Occupational therapy decision-making requires consideration of both the potential benefits and potential risks associated with any intervention.

This is particularly important in assistance animal practice because an assistance animal is not a piece of equipment or a short-term intervention.

It is a living partner requiring:

• ongoing care;
• emotional commitment;
• financial resources;
• environmental compatibility;
• long-term planning.

Therefore, recommending an assistance animal requires consideration of:

“Is the potential occupational benefit significant enough to justify the responsibilities, risks and commitments involved?”

A positive intention is not enough.

A recommendation must be based on careful clinical reasoning.

Why Risk–Benefit Analysis Is Essential

Assistance animals can provide meaningful outcomes for some people, including:

• increased participation;
• improved independence;
• greater confidence;
• improved access to environments;
• support with disability-related tasks.

However, an assistance animal may also introduce challenges.

These may include:

• additional responsibilities;
• financial costs;
• changes to routines;
• emotional demands;
• family impacts;
• animal welfare concerns;
• unrealistic expectations.

The occupational therapist must consider the whole picture.

The question is not:

“Could this animal help?”

The question is:

“Are the likely benefits greater than the potential risks, and can those benefits be achieved sustainably?”

Potential Benefits of Assistance Animal Partnerships

Potential benefits may include:

Improved Occupational Participation

An assistance animal may enable participation in occupations that were previously difficult or inaccessible.

Examples:

• attending education;
• maintaining employment;
• accessing healthcare;
• participating socially;
• completing daily routines.

Increased Autonomy and Choice

A successful partnership may allow a person to:

• make independent decisions;
• access environments;
• manage disability-related barriers;
• participate more confidently.

Support for Meaningful Roles

An assistance animal may support important identities and roles, such as:

• student;
• worker;
• parent;
• community member.

Increased Routine and Structure

For some people, caring for and working with an animal may support:

• daily routines;
• motivation;
• engagement;
• participation.

However, these potential benefits must always be considered individually.

An assistance animal is not beneficial simply because animals are generally positive influences.

Potential Risks for the Person

Increased Responsibility

An assistance animal requires daily care regardless of:

• fatigue;
• illness;
• stress;
• competing responsibilities.

The occupational therapist must consider whether the person has sufficient capacity or support to manage this responsibility.

Unrealistic Expectations

Some people may expect an assistance animal to:

• eliminate symptoms;
• prevent distress;
• solve social difficulties;
• replace therapy;
• remove all barriers.

These expectations may lead to disappointment and partnership breakdown.

Education and realistic goal setting are essential.

Reduced Participation Rather Than Increased Participation

While assistance animals may increase access for some people, they may also create barriers.

Examples include:

• increased preparation time;
• difficulty accessing certain environments;
• additional social attention;
• increased sensory demands;
• restrictions related to animal management.

The occupational therapist must consider the actual impact on the person’s life.

Potential Risks for Families and Support Networks

An assistance animal affects more than the individual handler.

Family and household considerations may include:

• additional caregiving expectations;
• financial responsibility;
• changes to routines;
• impacts on other family members;
• interaction with existing pets.

This is particularly important for:

• children;
• people requiring significant support;
• households with multiple disabilities.

A family’s willingness to support the partnership is important, but willingness alone does not replace realistic capacity assessment.

Potential Risks for the Animal

Animal welfare is central to ethical assistance animal practice.

Potential risks include:

• excessive workload;
• insufficient rest;
• inappropriate expectations;
• inadequate care;
• mismatch between animal temperament and role.

A recommendation must consider whether:

• the animal is suited to the work;
• the workload is reasonable;
• the environment supports welfare;
• retirement planning exists.

A partnership cannot be considered successful if the person benefits while the animal experiences poor welfare.

Considering Alternative Interventions

Risk–benefit analysis requires considering whether another intervention may achieve the same goal with fewer risks.

Alternatives may include:

• environmental modifications;
• assistive technology;
• therapy;
• skills development;
• human supports;
• workplace or education adjustments.

The occupational therapist should not compare:

“Assistance animal versus no support.”

The comparison should be:

“Assistance animal versus the range of possible interventions available to achieve this occupational goal.”

Examples of Risk–Benefit Reasoning

Example 1: Child Requesting an Assistance Animal

Potential benefit:

• increased participation;
• support with routines;
• improved confidence.

Potential risks:

• child may not be developmentally ready;
• family may underestimate care requirements;
• animal may increase household demands.

Assessment considers:

• child’s goals;
• family capacity;
• developmental needs;
• environmental fit.

Example 2: Adult Seeking a Psychiatric Assistance Animal

Potential benefit:

• improved community participation;
• support during disability-related challenges.

Potential risks:

• unrealistic expectation that the animal will remove symptoms;
• reduced development of other coping strategies;
• difficulty maintaining animal care during periods of illness.

Assessment considers:

• functional goals;
• existing supports;
• realistic role of the animal.

Example 3: Older Person Considering an Assistance Animal

Potential benefit:

• maintaining valued routines;
• supporting independence.

Potential risks:

• changing health;
• reduced ability to provide care;
• future accommodation changes.

Assessment considers:

• lifespan planning;
• support networks;
• sustainability.

Risk–Benefit Analysis Does Not Mean Avoiding Risk Entirely

All meaningful interventions involve some level of risk.

The purpose of clinical reasoning is not to eliminate all risk.

It is to:

• identify risks;
• reduce avoidable risks;
• make informed decisions;
• develop appropriate supports.

A carefully considered assistance animal partnership may involve manageable risks when appropriate planning occurs.

The Occupational Therapist’s Role in Risk–Benefit Analysis

The occupational therapist contributes by evaluating:

• occupational benefit;
• functional need;
• environmental factors;
• sustainability;
• alternatives;
• risks.

The OT does not determine the animal’s training suitability.

That remains the responsibility of qualified animal professionals.

However, the OT ensures the intervention fits within the person’s life.

Key Practice Principles

1. Every Intervention Requires Risk–Benefit Analysis

Assistance animals should be recommended because benefits outweigh risks.

2. Potential Benefit Is Not Enough

A positive outcome must be realistic and sustainable.

3. Risks Affect Both People and Animals

The welfare of the animal must be considered alongside human outcomes.

4. Consider Alternatives

The best intervention may not always be an assistance animal.

5. Expectations Must Be Realistic

Assistance animals support participation; they do not eliminate disability.

6. Sustainability Is Essential

A partnership must work over time, not just at the point of placement.

7. Ethical Decisions Consider the Whole System

The person, animal, family and environment all influence outcomes.

Risk–benefit analysis ensures assistance animal recommendations are based on thoughtful clinical reasoning rather than optimism alone. By considering potential occupational gains alongside practical responsibilities, environmental factors and animal welfare, occupational therapists can support partnerships that are meaningful, realistic and sustainable.