Anxiety Disorders, Depressive Disorders, Eating Disorders, Emotional Dysregulation, Mental Health Disorders in Adolescents
Conditions
Keywords
Keywords: Dog-assisted therapy, Mental health day hospital, Mental health symptomatology
Brief summary
This study aimed to evaluate the feasibility and effectiveness of a dog-assisted therapy program integrated into a Child and Adolescent Mental Health Day Hospital, as well as to explore participants' subjective experiences. Mental health disorders in adolescence are common and often require intensive treatment approaches. Day hospitals provide structured care while allowing adolescents to remain in their family and social environments. Dog-assisted therapy has been proposed as a complementary intervention that may support emotional regulation, reduce distress, and enhance motivation and engagement in treatment. A mixed-methods study was conducted, combining a randomized controlled trial with a qualitative phenomenological analysis. A total of 70 adolescents aged 12 to 18 years attending a mental health day hospital were included. Participants were randomly assigned to an experimental group, which received dog-assisted therapy in addition to treatment as usual, or to a control group that received treatment as usual only. The intervention consisted of eight structured sessions of dog-assisted therapy, each lasting approximately 45 minutes. Clinical and emotional outcomes were assessed before and after the intervention using standardized instruments. In addition, immediate emotional changes were evaluated before and after each session. A qualitative component based on semi-structured interviews was conducted to better understand participants' experiences. The study seeks to provide evidence on whether dog-assisted therapy can be a useful complementary intervention in adolescent mental health care, particularly in improving immediate emotional regulation, motivation, and therapeutic engagement. This is an interventional trial registered retrospectively after study completion. Data were collected between \[01/01/2024\] and (31.12.2025\]
Detailed description
Adolescence is a critical developmental period associated with increased vulnerability to mental health disorders, including affective, anxiety, behavioral, and eating disorders. These conditions often present with complex symptom profiles and significantly impact emotional regulation, interpersonal functioning, and engagement in treatment. Child and Adolescent Mental Health Day Hospitals provide intensive, structured care while allowing adolescents to remain in their family and social environments. However, maintaining motivation and therapeutic engagement in this context can be challenging, highlighting the need for complementary interventions that facilitate emotional connection and participation. Dog-Assisted Therapy (DAT) is a structured intervention involving interactions between patients and trained dogs under professional supervision, with predefined therapeutic goals. Previous research suggests that DAT may reduce stress and anxiety, enhance emotional regulation, and improve motivation and social interaction. Nevertheless, evidence from controlled studies in intensive treatment settings remains limited. This study evaluates the effectiveness and feasibility of integrating DAT into routine care in a Child and Adolescent Mental Health Day Hospital. A mixed-methods design was used, combining a randomized controlled trial with a qualitative phenomenological approach. Participants were randomly assigned to receive either DAT in addition to standard treatment or standard treatment alone. The intervention consisted of eight structured sessions delivered over approximately eight weeks within the Day Hospital program. Quantitative analyses focused on changes in clinical and emotional outcomes between baseline and post-intervention, as well as between-group differences. In addition, immediate emotional responses associated with DAT sessions were explored. Qualitative data were collected through semi-structured interviews to examine participants' lived experiences and perceived impact of the intervention. Data were analyzed using appropriate statistical methods for pre-post and between-group comparisons, alongside a phenomenological-hermeneutic analysis of qualitative data to identify emerging themes and capture subjective experience. This study aims to contribute to the evidence base on complementary interventions in adolescent mental health care, particularly regarding the role of DAT in enhancing emotional regulation, motivation, and therapeutic engagement within intensive treatment settings.
Interventions
BEHAVIORALExperimental: Experimental: Dog-assisted therapy + Treatment as usual
Participants received a structured dog-assisted therapy program integrated into routine care in a Child and Adolescent Mental Health Day Hospital. The intervention consisted of eight sessions, each lasting approximately 45 minutes. Each session followed a standardized structure including an initial phase of contact with the dog, a main phase involving structured therapeutic activities aimed at promoting emotional regulation, social interaction, and therapeutic engagement, and a closing phase for reflection. Sessions were delivered by mental health professionals with the support of a certified canine specialist.
Los participantes asignados al grupo de control recibieron el tratamiento habitual proporcionado en el Hospital de Día de Salud Mental Infantil y Adolescente, sin exposición a la terapia asistida con perros. La atención estándar incluyó un programa multidisciplinario compuesto por psicoterapia individual y grupal, psicoeducación, apoyo académico y actividades terapéuticas que se imparten de forma rutinaria en el entorno del hospital de día. Los participantes continuaron recibiendo esta atención estándar durante todo el período del estudio.
Sponsors
Hospital Clinic of Barcelona
Obra Social La Caixa, Spain
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
A Retrospectively Registered Interventional Trial
Eligibility
Sex/Gender
ALL
Age
12 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
* Adolescents aged between 12 and 18 years * Receiving treatment at a Child and Adolescent Mental Health Day Hospital * Willingness and motivation to participate in the intervention * Written informed consent provided by the participant and their legal guardians
Exclusion criteria
* Estimated intelligence quotient (IQ) below 80 * Allergy to dogs * Fear of dogs or animal phobia * History of aggressive behavior towards animals
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| HONOSCA | Baseline and post-intervention at Week 8 | Change in global clinical functioning assessed using the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA). This instrument evaluates behavioral, emotional, and psychosocial difficulties in adolescents attending mental health services. Higher scores indicate greater severity of problems. The outcome measures the difference between pre-intervention and post-intervention total scores. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in state anxiety (STAIC) | Baseline and post-intervention at Week 8 | Change in anxiety levels assessed using the State-Trait Anxiety Inventory for Children (state subscale). This instrument measures situational anxiety in children and adolescents, with higher scores indicating greater anxiety levels. |
| Change in emotional regulation difficulties (DERS) | Baseline and post-intervention at Week 8 | Change in emotional regulation difficulties measured using the Difficulties in Emotion Regulation Scale (DERS), a self-report instrument assessing multiple domains of emotional dysregulation. Higher scores indicate greater difficulties in emotional regulation. |
| Change in depressive symptoms (CDI) | Baseline and post-intervention at Week 8 | Change in depressive symptomatology assessed using the Children's Depression Inventory (CDI), a self-report measure widely used to evaluate depressive symptoms in children and adolescents. Higher scores indicate greater depressive symptoms. |
| Change in eating disorder symptomatology (EDI-2) | Baseline and post-intervention at Week 8 | Change in eating disorder-related symptoms assessed using the Eating Disorder Inventory-2 (EDI-2), administered only in participants diagnosed with eating disorders. Higher scores indicate greater symptom severity. |
| Immediate change in emotional state (FIS) | Immediately before and after each session, throughout the 8-week intervention period] | Immediate change in self-reported emotional state assessed before and after each dog-assisted therapy session using the Facial Image Scale (FIS). This scale consists of five facial expressions ranging from very unhappy to very happy, providing a rapid measure of emotional response to the intervention. |
Countries
Spain
Outcome results
None listed