Cinotherapy: how therapy with dogs helps children and the elderly

Pets! Throw the first stone who has never spent time on the internet watching videos of these little creatures.

Be it cats, dogs, rabbits, hamsters or other pets, they are present in our lives and in our memories. In happy moments, like the arrival of these new friends, or in sad moments, like in departures and goodbyes.

This coexistence, however, we know is not today. Animals were once very important for our survival and for the evolution of man, as when they were used to assist during hunting, or used as transport, in the case of horses. Today, above all, they are our day-to-day companies.

In the following article we will understand how dogs, through kinotherapy, can act as co-therapists.

After all, to help several patients and people who need special care, nothing is more appropriate than the presence of man’s best friend!


What is kinotherapy?

Kinotherapy is a method that uses dogs or other animals as co-therapists in therapy sessions for several patients, in various situations.

This type of therapy presents a series of variations and can be known by different nomenclatures, such as Animal Assisted Therapy (TAA), Pet therapy, Dog Facilitated Therapy (TFC), Animal Facilitated Therapy (TFA), Zootherapy and Assisted Physiotherapy by Animals (FAA).

Accompanied by a multidisciplinary team, these puppies act as an instrument to relieve the treatment of patients, making this process less painful. The term kinotherapy is the addition of the Greek prefix “cino” (dog) to the radical “therapy” (treatment).

The origin of this technique is ancient. Cinoterapia started in the 18th century, in England, with the objective of contributing to the treatment of people with mental illnesses.

From this experience, they discovered the “healing” power of these animals. It was observed that living with dogs brought psychological, social and pedagogical benefits to these patients.

With children, kinotherapy proves to be even more positive. Contact with these dogs allows them to establish a reciprocal communication. The activities carried out stimulate creativity and improve the child’s self – esteem .

In addition, they provide a feeling of well-being and happiness, as contact with dogs stimulates the release of substances such as endorphins and adrenaline, responsible for these benefits.

In this type of therapy they still learn about respect and companionship, as they are encouraged to socialize with animals and other children.

Objectives of kinotherapy

The main objective of kinotherapy is to be a complementary treatment to traditional treatments, being a light and easy way to bring well-being to patients.

Through contact with the animal and activities, kinotherapy can stimulate motor functions, develop speech, improve socialization, increase confidence, self-esteem and attention of patients, especially in the case of children.

The kinotherapy also aims to work on aspects such as cognition, expression, body image, memory, balance, affective aspects, therapeutic reintegration and language in the patient.

This type of therapy can help professionals from different areas, such as psychologists, educators, occupational therapists and physiotherapists, as they can find in the technique a way to stimulate and facilitate the recovery of patients.

Why the dogs?

After all, among so many animals, why the dog? There are treatments made with other animals, such as horses, but dogs are the stars of cinoterapia.

They proved to be excellent co-therapists in the psychological, physical and emotional treatment of various people with special needs, in different age groups.

According to occupational therapist and cinoterapist Andressa Chodur , from the Amigo Bicho project , dogs are the most used for the affection they promote, for being playful, docile, cuddly, and for the fact that, historically, people have a good bond with them.

(Photo: Reproduction / Facebook – Amigo Bicho Project)

However, despite being more present, they are not the only ones who participate in animal-assisted therapies. As the kinotherapist explains, the dog is not the only one who can participate, but it ends up being the most used for its personality and for promoting well-being and joy.

“In our project, Amigo Bicho, also has two kittens that participate. In other projects in Brazil, there are places that use escargot, chickens and other birds for cinotherapy. Still other places also use exotic animals, such as lizards ”.

According to the therapist, the animals only need to be well selected and be within the profile of kinotherapy. It is also necessary that they are thought out according to the patient’s profile and the type of activities they will do during the session.

What are the benefits of kinotherapy?

Cinoterapia is a method that has been gaining a lot of interest from researchers. They seek to understand the relevance of this therapy in the treatment of various diseases.

In 1999, for example, a survey by cardiologist Karen Allen, from New York University, brought together 48 people, men and women, who worked as financial market brokers. The people in the group had high levels of stress and blood pressure.

At random, a dog or cat was distributed to half of the group for each person. After that, they started to live with the pet for a period of 6 months.

After that time with the pet, the treated group showed a significant improvement in stress reduction, in addition to not having altered blood pressure.

In addition to helping in the treatment of diseases, as in the example of the research cited, kinotherapy helps patients to have a great sense of well-being. Many patients feel alone and the company of animals makes them feel necessary, especially when it comes to palliative treatment or when they have been hospitalized for a long time.

In addition, contact with dogs makes them refer to the home or pets that they had or still have. Other benefits that the presence of these animals bring range from physical, mental, emotional to social. Some of them include:

  • Increased motor capacity;
  • Improvement of the immune system;
  • Reduction of symptoms of depression;
  • Decreased anxiety;
  • Decreased stress and cortisol rates (hormone produced by the adrenal glands to help the body reduce stress);
  • Blood pressure reduction;
  • Reduction of the need to use medications, as a consequence of the listed benefits.

Animals also stimulate the hormones of good, those that provide a greater sense of well-being, such as endorphins and serotonin .

Endorphin is considered a natural pain reliever and serotonin is a hormone that acts on the brain, regulating mood, appetite and sleep.

In cases of more stressful disease treatments, such as cancer, in which it is sometimes necessary to undergo radiotherapy and chemotherapy, kinotherapy can be a relief dose. Dogs, docile and friendly creatures, allow these patients to divert the focus of the disease for a moment.

In another study by researchers Alan Beck and Aaron Katcher, professors at the University of Pennsylvania, made to assess the benefits of kinotherapy, the intention was to analyze how pets influenced the lives of people who survived a coronary heart attack . In this survey, carried out with 92 people, 53 owned a pet.

Within the group of 53 people, the reported survival rate was 94% after a heart attack. In the rest of the group, which did not live with any pets, the survival rate was lower, at 71%.

The relationship between men and animals was also present in studies to identify the benefits of this interaction in cases of psychological rehabilitation treatments.

A 1997 survey by Katcher, in which 2805 people were followed for more than 7 years, found that people who took antidepressants and who had a pet companion did not need doses as high as people who had no contact with the animals.

One of the hypotheses for this to happen, in all cases, is the idea that caring for another living being is a self-healing action.

According to the kinotherapist Andressa Chodur, just living with dogs on a daily basis, as pets, is enough to bring benefits.

“There are studies today that prove that, even if not in therapy, dogs provide a greater release of neurotransmitters responsible for pleasure and well-being and that having a dog in your life helps to lower blood pressure and even depression .”

Humanized treatment

Hospitals are not always pleasant environments to be, because people are impatient, hospitalization is not legal, the treatment of a disease can leave the patient sad and unmotivated, with the pain and symptoms and medication schedules, even more.

In order to have a humanized treatment, the medical team needs to see the patient as a person and not just as the pathology. Thus, humanized treatment, in addition to seeking a cure for the patient’s disease, is concerned with their mental health and well-being.

This is not always possible, due to the lack of staff and sufficient staff to attend to the always high number of patients. Therefore, introducing kinotherapy, establishing a partnership with institutions, can be even more advantageous.

Cinotherapy with the elderly

Kinotherapy for the elderly provides a rescue of self-esteem. It also awakens greater responsibilities: when they have to take care of the pets, they feel useful and important.

(Photo: Reproduction / Facebook – Amigo Bicho Project)

This type of therapy is a very welcome activity in nursing homes, as it becomes a form of entertainment, leisure and recreation.

It is also possible to realize that therapy with animals helps the elderly as an exercise in memory. As they get involved with the animals, they end up memorizing the names and visiting hours.

In nursing homes or hospitals, contact with these companions makes the routine lighter, in addition to bringing greater well-being and comfort to these patients.

(Photo: Reproduction / Facebook – Amigo Bicho Project)

For Maria Luiza Mandu Kuiaski, 57, a patient diagnosed with Parkinson’s disease 7 years ago, kinotherapy is an activity that helps even in the simplest daily exercises.

With the activities carried out with the animals, she is able to stimulate touch and memory, which helps her in other tasks.

One of the activities mentioned by the patient involves these two stimuli: “In one of them, we put our hands behind the chair, with closed eyes, and with tact we try to recognize the dogs and remember the names and the breed of each one”.

Some therapy activities are done with the use of hula hoops, others are done with the elderly with their legs extended for the dogs to pass underneath, as a path for them. Before these “games”, everyone goes through a warm-up.

(Photo: Reproduction / Facebook – Amigo Bicho Project)

In addition to the physical benefits, kinotherapy also brought Maria more quality of life. “The contact with the therapy with the animals was a great joy, it always leaves me calm and makes me put the disease aside a little.”

She has been attending the Parkinson’s Association of Paraná for 5 years. It was there that he met the Animal Assisted Therapy of the Amigo Bicho project.

For her, the encounter with these animals happens once a month, in sessions of 1 hour. However, even if it is a brief meeting, it ensures that contact makes all the difference.

“I have been participating for more or less 4 years. When it’s over, I miss you. It’s great and for 1 hour we forget about the disease, it improves our mood and disposition ”, he reports.

As for Maria, kinotherapy is a very effective practice for the majority of the elderly population, since prejudice, abandonment and lack of affection within this group is common.

Cinotherapy with children

Children earn a lot when they are in contact with animals. They are able to establish a reciprocal communication with pets, in a relationship of friendship, companionship and respect.

(Photo: Reproduction / Facebook – Amigo Bicho Project)

Therapy increases self-esteem and autonomy. The joy of being with these animals still stimulates the production of endorphins and adrenaline. When children are active with dogs, for a moment, they let go of the disease, just to enjoy the company of the animals.

Cinoterapia can be efficient in the treatment of several conditions, but in the infant sector it is usually used in the treatment of children with cerebral palsy , Down syndrome, autism and other special needs.

(Photo: Reproduction / Facebook – Amigo Bicho Project)

It is a way of proposing social interaction and well-being for these patients, and also a way of escaping activities that isolate them, such as always being connected, with the cell phone or the video game.

When is kinotherapy recommended?

Kinotherapy is indicated to treat various behaviors and pathologies. It can be an aid in the treatment of some fears and phobias, in addition to helping people who have suffered some trauma or been victims of some violence, such as sexual abuse.

This therapy can also be useful in helping children to express themselves better, to communicate with other children and to feel less isolated. The dog is an emotional support in different circumstances, brings tranquility and provides lighter and happier moments for them.

Therefore, we can say that kinotherapy is indicated for all people who need a good companion, to stop focusing on the problems, loneliness, pain, frustrations, stress and anxiety of everyday life.

Thus, the elderly, adults, people with physical or mental disabilities, people with diseases such as cancer or HIV positive, all, in general, can receive the visit of dogs.

Although kinotherapy can be applied to all types of people, it shows more satisfactory results in groups of patients with autism, Asperger’s Syndrome, Rett’s Syndrome, patients with neuromotor dysfunction and other global developmental disorders.

In addition to hospitals, places such as outpatient clinics, nursing homes, rehabilitation homes, schools and physiotherapy clinics can also receive kinotherapy.

Are there any contraindications?

Kinotherapy is indicated as a complement to other conventional treatments. Cinotherapy, despite its benefits, does not replace medical monitoring or the use of medications , when necessary.

It can be used as an aid in the treatment of children and adults. Only in some circumstances can kinotherapy be applied. Are they:

  • Allergic patients;
  • People with neutropenia, a condition in which the patient is more vulnerable to infections, as it has a substandard amount of defense cells;
  • Immediate postoperative period;
  • In situations where the animal becomes a source of rivalry;
  • When patients demonstrate possessive behavior towards the animal;
  • In cases where the patient may hurt the animals;
  • When there is a risk of the animal transmitting some disease to the patient (zoonosis);
  • In patients with aversion or fear of animals.

What are the requirements and recommendations?

There are some necessary requirements for kinotherapy to happen and recommendations that must be followed by patients, dogs and hospital staff. Here’s what you need:


Dogs of any breed can be co-therapists, even those of mixed breed, popularly known as mongrels.

However, on certain occasions certain breeds stand out, as in the case of assistance dogs, which need more accentuated characteristics than other breeds may have in a smaller percentage.

Some of the most common dogs in kinotherapy are those of the Labrador and Golden Retriever breed. They are considered excellent temperament and sociability dogs and are therefore considered by some therapists to be ideal for this type of therapy.

The conditions for being a co-therapist dog are as follows:

  • Be healthy;
  • Be trained;
  • Be docile;
  • Be very sociable and interested in interacting with people;
  • Don’t be fearful;
  • Don’t be aggressive;
  • Be calm, tolerant, friendly.

It is also crucial that dogs do not react to possible aggressions, such as pulling on their hair or ear. This kind of thing can happen, as patients may, unintentionally, end up hurting the animal.

In cases where the patient may behave like this, tutors usually maintain greater care, as the dog’s aggressive reaction can be traumatic to the patient.

To prevent this from happening, these dogs are put to the test, are analyzed by trainers specialized in animal behavior, in addition to undergoing a selection to fit within the listed requirements.

Who performs this evaluation of dogs is a veterinarian who specializes in animal behavior. He must analyze the dog’s behavioral and clinical issues, to know how he reacts under stress, in the face of noises and other adverse situations, in addition to checking his health.

It is important that this professional realizes how the dog can behave in these situations, because, sometimes, the patient may exhibit some involuntary behavior that scares him.

Even an environment like the hospital, unknown to the animal, can make you more alert and afraid.

To be fit for kinotherapy, you also need to have your vaccination card up to date and receive the report from the responsible veterinarian, stating that there are no risks in relation to your behavior or the possibility of disease transmission.


Before kinotherapy, patients must agree to receive a visit from the animals. It is important to explain to them how the dynamics of therapy work and what the activities will be.

In the case of underage patients, hospitals need authorization from parents or guardians.

Kinotherapy is not recommended for patients who have a phobia for animals or who have low immunity and other contraindications.

Involuntarily or not, patients should not mistreat the animal, as this can induce an aggressive response.

They should also wash their hands before and after contact with dogs. Contact with the animal’s saliva, urine or feces should be avoided, as well as the opposite, the dog should also not have contact with the patient’s urine and other secretions.

In the case of bites, scratches or any unusual changes in the animal’s behavior, patients must inform the responsible team.

Health professionals

There are some recommendations for health professionals and for locations receiving kinotherapy.

First, the teams that perform the kinotherapy – usually non-profit organization projects – need the authorization of the clinical staff responsible for the place or hospital unit.

Health professionals need to be aware of the contraindications for kinotherapy and the guidelines that must be taken in relation to the patient’s health and also the animal’s well-being.

Knowing this, some more specific guidelines include:

  • It is necessary to limit the access of animals in some specific areas within the hospital, such as in food preparation, medication, sterilization and disinfection centers, laundries, surgical centers and isolation rooms;
  • Make sure that visits are being made under the supervision of the coach and a health team professional;
  • When possible, make a nurse available to assist during the cinoterapia, as they are professionals who help in communication and are able to establish an effective relationship with patients;
  • Make the patient safe and confident with the visits;
  • Guide patients about hand hygiene and avoid having contact with saliva, urine or feces of the animal.


Before coming into contact with patients, dogs go through a very rigorous hygiene process. Usually, accompanied by professionals such as the occupational therapist, physiotherapist, psychologist and animal tutor.

The care these animals receive includes going to the pet shop to bathe, sand and cut their nails, brush their teeth and dry their hair.

Some additional procedures that can be performed in hospitals include cleaning (again) the legs and spraying a product based on 70 ° alcohol and chlorhexidine , which provides a sterilization of the animal, preventing the presence of any type of bacteria present in your fur.

So, completely clean, smelling and well maintained, they are ready for patients.

In addition, all people participating in the therapy should have their hands clean, before and after contact with the dogs. At the same time, tutors and therapists need to be careful that the animal does not come into contact with secretions such as feces, vomiting, urine or wounds of patients.

How to do therapy with dogs?

The kinotherapy sessions may vary according to the patients and animals that are part of the project. Usually, the therapy happens with the presence of the dogs and for that reason we will describe the process based on these pets.

The therapy lasts 1 hour, on average. This time is defined to also meet the needs of the dogs.

As the kinotherapist explains, the therapy is not very long because the animals also show some wear and tear. “They are also tired and stressed out. They are very fond of ‘working’, but they have a working time limit ”.


There are three main types of methodologies within kinotherapy. They are divided according to the professional who performs the activities. The activities are similar, but the name is different. Are they:

Animal Assisted Therapy (TAA)

It is when the kinotherapy is performed by a health professional. To be an animal-assisted therapy, it is necessary to be from that area and have at least a basic course on animal-assisted interventions.

Animal Assisted Activity (AAA)

When the professional who performs the activities has no training in the health field, but has a course in kinotherapy, he is considered a technician in kinotherapy.

Animal Assisted Education (EAA)

Animal-assisted education refers to activities provided by education professionals, such as teachers and pedagogues.


Activities may vary according to the methodology, but generally involve similar actions, such as:

  • Caress the dog : simple activity that can be practiced by most patients, in any age group, being soothing for them;
  • Walks : it is an important activity to stimulate the patient’s motor functions, with working gait and motivating rehabilitation;
  • Brushing the animal’s fur : it is an activity that provides greater stimulation of the limbs, providing the stretching and muscle strength of the patient’s arms;
  • Playing with bows and other objects : these are exercises that stimulate the patient’s creativity, provide well-being and work on aspects of different areas;
  • Colored objects : they are used to make therapy more playful, promoting the perception of colors and shapes. Usually, they are activities carried out with children. Some objects that can be used are the brush itself to comb the dog, balls, bows, collar, etc.

In the case of Assisted Therapy, specifically, the therapist Andressa Chodur mentions that the activities can range from games and walks to adapted games, such as “pass petisco”, a canine version of the game of passing the ring.

At Amigo Bicho, one of the activities developed by the project is done with a functional vest, where patients work the movements of the hands and fingers. In the activity, the dog wears a waistcoat and patients interact with the velcro objects that can be glued to the waistcoat.

In the case of Animal Assisted Activity (AAA), activities are even more free. “In this model, games, conversations, games for recreation and the breaking of hospital routines are included”, reports the kinotherapist.

Clearance for pets

In addition to worrying about the patient’s well-being, it is also necessary to pay attention to the well-being of the dogs, because without them this work so beneficial to so many people is not possible.

Like patients, kinotherapy dogs also need care and rest. Because these projects are not very common, the groups that carry them out sometimes need to serve a very large number of hospitals and nursing homes.

So that the dogs do not get tired, the therapist must perform a kind of rotation with the dogs, making the animals “work on a scale”. Thus, they are able to rest.

It is important that the team that accompanies these animals also know how to recognize their limits. They also cannot act as co-therapists forever.

When they turn 10, they are “retired” from that role. This is done gradually as well, as the animal also misses the routine with the patients and can become depressed if it is abruptly removed only once from the kinotherapy.

Cinoterapia in Brazil

In Brazil, kinotherapy can be adopted by all hospitals. Usually, the service is performed by a multidisciplinary team. Most of the projects are from Non-Governmental Organizations (NGOs), which go to hospitals, nursing homes, rehabilitation homes, associations and other places that are interested in this type of therapy.

Before the hospitals receive the visit of these co-therapists, some procedures are necessary to evaluate the possibility of this service, such as a previous assessment by hospital infection control commission teams.

These professionals need to verify that the animals are fit, checking the report of a veterinarian specialized in this type of analysis.

Where to find?

If you are a patient undergoing treatment and want to participate in this type of therapy, talk to the hospital staff to see if there is already a project like this in progress.

Some associations also offer this type of activity to the participants, but in most cases, it is the NGOs themselves who contact the hospitals or professionals in the area who go to these organizations and seek this type of complementary therapy.

On social networks, it is possible to find several projects like these spread across Brazil.

How do the courses work?

For those who want to work with this type of therapy, there are technical courses that teach the dynamics of kinotherapy. Anyone who has an interest can do it.

Cinotherapist Andressa Chodur is responsible for teaching this type of course. According to her, the courses are still few, with São Paulo being the state with the greatest demand and supply of this type of specialization.

In addition, depending on the academic background, the title of the course is different. Professionals in the area of human health that carry out the course can be called cinoterapeutas. In the case of people who do not have training in the area, they are considered technicians in kinotherapy.

In the case of veterinarians, they are also considered technicians in kinotherapy, for example.

The course is fast, usually lasting a few days. Some topics covered by the therapist include:

  • General notions about dressage;
  • Conduct of the tutor during the kinotherapy;
  • Choice of dogs;
  • Animal welfare;
  • How to identify signs of stress in dogs;
  • Ideal environment for kinotherapy;
  • Practical demonstration;
  • How to act in stressful situations etc.

Assistance dogs

In addition to kinotherapy, dogs can also exercise the role of assistance dog. They are not two connected activities, because kinotherapy dogs are not considered assistance dogs, but both provide benefits for patients.

They are trained to help patients with special needs, bringing more autonomy to the owner, in addition to being a happy companion for everyday life.

There are some types of assistance dogs, that is, a kind of categories of animals for each patient’s need.

They are trained and extremely docile and calm dogs. They are trained to always be with the patient and have access to public places that other animals are not allowed.

They are also able to follow some specific commands to help their owner / patient, in addition to the basic ones like “lie down”, “sit” and “stay”. Meet some types of assistance dogs:

Listening dogs

Hearing dogs help people with hearing impairment. They are trained to emit signals that help these patients to notice some important alerts, such as the sound of a bell, when someone knocks on the door, when the phone rings, fire alarms or a baby crying.

Guide dogs

Guide dogs are the most well-known assistance dogs. They were the first to be trained in the country and therefore became more popular.

They are responsible for helping people with visual impairments, so that they avoid accidents and can move around with greater autonomy.

For this very important role, the guide dog is allowed in public places. In order for him to be able to perform this role of great responsibility, the dog undergoes rigorous training, so that he can learn all the rules.

Thus, the animals chosen to be guide dogs must have some characteristics, such as being strong, docile and healthy. The most common breeds of guide dogs are the golden retriever, German shepherd and labrador.

Service dogs

Service dogs are a more specific type of assistance dog. They are prepared to meet the patient’s most particular needs. Some examples are:

Assistance dogs for wheelchair users

Service dogs, in this case, learn ways to help wheelchair users to have greater mobility and autonomy on a daily basis.

Some of the techniques taught to these dogs involve learning how to turn on lights, look for objects, call the elevator, open doors, open drawers and cabinets or even help the person say goodbye. Thus, they contribute to making many activities easier for these people.

Assistance dogs for people with diabetes

These dogs receive a treatment focused on identification through smell so that they can see when the type 1 diabetes patient has a drop in blood glucose.

Assistance dogs for people with epilepsy

The Epilepsy is a common neurological disorder. Patients in this condition suffer from seizures . The assistance dog helps them because they are taught to identify when a crisis begins.

From this, the dog signals to the family members or close people about the episode. In some cases of patients with epilepsy who adopted the assistance dog, a reduction in the number of seizures was noticed.

Assistance dogs for people with autism

Assistance dogs are true companions for people with autism, especially in the case of children. They are trained to help them with activities that are difficult, as well as being part of the family.

They are trained to help the parents with the child’s oppositional conduct and escapes. In addition, they also collaborate to regulate sleep, as they keep company at bedtime.

They are also present to reduce isolation, develop affection and socialize with other children.

Dogs and the habit of reading

A non-profit organization, Therapy Dog International , of New Jersey, promotes, in addition to kinotherapy, events that seek to awaken the will to read in children.

Dogs, normally restless, occupy the quiet space of libraries. With this program, children come into contact with animals, patient partners and exempt from judgments in reading while still young.

In this way, the little ones associate the habit of reading with a pleasurable activity, which stimulates them to read more and more.

The reading sessions promoted by the NGO are short, in a quiet area. The child chooses a book he would like to read and sits next to the dog and helper to begin.

Thus, in addition to the interaction with animals and all the benefits that this interaction provides, the child enters the world of reading and stimulates his imagination and skills.