Therapy Dogs District-Wide: Mental Health and Well-Being Influences in PK-12 Education

Abstract

The mental health of prekindergarten (PK)-12th grade students is of extreme importance. Therapy dogs are a unique intervention to address mental health needs in educational frameworks. The purpose of this pilot study is to examine the components of a PK-12 district-wide therapy dog program and the implications for the mental health and well-being of students, faculty, and staff. This research used qualitative methods for semi-structured interviews with therapy dog handlers, observations including photographs, and researcher field notes of therapy dogs and handlers in their education environment. Thematic analysis of transcripts from semi-structured interviews was used for qualitative analysis. The results indicated that the strategic implementation of a district-wide therapy program supported a sustainable program that is integrated into the educational ecosystem. The participants perceived that the therapy dogs impacted mental health in the domains of social, emotional, and behavioral support. A district-wide systematic approach to addressing mental health and well-being needs of students, faculty, and staff with therapy dogs’ hinges on a comprehensive training and evaluation process, district-level support, and consistent implementation across educational settings. Therapy dogs can be embedded within educational structures to create a multilevel impact from the classroom to school to district level for a sustainable program. Therapy dogs positively contribute to the mental health and well-being of students, faculty, and staff in PK-12 education settings.

1. Introduction

The COVID-19 pandemic has dramatically exacerbated mental health concerns among both students and educators, creating an urgent need for effective interventions (Zhao & Akhter, 2023). Recent epidemiological data indicated that anxiety, depression, and trauma-related symptoms surged by up to 25% among prekindergarten (PK)-12 students during the pandemic, with over half of educators reporting elevated stress and burnout during phased school reopenings (RAND Corporation, 2022; World Health Organization, 2022). Meta-analyses estimated that one in three students exhibited clinically significant anxiety or depressive symptoms during school closures, and educator surveys revealed that 50–60% of PK-12 teachers experienced heightened stress and diminished well-being in the 2021–2022 academic year (Li et al., 2021; Peck, 2022; Radwan et al., 2021).

Addressing the mental health of PK-12 stakeholders is fundamental in supporting the education of our future generation, educators, and communities (Childs & Iachini, 2024). The COVID-19 pandemic has had major implications on the mental health of PK-12 children and youth (Naff et al., 2022). Naff et al. (2022) examined the health impacts of COVID-19 and found “that the pandemic led to widespread increase in fear, anxiety, depression, loneliness, and behavioral issues in PK-12 students” (p. 21). Educators were also impacted by the pandemic with specific stressors, such as their personal and psychological health and expectations from education jobs (Cavallari et al., 2024).

The current mental health landscape in schools calls for innovative approaches that can be sustainably implemented within educational settings (Heinrich et al., 2023). The integration of therapy dogs represents a promising evidence-based intervention to address these pandemic-related mental health concerns (Pandey et al., 2024). Research specifically examining therapy dogs in addressing pandemic-related anxiety is emerging, with preliminary findings suggesting positive outcomes for both students and educators (Wintermantel & Grove, 2022). Therapy dogs offer a unique intervention that aligns with existing educational frameworks while addressing critical mental health needs (Pandey et al., 2024). These interventions are particularly valuable given the increased recognition of the bidirectional relationship between mental health and academic success (Blad, 2023).

1.1. Human–Animal Interactions

The topic of animals in education spans countries and disciplines, bridging some of the gaps that exist in educational research (e.g., Grové et al., 2021; Henderson et al., 2020; Johinke et al., 2018; Pinto & Foulkes, 2015). A growing body of research examined human–animal interactions (HAI) and the impact on learning and social emotional health. Gee et al. (2017) explained that “HAI activities can benefit both typically developing children and those with developmental disabilities by reducing stress and anxiety and improving social interactions and by enhancing motivation, engagement, and learning” (p. 1). Animal interactions have been shown to support stress relief for humans (Pendry & Vandagriff, 2019). Researchers have demonstrated that animal-assisted interventions (AAIs) have gained widespread acceptance as therapeutic approaches for individuals with developmental disabilities and have also been successfully integrated into physical therapy and activity-based settings to improve motor skills, increase motivation, and support engagement (Abadi et al., 2022).

Dogs are one animal that has become popular in educational spaces to support a variety of outcomes. AAIs and animal-assisted education (AAE) are two of the ways that animals are often used in educational settings. Therapy dog refers to a dog that has undergone and completed training and certification to qualify for providing services to support others (Grové et al., 2021). AAIs refer to the incorporation of a therapy dog to support specific goals and learning objectives on a consistent basis (Abat-Roy, 2021). AAE is different in that the activities of the animal are focused on educational matters without learning objectives, while providing the handlers and educators with more structure for designing the time that the therapy dog is in the educational setting (Sandt, 2020). Therapy dogs are also viewed as “co-educators” due to the considerable role that they have in assisting students with developing and practicing skills (Harris & Binfet, 2022).

Neurobiological Evidence and Trauma-Informed Approaches

Neurobiological research provides compelling evidence for the physiological mechanisms underlying these benefits. Researchers have demonstrated that animal interactions can significantly reduce the levels of cortisol—a primary stress hormone—in educational settings (Meints et al., 2022). Pendry and Vandagriff (2019) conducted a randomized controlled trial examining the effects of animal visitation programs on university students and found significant reductions in cortisol levels among participants. Similar physiological stress reduction has been documented in children, which found that interactions with pet dogs resulted in measurable decreases in children’s perceived stress and cortisol stress responses, particularly when children faced social stressors (Kertes et al., 2017). Additionally, researchers demonstrated stress reduction and immune response benefits for healthcare professionals following therapy dog interactions, suggesting potential applications for educational staff (Barker et al., 2005).

Prolonged or excessive stress can significantly impact children’s and adults’ cognitive functioning, emotional regulation, and behavioral responses (Pechtel & Pizzagalli, 2011). In educational settings, elevated stress levels have been linked to impaired attention, decreased memory retention, reduced academic performance, and increased behavioral challenges (McEwen, 2017). For students, chronic stress can manifest as difficulty focusing, emotional outbursts, withdrawal from social interactions, or avoidance of academic tasks (Córdova et al., 2023). Similarly, educators experiencing ongoing stress may demonstrate reduced teaching effectiveness, diminished job satisfaction, and increased vulnerability to burnout (Greenberg et al., 2016).

When individuals experience chronic stress or are unable to regulate their stress responses effectively, they become more vulnerable to developing trauma responses (U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, & Center for Substance Abuse Treatment, 2014). This connection between stress regulation and trauma resilience highlights the importance of interventions that support physiological and emotional regulation (Flores-Kanter et al., 2021). The trauma framework emphasizes key principles including safety, trustworthiness, choice, collaboration, and empowerment (The Recovery Center, 2022). Therapy dogs naturally embody many of these principles by creating safe, non-threatening environments that promote emotional security and agency for individuals (Coffman et al., 2023).

These findings align with trauma-informed approaches to education. Therapy dogs have shown particular promise in supporting children experiencing trauma (O’Haire et al., 2015). Research has highlighted the significant role animals play with pediatric patients, detailing how therapy dogs can provide comfort, reduce anxiety, and foster emotional expression in children experiencing medical trauma—findings with clear applications to educational environments where students may experience various forms of trauma or adverse experiences (Goddard & Gilmer, 2015). Clinician perspectives further validate the effectiveness of AAIs as adjunctive approaches for supporting youth, as the study found that mental health professionals view AAIs as valuable complementary interventions that can enhance therapeutic engagement, particularly for children experiencing trauma or having difficulty with traditional therapeutic approaches (Flynn et al., 2020).

HAIs are also impacting the social-emotional well-being of students. A comprehensive literature review of dogs in education found “positive social-emotional, cognitive, and physiological effects resulting from the presence of dogs in educational contexts” (Abat-Roy, 2021, p. 10). More specifically, therapy dogs in a social and emotional intervention may contribute to students’ mental health and social competence (Wintermantel & Grove, 2022). In addition, therapy dogs have been found to improve preschooler focus and motivation (Gee et al., 2007). Although the presence of animals in educational settings is increasingly common, the peer-reviewed literature remains limited in certain areas, particularly for early and middle childhood populations and in qualitative research contexts. Much of the existing research on HAIs in schools focuses on quantitative outcomes such as academic performance or behavior metrics, with fewer studies exploring the lived experiences of students and educators involved in therapy dog interventions. This study contributes to the field by qualitatively examining PK-12 in a real-world school setting, adding depth to our understanding of how therapy dog interventions are experienced by educational stakeholders.

1.2. Frameworks Supporting Therapy Dog Integration

The integration of therapy dogs in educational settings can be effectively understood through several complementary theoretical frameworks (Moe et al., 2025). The Collaborative for Academic, Social, and Emotional Learning (CASEL, 2022) framework provides a comprehensive approach to understanding how therapy dogs can support social-emotional learning competencies. This framework identifies five core competencies: self-awareness, self-management, social awareness, relationship skills, and responsible decision-making (CASEL, 2022). Therapy dogs offer opportunities to develop these competencies that promote emotional regulation, empathy, and positive relationship-building (Wintermantel et al., 2025). Also, therapy dogs can provide a form of attachment that supports this regulatory capacity, particularly for students who may have experienced disrupted attachment relationships (Hawkins et al., 2022).

Trauma-informed approaches provide another valuable framework for understanding therapy dog interventions. The principles of trauma-informed care, safety, trustworthiness, choice, collaboration, and empowerment align closely with the benefits that therapy dogs can provide in educational settings (The Recovery Center, 2022). By creating safe, non-judgmental spaces for interaction, therapy dogs can help establish environments conducive to support and learning for students who have experienced trauma (Jalongo & Guth, 2022).

1.3. Outcomes of School-Based Therapy Dog Programs

1.3.1. Student Outcomes

A therapy dog intervention is acknowledged as supporting a nonjudgmental learning environment where students feel free to share and take risks (Hall et al., 2016; Henderson et al., 2020; Parbery-Clark et al., 2021; Shaw, 2013; Wintermantel et al., 2025). Therapy dogs have consistently demonstrated effectiveness in reducing stress and supporting emotional regulation among students across various educational levels. This stress-reducing effect has been documented through both self-report measures and physiological indicators, with researchers showing reduced cortisol levels and improved parasympathetic nervous system activity following dog interactions in educational settings (Pendry & Vandagriff, 2019; Kertes et al., 2017).

The cognitive and academic benefits of therapy dog programs extend beyond emotional well-being to include tangible improvements in academic performance and executive functioning (Tepper et al., 2023). Studies have indicated positive impacts on student learning in environments with dogs present. Hall et al. (2016) found that reading to dogs supported a positive learning environment for reading, which has led to improved reading abilities for children. Similarly, Shaw (2013) described how a program where students read to a therapy dog, Reading Education Assistance Dog, promoted a joy for reading and improved reading scores, as well as improved social emotional well-being for students in areas such as self-efficacy. Therapy dogs have also been found to support improved focus and motivation during cognitive tasks for preschoolers (Gee et al., 2007). These attentional benefits are particularly valuable for students with attention-related challenges or learning disabilities (Schuck et al., 2015).

School attendance and engagement represented additional areas of improvement associated with therapy dog programs (Friesen, 2010). Students demonstrated increased motivation to attend school when therapy dogs are present, with some programs reporting significantly improved attendance rates among previously chronically absent students (Zents et al., 2017). The anticipation of interacting with therapy dogs provided concrete motivation for school attendance, particularly for students who may otherwise experience school-related anxiety or disengagement (Beetz et al., 2013).

For students with specific learning needs, therapy dogs offered targeted support that complements traditional interventions (Busch et al., 2016). The presence of therapy dogs has shown promise in supporting students with autism spectrum disorders, attention-deficit/hyperactivity disorder, emotional and behavioral disorders, and specific learning disabilities (O’Haire et al., 2014). The non-judgmental, motivating presence of dogs creates opportunities for these students to practice skills that may otherwise provoke anxiety or resistance (Lane & Zavada, 2013).

1.3.2. Educator and Staff Outcomes

The benefits of therapy dog programs extend to educators and staff, addressing critical concerns, including job satisfaction and burnout mitigation (Barker et al., 2016). Teaching represents a high-stress profession with significant rates of burnout and attrition (Herman et al., 2018). Therapy dogs provide emotional support not only for students but also for the adults in educational settings, offering moments of connection and stress relief during demanding workdays (Jalongo et al., 2004). These benefits contribute to improved staff retention and overall school climate, creating positive ripple effects throughout educational communities (Gee et al., 2017).

1.3.3. Handler and Animal Welfare

The identity and well-being of therapy dog handlers and the dogs themselves represent important considerations in school-based programs (Ng et al., 2019). Handlers often reported significant personal and professional benefits from their roles, including enhanced relationships with students and colleagues, increased job satisfaction, and a sense of purpose in contributing to school community well-being (Krause-Parello et al., 2018).

Simultaneously, ensuring therapy dog well-being remains essential for ethical program implementation (Glenk, 2017). Considerations, including appropriate work schedules, rest periods, designated quiet spaces, and ongoing assessment of the dog’s stress indicators, are critical for maintaining therapy dog welfare in educational settings (Clark et al., 2020). Well-designed programs incorporate specific protocols to protect animal welfare while maximizing benefits for students and staff (Ng et al., 2015).

1.4. The Present Pilot Study

Despite the growing implementation of therapy dog programs in educational settings, significant research gaps remain. Qualitative research on handler perspectives is particularly limited, despite handlers serving as critical mediators between therapy dogs and educational communities (Kropp & Shupp, 2017). Understanding handler experiences, challenges, and insights offers valuable information for program improvement and sustainability (Johnson et al., 2018).

Additionally, there is a notable lack of studies examining district-wide implementation models for therapy dog programs (Rousseau & Tardif-Williams, 2019). Most existing research focuses on individual classrooms or schools rather than comprehensive system-wide approaches (Finn-Stevenson, 2016). Research on large-scale implementation would provide valuable guidance for districts considering broader adoption of therapy dog interventions (Zents et al., 2017). Research examining how therapy dog interventions specifically support mental health in post-COVID educational contexts also remains limited (Nieforth & O’Haire, 2020). Given the dramatic increases in mental health concerns following the pandemic, understanding how therapy dog interventions can address these emergent needs represents a critical research priority (Marzouki et al., 2021).

This pilot research aims to contribute to this growing area of qualitative research to examine components of a therapy dog program in PK-12 education and the implication on the mental health and well-being of students, faculty, and staff within the district, as well as the therapy dogs and their handlers. Malmqvist et al. (2019) describe the importance of pilot studies in qualitative research to support future components of the research process. The three research questions for this pilot study are as follows:

• What are the focal components of a therapy dog program in PK-12 education?
• How do therapy dog interventions in PK-12 school district impact students, faculty, and staff mental health and well-being?
• How does a therapy dog program impact the mental health and well-being of handlers and therapy dogs?

2. Materials and Methods

This research study was approved by the Arizona State University Internal Review Board and the Mesa Public School District Research and Evaluation Department.

2.1. Setting

Mesa Public Schools (MPS) is the largest district in the state of Arizona, United States, with 78 schools (PK-12th grade), approximately 58,343 students (U.S. News & World Report, 2025). The students within the district represent both general education and special education students, as well as a diverse student population with minority enrollment making up 60% of the student body.

Paws and Peers

The Paws and Peers program is a therapy dog program in MPS. According to Mesa Public Schools (2024)

Paws & Peers seeks to meet the social and emotional needs of Mesa Public Schools students and staff. These dogs serve as trusted companions in classrooms, counseling, nurse, or administrative offices for crisis intervention, behavioral de-escalation, or simply to address stress, anxiety and/or isolation. (para. 1)

The idea for the therapy dog program came from the director of community education in the district, after attending a school board meeting in January of 2018. High school students that were members of an organization called March for Our Lives, came and spoke at the school board meeting after the Marjory Stoneman Douglas School Shooting. Students from the organization, including a student from one of the district’s high schools, spoke about their concerns with the mental health and well-being of themselves and their peers. The director of community education reached out to the then superintendent and school board president about the idea of incorporating therapy dogs in the district to address mental health and well-being concerns. She then began researching therapy dog programs in education, and she found the Mutt-i-grees program, created by Yale University and the North Shore Animal League. “The Mutt-i-grees Curriculum uses the natural affinity between children and animals to teach social emotional learning (SEL) skills like empathy, self-confidence, teamwork, and decision-making” (North Shore Animal League America, n.d., para. 1). With the support of the school board president and superintendent at the time, she identified schools within the district to pilot the program. Members of the district met with the North Shore Animal League, learned about the curriculum, and visited schools with therapy dogs.

The therapy dog training process for MPS consists of a 6-week obedience course, followed by an 8-week therapy dog training course, and then an animal-assisted therapy dog final evaluation. The therapy dog must pass each stage of training to be qualified to be a part of the Paws and Peers therapy dog program. The therapy dog program pilot began in 2020 with 12 therapy dog and handler teams incorporated across five district locations in MPS. Handlers in MPS continue to have access to the Mutt-i-grees curriculum and can utilize lessons to promote social emotional learning with the therapy dog interventions. By the 2024–2025 academic school year, the program had grown to include 82 handlers and 83 therapy dogs across 43 district locations. Therapy dogs and handlers continue to be consistent staples in the school locations that they serve, with most therapy dogs attending work with their handler in the district one to three days each week. Therapy dogs are included throughout the district at school drop off and pick up, in therapy (ex. occupational and speech) sessions, to support behavior regulation, during general education and special education classroom activities, teacher and staff meetings, and parent–teacher meetings to name a few. Therapy dog interventions from the MPS program also provide community outreach at city-wide events and local universities and colleges. Therapy dogs and handlers in the program complete a renewal course every three years after passing the initial therapy dog evaluation exam.

2.2. Procedure

The researcher asked the director of the Paws and Peers program to suggest handlers in the program to represent the different educational spaces and grade levels that therapy dog interventions are a part of throughout the PK-12th grade school district. The director of the Paws and Peers program identified and recommended handlers representing different grade levels, general and special education, and a staff member for the district. Recruitment emails were then sent to each of the potential participants to explain the research and invite them to participate in the study. Qualtrics was used for potential participants to identify their interest to participate in the study. The first author and PI of the study followed up with an email to each handler upon receiving their consent to follow up with them to participate in the study. The first author then scheduled a date and time to visit each handler at their work, during non-instructional time, to ask for their consent to participate, answer questions, provide permission forms to be sent home with students in their class, and to complete the semi-structured interview. All participants formally consented to participate in the study prior to the semi-structured interview and observation.

Semi-structured interviews were conducted by the first author in person, either in the handler’s classroom or office space. The average length of each semi-structured interview was 45 min to an hour. All semi-structured interviews were audio recorded and transcribed by a transcription program. Field notes were made upon the conclusion of each interview to record potential themes and summarize information shared. Upon the completion of the semi-structured interview, each handler was emailed an additional recruitment request to complete a demographic survey that included questions about them and their therapy dog/s.

Once handlers had received signed permission forms from parents of students in their classes, then a date and time was set up for the first author to observe interactions between the therapy dog/s, handler, students, and any other school faculty and staff present. Consent forms were provided to staff and faculty that were also present during the observation. During the observations, photographs were taken to capture interactions between the therapy dog/s, handler, students, and any other school faculty and staff that were present. During and upon the completion of each observation, field notes were recorded by the first author to capture information shared by students and staff about their interactions with the therapy dog/s and with themselves, as well as observational data. In exchange for participation in the study, each handler received a USD 25 Amazon gift card.

2.3. Participants

All seven participants were handlers in the Paws and Peers therapy dog program for MPS during the 2022–2023 academic school year. During the 2022–2023 school year, the focus of this study, the program had 77 handlers and 85 therapy dogs across 40 district locations. While the district had 77 handlers during the 2022–2023 school year, this research was designed as a pilot study to better understand the context of the program design, role of handlers and therapy dogs, as well as supports and challenges of the therapy dog program. Seven handlers participated in the study representing preschool, elementary, junior high, high school, and district office employees of MPS. Two of the handlers (28.6%) worked on the Paws and Peers program in the district community education department. Two of the handlers (28.6%) were junior high school teachers, with one teaching math and one teaching self-contained mild moderate special education. One handler was a kindergarten teacher (14.3%), one handler was a high school teacher (14.3%) in sports medicine and worked as an athletic trainer, and one handler was a principal (14.3%) in a preschool campus. Six of the handlers were female (85.7%), and one handler was male (14.3%). Two handlers had two therapy dogs in the program.

All therapy dogs were the pet of the handler. The therapy dogs traveled with each handler to and from their work and lived with the handler. Five therapy dogs were male (55.6%), and four therapy dogs were female (44.4%). Seven (77.8%) of the nine therapy dogs were rescues. The therapy dogs represented a range of breeds, such as golden retriever, cockapoo, boxer/American Pitbull, dachshund, Plott hound/greyhound, Pyrenean sheepdog, and soft-coated wheaten terrier.

2.4. Semi-Structured Interviews

The semi-structured interview questions were designed by the first author to examine the role of the Paws and Peers program in the district and schools, as well as the process for therapy dog training, roles of the handlers, the impact of therapy dog interventions in the district, and perceived benefits of the program. Additional questions were included for the program director to learn more about how and why the program began, as well as to provide advice for other districts and schools interested in starting their own therapy dog program.

2.5. Data Analysis

All semi-structured interviews were transcribed. Thematic analysis was the qualitative analytic method used to analyze the transcripts (Braun & Clarke, 2006). The following steps illustrate Braun and Clarke’s (2006) thematic analysis phases that were used: 1. reading and re-reading all transcripts, 2. creating initial codes, 3. grouping all data connected to a theme, 4. reviewing themes, and 5. naming and defining all themes and sub-themes. Upon the completion of coding, all major themes, sub-themes, and illustrative quotes were organized and examined to identify the codes that appeared consistently across transcripts by the first author. Next, the first author reviewed the themes and named and defined themes and sub-themes.

The interview transcripts were then anonymized to remove any identifiable information and uploaded into generative artificial intelligence (AI) platform, AILYZE. The AI qualitative research tool AILYZE has been used in other qualitative studies to identify themes from interview transcripts (Floris et al., 2024; Placa et al., 2024) and for document analysis (UNFPA, 2024), supporting the qualitative data analysis process. AILYZE was used to identify themes by research questions in the initial stage and to review alignment with the first authors themes and sub-themes. All AI-generated content was reviewed, revised, and validated by the first author to ensure accuracy, relevance, consistency, and alignment with the research objectives. The transcripts were compared with the AI-generated thematic coding and the first author’s coding to identify alignment with major themes, as well as sub-themes throughout the coding process to inform the different phases of the thematic analysis. The first author refined codes for the themes and sub-themes after comparing them with the AI reports and identified four common themes during the coding process. The data was rerun a second time through the AI software to confirm the alignment of the quotes with specific themes and sub-themes. AI technology was used as a thought partner to confirm and refine codes identified by the first author. The authors came to an agreement on the naming of themes and sub-themes. Lastly, illustrative quotes were organized by theme and sub-theme.

The field notes and images from the observations of therapy dogs in their educational environment were used to triangulate with the data about the role of therapy dog interventions, description of the program, and interactions between therapy dogs and those in their educational environment.

3. Results

The semi-structured interviews with the handlers are categorized by themes to examine the handlers’ perceptions of the therapy dog program in educational settings and address the research questions. Four themes were identified from the semi-structured interviews to describe the Paws and Peers therapy dog program and the impact on students, faculty, staff, handlers, and therapy dogs: (a) components of a therapy dog program, (b) support provided by therapy dogs, (c) professional benefits of a therapy dog program, and (d) potential challenges of a therapy dog program. The themes are supported by the participants’ quotes during the semi-structured interviews. Below, each theme and sub-theme will be described, with specific examples from the transcripts for each sub-theme.

3.1. Components of a Therapy Dog Program in Education Spaces

Comments that detailed information that explained a component of the therapy dog program and things to be aware of when being a part of or creating a therapy dog program in PK-12 education were identified as components of a therapy dog program in education spaces. This theme was coded the second most in the data. Five sub-themes were classified under this theme: (a) program creation, (b) rationale/how to become a therapy dog handler, (c) training process, (d) therapy dog role and advocacy, and (e) support from district and administration. The therapy dog role and advocacy sub-theme was the most prominent within this theme and the second most prominent across all four themes.

3.1.1. Program Creation

The program director and handlers provided information about the creation of the therapy dog program. The program director who was instrumental in the creation of the program stated the following:

When I think about the starting of it [therapy dog program], I did not want to start something that created a situation…where I brought the dog in for 45 min and then they’re all loving it and then it’s gone. With the stress and a lot of the trauma that our kids experience, to have a reliable presence of a dog on campus, that’s what I wanted to see for our kids.

This program was designed so that the therapy dog interventions would be embedded throughout the school district and become a consistent presence to support the mental health and well-being of students, faculty, and staff.

3.1.2. Rationale/How to Become a Therapy Dog Handler

Handlers shared their rationale for becoming a handler in the program and most indicated that they knew that their dog had the temperament for the work, and they thought their students would benefit from the work. One handler shared the following:

When I transferred from sixth grade to fifth grade, I noticed that I had a lot more emotional students in my class, and I was transitioning over the summer and I’m like, ‘How can I support them? How am I going to deal with the difference in grade level as a new teacher in that grade?’ And when I heard about this, I knew it would be a good tool in the classroom, I knew that she would love it, Nelly [therapy dog] would love it, and my kids would love it.

3.1.3. Training Process

The school district has a process in place for handlers and their dogs to go through training and a formal evaluation to become therapy dogs in the district. One handler described the process, “After you pass the obedience course [6 weeks] with the handler, then you can transition into the therapy dog training [8 weeks].” After the dog has passed those two stages of training, then the final stage is for the dog to pass an animal assisted therapy final evaluation exam.

3.1.4. Therapy Dog Role and Advocacy

The specific role of each therapy dog was described in alignment with the handler’s job responsibilities within the school district. Handlers that were also classroom teachers had their dogs present within the classroom, while handlers that worked in office settings brought theirs to meetings, district events, and to visit schools and classrooms within the district when possible. One handler explained how her therapy dog is part of the kindergarten classroom environment.

I know one of the things that we do in here that I think the kids really buy into is he’s [therapy dog] a student in our classroom, just like everybody else. He has to learn to do things. We have to learn to do things. He’s learning to be in the classroom. They’re learning to be in the classroom. So, for kindergarten, we just kind of play off that. And luckily, he was five and turned six in kindergarten, just like them. So that has been just kind of a selling point to them that he’s learning these things.

This therapy dog’s role was to be a part of the day-to-day classroom activities alongside his handler and the students.

3.1.5. Support from District and Administration

The handlers noted that the school district and administration in their schools has supported them and their involvement in the program. One handler shared how the district support specialist provides support to handlers and therapy dogs in the program.

If I need anything, she [district support specialist] will be right there. She’s there to answer questions. She came out and did an observation. So that was a surprise to me, that the dogs had an observation like we do. And so, she came out and sat and did a little observation. She answered a lot of questions.

Another handler shared how the administration in her school has supported her having two therapy dogs in the program and that they also benefit from the therapy dogs being a part of the school community. “They’re [administration] just happy to see them [therapy dogs]. And sometimes when they’re having a tough day, they’ll actually come seek us out too. So very, very supportive.”

3.2. Support Provided by Therapy Dogs

Support provided by therapy dogs is the theme that was identified the most in the data. This theme was used when details were described implicating a positive effect as a result of interacting with a therapy dog for the students, faculty, staff, or handlers. Nine sub-themes were identified: (a) supporting specific students, (b) community, (c) emotional support, (d) happy/joy, (e) self-efficacy, (f) self-regulation/behavior de-escalation, (g) responsibility, (h) empathy/compassion, and (i) trauma-informed care. Community was the most prominent sub-theme across all four themes.

3.2.1. Supporting Specific Students

The specific student sub-theme was associated with stories that were shared that connected the therapy dog interventions with providing individualized support or care for an individual student that contributed to their well-being. One handler shared how her therapy dog Charlie provided personalized support for children throughout her campus According to the handler:

PT [physical therapy], being able to take steps away from that walker, being scared. But then we’re like, ‘Can you walk to Charlie [therapy dog]?’… It’s just that distraction. We had a little one for a long time. She just would not take those steps away from that walker … She was death grip on it [walker], and she would to Charlie then. So, we have a lot of success with physical therapy. Charlie will do it, you’ll do it. They’ll copy him.

In this instance, Charlie served as a trusted friend when the student was scared and needed personalized support during her physical therapy.

3.2.2. Community

Community was identified as a sub-theme for all comments that indicated that a sense of community was created because of the therapy dog interventions in the district, the individual school, classroom, larger community, or with families. One handler shared how her therapy dog, Bowie, created a community with staff and students on their school campus. According to a junior high school handler:

I just feel like people on campus recognize us, the other staff, and then a lot of other kids on campus that aren’t—because in self-contained, we end up being so partitioned off that if we’re out on campus, I’ll try to have her [therapy dog] move through the middle of campus during different times of the day or going to the library when a lot of kids are in there. It offers an opportunity to have a connection or a conversation, which I would’ve never had a conversation with that child otherwise, or a staff member who might say something or the kids will often say, ‘I’ve got a dog too.’ Then, ‘Oh, tell me about your dog.’ It builds a bond and a comradery that wouldn’t exist otherwise.

3.2.3. Emotional Support

Emotional support was identified as a sub-theme in instances where the therapy dog interventions supported a student, staff, or handler with feeling better and releasing stress. It was not used in instances where extreme behavior or trauma was noted for a student, staff member, or handler.

I think the staff almost gets more out of it than the kids do. I know that it’s a big deal for the kids…sometimes the staff will come to me and say, ‘I just need Winnie [therapy dog] time.’…Or I’ve got kids who just, they’re having a hard time at home, and they just need somebody that isn’t going to ask them questions and they can just cuddle with. So, they’ll go sit in a chair over there and he’ll hop up on the chair with them. And I think, okay, that really helped that kiddo just to have that.

3.2.4. Happy/Joy

Happy/joy was marked in instances where positive feelings of happiness, love, or joy, as well as physical descriptions of smiling were described because of being with a therapy dog. See Figure 1 for images of students interacting with therapy dogs and exhibiting happiness and joy.

A junior high school handler shared the following:

Just the genuine love, care, and interest, it sparks some enthusiasm. You know what? In the long run, if I’ve got a more enthusiastic crowd every day versus if Bowie [therapy dog] had never been in here, to me, that’s really special on its own.

3.2.5. Self-Efficacy

Self-efficacy was identified as a sub-theme in instances where someone described a situation where they or someone else believed in themselves or their abilities because of being with a therapy dog. According to one handler:

I think my teaching experience was better having Nelly [therapy dog] in the room, not just because I think it benefited my students, but it made me feel more confident in my role. She was like a huge tool that I used that made me feel like one of the best teachers. I really felt confident, I felt like my classroom community was better, and that made me like my job better. It made me feel like I was connected to my students more.

This handler explained how being a handler made her believe more in her abilities as a teacher, and the way that the therapy dog intervention supported her classroom community and the relationships she had with her students.

3.2.6. Self-Regulation/Behavior De-Escalation

Self-regulation and behavior de-escalation were associated with comments describing how a therapy dog intervention supported a student with dysregulated behavior. This was noted in instances where a student may be brought to a therapy dog, when one is present on the school campus, specifically when their behavior was dysregulated. A high school handler explained the following:

When the counselors bring a student down and I can see them in turmoil when they first walk in. And when they walk away, they’re hesitant to walk away at first because they don’t want to leave the dog. So, they’re just happy to be around that environment, but they come in crying, visually upset and everything else. And then I’m not necessarily there for the story part, whatever the actual background is… And then they keep coming back [to spend time with the therapy dog].

The above quote illustrates how students with dysregulated behavior on a campus with a therapy dog can be brought to a private space with a therapy dog at the school to support behavior regulation.

In another example, a therapy dog was present in an educational setting when students were demonstrating dysregulated behavior. The junior high school handler described the therapy dog intervention’s impact on a student’s behavior:

It was one of the first few weeks that he [therapy dog] was on campus. Last year, I taught one section of PE. And he would go with me to the gym. And I remember, one time…there was a conversation going on between two ladies. And it was clear that one of the ladies was getting upset and bothered by what the other one was saying…and the young lady came by me, and we sat. And that was the first time I had ever met her, we sat, and we talked. And Phoenix [therapy dog] was sitting between us and it was almost magical. Within a second, she was petting and hugging Phoenix. And the smile that went through her, I still remember it. I mean, it’s emotional. I still remember that moment.

This example provides insight into how the presence of a therapy dog provided comfort for a student with dysregulated behavior by petting and hugging the therapy dog that was present in her classroom setting.

3.2.7. Responsibility

Responsibility was identified as a theme for comments that indicated that interacting with the therapy dog supported a behavioral feeling of responsibility. Multiple handlers indicated that they have incorporated opportunities for students to participate in a more active role with a therapy dog. At the kindergarten level a handler stated, “I have a pet helper, so that’s one of the classroom jobs. So, it’s one kid’s job all week long to fill the water, to give him [therapy dog] a snack.” At the junior high school level another handler described how students are able to gain responsibility by their participation in basic dog training. According to the handler:

They’re [students] doing some very basic dog training, too. They love it. That’s another one of the big pieces for them is, ‘Can we do the treats, and can we get her [the therapy dog] to do some obedience?’ I can see an emerging area to expand on their physical involvement.

3.2.8. Empathy/Compassion

Handlers indicated that students and handlers both were able to relate to others with more empathy and compassion due to the presence of a therapy dog. A kindergarten handler described the following:

From where these kids started, the days that Winston [therapy dog] is here, and when he started coming, it was almost an immediate change. The kids are more compassionate. They are polite. They are responsible. They know what they are responsible for, and they take care of it. They want to have the opportunity to be with him, so they work harder.

In the above example, the handler described how the students demonstrated increased compassion when interacting with others as well as how they act when at school because of the presence of the therapy dog in the classroom.

Another handler described how having her therapy dog in the classroom has supported her with being a more empathetic educator. She shared the following:

With Bowie [therapy dog], it’s like she’s brought in this other part that brings out a little bit more empathy. I’m not a tough teacher, but I set expectations, and I want for the students to strive towards what they can succeed in. I feel like I’m a little more sensitive now to things like when there’s trauma at home…I’ve got these pockets of things happening where I feel like because of Bowie, they come in and I can see the exchange between Bowie and them and then my heart softens a little bit more about my empathy to be like, ‘They are going through something really difficult.’ They’re junior high, but they’re going through really challenging stuff…My heart’s growing three times.

The interactions between her therapy dog and her students have supported her with being a more empathetic educator for her students and understanding the individual challenges that each of them face.

3.2.9. Trauma-Informed Care

Trauma-informed care is a theme that was aligned with comments that demonstrated that the therapy dog intervention was used specifically to target how others felt or acted. For example, a handler described how their therapy dogs were able to be present at a high school after the death of a student to provide targeted care for students, faculty, and staff. She shared, “I took both of them [therapy dogs] to a high school where a student had died…I appreciate the true difference and the gift that dogs provide. They’re just unique. They have that sense.”

3.3. Professional Benefits of a Therapy Dog Program

Professional benefits of a therapy dog program was the third theme that was used to categorize information from the transcripts that described positive impacts of the program on students, faculty, staff, handlers, and therapy dogs throughout the PK-12 education spaces. While this theme was the least frequently identified theme in the transcripts, it was still addressed by all handlers. Three sub-themes were identified under this category that further explained the professional benefits of therapy dog practices: (a) motivation, (b) handler job satisfaction, and (c) therapy dog benefits. Handler job satisfaction was the sub-theme identified most in handler comments for professional benefits of a therapy dog program.

3.3.1. Motivation

Motivation was marked as a sub-theme for a range of comments that indicated that students and handlers were motivated by the presence of the therapy dog in their classroom or educational environment. Therapy dog interventions were identified as motivation for student behavior, attendance, and academics.

Many handlers stated that students were better behaved when the therapy dog was present in comparison to when the therapy dog was not present. For example, one handler said, “The first day that he [therapy dog] came, sure enough, he chose the quiet table, and the kids were like, ‘It’s us. We’re the ones. We have the quiet table.’ It became a super motivator for them, which is really cool.”

Student attendance was another area where therapy dog interventions served as motivation for students. The district support specialist reflected on her time being a classroom teacher:

I had the highest, the best attendance out of the whole fifth grade. And even though we did have students rotating in, it really makes an impact when it’s your homeroom. I mean, my homeroom [students] spent most of the day in my classroom. For opening and closing, we had homeroom time and then we would rotate just that one hour for our subject, and my class had the best attendance. And I did notice that some students who didn’t go to school a lot, they would come in during our rotations and be like, ‘Oh, I’ve been waiting to see Nelly [therapy dog]. I’ve been so excited.’

The handler noted that her attendance was the best for her grade level, in part, she believed, due to students looking forward to spending time with the therapy dog Nelly.

Lastly, learning was also singled out as another instance where handlers described the therapy dog interventions as motivating students to want to learn. A kindergarten handler shared the following:

It’s motivating to them. Math, at the beginning of the year, we were learning just our numbers. We were counting Winston’s [therapy dog] bones…I think it helps me motivate the kids…Dr. Seuss week, we did Teach Your Dog 100 Words. So, they were teaching Winnie 100 words, and they had to go find 100 words that they could teach to Winston. So, I think it’s those things where it just might be just a random lesson, now I’m able to roll it into the dog and for them to be interested in that.

In this example, Winston provided motivation for students in academic teaching and learning activities, such as counting and vocabulary/sight words.

3.3.2. Handler Job Satisfaction

Handlers described the pride they take in their roles within the school district and the satisfaction that being a handler has brought to their job. According to a junior high school handler:

Just the joy and mood uplift…I think it [being a handler] makes me feel like I’m offering something a little bit more than what just teaching does. I feel like it makes me feel very proud and I think it makes the kids just look forward to it.

3.3.3. Therapy Dog Benefits

The handlers also described that their dogs enjoy being therapy dogs in their school district and look forward to days when they get to go to work. A junior high school handler explained, “People ask me, ‘Does he [therapy dog] really enjoy it?’ And I tell them, I can honestly answer that, that he is just so excited when it’s time to come.” Handlers indicated that the therapy dogs also benefit from being in the program. For example, one of the therapy dogs came from an abusive home prior to being rescued by his handler. The handler stated, “He [therapy dog] came from a fairly abusive background, but it’s amazing just how resilient pups can be and just everything that he offers. He has a lot of energy. He loves being around this place [school].” This example showed that the dog was able to combat negative challenges that he faced in his previous abusive home, and he became a therapy dog after being adopted into his new home. The therapy dog’s name, Phoenix, embodies how the dog was able to rise above his challenges and make himself new again after being adopted to a caring home and becoming a therapy dog (see Figure 2).

3.4. Potential Challenges of a Therapy Dog Program

Potential challenges of a therapy dog program as a theme was identified to describe specific comments that referenced challenges that have arisen or could arise from a therapy dog program in PK-12 education. All handlers addressed potential challenges during their interviews and a dog not being appropriate for a therapy dog role was the potential challenge that was mentioned the most. Potential challenges of a therapy dog program in a PK-12 school district were aligned within three sub-themes: (a) potential challenges at the school district level, (b) potential challenges that may arise for handlers, and (c) potential challenges with dogs.

3.4.1. Potential Challenges at the School District Level

Many potential challenges were classified as district-level challenges that included liability if something goes wrong, chaotic school environment for dogs, people being allergic to dogs, people not liking dogs, and therapy dogs not being present in all schools and classrooms throughout the district. Liability was identified as a district-level concern that needs to be considered in case something goes wrong. One handler emphasized, “The insurance component behind it is something that needs to be watched carefully.” Handlers also emphasized that the school environment can be chaotic and unpredictable. For example, a high school handler stated, “Because it [school] is a chaotic environment. Sometimes there are a lot of stimuli. I have students walking by barking at my dogs or doing other things that you wouldn’t normally expect.” Handlers and therapy dogs need to be mindful of the different stimuli within the school district.

In addition, people may be allergic to dogs or not like dogs. A handler explained, “there’s always that risk when I have students that are either allergic or they’re not comfortable [around dogs].” Handlers also expressed concerns that not all students within the district have access to therapy dogs. One elementary school handler shared the following:

I feel bad that not everybody has access to Winston [therapy dog]. I try, but there’s only so much you can do. I can’t get to all the classrooms. I can’t get to all the kids. I try on my specials, on my prep time, to just wander outside and stop when they’re at the bathroom or whatever. But I know there’s kids that need the dog that I can’t get to.

3.4.2. Potential Challenges That May Arise for Handlers

Additional challenges were focused on the handler role, such as double duty of being a handler and performing job-related duties, principals imposing additional requirements for handlers, and the time and cost of being a handler. One handler explained the double duty of being both a handler and a teacher. She stated the following:

You are doing double duty. You’re doing two different things at once. You’re doing your instructional job, and then you’re also doing therapy work with your dog. And so, one of the challenges is you’re adding that onto your plate, you’re adding this extra job position almost onto your job duties.

Another handler described additional requirements that her principal put in place for her as a handler at her school. “My principal wanted permission slips. …Here, every child has to have a permission slip, and I have to keep track of who has opted out.” The school district has an opt out form for students and families that do not want to participate in the program, and this handler’s principal required an additional requirement of permission slips for each student in the school.

Handlers also emphasized the challenge related to the time and cost of being a handler. One handler shared, “You have to really buy into it. And it’s a lot of work. You put in a lot of work and a lot of money.” Handlers indicated that they spent a lot of time attending obedience and therapy dog trainings, and that there are costs associated with the trainings, veterinarian visits, grooming, and supplies for their therapy dog.

3.4.3. Potential Challenges with Dogs

Some additional potential challenges focused more on the therapy dog, such as not being appropriate for a therapy dog role, getting tired, and breed misconceptions. For example, one handler shared that not all dogs are a good fit for therapy dog work. For example, in many cases, a “dog would be more of a distraction in the classroom than a help.” Handlers also mentioned that being a therapy dog can be tiring on the therapy dog, so therapy dogs are not able to present every day. One stated, “I know that when he [therapy dog] comes four days a week, he’s really tired. There’s a lot going on in here [school] all the time.” Handlers noted that sticking to a schedule of one to three days a week is important to provide the therapy dogs with time to recover in between their days at work.

The district has no breed restrictions, but there are some misconceptions about dog breeds. One handler noted that his dog has become a positive example of how dogs can be judged and overcome this challenge through the positive interactions people have with his dog who is a Pitbull mix. The junior high school handler shared, “He’s [therapy dog] a great ambassador…for his breed.” In this instance the therapy dog helped combat the challenge that many see in his breed and served as a positive ambassador for his breed to combat misconceptions.

4. Discussion

The findings demonstrate how one PK-12 school district created a district-wide therapy program to address the mental health and well-being of students, faculty, and staff. This study provides compelling empirical evidence regarding the strategic implementation of Mesa Public Schools’ comprehensive therapy dog program. With its 83 therapy dogs across 43 district locations serving approximately 58,343 students, the Paws and Peers program establishes an unprecedented model of how meticulously structured therapy dog practices can be systematically embedded within a complex district infrastructure to address escalating post-pandemic mental health concerns directly. This district-wide implementation substantiates emerging clinical research, which identified therapy dog practice as one of the most promising evidence-based interventions, specifically targeting the 25% surge in anxiety and depression symptoms documented among PK-12 students following the COVID-19 pandemic (Pandey et al., 2024).

The findings align with previous research on classroom-level therapy dog interventions, particularly studies demonstrating improved academic engagement when therapy dogs are present (Friesen, 2010; Hall et al., 2016). The program’s emphasis on creating an educational environment with therapy dog interventions throughout the district represents a paradigm shift from short-term, sporadic animal visitation programs to embedded, consistent interventions integrated into the educational ecosystem. This systematic approach directly operationalizes recommendations from the research, which assert that sustainable therapy dog interventions must be integrated within existing educational frameworks rather than functioning as isolated, sporadic activities disconnected from broader educational objectives (Gee et al., 2017, p. 1). To ensure ethical and effective implementation of animal-assisted interventions, it is essential that professionals adhere to standards of practice and acquire relevant competencies (Trevathan-Minnis et al., 2021). Organizations such as the Association of Animal-Assisted Intervention Professionals provide guidelines, training, and continuing education to support best practices and minimize risks to both human and animal participants (Dixon et al., 2025).

Numerous potential challenges were noted for schools and districts considering implementing a therapy dog program. Some challenges noted were students’ allergies to animals and children’s fear of an animal, which are challenges that have been noted in other related literature (Flynn et al., 2020). An additional concern was the chaotic and unpredictable school environment, which is similar to findings that indicated that keeping therapy dogs safe in small educational environments was a challenge and barrier (Baird et al., 2023). The double duty that handlers may face when completing their educational job and being a handler has also been identified as a concern educational staff have when thinking about their workload with a therapy dog (Grové et al., 2021). To address potential challenges of a therapy dog program, the district has implemented opt out forms for students and continued review of therapy dogs in their settings to ensure safety expectations are being met for students and the therapy dog. In addition, the district has implemented a training and examination process, as well as annual evaluations and enrichment from the support specialist for continuous support throughout the school year. Therapy dogs have a crate available in their education environment where they can take a break if they become tired or need a break. While there are several potential challenges, the findings indicate that the benefits of the program outweigh the potential challenges.

The findings regarding the support provided by therapy dogs align with three domains of mental health support (social, emotional, and behavioral) illustrated in Figure 3 align with established theoretical frameworks for mental health components of well-being in schools (Chafouleas, 2020; U.S. Department of Education, Office of Special Education and Rehabilitation Services, 2021). The social components of community building, relationship development, and empathy/compassion directly connect with widely recognized core competencies in social awareness and relationship building that contribute to comprehensive mental health and well-being (Wintermantel et al., 2025). These components parallel established frameworks that emphasize self-awareness, social awareness, responsible decision-making, self-management, and relationship skills as foundational elements for developing healthy social-emotional capacities (CASEL, 2022). The emotional components, particularly non-judgmental trauma-informed care and stress relief, support the neurobiological evidence presented in the literature review about documented physiological stress reduction associated with animal interactions (Meints et al., 2022; Pendry & Vandagriff, 2019). Handlers’ observations of therapy dogs helping to de-escalate dysregulated behavior align with research on how animal interactions can promote parasympathetic nervous system activity and reduce cortisol levels (Kertes et al., 2017).

The behavioral domain components in Figure 3, including motivation, responsibility, and self-regulation/behavior de-escalation, demonstrate how therapy dog interventions provide tangible support for observable behaviors that contribute to academic success and positive school climate. The integration of these three domains creates a comprehensive mental health support structure that addresses both immediate needs (like crisis support and behavior de-escalation) and long-term developmental goals (such as empathy cultivation and self-efficacy). The trauma-informed principles of safety, trustworthiness, choice, collaboration, and empowerment (The Recovery Center, 2022) were particularly evident in handlers’ descriptions of how therapy dog interventions created safe spaces for students experiencing distress. As one handler described, students in emotional discomfort would seek out therapy dogs during moments of crisis, with the therapy dog interventions providing a non-judgmental presence that enabled emotional regulation, which is a key component of trauma-informed approaches. From a biopsychosocial perspective, the findings support the concept that therapy dog interventions facilitate regulatory relationships that support emotional development. Handlers report of improved focus, attention, and emotional regulation among students, particularly how secure attachment relationships support stress regulation (Eilert & Buchheim, 2023). The finding that therapy dog interventions helped create community both within classrooms and across schools demonstrates how animal-facilitated relationships can strengthen social connections, a core element of the biopsychosocial model.

Beyond the mental health components illustrated in Figure 3 the study’s findings also highlight the multi-level impact of the therapy dog program across classroom, school, and district levels. This multilevel impact framework provided in the findings offers a valuable lens for understanding how therapy dog interventions function across different educational layers. At the classroom level, the impacts manifest in specific teaching and learning contexts, with handlers reporting improvements in student focus, engagement, motivation, and emotional regulation. See Figure 4 for two examples of therapy dog interventions in educational environments in the district.

What distinguishes this study is its documentation of impacts at the school and district levels, which are the areas less frequently addressed in the existing literature. At the school level, therapy dog interventions facilitated what might be termed “relational infrastructure”, which is the networks of connection between students and staff who might otherwise have limited interaction. The creation of this cross-role, cross-department community represents a significant contribution to a positive school climate, which research consistently links to improved academic and social-emotional outcomes (Zhao & Akhter, 2023). Figure 5 outlines the structure and outcomes of the Paws and Peers therapy dog program implemented across PK–12 education settings. The figure highlights two foundational pillars of the program: the structured therapy dog training process and district support. These pillars support defined therapy dog roles and collectively, these roles yield critical outcomes. This systematic approach demonstrates how structured therapy dog interventions can be effectively integrated into educational environments to support comprehensive well-being goals.

At the district level, the program’s strategic alignment with broader mental health initiatives represents a significant policy innovation. By institutionalizing therapy dogs as a recognized form of mental health support rather than an educational element, the district positioned this intervention within its comprehensive well-being framework. This district-wide approach enabled cross-campus collaboration, resource sharing, and consistent implementation protocols, which are the elements often missing in more isolated therapy dog interventions (Rousseau & Tardif-Williams, 2019).

The multi-level impacts observed also suggest potential long-term implications for district culture and policy. As therapy dog interventions became integrated into the district’s identity, which is represented at community events, highlighted in communications, and incorporated into crisis response, they transitioned from functioning as a marginal, adjunct intervention to serving as an evidence-based major intervention. This transformation suggests that well-implemented therapy dog programs may influence not only immediate stakeholder well-being but also institutional values and priorities regarding mental health support.

4.1. Practical Implications

The findings illustrated in Figure 3, showing the three domains of mental health support, offer several practical implications for educators, administrators, and policymakers considering therapy dog programs. This framework, expanded upon in Figure 5, emphasizes the critical importance of comprehensive training protocols for handlers and dogs. The district’s sequential training structure, beginning with basic obedience, progressing to therapy-specific skills, and culminating in a formal evaluation, provides a replicable model for other districts. This approach addresses concerns about quality control and safety that often emerge around AAIs in educational settings (Grové et al., 2021).

Future implementation of therapy dog programs should also incorporate explicit guidelines for animal welfare, including limits on working hours, regular health and behavior assessments, and ensuring that participation remains voluntary for the dog, thereby aligning with ethical standards in animal-assisted interventions (McDowall et al., 2023).

For district-wide implementation, findings highlight the importance of centralized coordination combined with site-based flexibility. The Paws and Peers program benefited from centralized training standards, evaluation processes, reevaluations every three years, and support structures while allowing individual handlers to adapt implementation to their specific contexts. This balanced approach enabled consistent quality standards while honoring the unique needs of different educational environments, from pre-kindergarten to high school, from general education to specialized settings.

The findings also suggest specific guidelines for effective program implementation. These include the following:

• Creating formal training and evaluation processes with ongoing evaluation components;
• Instituting support structures for handlers, including observation, coaching, and professional learning communities;
• Integrating therapy dog interventions with existing social-emotional curricula;
• Establishing communication protocols to inform families;
• Creating documentation systems to track program impacts and guide continuous improvement.

4.2. Limitations and Future Research

The study design has several limitations. First, the number of handlers that participated in the pilot study is small, with only seven handlers participating in the semi-structured interviews and observations. This study was designed to be a pilot study to better understand the context of the creation of the therapy dog program, as well as the benefits, challenges, and roles of therapy dogs and handlers throughout the PK-12 school district to contribute to the current literature base and inform future research in this area. Pilot studies are an important part of qualitative research projects and can provide valuable insight into instruments to use for future research and potential challenges that can arise (Malmqvist et al., 2019). The handlers’ perspectives are not representative of all therapy dog handlers but do provide personal opinions of handlers representing different grade bands, such as PK, elementary, junior high, and high school, as well as general education, special education, and office spaces. Also, the director of the Paws and Peers program recommended the handlers to be contacted to participate in the study that were representative of different grade levels and educational spaces throughout the PK-12 school district. It is possible that the director may have recommended handlers that she knew had a positive view of the program. Also, the multilevel framework of the district level therapy dog program is representative of a school district in the United States and is not generalizable to other districts, regions, and countries. We recommend additional research in different school districts, as well as different regions and countries to identify additional frameworks for implementation.

While more research in this area is needed, this study is important in that it represents the perspectives of handlers from a large-scale therapy dog program that is currently being implemented in a PK-12 educational context to support the mental health and social emotional well-being of students, faculty, and staff. Additional research is needed to continue to understand the perspectives of handlers, students, and faculty, as well as more information about how the therapy dog interventions are utilized throughout the school district to further comprehend the impact of therapy dogs. Also, another limitation to consider is that the study was conducted within a U.S. educational context, suggesting that while the multi-level framework offers valuable insights, educational systems in other countries may need to adapt these components to align with their unique cultural contexts, school structures, and educational policies for successful implementation. Even with these limitations, this qualitative study contributes to the limited research that examines the perspectives of therapy dog handlers that are also educators, administrators, and staff in PK-12 educational settings. This data has the potential to inform educators and policymakers interested in creating and implementing a therapy dog program in PK-12 education to support the mental health and well-being of students, faculty, and staff.

The findings from this pilot study suggest several additional directions for future research. First, quantitative studies examining specific outcome measures, such as attendance rates, behavioral incidents, standardized test scores, and staff retention, would complement the qualitative insights gained here. Such research could provide empirical validation of the perceived benefits reported by handlers while addressing calls for more robust evidence of therapy dog intervention efficacy (Kropp & Shupp, 2017). Second, comparative studies examining different therapy dog program models would help identify optimal implementation approaches. Third, research exploring the intersection of therapy dog programs with other mental health initiatives would help position these interventions within comprehensive well-being frameworks. Understanding how therapy dog interventions complement or enhance other approaches, such as mindfulness practices, trauma-informed teaching, or tiered intervention systems, could guide integrated implementation strategies. Additionally, longitudinal and large-scale studies are needed to assess the long-term impacts of therapy dog interventions across diverse student populations and educational contexts (Brelsford et al., 2017). Such research would strengthen the evidence base for therapy dog programs and inform their continued development and implementation (Maujean et al., 2015). Lastly, research incorporating diverse stakeholder perspectives—including students, parents, administrators, and community members—would provide a more comprehensive understanding of therapy dog program impacts and implementation considerations (Henderson et al., 2020). These multiple perspectives would offer valuable insights for program refinement and expansion (Fine et al., 2019).

5. Conclusions

This pilot study provides valuable insights into the implementation and impact of a district-wide therapy dog program in PK-12 education. The Paws and Peers program in MPS represents a systematic approach to addressing the mental health and well-being needs of students, faculty, and staff through HAIs. The findings reveal that the program’s success hinges on several key components: comprehensive training and evaluation processes, district-level and administrative support, and consistent implementation across educational settings. The mental health framework identified in this study, with its social, emotional, and behavioral domains, offers a fundamental structure for understanding how therapy dog interventions contribute to well-being across the educational ecosystem.

The pilot study’s findings regarding multi-level impacts, from classroom to school to district, illuminate how therapy dog interventions can become embedded within educational structures to create sustainable change. This systematic district-wide implementation represents a significant advancement from the more common classroom-level or single-school approaches documented in previous research. The evidence suggests that well-implemented therapy dog programs not only support immediate mental health needs but can also transform educational environments by facilitating stronger relationships, enhancing school climate, and prioritizing well-being at a systemic level.

While the sample size in this pilot study is limited, the benefits appear to outweigh these potential barriers when thoughtful implementation protocols are established. It offers valuable insights into the lived experiences and perceived outcomes of participants directly involved in the therapy dog intervention. As such, conclusions are intended as contextually grounded recommendations rather than generalizations. Future research should explore quantitative outcomes, comparative program models, integration with other mental health initiatives, and diverse stakeholder perspectives to strengthen the evidence base further. Also, large-scale or longitudinal studies are needed to determine the broader applicability of these findings across the district and in varied educational contexts. The Paws and Peers program demonstrates how HAIs can be thoughtfully integrated into educational settings to address the complex mental health challenges facing our educational communities in the post-pandemic era.