Animal-assisted Interventions (AAI) proliferated rapidly since clinicians and researchers first noted the positive effects animals have on people struggling with physical and mental health concerns. The intersection of AAI with the field of animal welfare evolved from considering animals’ basic needs, such as freedom from pain, to recognition that animals experience nuanced emotions. Current conceptualizations of the various roles of companion animals as an adjunct to treatments for humans emphasize not only the animals’ physical comfort and autonomy, but also their mental well-being and enjoyment of AAI activities. However, numerous challenges to effective monitoring of animals involved in AAI exist. This article focuses specifically on dogs, highlighting factors that may lead handlers and therapists to miss or ignore canine stress signals during human-animal interactions and offers strategies to recognize and ameliorate dogs’ distress more consistently. The primary goals of this discussion are to summarize the current thinking on canine well-being and to highlight practical applications of animal welfare principles in real-world AAI settings. The paper highlights contextual factors (e.g., physical setting, patient demand), human influences (e.g., desire to help), and intervention characteristics (e.g., presence or absence of a dog-specific advocate) that may promote or inhibit humans’ ability to advocate for therapy dogs during AAI activities. Deidentified examples of each of these factors are discussed, and recommendations are provided to mitigate factors that interfere with timely recognition and amelioration of canine distress.

The field of human-animal interaction (HAI) has experienced prolific growth in the scope, breadth, and rigor of research conducted on animal-assisted interventions (AAIs). As knowledge regarding the preliminary efficacy of AAIs on outcomes of human health and wellbeing continues to accumulate, so has information regarding the feasibility, safety, and acceptability of AAIs. This progression, combined with an increase in funding opportunities, institutional resources, and growing recognition of the field from mental and medical health professionals, has led to more widespread implementation of randomized controlled trials (RCTs) in the field. While conducting RCTs in any field of study is an intensive and complex undertaking, researchers conducting RCTs to evaluate the efficacy of AAIs are faced with unique considerations. The goal of this manuscript is to discuss these complexities and considerations surrounding conducting an RCT of an AAI program in regard to study planning, conceptualization, design, implementation, and dissemination. We highlight common confounders in HAI research and provide strategies for minimizing or ameliorating them. Recommendations pertain to such unique issues as ethical considerations, theory, control and comparison groups, sampling, implementation fidelity, and transparent reporting of findings. These considerations and recommendations seek to aid HAI researchers in the design, implementation, and dissemination of future RCTs to continue to advance the rigor of the field.