Mental Health and Well-Being  | HABRI

Mental Health and Well-Being 

Child Health & Development

Mental health refers to our cognitive, behavioral, and emotional well-being.

Mental health and well-being is important at every stage of life, from childhood and adolescence through adulthood.

A broad range of studies have demonstrated how the human-animal bond can play an important role in the management of mental health in children and adolescents.

Stress, Anxiety and Social Connectedness


Pet dogs have a notable impact in the lives of children, including the management of their mental health. Studies have shown that children report strong emotional bonds with their pet dogs.[1]

  • A study on the role of social support in the lives of children found that children typically view emotional and companionship support more effective at reducing distress than informational or instrumental support. Researchers identify pet dogs’ support as generally emotional in nature and able to provide companionship. This is significant because as children age, they tend to rely less on their parents for emotional support and more on their pets instead.[2]
  • A comprehensive study[3] of 101 children age 7 to 12 examined the effect of the presence of a pet dog on children’s perceived stress levels. When compared to children alone or in the presence of a parent, the presence of a pet dog significantly buffered increases in perceived stress.
    • In discussion of the results, the study points out that a common reason dog companionship is valued is because dogs are non-judgmental and accepting of everyone.[4].
      • This is important, as the feeling of evaluation or judgement in social settings is one of the major triggers for socially related anxiety issues,[5]
    • During middle childhood children engage in more of such social comparison and incorporate others’ feedback more into their sense of self.[6]
    • The study suggests that because dog companions are by nature not evaluative in the same way as human companions, they may buffer perceived stress more effectively under certain conditions.

Social & Emotional Development

In both western and non-western cultures, pet ownership has been found to offer psychological support for children and young adults. This effect helps improve self-esteem and enables them to create more positive images of themselves.[7]

  • Pet horses and dogs have been found to increase social circles and the number of human contacts in children, which can increase emotional health outcomes such as self-esteem.[8]
  • A study examining the level of childhood attachment to pets identified a link between pet attachment and empathy, positive attitudes to animals, and prosocial orientation and behavior.
    • The study suggests that increased direct involvement and responsibility for the care of a pet can facilitate childhood attachment to that pet.
    • While children reported the highest level of attachment to dogs, the children in the study also demonstrated strong attachment to cats, followed by small animals.[9]
  • Child-dog interactions may prevent the evolution of emotional problems into full-fledged mental, emotional or behavioral disorders during adolescence or during adulthood. According to a cross-sectional study of over 600 children in a primary care setting, having a pet dog in the home was associated with a decreased probability of childhood anxiety. [10]
    • The study postulates that pet dogs could reduce childhood anxiety, particularly social and separation anxiety.

Potential mechanisms discussed in the above study were that a pet dog can stimulate conversation and alleviate social anxiety via a social catalyst effect. Hormonal effects, such as increasing oxytocin levels and decreasing cortisol levels can attenuate physiologic responses to stress, which may underlie the observed emotional and behavioral benefits of pet dogs and AAT. Qualitative data from homeless youth suggest that vulnerable adolescents who are homeless recognize the therapeutic value of pets, and pets are often used as a coping strategy for loneliness.[11]

Reducing Loneliness & Social Isolation

Loneliness is likely a precursor for anxiety, depression and low self-esteem. There is some evidence that pet ownership may protect children and youth from loneliness and social isolation, and therefore may help to prevent depression.[12]

  • A study measuring dog attachment and perceived social support in overweight/obese and healthy weight children found that the overweight/obese children were more attached to their pet dogs than healthy weight children and had less perceived social support from friends, which is consistent with other findings in adults.
    • A higher dog attachment in overweight/obese children was thought to be attributed to the pet dogs taking the place of peer social support due to the unconditional love from the dogs that the children reported.[13]
  • A study of 400 homeless youth found that 23% of those surveyed reported owning pets. Those who did report owning a pet reported experiencing less depressive symptoms and loneliness than their non-pet-owning peers.[14]
  • The ameliorating effects of pet ownership on loneliness have also been observed in less vulnerable adolescent populations. A study of high school students, age 13-19, showed that pet-owners reported significantly lower levels of loneliness compared to their non-pet-owning peers.
    • These results were found to be consistent even after accounting for length of time owning a pet, family composition, and number of pets owned.[15]

Improving Mental Health in Hospitalized Children

Normalizing the Hospital Experience

One of the primary issues facing children with cancer and other chronic disease is adjusting to life after diagnosis and time spent in the hospital. Evidence increasingly supports the ability for HAI to improve quality of life in hospitalized children.

  • Dogs can make children perceive the hospital as less foreign, in part because dogs are likely familiar and representative of the child’s everyday environment.
    • Results of a descriptive study of animal-assisted therapy showed that the presence of animals can help normalize the hospitalization experience for pediatric patients and their families.[16]
  • In a study of canine visitation therapy on pain management in hospitalized children, dogs were found to remind children of life, interests and relationships outside of the hospital setting.[17]
  • In a study of pediatric cardiology patients, respondents listed “motivation to stay optimistic” as one of the primary reasons for visiting a therapy dog.[18]
    • In the same study of pediatric cardiology patients, 61 percent of children stated the presence of visiting therapy dogs served as a pleasant distraction from the reality of hospitalization. 40 percent of parents in the study reported a pleasant distraction as a result of a therapy dog.

Alleviating Stress & Anxiety in Hospital Settings

In addition to normalizing the hospitalization process, HAI can alleviate stress and anxiety in young patients.

  • A study of children aged two to six years undergoing a simulated medical exam found that the presence of a companion dog lowered behavioral distress, suggesting that animals can decrease procedure-induced distress in children in a variety of health care settings.[19]
  • The presence of dogs during blood draw procedures can reduce distress in children. In a study of 50 children between 4 and 11 years undergoing a blood draw, children with a dog present evidenced significantly lower levels of distress and stress levels in comparison to the children who underwent blood drawing with no dog present.[20]
  • Results of a study examining over 4,000 children diagnosed with cancer indicated animal-assisted therapy (AAT) can contribute to improvement in pain and psychological parameters, including irritation, stress, anxiety, mental confusion, and tension in patients undergoing outpatient treatment.
    • The researchers in this study conclude the improvement observed after participation in AAT may be directly related to the benefits of the human-animal bond.[21]

Addressing Trauma in Adolescence

A systematic review on AAI for youth with at-risk mental health problems concluded that animal-assisted therapy can improve functioning in adolescents who have experienced trauma, including enhanced mental wellness, quality of life, and improved maintenance of long-term mental health conditions.[22] In the review, results of the following studies were cited to support the conclusions made:

  • In a study of at-risk adolescents aged 14 to 18 in a residential treatment facility, equine-facilitated psychotherapy (EFP) was found to improve self-control and self-image compared to the control group. Additionally, adolescents who received EFP had fewer arrests and drug use at the follow-up.[23]
  • A study examining children aged 7 to 17 with trauma symptoms who had been sexually abused found that, following AAT, children in the group that included therapy dogs showed significant decreases in trauma symptoms, including anxiety, depression, anger, PTSD, and dissociation.[24]
  • In a twelve-week cognitive behavioral therapy (CBT) intervention on 24 children with ADHD, children who received both CBT and canine assisted intervention showed greater decreases in ADHD symptoms than children who received just CBT.[25]
  • After examining the impact of animal-assisted therapy (AAT) for teenagers in residential care who suffered traumatic childhood experiences and currently suffer mental health issues, researchers found that AAT improved attachment, and reduced anxiety, depression, anger, PTSD, and dissociation.[26]




Westgarth, C., Boddy, L. M., Stratton, G., German, A. J., Gaskell, R. M., Coyne, K. P., … & Dawson, S. (2013). Pet ownership, dog types and attachment to pets in 9–10 year old children in Liverpool, UK. BMC Veterinary Research, 9(1), 102.


Bryant, B. K. (1985). The neighborhood walk: Sources of support in middle childhood. Monographs of the society for research in child development.


Kertes DA, Liu J, Hall NJ, Hadad NA, Wynne CDL, Bhatt SS. Effect of Pet Dogs on Children’s Perceived Stress and Cortisol Stress Response. Soc Dev. 2017;26(2):382–401. doi:10.1111/sode.12203


Allen, K. M., Blascovich, J., Tomaka, J., & Kelsey, R. M. (1991). Presence of human friends and pet dogs as moderators of autonomic responses to stress in women. Journal of personality and social psychology, 61(4), 582.


Rapee, R. M., & Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia. Behaviour research and therapy, 35(8), 741-756.


Cole, D. A., Maxwell, S. E., Martin, J. M., Peeke, L. G., Seroczynski, A. D., Tram, J. M., … & Maschman, T. (2001). The development of multiple domains of child and adolescent self‐concept: A cohort sequential longitudinal design. Child development, 72(6), 1723-1746.


Purewal, R., Christley, R., Kordas, K., Joinson, C., Meints, K., Gee, N., & Westgarth, C. (2017). Companion animals and child/adolescent development: a systematic review of the evidence. International journal of environmental research and public health, 14(3), 234.


Ibid. Purewal


Hawkins, R. D., & Williams, J. M. (2017). Childhood attachment to pets: Associations between pet attachment, attitudes to animals, compassion, and humane behaviour. International journal of environmental research and public health, 14(5), 490.


Gadomski, A. M., Scribani, M. B., Krupa, N., Jenkins, P., Nagykaldi, Z., & Olson, A. L. (2015). Peer Reviewed: Pet Dogs and Children’s Health: Opportunities for Chronic Disease Prevention?. Preventing chronic disease, 12.


Rew, L. (2000). Friends and pets as companions: Strategies for coping with loneliness among homeless youth. Journal of child and adolescent psychiatric nursing, 13(3), 125-132.


Ibid. Purewal


Linder, D. E., Sacheck, J. M., Noubary, F., Nelson, M. E., & Freeman, L. M. (2017). Dog attachment and perceived social support in overweight/obese and healthy weight children. Preventive medicine reports, 6, 352-354.


Rhoades, H., Winetrobe, H., & Rice, E. (2015). Pet ownership among homeless youth: Associations with mental health, service utilization and housing status. Child Psychiatry & Human Development, 46(2), 237-244.


Black, K. (2012). The relationship between companion animals and loneliness among rural adolescents. Journal of Pediatric Nursing, 27(2), 103-112.


Gagnon, J., Bouchard, F., Landry, M., Belles-Isles, M., Fortier, M., & Fillion, L. (2004). Implementing a hospital-based animal therapy program for children with cancer: a descriptive study. Canadian Oncology Nursing Journal/Revue canadienne de soins infirmiers en oncologie, 14(4), 217-222.


Sobo, E. J., Eng, B., & Kassity-Krich, N. (2006). Canine visitation (pet) therapy: pilot data on decreases in child pain perception. Journal of Holistic Nursing, 24(1), 51-57.


Wu, A. S., Niedra, R., Pendergast, L., & McCrindle, B. W. (2002). Acceptability and impact of pet visitation on a pediatric cardiology inpatient unit. Journal of pediatric nursing, 17(5), 354-362.


Hansen, K. M., Messinger, C. J., Baun, M. M., & Megel, M. (1999). Companion animals alleviating distress in children. Anthrozoös, 12(3), 142-148.


Vagnoli, L., Caprilli, S., Vernucci, C., Zagni, S., Mugnai, F., & Messeri, A. (2015). Can presence of a dog reduce pain and distress in children during venipuncture?. Pain Management Nursing, 16(2), 89-95.


Silva, N. B., & Osório, F. L. (2018). Impact of an animal-assisted therapy programme on physiological and psychosocial variables of paediatric oncology patients. PloS one, 13(4).


Hoagwood, K. E., Acri, M., Morrissey, M., & Peth-Pierce, R. (2017). Animal-assisted therapies for youth with or at risk for mental health problems: A systematic review. Applied Developmental Science, 21(1), 1-13.


Bachi, K., Terkel, J., & Teichman, M. (2012). Equine-facilitated psychotherapy for at-risk adolescents: The influence on self-image, self-control and trust. Clinical Child Psychology and Psychiatry, 17(2), 298-312.


Dietz, T. J., Davis, D., & Pennings, J. (2012). Evaluating animal-assisted therapy in group treatment for child sexual abuse. Journal of child sexual abuse, 21(6), 665-683.


Schuck, S. E., Emmerson, N. A., Fine, A. H., & Lakes, K. D. (2015). Canine-assisted therapy for children with ADHD: preliminary findings from the positive assertive cooperative kids study. Journal of attention disorders, 19(2), 125-137.


Balluerka, N., Muela, A., Amiano, N., & Caldentey, M. A. (2014). Influence of animal-assisted therapy (AAT) on the attachment representations of youth in residential care. Children and Youth Services Review, 42, 103-109.