Six years ago, Norma Grogan's doctor told her she should no longer be cleaning her cats' litter box. Grogan, 71, has limited mobility, and her doctor was afraid that she would fall doing the chore. But Grogan couldn't imagine giving up her pets. "Honestly, they're the most important thing to me, besides my kids," she says. "They're what keeps me going.

That sentiment, echoed by so many other pet owners, is backed by some research. Various studies have shown that having pets may be associated with improved mental and physical health, and that even shorter-term interactions with animals may have benefits.

In a landmark study published in 1980, Erika Friedmann, PhD, and her colleagues found that among patients discharged from a coronary care unit, those who owned a dog or cat were more likely to survive at a one-year follow-up than their non-pet-owning peers (Public Health Reports). In the years since, research by Friedmann—now at the University of Maryland School of Nursing—and others have suggested explanations for that: Dogs and cats may reduce their owners' stress and anxiety, lower heart rate and blood pressure, promote social interaction and assuage loneliness, she says.

Like Friedmann's original study, most of the research is correlational—it does not prove that pet ownership causes better health, only suggests that it is associated with it. Still, it was with these potential benefits in mind that Colorado State University psychologist Lori Kogan, PhD, founded a nonprofit called Pets Forever with the university in 2009, to help low-income older adults and people with disabilities keep their pets at home for as long as possible. For the past five years, students volunteering for the program have come by twice weekly to help Grogan care for her cats, Cassie and Rocky.

"It's just a wonderful program, I really don't know what I'd do without it," Grogan says.

While Kogan focuses on pet owners who are older or have disabilities, many nonprofit groups around the country run programs that bring animal interaction to other people who might not otherwise have access to it—prison inmates, at-risk youth, even students with reading difficulties.

In many cases, though, these types of programs are so popular that their growth has outstripped research evaluating their effectiveness. Now, psychologists are getting involved, in some cases helping to run the programs while in other cases studying what effects they may have, and to what extent we humans benefit from our interactions with the animals in our lives.

Lifelong companions

Kogan, who is chair of the Human-Animal Interaction Section of APA's Div. 17 (Society of Counseling Psychology), began Pets Forever because she was dismayed by stories she heard of older, low-income pet owners having to give up their animals, many of which were also older and therefore difficult to re-home. "It seemed like such a lose-lose situation," Kogan says, and she saw a way to help.

Animal companionThrough Pets Forever, students in veterinary, pre-vet, social work, psychology and other programs can earn course credit for a service-learning class in which they regularly visit clients in their homes to walk dogs, scoop litter boxes, coordinate vet appointments and more. The students gain experience helping and problem-solving with older adults, a population many will likely work with in their future jobs, Kogan says. They also take part in a seminar where they discuss and write about their experiences. Today, the program serves about 170 clients in Fort Collins and Loveland, Colorado.

Though the research is not definitive, some studies suggest that a program that helps older adults keep their pets could also help them maintain better health. In 2013, for example, the American Heart Association released a scientific statement saying that pet ownership—particularly having a dog—was associated with a lower risk of heart disease, though it cautioned that almost all of the research was correlational. Among the research cited in the report, only one published study involved a randomized controlled trial: Researchers assigned hypertensive stockbrokers to either adopt a dog or not, and found that the ones who adopted a dog had a lower blood pressure response to stress in the presence of their dog six months later (Hypertension, 2001).

Meanwhile, some research looking at large national surveys has found an association between pet ownership and health more broadly: An analysis of German and Australian medical records from more than 10,000 survey respondents, for example, found that pet owners made significantly fewer doctor visits than nonowners each year (Social Indicators Research, 2007).

But despite a popular conception that pets can help reduce depression among pet owners, the results on mental health are mixed. A recent meta-analysis, for example, found that pets seemed to ameliorate loneliness and social isolation in older adults—but, importantly, that did not necessarily correlate with lower rates of or less severe depression (Geriatrics, 2016).

Still, for someone like Grogan, who is attached to her pets, giving them up would be wrenching. And the program has another indisputable benefit—it puts students and older adults into regular contact, inspiring unlikely friendships and an extra source of support for both students and clients.

"They establish long-term relationships," says Kogan, adding that the students' regular visits serve as a kind of safety net for the clients. "We can connect them with other service agencies when needed, or their family that might not be in town," she says.

Pen pals

Lucian Friel was two-and-a-half years into a five-year prison sentence when, in 2012, he was sent to Deerfield Men's Work Center, a privilege reserved for nonviolent offenders with a record of good behavior. At first, Friel worked in the prison's greenhouse, but he noticed that other inmates had a more intriguing job: living with, caring for and training dogs.

The dogs were part of Pen Pals, a Richmond-based program that pairs shelter dogs in need of training with inmates who are taught to train them, with the goal of preparing the dogs for adoption. The inmates, called "handlers," live with, feed, groom and train the dogs for two to three months. Friel volunteered to help out, and after seven months he became an official handler.

"Once I became a handler, it was like a shock to the system. Because I was almost four years into a sentence, and up until then it had been all about me," he says. "In prison that's what you do, only worry about yourself. It's not a social environment. But now I had a living animal I was responsible for. And it just completely changed the dynamics of my time there."

Pen Pals is one of several hundred similar programs around the country. The first began in Washington state in 1981; a recent literature review and meta-analysis counted 290 dog training programs in prisons in the United States (The Prison Journal, 2016). The programs are not centrally coordinated—they are independently run by nonprofit agencies and corrections departments. For the most part, their stated purpose isn't to improve inmates' mental or physical health, but to provide vocational training for inmates and to boost hard-to-place shelter dogs' chance of adoption, or in some cases train service dogs. But over the years, psychologists interested in the benefits of human-animal interaction have begun studying whether the programs could improve inmates' lives above and beyond the vocational skills.

For now, most of the supporting evidence is anecdotal, though there have been some small-scale quantitative studies.

Angela Fournier, PhD, now a psychology professor at Bemidji State University in Bemidji, Minnesota, studied the Pen Pals program as part of her dissertation research at Virginia Tech. In a 2007 study published in Behavior and Social Issues, she found that program participants had fewer institutional violations, advanced further in the prison's substance abuse therapeutic community, and improved their scores on a test of social sensitivity skills compared with a control group of inmates wait-listed for the program.

Not every study of prison-based dog-training programs has found such significant differences—and participants' progress can be difficult to measure in part because the guidelines for participating in programs can be stringent. Inmates must apply to take part, and those who are accepted are generally the "healthiest of the healthiest," Fournier explains, with low baseline levels of problems like depression and anxiety.

In a recent meta-analysis, Barbara Cooke, PhD, found that there was a need for more large, peer-reviewed studies in the area (The Prison Journal, 2016)—and particularly for randomized controlled trials.

She did find some encouraging results in the meta-analysis, though, in which she reviewed 10 studies involving 310 total program participants and 514 controls. She found that the programs significantly improved inmates' "externalizing symptoms," like violence and aggression, as well as "internalizing symptoms," such as depression and self-esteem. However, she cautioned that many of the studies had small sample sizes and/or did not use control groups.

"For now, some of the strongest rationale for implementing [these programs] is that there's a lot of anecdotal evidence of how effective they are," she says.

At-risk youth, at-risk dogs

Eight years ago, as a 15-year-old in a Michigan juvenile detention center, Lanae Burdett got a chance to spend 10 weeks training shelter dogs in basic obedience skills, to prepare them for adoption.

The short program "made a huge difference in my life," Burdett says. "I was used to everyone telling me what I'd done wrong. It was the first time in my life people told me I was doing something right."

That kind of boost is at the heart of Teacher's Pet, according to Amy Johnson, a licensed professional counselor and member-at-large of APA's Human-Animal Interaction section, who also runs a certificate program in Animal Assisted Therapy at Oakland University in Michigan. In the past decade more than 2,300 Michigan teens—most of whom were either serving time at a residential juvenile detention center, or attending local alternative schools for students with emotional impairments—have helped train more than 3,200 shelter dogs.

Teacher's Pet is one of many similar programs around the country that pair at-risk kids with at-risk dogs. Johnson was inspired by Project Pooch, the first such program, which began in Oregon in 1993.

Animal companionIn the Michigan program, the students attend two two-hour sessions per week. Half the time is spent in the classroom learning training skills, including how to read the dogs' body language to understand when they are stressed or fearful, and how to calm them; the other half is spent working with the dogs.

The aim of the program is to develop empathy, confidence and social skills in the kids, says Johnson, and also to help develop connections between the youth and their therapists and other staff at the facilities, who can encourage the kids to draw on the experience as part of their therapeutic process.

Burdett, and many others, offer anecdotal evidence of the program's success—Burdett, in fact, still works with Teacher's Pet, transporting the dogs on their twice-weekly trips from the shelter to the schools and detention centers for the training sessions.

But as with the prison dog training programs, there has been relatively little research to quantify the outcomes of programs that pair at-risk dogs and at-risk youth, according to Lisa Lunghofer, PhD, executive director of the consulting company Making Good Work, who helps nonprofit clients in child welfare and violence prevention to develop programs, write grant proposals and evaluate outcomes, and has worked with programs that pair at-risk youth and at-risk dogs.

Some programs, like Teacher's Pet, are working to change that, and a recent randomized controlled trial of the program found some unexpected results. Johnson worked with researchers from Wayne State University's psychology department to compare youth who took part in the training program to a control group who participated in the classroom portion of the program, but then simply walked a variety of dogs rather than trained them. The study found that, contrary to expectations, both groups increased slightly in empathy over the 10 weeks—a finding that may suggest simply learning about and spending time with the dogs, rather than developing a training relationship with one, could develop empathy (Applied Developmental Science, 2016). They also found, unexpectedly, that both groups had a small increase in internalizing symptoms such as anxiety and depression at the end of the program—perhaps, Johnson suggests, because the increase in empathy increased their emotional awareness, and perhaps because there was some sadness that the program was ending.

Teacher's Pet organizers have already begun to use these results to tweak the program, she says—for example, increasing the amount of unstructured time that participants spend with the dogs, and also implementing a mentoring program so that kids who complete the program can mentor new participants.

Four-legged tutors

Once a week, Merilee Kelley and her dog Tarra visit a local elementary school in Orlando, Florida. Tarra settles down on a blanket while Kelley sits with her, and one by one, students take turns snuggling up with the golden retriever to read her a story.

Kelley and Tarra are part of a program called Reading Education Assistance Dogs (R.E.A.D.), which sends trained therapy dogs and their handlers into libraries and schools to help young readers—especially struggling readers—improve their literacy skills.

R.E.A.D., which is run by the nonprofit Intermountain Therapy Animals, began with one program at the Salt Lake City public library in 1999. Today, "reading-to-dogs" programs can be found in hundreds of libraries and schools around the country. R.E.A.D. alone has trained more than 5,300 dogs and their handlers in 50 states and 17 countries, and other nonprofits have been inspired to start their own programs: "Tail-waggin' Tutors," "PAWS for reading" and many more.

Anecdotally, the programs are wildly successful.

"We are in such demand, I get calls every week from teachers and principals and guidance counselors [who want to bring the program in]," says Nancy George-Michaelson, who runs the R.E.A.D. program in New York City.

Why would reading to a dog help a child struggling to learn to read?

Animal companion"Learning to read takes practice, and reading to a dog is an amazing way of practicing in a nonjudgmental environment," says Nancy Gee, PhD, a psychology professor at the State University of New York–Fredonia, who researches the effect that dogs can have on young children's cognitive processes. Her lab studies suggest some reasons that reading to dogs programs might work. She's found that young children are better able to follow instructions on a motor-skills task (Anthrozoos, 2009), require fewer instructional prompts to perform a memory task (Anthrozoos, 2010), and do better on an object categorization task (Anthrozoos, 2012) when a dog is present. In a not-yet-published study of language-impaired preschoolers, she found that the children used more words when telling a story to a dog than when telling it to a human.

The key, she believes, is that the dog is a nonjudgmental audience that allows the child to relax, while at the same time motivating him or her to stay with the task.

Recently, Gee and Sophie Hall, PhD, a research fellow at the University of Lincoln in the United Kingdom, completed the first systematic review of the literature on children reading to dogs (PLOS ONE, 2016). They analyzed 48 studies, and found some evidence that reading to dogs could reduce anxiety, increase confidence and boost motivation in children. And there were a few studies that showed children improving on different measures of reading fluency. However, they also found that much of the research was done on a very small scale, lacked a control group, and lacked standardized measures of reading improvement.

Larger, more rigorous, randomized controlled studies are sorely needed, Hall says.

"When you talk to the people doing it, they say, ‘It really works, it's so valuable,'" she says. "And there aren't a lot of strategies out there to increase motivation for reading. Teachers just want to find something that will motivate children to read."

Additional reading

The Social Neuroscience of Human-Animal Interaction
Freund, L.S., McCune, S., Esposito, L., Gee, N.R., & McCardle, P. (Eds.), 2016

How Animals Affect Us: Examining the Influence of Human-Animal Interaction on Child Development and Human Health
McCardle, P., McCune, S., Griffin, J.A., & Maholmes, V. (Eds.), 2011

Men and Their Dogs: A New Understanding of Man's Best Friend
Blazina, C., & Kogan, L.R. (Eds.), 2016