Module 5: Therapy Dog Behaviour & Care

Developed by:
M. D. Daschuk, PhD, Department of Sociology; University of Saskatchewan
Colleen A. Dell, PhD, Department of Sociology; University of Saskatchewan
Ann R. Howie, CCA, CCFT, LICSW, ACSW; Human-Animal Solutions, PLLC

Ben Carey, BA, Department of Sociology; University of Saskatchewan
Linzi Williamson, PhD, Department of Sociology, University of Saskatchewan
Maryellen Gibson, MPH, Department of Sociology; University of Saskatchewan

Therapy Dog Handler Reviewer:
Jane Smith, B.Trad., B.Ed, MStJ; St. John Ambulance Therapy Dog Program


In this module you will have the opportunity to increase your awareness and skills about the basics of dog body language and therapy dog care, during and after a visit. You will also be introduced to an animal ethics perspective, explore how it aligns with traditional Indigenous perspectives, and have the chance to review animal treatment standards that are recognized by the international community of animal welfare workers. Finally, you will be invited to consider popular perspectives on ethical canine treatment developed specifically for therapy dog handlers, including strategies to reduce canine stress and promote their therapy dog’s welfare before, during, and after your visits.

Figure 5-1: Ann and Gusto. Permission: Courtesy of Ann Howie, Human-Animal Solutions.


Ann Howie began her life by being friends with the animals on her family farm. As an adult, she found ways to incorporate animals into her psychotherapy practice and to advocate for animals’ perspectives as a dog trainer. She is a licensed clinical social worker and a Certified Canine Fitness trainer who is passionate about enhancing the lives of both humans and animals. Ann helped develop the first Standards of Practice in the field of animal-assisted interventions, authoring books for both volunteers and professionals, and she continues to develop and teach curricula on-line and in-person whenever possible. Kindness is central to Ann’s way of being, toward both humans and the animals with whom we share this planet. Ann is also the creator of the Therapy Dog’s Bill of Rights, a collection of thirteen principles for therapy dog handlers that boldly reflects Ann’s complete lack of fear of unlucky numbers!

Learning Objectives

When you have finished this module, you should be able to: 

  1. Discuss ethical practices related to animal welfare and being a therapy dog handler.
  2. Recognize eustress, stress, and distress in domesticated dogs.
  3. Identify five common canine behaviors and explain their meaning.
  4. Describe a basic care routine for therapy dogs before, during, and after a visit.

Key Terms

  • Animal Ethics
  • Speciesism
  • Positive Welfare
  • Nonmaleficance
  • Beneficence
  • Distress
  • Care routine


Essential Information for Therapy Dog Handlers

Click to expand each section.



In Module 2 we focused on how to interact with therapy dog program participants in ways that are respectful of their diversity so that we are providing them with an inclusive therapy dog experience. In Module 3 we took this further and specifically discussed the importance of interacting with therapy dog program participants in trauma-informed ways. In Module 4, we focused on the importance of assessing your own mental health as a therapy dog handler, and strategies to attend to your emotional, spiritual, mental, and physical wellness as you interact with therapy dog participants in a range of environments. This final module spotlights how to ensure the health and happiness of your therapy dog – an area of consideration that is attracting increased attention by therapy dog programs – and rightfully so!

To start off, consider the outcomes of a recent evaluation of the St. John Ambulance Therapy Dog Program on a mental health range at Stony Mountain Institution, a federal multi-sector prison located outside of Winnipeg, Manitoba. Our team concluded that participants experienced meaningful benefits visiting and connecting with the therapy dogs. However, like with the majority Animal Assisted Activity studies, this research did not assess the impact of the visits on the therapy dog teams. Just like we reviewed in the prior modules that each handler and therapy dog participant we visit with has a unique background and personality and can react differently to varying visiting situations, this is also true of each therapy dog.

Visiting St. John Ambulance therapy dogs and handlers undergo a national standardized evaluation and it is up to the handler to determine the environments they and their dog are best suited to visit. Consider, for example, that a prison can be challenging place to visit because prisoners are subject to the harshness of prison culture, the impacts of isolation and constant supervision, and fear of violent behavior. Given that dogs can smell hormones related to stress, visiting therapy dogs are likely tuning in to such tension in prisoners if it exists. It is possible that some therapy dogs will experience discomfort in certain environments (like a prison, or a hectic hospital emergency room) or even when interacting with certain groups of people (such as high-energy children). It is very important to identify which interactions are well suited to your therapy dog’s personality and which are not. This module considers ways to become more aware of behaviors your dog will use to tell you how they feel and will help you develop skills to best ensure their mental and emotional health.

Animal Ethics and Traditional Indigenous Perspectives

Animal Ethics and Traditional Indigenous Perspectives

Animal Assisted Activities, such as therapy dog visiting, are rooted in an animal ethics perspective that recognizes animals as living beings with thoughts, feelings, and emotions not unlike those of people. Animal rights advocates oppose practices of speciesism, or the commonplace belief that animals are morally inferior to humans (Animal Ethics, 2021). While disturbing forms of speciesism include the way animals are mistreated by some food industries, cosmetics manufacturers, and pharmaceutical companies, any instance where animals are subject to treatment that does not recognize their rights and freedoms is potentially problematic (Animal Ethics, 2021). You can even think about how speciesism seeps into our everyday conversations and is reinforced with anti-animal language. Think of common sayings that might be problematic, such as “kill two birds with one stone” and “be a guinea pig”. Our words matter!

Given that many therapy dog programs visit with clients who experience historical and intergenerational forms of trauma, it is important to consider how endorsing an animal ethics perspective is compatible with Indigenous worldviews and ways of knowing, and how it can challenge colonial thinking and actions and support reconciliation. The final report of the Truth & Reconciliation Commission (2015: 18) shares the following:

Elder Reg Crowshoe told the Commission that Indigenous peoples’ world views, oral history traditions, and practices have much to teach us about how to establish respectful relationships among peoples and with the land and all living things. Learning how to live together in a good way happens through sharing stories and practicing reconciliation in our everyday lives.

For example, while Indigenous cultures make use of animals for food and the production of necessary goods, they traditionally respect the spirit that all living creatures have and honor the sacrifice made by the animals (McGinnis, Kincaid, Barrett, Ham and Community Elders Research Advisory Group, 2019).

For some Indigenous program participants, engaging in therapy dog visiting may provide them with an experience and a celebration of traditional Indigenous ways of being. For example, our team’s 2018 paper in the Journal of Indigenous HIV Research shares that a program participant “wants the [therapy dog] program to be more widely available to other Indigenous people”. Let’s learn more about a few organizations and individuals that promote animal ethics as a way of pursuing reconciliation and revitalizing Indigenous perspectives. This is an equally important consideration in the associated therapy dog field.

Figure 5-2: Logo for the NAHS. Source: Permission: This material has been reproduced in accordance with the University of Saskatchewan interpretation of Sec.30.04 of the Copyright Act.

The Native American Humane Society

The Native America Humane Society (NAHS) assists tribal communities in the United States to form relationships with animal welfare service provider organizations. These services empower communities to engage with and manage local animal populations, and reinvigorate cultural practices involving animals, in ways that align with traditional perspectives based in animal ethics. For more information, visit the NAHS website at

Figure 5-3: Dr. Michael Yellowbird. Source: Permission: This material has been reproduced in accordance with the University of Saskatchewan interpretation of Sec.30.04 of the Copyright Act.

Dr. Michael Yellowbird

The work of Dr. Yellow Bird, the Dean of Social Work at the University of Manitoba,  challenges the influence the colonial mindset has on the relationship Indigenous communities have with animals. Yellowbird’s research and advocacy focuses on the devastating impacts of colonization on Indigenous peoples’ relationship with dogs, both with regard to lost cultural practices and contemporary community policies on the management of ‘Rez Dog’ (undomesticated dogs on reservation land) populations. To learn more about Dr. Yellow Birds’ research, visit his website at

Figure 5-4: Save Rez Dogs logo. Source: Permission: This material has been reproduced in accordance with the University of Saskatchewan interpretation of Sec.30.04 of the Copyright Act.

Save Rez Dogs

Founded by Leah Arcand from Muskeg Lake Cree Nation in Saskatchewan, Save Rez Dogs draws from Indigenous perspectives to assist communities to develop dog management strategies that promote animal ethics. Save Rez Dogs is a non-profit group staffed entirely by volunteers and raises funding through the sale of (very stylish and affordable) clothing and merchandise. Leah Arcand also offers consulting services and can be contacted to arrange presentations to better assist the development of dog management strategies that honor their rights and empower community bonds in line with traditional perspectives. For more information, please visit

The Five Freedoms and Five Domains of Animal Welfare

The Five Freedoms and Five Domains of Animal Welfare

Animal welfare organizations throughout the world collectively support standards of practice that they believe all animal handlers should acknowledge and respect. For example, numerous animal welfare organizations, including Humane Canada (2017), support the five freedoms of animal welfare to help ensure the humane treatment of animals. This ranges from dairy cows through to backyard hens. The 5 freedoms are:

  1. Freedom from hunger and thirst
  2. Freedom from discomfort
  3. Freedom from pain, injury or disease
  4. Freedom to express normal behavior
  5. Freedom from fear and distress

While these five freedoms are consistent with ethical treatment, their focus on the prevention of harm has led to suggestions that greater attention should be paid to the equally important duty of providing positive welfare. Positive Welfare involves giving animals the freedom to attend to whatever activities bring them feelings of joy and free will. When you provide your therapy dog opportunities to play, visit with other animals, and enjoy time ‘off the clock’ to relax and go about their business, you are actively contributing to their positive welfare.

Other animal welfare organizations and Animal Assisted Activity scholars approach the overall welfare of animals as consisting of five domains of physical and mental health (Peralta and Fine, 2021; Mellor, Beausoleil et al., 2020). The ‘five domains’ reflect the importance of the ‘five freedoms’, while also accounting for the benefits animals receive when handlers attend to providing positive welfare. Physical welfare is associated with the domains of Nutrition, Environment, Health and Behavior, while mental welfare is related to the fifth domain of mental state.

1.Domain of Nutrition: Animal handlers should provide ready access to fresh water and a diet to maintain full health and vigor. 2. Domain of Environment: Animal handlers should provide shade/shelter or suitable housing, good air quality, and comfortable resting areas. 3. Domain of Health: Animal handlers should prevent or rapidly diagnose and treat disease and injury, and foster good muscle tone, posture, and heart and lung function. 4. Domain of Behavior: Animal handlers should provide sufficient space, proper facilities, congenial company, and appropriately varied conditions. 5. Domain of Mental State: Animal handlers should provide safe, pleasant and breed-appropriate opportunities to have pleasurable experiences.

Figure 5-5: The Five Domains of Animal Welfare. Permission: Courtesy of course author Colleen Anne Dell, Department of Sociology, University of Saskatchewan, based on Mellor, D., et al, (2020). The 2020 Five Domains Model: Including Human–Animal Interactions in Assessments of Animal Welfare. Animals 2020, 10(10), (p. 3).

We will soon turn our attention from principles for the ethical treatment of animals generally to principles more explicitly related to therapy dogs. First, however, it may be worthwhile to check in on how well you can recall the five freedoms of animal welfare, the five domains of animal welfare, and give you an opportunity to consider the close relationship between the two.

Learning Activity 5-1: Making Connections: Five Freedoms and Domains of Animal Welfare

While the five freedoms relate to ethical views on the rights of all animals, and the five domains refer to ways to actively ensure the physical and mental health of animals, it is important to acknowledge that we can recognize these freedoms and ensure these domains at the same time. First, refresh your memory with the list of freedoms and domains of animal welfare.

The Five Freedoms of Animal Welfare The Five Domains of Animal Welfare
Freedom from Hunger and Thirst Nutrition
Freedom from Discomfort Environment
Freedom from Pain, Injury, or Disease Health
Freedom to Express Normal Behavior Behavior
Freedom from Fear and Distress Mental State

Next, review the therapy dog visiting scenarios that follow. See if you can identify how (at least) one of each freedom and each domain is being attended to.

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Handler Story (Jager and Grace)

Handler Story (Jager and Grace)

Please watch the following video.

Written content and video by Grace Rath.

Who you are?

My name is Grace Rath, and I was a therapy dog handler for about 3 years.

Who is your therapy dog?

I have my retired therapy dog Jager here with me today, who is a 14-year old Labrador retriever. Jager has always been well suited to be a therapy dog, but it wasn’t until we got his younger brother Reacher, that I decided to get Jager certified. Part of the reason was to have something to do that was just for the two of us, away from the high energy puppy in our home. Jager was a natural at his job, even as a senior dog he made the most of his visits and made his rounds everywhere we visited. This included a mental health community centre, a home for non-verbal adults with disabilities, and the university. Jager has great intuition when it comes to knowing when someone needs comfort, and the level of comfort they need. It was not uncommon for him to insist that he lay on a bed with an appreciative person when I had not asked him to. He was a very easy going visitor and he tolerated a lot of loud yelling from non-verbal clients trying to express themselves, laying on him, and hugging him. Because he was so easy going it was hard to tell where his limits were, and when not to push them. Being a senior dog, Jager was physically weaker and needed a particular set up to continue doing the therapy dog visits he seemed to love so much.

What are you going to share?

This leads me to the topic of my story today. Today I will be sharing my personal experiences about the importance of maintaining therapy dog care and understanding how their behavior can be an indication of stress.

This story is important because, as handlers, it can be hard to admit there are aspects of therapy dog visits our dogs may not enjoy because we enjoy it so much. We want our dogs to love it because we love it. It is important to recognize that we owe it to our wonderful dogs to make sure that being a therapy dog is a great experience for them, and to know when environmental adjustments, for example, need to be made. I have to two stories about this.

As I mentioned, Jager and I used to visit a care home for non-verbal adults with disabilities. All of the residents were in wheelchairs and needed a special set up for our visits. Everyone had different personalities and needs that we became very familiar with. We also became familiar with the staff who knew the participants the best and who I consulted with on visits to decide what the best set up for that visit. These stories pertain to visiting with two of the residents.

The first story involves a resident who is seeing impaired and in a wheelchair. We mainly did tactile visiting with, where I would assist the resident in petting Jager and talking to him about Jager since he was unable to see him. The second story involves a resident who was also in a wheelchair, but who had some tendencies to pinch and grab staff members and volunteers out of expression. Both of my stories are related to maintaining therapy dog welfare and the lessons.

Resident 1 story: When initially visiting with resident 1, Jager and I struggled with offering him a meaningful therapy dog experience due to his being in a higher set wheelchair and Jager having to stand beside the wheelchair as a shorter dog with arthritis. Because of his arthritis, Jager was unable to stand or sit for long periods of time. To help with this we took a lot of breaks to allow Jager to lie down, but it ended up being less enjoyable for him and he became every tired and likely sore by the end of the visit. I knew something had to change to be able to help my dog continue getting the love and attention he enjoyed while also making sure the process was not stressful or painful for him. I ended up talking to one of the staff members who mentioned that resident 1 enjoyed sitting in his recliner chair in the living room and that they had a special apparatus to get him into the chair. I joked that Jager loved to sit in recliners too and this sparked the idea of having the two sit together in the chair. The staff put resident 1 in his recliner, and I lifted Jager up and placed him beside resident 1. Immediately, a smile appeared across resident 1’s face when he could feel Jager. This communicated to us that the resident enjoyed Jager’s company, and he was able to fully experience the calming nature of a therapy dog. I also knew that Jager was enjoying it just as much because he wagged his tail a lot! This became our routine each visit, and it taught me that sometimes, for our dog’s wellbeing, traditional ways of visiting may not be applicable, and adjustments need to be made to make it an enjoyable experience for everyone.

Resident 2 Story: My second story is about a time when I was not as diligent as I could have been in maintaining Jager’s welfare and what could have led to a more stressful experience for him than needed to be. As I mentioned, resident 2 had a tendency to grab at people and things with a very strong grip to express herself. The staff made me aware of this when we started visiting and they were constantly asking her to not grab and were trying to avoid her pinching. Being aware of this, Jager and I tried visiting with her one day by having Jager lay beside her chair that was stretched out and low enough to the ground that she could see Jager. She seemed to be very interested in Jager during this visit, something that would rarely happen. Excited by this, I had Jager go close enough to her where she could gently touch him. She started to pet Jager very nicely and thing seemed to be going well. Quickly, the resident began pinching Jager’s ears quite tightly. I was told by the staff that if the resident grabbed one of us to try and gently remove her hand. I attempted to this but it was harder than expected and it took me longer than I would have liked. Eventually she released her grip and we continued by having Jager sit beside the resident calmly. Jager was not harmed and did not seem too bothered by the experience, but I do wonder that if I was watching his body language more if I would have noticed anything earlier on.

What do you wish you knew at the time?

For both stories, I wish I had considered how different situations may create some undue stress for Jager earlier on, and especially being a senior dog. Since Jager is so easy going, I think I often glossed over situations that could be potentially problematic for Jager. I could have paid more attention, probably, to more subtle clues of what he was communicating to me. With the second story in particular, I wish I knew at the time how important it is to really understand who you are working with and have the staff involved as much as possible. I did not actually think that the resident would pinch Jager because they seemed to enjoy his presence. Ultimately, it did not matter whether or not the resident enjoyed visiting with Jager, pinching was just their general form of expression. Not every participant is going to respond to a therapy dog in the same way, and it became important for me to consider Jager first and really analyze the potential risks of any therapy dog visit and adjust if needed. And this adjustment needed to consider my awareness about what Jager was relaying to me.

My awareness, actually, was why I retired Jager. Although Jager and I both loved visiting, I knew putting him in different environments where he would have to walk around a lot more than he is used to, for example, would be too much for him. I know my dog, and this was ultimately the best decision for him.

I am incredibly thankful to Jager for opening me up to this new way of spreading kindness and compassion to others. Being a therapy dog volunteer was the start of my journey within animal assisted activity programming and research, and it all started with a senior dog who just loves people without judgement. The experiences I share here have taught me to always be conscious of my dog’s needs, and to really understand the environment I am visiting in and what will be possible in that space to make the visits the best they can. I have also learned to communicate with staff to better understand the needs of those we visit as well as my therapy dog partner.

Ethical Principles for Therapy Dog Visiting & The Therapy Dog Bill of Rights

Ethical Principles for Therapy Dog Visiting & The Therapy Dog Bill of Rights

The start of this module highlighted the importance of being aware that as a therapy dog team you may encounter environments that your dog may not be suited to visiting in, such as a tense prison or hectic hospital emergency department. You also may not know this until you are in a specific situation. Grace’s story demonstrates the high likelihood that you may also encounter situations during a visit that can cause your dog to feel stress or discomfort. Grace’s reflections show how a handler can quickly come up with creative ways to reduce stress for their dog and continue with an enjoyable visit for the dog, themselves, and the people participating. Grace’s quick thinking during the visit reflects the attention she was paying to Jager’s welfare.

There has been a great deal of thought and increased research over the past decade or so on what ethical practice involves for handlers during a therapy dog visit. Animal Assisted Activity scholarship has identified four ethical principles for therapy dog handlers to apply during visiting sessions to best reduce their dog’s discomfort and respect their freedoms. These are: Respect for Autonomy, Nonmaleficance, Beneficience, and Justice (Glenk and Foltin, 2021). Indeed, a couple of these terms may look complex and intimidating, but don’t worry – the practices they relate to are very simple (and they won’t be on a final exam).

  1. Respect for autonomy involves a handler recognizing and respecting the decisions their therapy dog is making in any given situation. If your dog behaves in a way to suggest they would rather not be in a certain environment, it is important to respect their decision. That said, you may encounter situations when your dog indicates that they do not care much for the company of a specific individual and you are faced with the conundrum of balancing respect for the autonomy of your dog and the principle of granting the therapy dog program participant an opportunity for therapeutic interactions with your partner. In this instance, it may be best to purse a middle-ground by allowing the individual an opportunity to engage with your dog, but ensuring your dog’s interactions with the client are brief and intervene should your dog indicate any signs of distress.
  2. Nonmaleficance refers to a handler’s commitment to not inflict pain, suffering, or harm of any kind onto their therapy dog, and that they will not expose their dog to physical force or mental trauma. Abiding by this principle would prohibit a handler from forcibly making their dog enter an environment they would prefer to avoid or scolding them for keeping their distance from certain people.
  3. Beneficence refers to a handler’s commitment to take responsibility for the safety and protection of their therapy dog above all other goals, and to act to prevent the dog harm in the wake of any threatening situation. This duty would call for the handler to keep their dog away from individuals should they be believed to mean harm to the dog or removing the dog from situations and environments where they believe the dog’s safety may be at risk.
  4. Finally, committing to justice involves the therapy dog perceiving that they, not the program participant, is of primary importance to the handler. Dogs are particularly perceptive to situations when a handler may be paying more attention to an individual than to themselves or treating the dog differently with respect to a situation. This can lead your dog to feel neglected and have a negative influence on their mental wellbeing.

These ethical principles for practice are closely linked with the Therapy Dog’s Bill of Rights, as designed by our final guest speaker, Ann Howie. This collection of thirteen principles for best practice are closely related to the freedoms and domains of animal welfare discussed above, as well as the practices Ann discusses to prepare a Basic Care Routine for therapy dog visiting in the later stages of her presentation.

The Therapy Dog’s Bill of Rights

As a therapy dog, I have the right to a handler who…

  1. Obtains my consent to participate in the work
  2. Provides gentle training to help me understand what I am supposed to do
  3. Is considerate of my perception of the world
  4. Helps me adapt to the work environment
  5. Guides the client, staff, and visitors to interact with me appropriately
  6. Focuses on me as much as the client, staff, and visitors
  7. Pays attention to my nonverbal cues
  8. Takes action to reduce my stress
  9. Supports me during interactions with the client
  10. Protects me from overwork
  11. Gives me ways to relax after sessions
  12. Provides a well-rounded life with nutritious food, medical care, physical and intellectual exercise, social time, and activities beyond work
  13. Respects my desire to retire from work when I think it is time

Program Participant Perspectives (Speaker – Ann Howie)

Program Participant Perspectives (Speaker – Ann Howie)

Dog Behavior and Stress

The first segment of Ann’s video discusses common behaviors your dog may exhibit if they are feeling stressed or experiencing distress. Ann talks about how dogs use their body language to communicate what they are feeling to their handlers, and notes that they sometimes indicate that they are feeling anxious or uncomfortable in ways that are misunderstood by humans. Ann’s presentation may lead you to uncomfortably reflect on times when you may have misread the body language of your therapy dog – Ann discusses a similar experience – but rest assured this overview will increase your awareness of ways to help make sure this oversight is not repeated moving forward.

Please watch the following video.

To this point, Ann has discussed a few of many possible examples of body language that suggests a dog may be feeling stress. On a related and paws-itive (positive) note, research surrounding Animal Assisted Activities is taking an increased interest in determining the best ways to assess whether participating in a therapy dog program is causing undue stress for dogs. In 2021, Glenk and Foltin reviewed a number of studies that measured stress in therapy dogs during visits through rigorous scientific means. Purely for the sake of interest, some of these methods are:

  • Measuring heart rate: Stressful situations can be associated with a rise in heartrate or the onset of a more erratic or unstable heartrate. Noting the presence of heartrate that is different than ‘baseline’ assessments taken when a dog is relaxed can help identify environments or interactions that cause a dog stress.
  • Measuring respiratory rate: Similar to heart rate, assessing notable changes in the breathing pattern of a dog can indicate they are experiencing stress – this is especially evident should their breathing increase in speed or become erratic.
  • Measuring tympanic ear membrane temperature: Increases or variability in a dog’s body temperature can also indicate a change in stress level. Should a dog love experiences with digital thermometers (as all dogs and children of course do) the normal range for canine tympanic ear membrane temperature sits at 36.6 to 38.8 degrees Celsius (Hall, 2017). Temperature readings above or below that range can indicate stress (as well as additional possible health issues).
  • Measuring salivary cortisol: Cortisol is a hormone associated with stress, and increases in cortisol due to stressful situations can be drawn from a sample of saliva and professionally analyzed in a veterinary science laboratory.

Based on measures such as these, Glen and Foltin (2021:226) concluded in their review that “safeguarding therapy dog well-being, and identifying situations, circumstances and protocols that may challenge animal welfare remains an emerging and crucial area of scientific effort”. Being aware of this and being committed to observing and understanding your dog’s behavior during your therapy dog visit is important to determining whether your dog is feeling stressed. There are additional ways to communicate with your therapy dog that you may not have considered, such as intuitive interspecies communication, which complements Indigenous ways of knowing. To learn more, see the work of McGinnis and colleagues.

Common Canine Behaviors

In the next segment of the video, Ann elaborates on the significance of different types of behavior your dog may use to ‘speak out’ to you should they be feeling distressed, anxious, threatened, or forced to act against their will.

Please watch the following video.

To this point, Ann has discussed the significance of ensuring your therapy dog is sheltered from experiencing distress and identified behaviors on their part that can be interpreted to suggest they are expressing a lack of pleasure or consent for the circumstance they are in. The following activity will help you to apply your awareness of what different types of dog behavior mean, as well as develop your skills for effectively responding to what your therapy dog is communicating to you while you are out and about serving your community.

Learning Activity 5-2: Behavior and Responses

The following scenarios describe situations you and your therapy dog may encounter and behaviors your dog may exhibit. Given the behaviors that Ann has associated with stress and consent, please use the following hypothetical scenarios to determine what the dog is trying to communicate and how you could best respond in an ethical manner. After taking some time to think about your answer, click to reveal the suggested response.

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Basic Care Routine

Next, Ann will discuss the importance of developing a care routine, or an organized schedule for you and your therapy dog, to best maintain their welfare and mental health prior to, during, and following therapy dog visits.

Please watch the following video.

Learning Activity 5-3: Planning Your Care Routine

Now that Ann has highlighted what you want to keep in mind for your dog’s wellbeing prior to, during, and after your visiting adventures, it would be good to consider what the care routine for your therapy dog may look like. Whether you are an experienced dog handler and already have a care routine in place, or are only beginning your adventures as a therapy dog tag-team member, use the following care routine planner tool to create a plan for some of the activities you could undertake at different stages in the day. There are some suggested elements provided to help you along. As an extra challenge, do not be afraid to consider how each activity is related to the Therapy Dog Bill of Rights, the five freedoms and five domains of animal welfare, and/or any other information related to animal ethics we discussed in this module!

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Down the road, if you want a refresher on possible care routine activities or some more specific guidance in alignment with popular therapy dog ethics, you can consult the Animal Assisted Intervention International Standards of Practice (2019) for a detailed and expansive overview of care routine possibilities. You can also have a look at some of the resources Ann recommends at the end of her presentation.


Looking Back, Looking Forward: The Best PAWS-ible Partnership

Congratulations! Over the span of this course, you have increased your awareness about an Animal Assisted Activity - therapy dog visiting - and developed skills associated with being a fantastic handler for your ‘theRUFFy’ (therapy) dog partner. You have:

  • Learned a bit about the research around the benefits of therapy dog visiting, including an introduction to the importance of the human-animal bond,
  • Discussed things to keep in mind to provide sensitivity and safety as you interact with diverse populations,
  • Considered strategies to provide therapy dog program participants trauma-informed services,
  • Reflected on ways to maintain your own mental, spiritual, emotional, and physical health, and
  • Learned about reading animal body language and developing care plans to maintain the wellbeing of your therapy dog.

With the awareness and skills you have developed, you are now better prepared for a long and satisfying tenure as a St. John Ambulance therapy dog handler. You are also better set up for sharing new experiences and mutually enriching the bond between yourself and your therapy dog partner.

Let's end the course by watching short stories of two St. John Ambulance therapy dogs - Ruby and Anna-Belle – expertly doing what they do because they enjoy and benefit from their human community interactions.

Thank you for participating in this course, and apologies for the PAWful (awful) puns!


Discussion/Self-Reflection Questions

  1. Are you able to identify 5 common canine behaviors (body language) that are typical in therapy dog visiting, and explain their meaning?
  2. Are you able to recognize eustress, stress and distress in domesticated dogs?
  3. Are you able to describe a basic care routine for your therapy dog(s) before, during and after a visit?


Supplementary Resources

Online Resources from Ann Howie

Indigenous Organizations and Animal Welfare Services

Resources for Ethical Animal Practice




Animal Ethics: Perspectives centered around the idea that all living creatures have rights to freedom and positive life experiences.

Beneficence: The ethical principle that handlers should at all times protect their dogs from the risk of pain, trauma and suffering.

Care routine: An itemized schedule to better assist you to ensure you and your dog’s wellbeing before, during, and after your therapy sessions

Distress: A state of extreme and persistent stress leading to emotional and physical exhaustion.

Nonmaleficance: The ethical principle that handlers must not subject their dogs to painful experiences, trauma or suffering.

Positive welfare: The perspective that handlers should not only protect their dogs from harm, but ensure they have positive experiences and interaction to give them feelings of joy.

Speciesism: The practice of thinking of animals as lesser than human beings and therefore exposing them to neglect, trauma and violence.



Anna-Belle the Therapy Dog, G.S Sewap, C. A. Dell, B McAllister and J. Bachiu. 2018. ‘She Makes Me Feel Comfortable’: Understanding the Impacts of Animal Assisted Therapy at a Methadone Clinic. Journal of Indigenous HIV Research, 9: 57-65.

Animal Assisted Intervention International. 2019. “AASI Standards of Practice”. AAII Website,

Animal Ethics 2021. “Speciesism”. Animal Ethics Online,

Connecting for Veteran Wellness course. Available at:

Dell, C., D. Chalmers, D. Cole and J. Dixon. 2019. “Prisoners Accessing Relational Connection with Dogs: A Just Outcome of the St. John Ambulance Therapy Dog Program at Stony Mountain Institution”. The Annual Review of Interdisciplinary Justice Research, 8: 14-64. #!fragment/zoupioTocpdf_bk_1/BQCwhgziBcwMYgK4DsDWszIQewE4BUBTADwBdoAvbRABwEtsBaAfX2zhoBMAzZgI1TMAjAEoANMmylCEAIqJCuAJ7QA5KrERCYXAnmKV6zdt0gAynlIAhFQCUAogBl7ANQCCAOQDC9saTB80KTsIiJAA

Glenk, L and S. Foltin. 2021. “Therapy Dog Welfare Revisited: A Review”. Veterinary Sciences 8, 226.

Hall, E. and A. carter 2017. “Establishing a reference range for normal canine tympanic membrane temperature measured with a veterinary aural thermometer”. Veterinary Nursing Journal, 32 (12) 369-373.

Humane Canada. 2017. “Five Freedoms of Animal Welfare”. Humane Canada Online,

McGinnis, A., A. Tesarek Kincaid, M. J. Barrett and C. Ham. 2019. “Strengthening Animal-Human Relationships as a Doorway to Indigenous Holistic Wellness. Ecopsychology (Special Issue on Indigenous Decolonization and Ecopsychology), 11 (3) 162 – 173 doi: 10.1089/eco.2019.0003, docs/animal-human_relationships_report

Mellor, D. J., Beausoleil, N. J., Littlewood, K. E., McLean, A. N., McGreevy, P. D., Jones, B., & Wilkins, C. (2020). The 2020 Five Domains Model: Including Human–Animal Interactions in Assessments of Animal Welfare. Animals, 10(10), 1870.

Perlata, J. and A. Fine. 2021. The Welfare of Animals in Animal-Assisted Interventions: Foundations and Best Practice Methods. Springer Nature Switzerland AG.

Service Dog Research Team. 2021. “Project Summary”. Connecting for Veteran Wellness Toolkit,

Truth and Reconciliation Commission of Canada. 2015. Final Report of the Truth and Reconciliation Commission of Canada Volume One: Summary. Toronto: Lorimer