Therapy Dogs Reduce Anxiety in Children Visiting the Emergency Department

A new study suggests that therapy dogs can significantly reduce anxiety in children receiving emergency medical care.

The randomized clinical trial, conducted at Riley Children’s Hospital in Indianapolis, Indiana, examined whether therapy dogs, when added to standard child-life therapy, could further alleviate stress in young patients and their caregivers.

The study included 80 children between the ages of 5 and 17 years who were identified as experiencing moderate to high anxiety upon arrival at the emergency department. Participants were randomly assigned to one of two groups: one receiving standard child-life therapy alone and another receiving standard child-life therapy plus a 10-minute session with a certified therapy dog and handler. Anxiety levels were measured using the FACES scale, a validated tool for assessing distress in children, and salivary cortisol levels were analyzed as a physiological marker of stress.

Children who interacted with therapy dogs reported a greater reduction in anxiety compared with those who did not. At 45 minutes post-intervention, child-reported anxiety decreased by an average of 2.7 points on the FACES scale in the therapy dog group, compared with 1.5 points in the control group. Parents also perceived a greater reduction in their child's distress, reporting a 3.2-point decrease in the therapy dog group versus a 1.8-point decrease in the control group. A greater proportion of children in the therapy dog group experienced a clinically significant reduction in anxiety, with 46 percent showing a decrease of more than 2.5 points compared to 23% in the control group.

Although salivary cortisol levels declined in both groups, the difference between them was not statistically significant. However, fewer children in the therapy dog group required medication for anxiety or sedation, including ketamine, midazolam, lorazepam, or droperidol, compared with those in the control group. While the reduction in medication use did not reach statistical significance, the researchers noted the potential for therapy dogs to serve as a non-pharmacologic method for anxiety management in pediatric emergency care.

While salivary cortisol levels declined in all parents over time, they remained consistently higher than their children's, highlighting the emotional strain caregivers experience during pediatric emergency visits.

Researchers noted several limitations to the study, including the inability to blind participants to the therapy dog intervention, which could have introduced bias. The single-center design limits generalizability to other hospitals, and the study did not assess long-term effects of the intervention beyond the emergency department visit.

“These findings provide initial evidence for the use of therapy dogs to minimize pain and anxiety without the use of chemical or physical restraint among pediatric ED patients,” the study authors concluded.

Reference:
Kelker HP, Siddiqui HK, Beck AM, Kline JA. Therapy dogs for anxiety in children in the emergency department: a randomized clinical trial. JAMA Netw Open. 2025;8(3):e250636. Published 2025 Mar 3. doi:10.1001/jamanetworkopen.2025.0636.