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Research: Animal-Assisted Intervention

News Story

CHP Professor Joanne Singleton, PhD, is engaged in ongoing initiatives around service dogs and animal-assisted intervention. Her work, which focuses on reducing stress among student veterans and generating evidence on the benefits of service dogs, was all inspired by a remarkable veteran who changed the course of her career.

In 2016, College of Health Professions Professor Joanne Singleton, PhD, was attending the National Academies of Practice annual conference where she met Luis Carlos Montalván and his service dog, Tuesday. Luis had presented at the conference, and told his story.

Montalván, who had been honorably discharged after serving two tours of duty in Iraq, suffered from PTSD, traumatic brain injury, and multiple physical disabilities. He discussed the rigors of navigating the health care system, his mental health difficulties, and finally, how being paired with a service dog radically changed his life for the better. After being paired with Tuesday, Montalván went on to receive a master’s in journalism from Columbia University, wrote a New York Times best-selling memoir, two children's books about service dogs, and became a major advocate for veterans, and the valuable role of service dogs in mitigating visible and invisible disabilities.

“I met Luis and Tuesday many years after they had been teamed together,” said Singleton. “During that time, Luis was able to be incredibly successful. He went from being very symptomatic, unable to be in public, and drinking himself to death, to being teamed with a service dog, and that addition to his plan of care, as Luis said, saved his life.”

Singleton’s interest was further piqued when Montalván discussed navigating the health care system with Tuesday, and how at times, this proved to be even more difficult. Oftentimes, health care practitioners weren’t adequately prepared for interaction with Tuesday, and sometimes, Tuesday wasn’t even allowed to enter certain health care facilities.

Singleton realized that as a health care provider, and educator, she was in the unique position to make a major difference.

“As I listened to Luis, I realized, these health care providers he is talking about, this could me be!" said Singleton. "No one has ever taught me about this. As an educator, I have an opportunity to teach our health profession students about this, and make a real change. It became a call to action.”

From there, Singleton began a conversation with Luis and Tuesday. Out of that conversation, Singleton developed a vision plan focusing on assistance animals and education, practice, research, and policy.

"From this we developed a curriculum to educate interprofessional healthcare providers to be knowledgeable about—and culturally competent in—working with individuals who are teamed with a service dog, benefit from a service dog, or participate in animal-assisted interventions to support their care," said Singleton.

Although the initiative began in 2016 with Luis; Lu Picard, Co-Founder and Director of Education and Programs, Educated Canines Assisting with Disabilities (ECAD); and CHP Professor Lucille Ferrara, it gained further momentum in 2017, with the official launch of Canines Assisting in Health.

Singleton notes that the group has been very active on this front—at Pace, locally, and nationally—through educational sessions, master classes, developing simulations, animal-assisted interventions, and more. Singleton became certified in the human-animal bond and animal-assisted interventions, and began thinking about what kinds of interventions could most positively affect veterans and other vulnerable populations. So she took her newfound knowledge, and applied it to affecting positive change on campus.

“We know in universities, everyone is stressed,” said Singleton. “We also know that within the larger University community are smaller communities—such as the student-veteran community—that have additional unique stressors. We wanted to do a controlled study where we could look at what we knew were potentially effective interventions, and to see if there was a reduction in stress from before to after the interventions, and also if there were any differences between the two interventions we were interested in working with.”

And so began one of Singleton’s ongoing research projects, with Ferrara as co-investigator. Titled, A Randomized Study of Non-Pharmacologic Interventions for Stress Management in Veteran College Students, Singleton’s research focuses on both student veterans and other student populations, and how to use non-pharmaceutical interventions to increase the overall well-being of students. Singleton is still in the research phase of the study, but is aiming to have concrete findings by the end of the calendar year.

Although there are myriad goals from Singleton’s research and activism, one concrete goal is to lay the groundwork for insurance companies to consider providing coverage for individuals to be teamed with a service dog.

“Policy is part of the vision plan. From the beginning of this work, Luis and I talked about generating evidence through research to be able to ask a forward-thinking insurance company to do a demonstration project and to consider providing insurance support for a person to be teamed with a service dog."

Singleton became increasingly aware of the unique issues facing veterans, and how those issues may carry over to the campus setting, particularly after Montalván took his own life at the end of 2016. Yet although Montalván and Tuesday—who passed away earlier this fall—are both no longer with us, their story and ability to effect positive change really impacted Singleton and this ongoing initiative in a major way. In fact, one of the more outwardly visible University community events highlighting Singleton’s work is her evidence-based Paws & Breathe® stress reduction practice with Professor Spirit, Pace's facility dog, who is teamed with Singleton, and is her teaching, practice, and research partner. Spirit is an ECAD alumni, and Tuesday's cousin.

"When we started this work, Luis said 'you can't just talk the talk, you have to walk the walk—you need to be teamed with an ECAD educated service dog,'" said Singleton.

Over the course of 2018, the outcomes of the group Paws & Breathe® sessions showed significant stress reductions from before to after the intervention, across students, faculty, and staff, including many veterans at Pace.

“I had no idea I would be working in this area, and now that I know how important this work is, it has become my passion project. Luis was a caring person, whose main goal was to help others. He was an author, he was an advocate, he created service policy with then Senator Al Franken, and as Luis would tell you, it was all because of Tuesday. While Tuesday was always by Luis' side, he was not with Luis when Luis took his life. All of this work we are doing was inspired by Luis and Tuesday, my colleagues, and friends, with the shared goal of helping others."

While Singleton’s work is ongoing, she invites anyone who is interested in getting involved with the initiative to email to inquire about volunteer opportunities. As Singleton notes, volunteers are always welcome to continue the group's ongoing efforts.

“Luis and I talked about having an army of advocates. Having the people that we teach be able and advocate for people with disabilities, with service dogs, with animal-assisted interventions. And we’re making that happen.”