Peace of Mind for Therapy Dog Handlers: How I’m Working to Reduce My Risk as an Animal-Assisted Speech Therapist
What’s the number one question I get from clinicians interested in adding a speech therapy dog to their practice?
“What if something happens…will my liability insurance cover me?”
It hasn’t been a straightforward question to answer, but recently an exciting opportunity opened up to allay those fears a bit. I’ve also spent a lot of time considering what else can be done to make sure we never get to the point of having to call upon liability insurance, and I’d like to share these thoughts here…
(Of course I’m a speech-language pathologist, not an insurance representative, so be sure to get your answers addressed by your own liability provider!)
Therapy dog Delta works with kids from two years old to young adults. She’s helped provide animal-assisted speech therapy for five years now, and just passed the new AAAIP Team Skills Evaluation (read on for more)!
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A Therapy Dog Specific Liability Policy
For the first five years I partnered with my speech therapy dogs I checked annually with my insurance provider and was always given a somewhat vague answer that as long as the dog was “certified” in some way their inclusion in sessions was covered, but they had no specific criteria for what was required.
I chose to have each of my canine co-therapists take the AKC Canine Good Citizen Test, as it was applicable to the work they do every day, readily available, and affordable. But given the vagueness of the answer I never felt very secure.
(Read more about how the CGC helps prepare speech therapy dogs for work.)
When I joined the Association of Animal-Assisted Intervention Professionals I found they had an additional policy available specifically for professional therapy dog work, but you had to be registered with Pet Partners or Alliance of Therapy Dogs (click here for animal-assisted speech therapy resources).
I personally never chose that route for the following reasons:
· Early in my career I had a bad experience training with a volunteer-based organization who didn’t understand my aims in bringing a therapy dog to work with families and children. That group’s particular focus was 100% on nursing home visits, so having a higher energy dog (my first Brittany, Harvey) I was quite directly told he would never pass because he needed to be able to sit or lie down for long periods; wiggling around was not tolerated
· For me, the closest opportunity for testing would be about a three-hour drive, which would prevent me from being able to accustom my dogs to the site before adding the pressure of a test. Delta in particular can be very skittish in unknown environments and “trigger stacks” with loud noises, but is totally relaxed in her familiar office
· Because volunteer groups often visit in groups, a significant portion of that testing assesses how comfortable dogs are working in close proximity to other dogs. My therapy dogs are all comfortable seeing others from a distance, but some have been reactive in close proximity. However, in my office they only work individually (your situation may be different).
So when I heard AAAIP was launching a pilot program to provide third party evaluation of professional therapy dog-handler teams, I emailed them immediately to get details of how testing would be conducted.
Delta is a great example of a dog who excels in providing animal-assisted therapy but would be unlikely to pass a volunteer therapy dog test due to her anxiety in unfamiliar environments and reactivity in close proximity to other dogs.
Here she provides non-judgmental listening and sensory input while a client practices applying new articulation skills while reading.
I was elated to see the requirements involve having a dog training professional observe you working together in your office (or a simulated work environment), doing the activities you would normally do with clients.
The emphasis is on teamwork—how you observe and react to your dog’s communication and how your dog responds to your direction—not on specific trained behaviors.
Having the chance for Delta and Sky to shine in their familiar work environment while working with the population they actually help during evaluation was too good to pass up, so I volunteered immediately.
But the best part is that once we pass the team evaluation I’m eligible for liability coverage specially designed to meet the needs of animal-assisted intervention!
“The AAAIP policy is a general liability policy specifically designed to cover bodily injury or property damage to a third party caused by negligent acts by you or your therapy animal while engaging in animal-assisted interventions. It also includes coverage for your therapy animal(s) that are listed on the policy for any injuries they may sustain while they are participating in therapy work with you as their handler. In addition, the policy offers an optional professional liability endorsement sublimit of $25,000 to cover errors or omissions/professional liability arising out of your work as an animal-assisted intervention practitioner.” https://aaaipinsurance.com/animal-assisted-intervention-professionals-liability-faqs or YouTube video on Obtaining Liability Insurance for AAI Professionals
It’s available to a wide variety of health and human service professionals, including speech-language pathologists. And it’s surprisingly affordable!
Team Skills Evaluation with Speech Therapy Dog Delta
I participated with Delta first. As I was waiting for the evaluator to arrive I got surprisingly nervous, but as soon as my volunteer family arrived I switched into comfortable work mode and went on autopilot.
We ran through a slightly abbreviated session of therapy activities this client was familiar with, having chosen them in advance to showcase the variety of ways in which Delta often helps at work such as:
· providing deep pressure input for sensory regulation,
· responding to commands with a targeted speech sound, and
· lying nearby to listen to a story.
Of course she also greeted the family and then waited on her bed during our initial transition routine of choosing treats and washing hands—all typical of daily sessions she participates in.
My evaluator asked to record the session with the family’s permission, since she was worried she might miss certain behaviors. In the end though, she said she didn’t feel recording was necessary.
Her biggest concern was that she might have been a distraction as she needed to flip pages back and forth to see all the requirements as there’s no set order of behaviors as in a CGC test, but honestly I didn’t notice.
In all we spent about 30 minutes in the mock session and another 15 or so after the volunteer family left to discuss results. I did not bill the family for the session as my focus was on showcasing how I work with my therapy dog and not specifically the client’s goals, and I paid the evaluator an agreed upon price for her time.
The only behaviors the evaluator hadn’t been able to verify during the session were leash-walking skills, as Delta had been at liberty the whole time.
This was fine since not every single skill listed needs to be observed to pass. When I test with Sky I will be sure to include having her help transition the client out of the therapy room on leash though, as this is a common part of sessions with certain clients anyway.
Speech therapy dog Delta’s forms after being evaluated by a dog trainer for the Association of Animal-Assisted Intervention Professionals (AAAIP) Team Skills Evaluation.
From my vantage point the most difficult components were:
1. Coordinating schedules—while I had several families that volunteered, I knew I wanted a child that would be fairly predictable in their behavior (as opposed to some of my clients who can be highly dysregulated some days). Given my current caseload that narrowed the options, and then finding a time that both a busy dog professional and a busy family can meet that didn’t require too much re-arranging of my own schedule took quite a bit of back-and-forth communication.
2. The volunteer child was somewhat distracted by “showing off” for the evaluator. This meant I had to be more directive than anticipated with this particular child in order to complete the activities and therefore was a little less focused on Delta than I had envisioned. Nonetheless, it probably better reflected how many real-life sessions go.
3. Delta was a bit distracted by the evaluator, clearly recognizing that she smelled of other dogs and treats since she had come right from a dog-training class.
However, since treats and toys are allowed, I was able to direct and reinforce Delta’s behaviors exactly as I would in any other session.
In the end, it went quite smoothly and…we passed!
If you’d like to learn more about the AAAIP Team Skills Evaluation, contact them here.
Prevention Practices for Therapy Dog Work
As much as having extra liability insurance for my animal-assisted therapy gives me peace of mind, ultimately my goal is to never need to use it. In no particular order, here’s the prevention practices I’m mindful of as I partner with my furry co-therapists:
Constantly working to improve how well I read my therapy dogs’ signals
I want to know if my therapy dog is feeling uncomfortable with a situation so that I can change it immediately, whether that means changing the type of interaction, giving them a break away from the activity, or teaching a different interaction style to my client.
For my favorite resource on this subject, see The Language of Dogs on the Animal-Assisted Therapy Books and DVDs page. Raising Canine also has an excellent webinar on observing precursors to aggression.
I’ve also created a FREE Therapy Dog Behavior Bingo Board to help you train your eye to recognize the more subtle signals a dog may give.
Example Therapy Dog Behavior Bingo board for Delta, who tends to be subtle in her cues.
Compare and contrast this with speech therapy dog Sky’s board below as her signs of both stress and release of stress are generally more active behaviors that draw attention.
While it doesn’t include everything and your dog may have unique cues, it has many common stress signs.
See if you can find examples while watching other peoples’ dogs in public places like a dog park or vet’s office, or watching video clips online or on social media (hint: many people post videos of their kids with dogs that are clearly showing distress but label it as “cute” behavior).
If you are working with other animal-assisted interventionists, this could be a fun and educational outing to complete together.
Then see what you observe in your own dog while out socializing (do not intentionally inflict stress, but do stay open to noticing signs and then respond accordingly to bring your dog back to a calm state).
An example Behavior Bingo board I created observing my speech therapy dog Sky during early socialization outings. Sky gives more obvious cues but also bounces back quickly with a full body shake-off to let me know she’s ready to resume an interaction.
Teaching “dog etiquette” to all clients and their family members
How does your particular dog like to be greeted and loved on? Does it vary depending on the person?
My own therapy dogs can be quite different in what they are comfortable with, being of very different sizes and temperaments. Regardless, there are certain things I teach to everyone who comes to therapy, including caregivers and siblings.
Of course every therapy dog-handler team is different, so be sure to personalize this to what best maintains your own therapy dog’s welfare.
I personally teach no hugs, as it can be interpreted as restraint to dogs, and I’ll have a blog with more details on this topic soon. This can be difficult for kids whose own pet tolerates hugs and I find needs constant vigilance, redirection to polite petting, and reinforcement.
One of my autistic clients with higher support needs has done better since establishing the rule of only one hand on the dog at a time, keeping the other hand on his thigh. He genuinely loves the dogs and doesn’t mean to be rough, but with two hands he tends to impulsively pull them towards him and clutch at their body due to poor motor grading and sensory seeking. Since instituting this expectation he uses less pressure and doesn’t accidentally restrain the dogs; approaching it as a black and white rule has allowed him more independence in his interactions with the dogs (though I’m always supervising).
Establishing a rule of only one hand on the dog at at time allows this particular client with significant learning differences more independence in safely interacting with my speech therapy dogs. Here Sky enjoys a chest rub.
I also teach all clients to:
· stay away from a dog’s face (i.e., no going in for a kiss, though I say if the dog approaches them for a kiss they are welcome to receive one if they want it)
· to pet from “shoulder to tail” to avoid patting their head, which can feel invasive to many dogs, and
· to put treats on their hand “like a plate” so the dog isn’t tempted to nip at fingers.
My dog’s are medium to large size, but if I was working with a small dog I would make sure clients knew to not pick up the dog as well.
Even though my dogs are well desensitized to being handled in various ways, I’d rather be safe than sorry should they be feeling tired or unwell and have a lowered threshold for stress on a given day.
Plus, the more comfortable they are at work the more likely they will want to continue working long-term.
Of course, all of this takes frequent reinforcement and constant vigilance with speech therapy clients who may struggle with impulse control and/or have language comprehension challenges. Many of my clients also have anxiety that presents as oppositional behavior and/or sensory regulation differences that can result in sudden outbursts or sensory seeking.
I’ve found role-playing with a weighted stuffed dog (who doubles as one of my favorite sensory regulation tools), creating personalized visual supports, modeling self-talk as I interact with my dogs (e.g., “Delta likes shoulders to tail” while I pet her), and praising the child’s efforts really help.
Perhaps the hardest part of teaching dog etiquette is making sure I’m modeling it correctly myself. This means I can’t grab Delta’s muzzle for a smooch or pull Sky in for a hug when they do something exceptional!
“Heavy puppy” doubles as a sensory regulation tool while kids work as well as an engaging tool for teaching dog etiquette prior to introducing a live therapy dog. Click to find this and other animal-related engagement favorites with brief explanations of how I incorporate them into my sessions.
Planning in rest and decompression throughout a therapy dog’s day
I have to admit I only really started contemplating this when Delta started coming three days a week after Johnny Utah and Bodhi retired. (She’s now is back to two days a week, with little Sky coming the other day). She was definitely getting tired by the end of the work week and I was worried about burn-out.
Though I learned early on to incorporate the therapy dogs only when it is most meaningful or flows organically in a session, thus leaving plenty of time for rest, more recently I’ve been intentionally finding moments for adding chewing and searching activities that are naturally calming.
Providing Kongs stuffed with sunflower butter (I don’t use peanut butter in case of client allergies), dog puzzles, and snuffle toys can be done quickly and helps a dog release calming endorphins. (Find all of these and more on the Therapy Dog Supplies page!)
When Sky first started I also found she was more likely to sleep instead of pacing the office during cancelled sessions if I put a spritz of natural dog appeasing pheromone on her bed. She’s since adjusted to the work routine and learned the skill of energy conservation, but at first she needed a little help to turn her energy level down during breaks.
Speech therapy dog Sky engages in some natural sniffing and searching behavior with our favorite puzzle toy. This and similar toys can be incorporated into animal-assisted therapy sessions or added between sessions to help therapy dogs decompress. See my favorites on the Therapy Dog Supplies page.
Watching my wording about animal-assisted therapy
This was a great tip from a Therapy Dogs Australia podcast on risk mitigation: be sure to say on your marketing that a therapy dog will be included “as appropriate” and/or “when available”. This way you aren’t obligated to provide this specific intervention if a client is not a good fit for animal-assisted therapy or you are unable to continue bringing your dog for any reason.
Conclusions About Risk Mitigation with a Speech Therapy Dog
Since what we humans call “aggression” is really just a dog’s way of communicating it wants space, putting practices in place to help them feel relaxed (choosing dogs naturally suited for the role, teaching dog etiquette, and providing decompression activities) and then training ourselves to recognize and respond accordingly to their communication of stress can go a long way towards keeping all parties involved safe and joyous.
If you’d like to learn more about partnering with a therapy dog in a professional role, check out Paws for Progress: Integrating Animal-Assisted Interventions Into Your Speech-Language Pathology Practice (ASHA Press, 2024) and online course Talk to the Paw: Therapy Animal Inclusion in a Professional Setting. And don’t hesitate to reach out with questions via the “contact me” form!
May your day be filled with puppy wiggles and children’s giggles,
Sharlet
Update: Sky also passed the AAAIP Team Skills Evaluation!
The only checkmark she didn’t earn was for “maintains a calm body,” because the examiner pointed out that she is so eager to participate she was wiggling and curious the whole session.
Our examiner also remarked that Sky clearly LOVES her job, so that was nice to hear from a non-biased observer!
