Boris Levinson. In 1961, while working with a withdrawn and
mentally impaired young boy, Dr. Levinson made an “accidental discovery”
involving his dog, Jingles. Levinson briefly left Jingles alone with the boy
and, when he returned, found the young boy interacting with the dog. This
inspired Levinson to do further research with Jingles and his young patients.
He found that the presence of a dog during therapy sessions had a positive
effect on impaired young patients. Levinson later used the expression “pet therapy”
in reference to Jingles’ beneficial effects on mentally impaired children in a
therapeutic setting (Levinson, 1964).
The term pet therapy marked the beginning of researchers’
and practitioners’ interest in the psychological effects of human and animal
interaction and highlighted the critical shift, which regards animals as
partners in therapy rather than tools to be exploited (Zamir, 2006).
Assisted Therapy and Depression Studies
Several studies have
evaluated the impact of AAT on agitation and aggression in Special Care Units
(SCUs), which are designed to manage the challenging behaviors of individuals
with dementia. Churchill et al. (1999) introduced pet therapy visits during the
difficult “sundown” time (1700–1730 hours) in three SCUs to examine the effect
on residents with a history of agitated “sundowning” behavior. Residents
exhibited significantly less agitated/aggressive behavior when interacting with
an investigator and a dog compared to interacting with the investigator when a
dog was not present. This effect was not related to the severity of dementia.
The researchers also documented more social behaviors in the presence of a dog.
This study controlled for human-interaction effects by using the handler
without a dog for control sessions. However, its observations were limited by
only being made on two 30-minute occasions. The duration of the calming effect
after the dog’s departure and the variability in resident response over time
were not explored. The authors do not mention whether residents were regularly
visited by dogs and handlers or if their exposure to AAT was a novel
The effect of a resident
pet in private homes was investigated by Fritz et al. (1995). On the basis of
caregivers’ reports, patients with Alzheimer’s disease who had pets in the home
displayed significantly less verbal aggression when compared to those not
exposed to pets. Greater attachment to pets was associated with significantly
fewer mood disorders, but other measures of psychiatric morbidity were
unchanged. Findings were unchanged when adjusted for severity of dementia. The
study’s limitations included being a postal survey with a 46.8% response rate.
A unique study was performed to
examine potential changes in mental health in people with clinical depression
who were working with farm animals as the only task on a farm. The intervention consisted of work and
interaction with farm animals twice a week for 12 weeks. Those who participated in animal-assisted
therapy experienced statistically significant changes in depression and
generalized self-efficacy. Additionally,
more participants in the intervention could have been beneficial for the
subgroups of clients and served as a useful supplement within mental health
care, although these changes were not significantly different from those in the
control group (Pederson 2012).
5-7 research articles that cover the topic you selected, which should consist
of a research process and/or outcome designed to improve health amongst
individuals and the broader community. (Keep in mind that an actual literature
review requires more than 5-7 articles, but due to time limitations you are
only required to review up to 7 articles).
Only articles published in professional (peer reviewed) journals can be
used. The purpose of this requirement is to encourage you to become more
familiar with the research literature in professional journals.
these articles to write a brief introduction to your research paper. It should
cover the scope and prevalence of the problem or issues you are addressing, the
history of its emergence as a topic of interest in social work and why this
issue needs to be addressed. Identify the theoretical basis or justification
for the research.
your introduction, explore in-depth the issues that you identified in the
introduction. Use the literature to establish a framework for this discussion;
however do not just report what each article says uncritically. Discuss why you
do or do not accept the findings; if appropriate point out the limitations of
the work. Establish themes and gaps in the literature that you feel need to be
further explored or perhaps addressed for the first time. These identified gaps
should form the basis for your research question.
II. HYPOTHESIS/RESEARCH QUESTION(S) (1 page)
your review of the literature showing how it leads naturally to either a
hypothesis to be tested or research questions to be explored. List 1-3 hypotheses that you would like to
test OR, if you plan an exploratory study, state the research questions that
you would like to investigate.
Hypothesis: Pet therapy animals
have a positive effect on long term facility patient’s depression
increasing number of older adults in the population will lead to an increase
in the number of individuals living in residential
care (Jongenelis et al., 2004). Further
studies on depression in the institutionalized
elderly, as well as the development of
adequate prevention and treatment strategies are of
upmost importance. Nursing homes
present a challenge for residents and staff regarding
how to cope effectively with a
combination of physical and mental health problems
(Smyer & Qualls, 1999).
Several studies suggest that forming a relationship
with an animal in the course
of an animal-assisted therapy program can lead to many
of the benefits associated with
receiving social support (Collis & McNicholas,
1996). Contact with a therapy animal
has also been demonstrated to reduce loneliness in
elderly residents of long-term care
facilities (Collis & McNicholas, 1996). The role
of an animal in facilitating social
interactions between people is widely supported by
research (Collis & McNicholas,
1996). Visiting animal programs have been found to
stimulate greater initiation of
social interactions among residents of long-term care
facilities (Collis & McNicholas,
There are numerous social benefits
animals provide that have been observed,
including companionship for withdrawn and isolated
people, increased socialization, as
well as decreased depression, anxiety and loneliness
(Kogan, 2000). Relationships
between animals and older persons are powerful, and
intimacy is often immediately
achieved (Kogan, 2000). In one study, 10.3% of
respondents that moved to a nursing
home stated they missed their pets more than any other
possessions (Kogan, 2000).
“Human-animal interactions can help long-term
residential patients maximize
functional abilities and enhance overall quality of
life” (Kogan, 2000, p. 33).
is limited empirical evidence to support the tremendous value in utilizing
animal-assisted interventions with long-term care
residents. More research is needed to
examine the specifics of practice of these
interventions to improve techniques and
expand use. Large-scale, well-funded studies of the
positive impact of utilizing animals
with the elderly are still lacking (Schren, 2001).
Developing adequate prevention and
treatment strategies to treat depression in
institutionalized elderly is obviously of great
importance, with special attention and
care focused on psychosocial factors such as
loneliness and lack of social support
(Jongenelis et al., 2004). With the enormous number of
people involved, there is a need
for further research to develop intervention
strategies for depression that are
specifically tailored to meet the needs of the nursing
home population (Jongenelis et al.,
2004). The purpose
of this study is to increase knowledge about the efficacy of AAT for reducing
depression and decreasing loneliness among elderly persons who live in
long-term care facilities.
III. RESEARCH DESIGN (4-5 pages)
who is to participate in the study by detailing known relevant characteristics.
the number of study participants and how they will be recruited including any
the sampling and/or assignment/selection methods to be employed.
the agreements and procedures for the protection of human subjects.
study would involve eight participants that will be 65 years of age and older The
purposive sample would include those living in a long-term nursing facility who
have symptoms of depression. The sample
population would ideally consist of an even number of males and females. A median age of both groups within 10 years will
attempt to be established. These eight
participants will be recruited from only one long term care facility. There will be a random control group (two men
and two women) who would have the animal assisted therapy, and the other group
(two men and two women) who would not.
participant will be assigned a number randomly.
The research participant’s initials will be the only thing documented on
record. All files will be secured and
password protected for confidentiality purposes on a thumb drive.
researcher will obtain
informed consent from patients/power of attorney’s. The researchers will have open and honest
communication with the study participant.
Attention will be given the consent document readability and its
comprehension. The consent document will
represent and reference the conversation with case study participants. Researchers
will outline the studies purposes, events, length, risks, benefits, substitute choices
and confidentiality of records/archives. Informed consent will be obtained after the participants
have been given all of the appropriate information, has had suitable
opportunity to review the consent document and have all queries responded. Consent will be obtained before any research
is initiated. Confidentiality during the
conversations with participants is paramount as it should be an atmosphere
without pressure or influence of the researcher.
the research design to be employed. If this is an intervention study include
the social work intervention to be used
will be a randomized controlled trial; study participants
will be randomly assigned to one of two groups: the experimental group
receiving AAF and a comparison group which receives no treatment. The group will that will be receiving the AAF
will receive AAF once a week for a month.
This will determine if any improvement was made that may be a result of
AAF. A baseline will be established at
the beginning of the study by having patients/families identify where the
subjects are on a Visual Analogue Mood Scale (VAMS) that will be uniform for
the data to be collected.
procedures for data collection including techniques to be employed and the
sequence of steps to be followed. If appropriate (e.g. if there are multiple
points in time or a number of instruments) include a time frame or flow chart.
The VAMS will be on paper
and will include facial representations of mood on a scale of 1-5 (in case
patient is non-verbal or has processing issues). One would represent very depressed, two would
be moderately depressed, three would be not depressed/no happy, four would be
happy and five would be very happy. Each
number will have a face to match the description of each number.
Auditory Scales (AS) are synonymous with pain
ratings and have been proven to be successful.
Largely AS research is incomplete in regards to mood determination. Research work on Auditory Mood Scales (AMS) by
Luria indicates that VMS is considered a valid test of mood in combination of a
symbol/digit scale. This was able to
distinguish patients with affective disorders better than a standard
self-rating depression scale.
the measurement instruments to be employed for each study variable.
the development of the measurement instruments.
information on the reliability and validity of the measurement instruments.
a copy of all instruments proposed for the study.
D. ANALYSIS OF DATA
each research question or hypothesis, describe and discuss the different
variables of interest and how they will be measured.
this is an intervention study discuss how you will determine whether or not the
desired outcome was achieved.
study will be analyzed using descriptive statistics. Summaries about the sample and the measures
will be provided. There will also be a graphics analysis/representation.