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Cited by 17Human-Animal Interaction StudiesMusic Therapy and HealthPsychotherapy Techniques and Applications

The DOI matches its Crossref record; 65 of the 65 references it cites were found in a registry or an index; none of the 61 sources its claims cite is checked for support yet.

Canine-assisted therapy in reducing stress and anxiety levels of university students: systematic review and meta-analysis of randomized controlled trials

Open access
Sim, Shu Qing, Liu, Zhiwei, Wu, Zishuo, Wang, Sian, Nisa, Claudia·2025·BMC Complementary Medicine and Therapies
DOI 10.1186/s12906-025-04955-2PMC PMC12341270
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Abstract

BACKGROUND: Due to the high prevalence of mental health issues among university students worldwide, canine-assisted therapy (CAT) has emerged as a potential intervention to reduce student stress and anxiety. This study systematically reviews and meta-analyzes the effects of CAT on reducing stress and anxiety levels among university students. METHODS: Following the PRISMA 2020 guidelines, we conducted a systematic search across multiple databases (APA PsycINFO, PubMed, Duke Libraries, CNKI, Wanfang, and Google Scholar) for randomized controlled trials published in English and Chinese. Only studies incorporating professionally trained dogs and handlers were included. Two reviewers (SS and ZL) independently extracted data, and the risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Effect sizes (Hedges' g) were pooled using a random-effects meta-analysis to account for the anticipated clinical and methodological heterogeneity. Subgroup analyses were conducted to explore moderators such as intervention duration, baseline stress levels, and control condition types. Publication bias was evaluated using funnel plots, Egger's test, and trim‑and‑fill analysis. RESULTS: Of 290 identified studies, 15 met the inclusion criteria and 14 were included in the meta-analysis. The meta-analysis yielded a statistically significant overall effect size of g = -0.67 (p <.001), indicating a moderate reduction in stress and anxiety among university students receiving CAT. Forest plots revealed effect sizes ranging from approximately - 1.34 to -0.13 across studies. Although substantial heterogeneity was observed, subgroup analyses showed that CAT was significantly more effective for students with high baseline stress and anxiety levels. Funnel-plot asymmetry suggested possible bias, but Egger's test was non‑significant. Trim‑and‑fill analysis imputed two missing studies, adjusting the pooled effect to g = -0.59, indicating the findings remain robust. CONCLUSION: CAT demonstrates promise in alleviating stress and anxiety among university students. Despite methodological variations and potential publication bias, the findings suggest that CAT may offer a feasible and accessible approach to enhancing mental well-being within university environments. Further studies are necessary to examine factors influencing methodological diversity and refine the integration of CAT within university settings.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review and meta-analysis of 14 RCTs found that canine-assisted therapy produced a moderate reduction in university students’ stress and anxiety (Hedges’ g = −0.67, p < .001). Effects were larger for students with high baseline stress/anxiety, but heterogeneity was substantial and all included studies had some risk-of-bias concerns or high risk.

Key findings

  • The pooled random-effects effect was g = −0.672 (95% CI [−0.892, −0.452], p < .001), a moderate reduction in stress and anxiety; heterogeneity was high (I² = 72.81, p < .001), and four studies had no statistically significant effects.
  • Trim-and-fill analysis imputed two missing studies and adjusted the pooled effect to g = −0.592 (95% CI [−0.816, −0.368]); Egger’s test was non-significant (z = −1.27, p = .21), though funnel-plot asymmetry suggested possible publication bias.
  • CAT was significantly more effective for students with high baseline stress/anxiety (g = −0.909, 95% CI [−1.225, −0.593]) than for those with low baseline levels (g = −0.494, 95% CI [−0.778, −0.209]); subgroup difference Qb = 3.67, p < .05.
  • Control type showed a non-significant trend favoring active controls (g = −0.834) over passive controls (g = −0.503; Qb = 2.96, p = .085); duration subgroups did not differ significantly (short 0–14 min g = −0.883; medium 15–29 min g = −0.651; long ≥30 min g = −0.497; Qb = 2.31, p = .283). No study had overall low risk of bias; 5 of 14 had “some concerns” and the rest were high risk.

Methods

  • PRISMA 2020 systematic review and meta-analysis (PROSPERO CRD42024518138); searched APA PsycINFO, PubMed, Duke Libraries, CNKI, Wanfang, and Google Scholar on April 10, 2025 for randomized controlled trials in English or Chinese, requiring professionally trained/certified dogs and a handler present.
  • From 290 records, 15 studies met inclusion criteria and 14 were meta-analyzed, totaling 1,868 university students; individual sample sizes ranged from 39 to 357 (M = 124, SD = 87), mean age was 19.61 years (SD = 2.37), and the overall male-to-female ratio was 1:3 (male N = 424; female N = 1,322).
  • Random-effects meta-analysis in Stata/SE 18.0 using Hedges’ g, with subgroup analyses by risk of bias, baseline stress/anxiety, control condition type, and intervention duration; publication bias assessed via funnel plots, Egger’s test, and trim-and-fill.

Limitations

  • The paper states that included samples were predominantly female (60–95%), limiting generalizability; many studies had high risk of bias because blinding was infeasible, outcome assessments may have been influenced by prior knowledge of CAT benefits, and several lacked pre-registration.
  • The paper also states high methodological heterogeneity, no standardized theoretical framework for CAT, and that social support mechanisms were not directly measured.
  • Evident from the text: all included studies were conducted in Western countries (3 Canada, 9 USA, 3 UK), so findings may not generalize to non-Western university students; one eligible study was excluded from the meta-analysis due to insufficient statistical reporting.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1186/s12906-025-04955-2

Cites

65 of 65 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

0 of 61 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    CAT was significantly more effective for students with high baseline stress and anxiety levels.

    “Although substantial heterogeneity was observed, subgroup analyses showed that CAT was significantly more effective for students with high baseline stress and anxiety levels.”
    Quote in the paperSubstantial claim
  • Findingown data

    Substantial heterogeneity was observed across studies.

    “Although substantial heterogeneity was observed, subgroup analyses showed that CAT was significantly more effective for students with high baseline stress and anxiety levels.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Trim-and-fill adjusted the pooled effect to g = -0.59.

    “Trim‑and‑fill analysis imputed two missing studies, adjusting the pooled effect to g = -0.59, indicating the findings remain robust.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Trim-and-fill analysis imputed two missing studies.

    “Trim‑and‑fill analysis imputed two missing studies, adjusting the pooled effect to g = -0.59, indicating the findings remain robust.”
    Quote in the paperSubstantial claim
  • Findingown data

    Effect sizes across studies ranged from approximately −1.34 to -0.13.

    “Forest plots revealed effect sizes ranging from approximately − 1.34 to -0.13 across studies.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim. 40
  • It may state two separate claims as one. 54

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Findingcitation

    Most studies did not screen for prior anxiety or mental illness diagnoses; only one reported that 33% of participants had previously been diagnosed with an anxiety disorder.

    “Most studies did not screen for prior anxiety or mental illness diagnoses; only one reported that 33% of participants had previously been diagnosed with an anxiety disorder [57].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [57] Anderson D, Brown S. The effect of animal-assisted therapy on nursing student anxiety: A randomized control study. Nurse Educ Pract. 2021;52:103042. source

  • It may state two separate claims as one.

    Findingown data

    The majority of studies reported reductions in stress and anxiety levels in the intervention group, but four did not yield statistically significant results.

    “Although the majority of studies reported reductions in stress and anxiety levels in the intervention group, four of them did not yield statistically significant results [13, 58, 60, 68].”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [13] Barker SB, et al. A randomized Cross-over exploratory study of the effect of visiting therapy dogs on college student stress before final exams. Anthrozoös. 2016;29(1):35–46. source
    • cites [58] Barker SB, et al. The effect of a Canine-assisted activity on college student perceptions of family supports and current stressors. Anthrozoös. 2017;30(4):595–606. source
    • cites [60] Carr AM. Pendry Effects of an Animal-Assisted Drop-In program on First-Year university students’ trajectory of psychological wellbeing. Pets. 2025;2. https://doi.org/10.3390/pets2010008. source
    • cites [68] Ward-Griffin E, et al. Petting away pre‐exam stress: the effect of therapy dog sessions on student well‐being. Stress Health. 2018;34(3):468–73. source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Findingown data

    The average age of participants was 19.61 years (SD = 2.37).

    “the average age of participants was 19.61 years (SD = 2.37).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Findingown data

    Intervention session durations varied from 1 min to 120 min (M = 32, SD = 31.6).

    “Intervention session durations varied considerably, from as short as 1 min to as long as 120 min (M = 32, SD = 31.6).”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingown data

    The meta-analysis yielded a statistically significant overall effect size of g = -0.67 (p < .001), indicating a moderate reduction in stress and anxiety among university students receiving CAT.

    “The meta-analysis yielded a statistically significant overall effect size of g = -0.67 (p <.001), indicating a moderate reduction in stress and anxiety among university students receiving CAT.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Findingown data

    One study met inclusion criteria but was excluded from the meta-analysis due to insufficient statistical reporting.

    “One study [61] met al.l inclusion criteria at the abstract and full-text screening stages; however, it was excluded from the meta-analysis due to insufficient statistical reporting.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [61] Crump C, Derting TL. Effects of pet therapy on the psychological and physiological stress levels of first-year female undergraduates. North Am J Psychol. 2015;17(3):575–90.

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Findingcitation

    Most studies implemented a single-session intervention; two studies administered the intervention over 6 and 7 weeks.

    “Most studies implemented a single-session intervention; however, two studies administered the intervention over 6 and 7 weeks, respectively [60, 64].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [60] Carr AM. Pendry Effects of an Animal-Assisted Drop-In program on First-Year university students’ trajectory of psychological wellbeing. Pets. 2025;2. https://doi.org/10.3390/pets2010008. source
    • cites [64] Kivlen C, et al. Canine-assisted intervention effects on the well-being of health science graduate students: A randomized controlled trial. Am J Occup Therapy. 2022;76(6):7606205120. source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Findingnone given

    All studies allowed students to interact freely with therapy dogs; students could pet, sit with, or play with the dogs based on their preferences.

    “All studies allowed students to interact freely with therapy dogs; students could pet, sit with, or play with the dogs based on their preferences.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Findingown data

    Most included studies were conducted in Western countries: 3 in Canada, 9 in the USA, and 3 in the UK.

    “Most of the included studies were conducted in Western countries– 3 in Canada, 9 in the USA, and 3 in the UK– with a total sample of 1868 university students.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Findingown data

    Individual sample sizes ranged from 39 to 357 participants (M = 124, SD = 87).

    “Individual sample sizes ranged from 39 to 357 participants (M = 124, SD = 87).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Findingnone given

    All interventions involved live, in-person interactions with a therapy dog accompanied by a trained handler.

    “All interventions involved live, in-person interactions with a therapy dog accompanied by a trained handler.”
    Quote in the paperNot a substantial claim
    • The authors state this as an assumption: For studies included in the analysis, if the presence of a handler was not explicitly stated, a handler was assumed to be present because this is standard practice in CAT.

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Findingown data

    The total sample of included studies was 1868 university students.

    “Most of the included studies were conducted in Western countries– 3 in Canada, 9 in the USA, and 3 in the UK– with a total sample of 1868 university students.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Findingown data

    The overall male-to-female ratio was 1:3 (Male N = 424; Female N = 1322).

    “with an overall male-to-female ratio of 1:3 (Male N = 424; Female N = 1322)”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingown data

    Of 290 identified studies, 15 met inclusion criteria and 14 were included in the meta-analysis.

    “Of 290 identified studies, 15 met the inclusion criteria and 14 were included in the meta-analysis.”
    • Also stated in: § Study selection · plain
      “In total, 15 individual studies [13, 21, 57–69] met al.l inclusion criteria.”
    Quote in the paperNot a substantial claim
    • The authors state this as an assumption: For studies included in the analysis, if the presence of a handler was not explicitly stated, a handler was assumed to be present because this is standard practice in CAT.

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Findingown data

    Six studies (40%) assessed anxiety using the State-Trait Anxiety Inventory, and five studies (33%) evaluated stress via versions of the Perceived Stress Scale.

    “Regarding outcome measures, 6 studies (40%) assessed anxiety using the State-Trait Anxiety Inventory (STAI), 5 studies (33%) evaluated stress via versions of the Perceived Stress Scale (PSS), and the remaining studies used alternative tools such as momentary stress ratings or diagram-based measures like the Family Life-Space Diagram.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingown data

    The largest effect size of -1.34 by Trammell [67] originated from the study with the second smallest sample size (N = 44), suggesting possible small-study effects.

    “For example, the largest effect size of -1.34 by Trammell [67] originated from the study with the second smallest sample size (N = 44), suggesting possible small-study effects.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [67] Trammell JP. Therapy dogs improve student affect but not memory. Anthrozoös. 2019;32(5):691–9. source

  • It may state two separate claims as one.

    Findingown data

    Although the shortest intervention duration group showed the largest effect size, subgroup differences by session length were not statistically significant.

    “Although the shortest intervention duration (0–14 min) group showed the largest effect size, subgroup differences by session length were not statistically significant.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Findingown data

    Interventions compared to passive controls yielded a pooled effect size of -0.503 (95% CI [-0.815, -0.191]), while those compared to active controls showed a stronger effect size of -0.834 (95% CI [-1.046, -0.622]).

    “Interventions compared to passive controls (e.g., waitlist or typical study routines) yielded a pooled effect size of -0.503 (95% CI [-0.815, -0.191]), while those compared to active controls (e.g., interaction with a handler or engagement in attention-matched tasks) showed a stronger effect size of -0.834 (95% CI [-1.046, -0.622]).”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Findingown data

    In the medium-duration group (15-29 min), the pooled effect size was -0.651 (95% CI [-1.001, -0.300]), with substantial heterogeneity (I2 = 74.52, p < .01).

    “The medium-duration group (15–29 min) also demonstrated a reduction in stress and anxiety, with a pooled effect size of -0.651 (95% CI [-1.001, -0.300]). However, substantial heterogeneity was observed (I² = 74.52, p <.01), indicating variability across studies.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Findingcitation

    Ward-Griffin et al. [68] reported the smallest significant effect size of -0.129 (95% CI [-0.379, 0.122]).

    “while Ward-Griffin et al. [68] reported the smallest significant effect size of -0.129 (95% CI [-0.379, 0.122]).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [68] Ward-Griffin E, et al. Petting away pre‐exam stress: the effect of therapy dog sessions on student well‐being. Stress Health. 2018;34(3):468–73. source

  • It may state two separate claims as one.

    Findingown data

    Across 5 risk of bias domains and 75 total outcomes, 17 were rated low-risk, 43 were evaluated to have some concerns, and 12 were identified as high-risk.

    “Across 5 risk of bias domains and 75 total outcomes, 17 of them were rated as low-risk, 43 were evaluated to have some concerns, and 12 were identified as high-risk.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingown data

    The pooled effect size for studies with some concerns was -0.780 (95% CI [-1.232, -0.328]), while for high-risk studies it was -0.607 (95% CI [-0.859, -0.456]).

    “The pooled effect size for studies with some concerns was − 0.780 (95% CI [-1.232, -0.328]), while for high-risk studies, it was − 0.607 (95% CI [-0.859, -0.456]).”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Findingcitation

    We identified nine relevant meta-analyses on animal-assisted therapy, but only one focused on higher education.

    “We identified nine relevant meta-analyses on animal-assisted therapy (Table 1), but only one focused on higher education [31].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [31] Huber A, et al. Animal-Assisted interventions improve mental, but not cognitive or physiological health outcomes of higher education students: a systematic review and Meta-analysis. Int J Mental Health Addict. 2024;22(3):1597–628. source

  • It may state two separate claims as one.

    Findingown data

    Sensitivity analysis excluding two multi-session studies [60, 64] showed that effect sizes and direction of results remained consistent, with no meaningful differences across subgroups.

    “Two of the included studies implemented multi-session interventions lasting several weeks [60, 64]. To examine their influence, we also conducted a sensitivity analysis excluding these studies. The effect sizes and direction of results remained consistent, and no meaningful differences were observed across subgroups.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [60] Carr AM. Pendry Effects of an Animal-Assisted Drop-In program on First-Year university students’ trajectory of psychological wellbeing. Pets. 2025;2. https://doi.org/10.3390/pets2010008. source
    • cites [64] Kivlen C, et al. Canine-assisted intervention effects on the well-being of health science graduate students: A randomized controlled trial. Am J Occup Therapy. 2022;76(6):7606205120. source

  • It may state two separate claims as one.

    Findingown data

    The pooled effect size for the low baseline stress/anxiety group was -0.494 (95% CI [-0.778, -0.209]), smaller in magnitude than the pooled effect size of -0.909 (95% CI [-1.225, -0.593]) for the high baseline stress/anxiety group.

    “Our analysis revealed that the pooled effect size for the low stress/anxiety group was − 0.494 (95% CI [-0.778, -0.209]), which is smaller in magnitude than the pooled effect size of -0.909 (95% CI [-1.225, -0.593]) for the high stress/anxiety group.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Findingown data

    Studies with some concerns showed a larger average effect size than high-risk studies, but this difference was not significant.

    “In general, our findings suggest that while studies with some concerns showed a larger effect size on average compared to high-risk studies, this difference was not significant.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingown data

    In the short-duration group (0-14 min), the pooled effect size was -0.883 (95% CI [-1.170, -0.596]), with no observed heterogeneity (I2 = 0.00, p = .564).

    “In the short-duration group (0–14 min), the pooled effect size was − 0.883 (95% CI [-1.170, -0.596]), with no observed heterogeneity (I² = 0.00, p =.564), suggesting a consistent and strong effect of brief sessions in reducing stress and anxiety.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Findingown data

    In the long-duration group (≥ 30 min), the pooled effect size was -0.497 (95% CI [-0.906, -0.088]) with high heterogeneity (I2 = 79.66, p < .001).

    “Similarly, the long-duration group (≥ 30 min) yielded an effect size of -0.497 (95% CI [-0.906, -0.088]) with high heterogeneity (I² = 79.66, p <.001), suggesting that longer sessions may be effective but vary in impact.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Findingown data

    Overall, no included studies were assessed as low-risk; 5 out of the 14 studies had some concerns, and the remaining were classified as high-risk.

    “Overall, no studies were assessed as low-risk; 5 out of the 14 studies had some concerns, while the remaining were classified as high-risk.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingown data

    The trim-and-fill analysis imputed two potentially missing studies on the right side of the funnel plot, suggesting that smaller or non-significant studies may be underrepresented.

    “The trim and fill analysis imputed two potentially missing studies on the right side of the funnel plot, suggesting that smaller or non-significant studies may be underrepresented.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Egger's test has low power to detect small-study bias when there are few studies.
    • The authors state this as an assumption: The trim-and-fill procedure assumes that funnel plot asymmetry is solely due to publication bias.

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductnone given

    Two reviewers independently extracted data.

    “Two reviewers (SS and ZL) independently extracted data, and the risk of bias was assessed using the Cochrane Risk of Bias 2 tool.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim.

    Study design and conductreasoning

    Effect sizes were pooled using a random-effects meta-analysis.

    “Effect sizes (Hedges’ g) were pooled using a random-effects meta-analysis to account for the anticipated clinical and methodological heterogeneity.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductnone given

    Missing data with no author response were imputed through mean substitution.

    “Missing data with no author response were imputed through mean substitution; in the case of subgroup analyses, such studies were excluded.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductown data

    A sensitivity analysis was conducted by excluding multi-session studies and re-running the analysis.

    “To assess the robustness of our findings for the intervention duration subgroup, we also conducted a sensitivity analysis by excluding multi-session studies and re-running the analysis.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductcitation

    The systematic review and meta-analyses were developed following the PRISMA 2020 statement.

    “Our systematic review and meta-analyses were developed following the PRISMA 2020 statement [36].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] Page MJ et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 2021: p. n71. source

  • Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.

    Premisecitation

    Canine-assisted therapy is a complementary intervention using professionally trained dogs to enhance individuals' physical, social, emotional, or cognitive functioning.

    “Canine-assisted therapy is a complementary intervention using professionally trained dogs to enhance individuals’ physical, social, emotional, or cognitive functioning [14, 15].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [14] McDowall S, et al. Understanding the role of therapy dogs in human health promotion. Int J Environ Res Public Health. 2023;20(10):5801. source
    • cites [15] Marcus DA. The science behind Animal-Assisted therapy. Curr Pain Headache Rep, 2013. 17(4). source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductnone given

    Publication bias was evaluated using funnel plots, Egger's test, and trim-and-fill analysis.

    “Publication bias was evaluated using funnel plots, Egger’s test, and trim‑and‑fill analysis.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductown data

    The review has a PROSPERO registration record with ID number CRD42024518138 as of April 2025.

    “As of April 2025, our PROSPERO registration record has ID number CRD42024518138.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductown data

    Two reviewers independently screened titles and abstracts based on predefined inclusion criteria.

    “Two reviewers (SS and ZL) independently screened titles and abstracts based on predefined inclusion criteria.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductnone given

    Small-study bias was assessed through Egger's test.

    “Small-study bias was assessed through Egger’s test, while potential publication bias was evaluated using trim-and-fill analysis and funnel plots.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductnone given

    Heterogeneity across studies was assessed using the I2 statistic.

    “Heterogeneity across studies was assessed using the I² statistic.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductnone given

    Data extraction was completed by both reviewers independently using an Excel sheet.

    “Data extraction was completed by both reviewers independently using an Excel sheet.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductcitation

    Risk of bias was assessed using the Cochrane Risk of Bias 2 tool.

    “Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool [51].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [51] Sterne J, Egger; M, Moher D. Chap. 10: addressing reporting biases. Cochrane handbook for systematic reviews of intervention. Version 5.0. 1. The Cochrane Collaboration; 2008. source

  • It may state two separate claims as one.

    Premisecitation

    Without professionally trained dogs and handlers, both the outcomes and integrity of the intervention could be compromised.

    “Without these elements, both the outcomes and integrity of the intervention could be compromised [39, 42].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [39] Mignot A, et al. Handlers’ representations on therapy dogs’ welfare. Animals. 2022;12(5):580. source
    • cites [42] IAHAIO. The IAHAIO Definitions for Animal-Assisted Intervention and Guidelines for Wellness of Animals Involved in AAI… 2019; Available from: https://otaus.com.au/publicassets/80cfd523-2030-ea11-9403-005056be13b5/AAII-Standards-of-Practice.pdf

  • Probably not a substantial claim. It may be too vague to check against evidence.

    Interpretationreasoning

    CAT is a promising solution for addressing the growing mental health challenges faced by university students, especially in the aftermath of the COVID-19 pandemic.

    “Despite the methodological limitations identified, CAT is still a promising solution for addressing the growing mental health challenges faced by university students, especially in the aftermath of the COVID-19 pandemic.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds. It may state two separate claims as one.

    Interpretationreasoning

    CAT's cost-efficiency, scalability, and high popularity, combined with demonstrated effectiveness in reducing stress and anxiety, make it a feasible option for institutions aiming to promote student well-being.

    “Its cost-efficiency, scalability, and high-popularity, combined with demonstrated effectiveness in reducing stress and anxiety, make CAT a feasible option for institutions aiming to promote student well-being.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Interpretationreasoning

    The consistent positive effects across all durations indicate CAT's adaptability and its potential to be tailored flexibly to various program structures.

    “Instead, the consistent positive effects across all durations indicate CAT’s adaptability and its potential to be tailored flexibly to various program structures.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.

    Interpretationreasoning

    The overrepresentation of female participants is likely due to recruitment practices in fields such as psychology and nursing, which tend to have higher proportions of female students.

    “The overrepresentation of female participants is likely due to recruitment practices in fields such as psychology and nursing, which tend to have higher proportions of female students.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Interpretationown data

    This meta-analysis provides strong evidence that CAT is an effective intervention for reducing stress and anxiety among university students, with an overall moderate effect size and consistent benefits across session durations and control conditions.

    “This meta-analysis provides strong evidence that canine-assisted therapy (CAT) is an effective intervention for reducing stress and anxiety among university students, with an overall moderate effect size and consistent benefits across session durations and control conditions.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Study design and conductreasoning

    The studies included in this review exhibited high methodological heterogeneity, which may have influenced the interpretation of our results.

    “In addition, the studies included in this review exhibited high methodological heterogeneity, which may have influenced the interpretation of our results.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Canine-assisted therapy effectively reduces stress among nurses.

    “Recent studies have shown that canine-assisted therapy effectively reduces stress among nurses [17] and enhances the quality of life for Alzheimer’s patients [18].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Machová K, et al. Canine-Assisted therapy improves Well-Being in nurses. Int J Environ Res Public Health. 2019;16(19):3670. source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Canine-assisted therapy enhances the quality of life for Alzheimer's patients.

    “Recent studies have shown that canine-assisted therapy effectively reduces stress among nurses [17] and enhances the quality of life for Alzheimer’s patients [18].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] Sánchez-Valdeón L, et al. Canine-Assisted therapy and quality of life in people with Alzheimer-Type dementia: pilot study. Frontiers in Psychology; 2019. p. 10. source

  • It may state two separate claims as one.

    Premisecitation

    62% of surveyed universities in the United States provide animal-assisted therapy programs, the majority of which exclusively involved dogs.

    “A report indicated that 62% of surveyed universities in the United States provide animal-assisted therapy (AAT) programs, the majority of which exclusively involved dogs [20].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] Haggerty JM, Mueller MK. Animal-assisted stress reduction programs in higher education. Innov High Educ. 2017;42(5–6):379–89. source

  • It may state two separate claims as one.

    Premisecitation

    Clinical interventions require qualified professionals and depend heavily on student motivation and engagement, which can further limit their accessibility and impact.

    “Clinical interventions require qualified professionals and depend heavily on student motivation and engagement, which can further limit their accessibility and impact [13].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [13] Barker SB, et al. A randomized Cross-over exploratory study of the effect of visiting therapy dogs on college student stress before final exams. Anthrozoös. 2016;29(1):35–46. source

  • It may state two separate claims as one.

    Premisecitation

    Mindfulness programs face operational challenges: universities must invest in staff training, program delivery, and materials, and students must dedicate considerable time and effort to learn and maintain mindfulness practices.

    “Peer support may deter students from disclosing personal issues to their peers, while mindfulness programs face operational challenges: universities must invest in staff training, program delivery, and materials, and students must dedicate considerable time and effort to learn and maintain mindfulness practices [10, 11].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [10] Mikolajczak-Degrauwe K, et al. Strengths, weaknesses, opportunities and threats of peer support among disadvantaged groups: A rapid scoping review. Int J Nurs Sci. 2023;10(4):587–601.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [11] Wagner AP, et al. Cost-effectiveness of providing university students with a mindfulness-based intervention to reduce psychological distress: economic evaluation of a pragmatic randomised controlled trial. BMJ Open. 2023;13(11):e071724. source

  • It may state two separate claims as one.

    Interpretationown data

    Overall, the meta-analysis demonstrates that CAT effectively reduces university students' stress and anxiety, with a moderate pooled effect size.

    “Overall, our meta-analysis demonstrates that canine-assisted therapy (CAT) effectively reduces university students’ stress and anxiety, with a moderate pooled effect size.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Interpretationown data

    While potential publication bias cannot be entirely ruled out, the adjusted effect size remained statistically significant, strengthening the overall conclusion that CAT is a promising intervention for improving student mental health.

    “While potential publication bias cannot be entirely ruled out, given the funnel plot asymmetry and the imputation of two potentially missing studies via trim-and-fill analysis, the adjusted effect size remained statistically significant. This strengthens the overall conclusion that CAT is a promising intervention for improving student mental health.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Egger's test has low power to detect small-study bias when there are few studies.
    • The authors state this as an assumption: The trim-and-fill procedure assumes that funnel plot asymmetry is solely due to publication bias.

  • It may state two separate claims as one.

    Study design and conductown data

    The samples across studies were not homogeneous in their baseline stress and anxiety levels, which may have either overestimated or underestimated the effect of CAT.

    “Another potential bias in our analysis is that the samples across studies were not homogeneous in their baseline stress and anxiety levels, which may have either overestimated or underestimated the effect of CAT.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. It may state two separate claims as one.

    Premisecitation

    Pets can complement existing human support networks and, in some cases, even serve as substitutes for lacking human connections.

    “As McNicholas and Collis [24] noted, pets can complement existing human support networks and, in some cases, even serve as substitutes for lacking human connections.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [24] McNicholas J. G.M. Collis 2006 Animals as social supports: insights for Understanding animal-assisted therapy. Handb animal-assisted Therapy: Theoretical Found Guidelines Pract 2 49–72.

  • Probably not a substantial claim. It may be too vague to check against evidence.

    Interpretationown data

    The results support the inclusion of CAT as part of a complementary suite of mental health interventions within universities.

    “While methodological limitations remain, the results support the inclusion of CAT as part of a complementary suite of mental health interventions within universities.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Premisecitation

    Huber et al. explored a range of mental, cognitive, and physiological outcomes, with stress and anxiety as only part of the focus, and included general animal-assisted interventions involving various animals beyond dogs.

    “While Huber et al. [31] explored a range of mental, cognitive, and physiological outcomes, with stress and anxiety as only part of the focus, their review also included general animal-assisted interventions (AAIs) involving various animals beyond dogs.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [31] Huber A, et al. Animal-Assisted interventions improve mental, but not cognitive or physiological health outcomes of higher education students: a systematic review and Meta-analysis. Int J Mental Health Addict. 2024;22(3):1597–628. source

  • It may state two separate claims as one.

    Study design and conductreasoning

    Carers and individuals delivering the interventions were often aware of participants' group assignments, as therapy dog interactions are conspicuous, making blinding infeasible.

    “First, carers and individuals delivering the interventions were often aware of participants’ group assignments, as therapy dog interactions are conspicuous (participants would see and interact with dogs), making blinding infeasible.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Interpretationown data

    While all durations show beneficial effects, no specific session length appeared significantly more effective than others.

    “Therefore, while all durations show beneficial effects, no specific session length appeared as significantly more effective than others.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.

    Interpretationreasoning

    The non-judgmental, unconditional support facilitates emotional relief, helping individuals reduce their stress and anxiety levels.

    “The non-judgmental, unconditional support facilitates emotional relief, helping individuals reduce their stress and anxiety levels.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Premisecitation

    Certified dogs are trained to remain calm, responsive, and adaptable in various therapeutic settings, reducing risks associated with patient inappropriate behaviors.

    “Certified dogs are trained to remain calm, responsive, and adaptable in various therapeutic settings, reducing risks (e.g., agitation or biting) associated with patient inappropriate behaviors such as abrupt gestures, rough handling, and direct interactions [39, 40].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [39] Mignot A, et al. Handlers’ representations on therapy dogs’ welfare. Animals. 2022;12(5):580. source
    • cites [40] Glenk LM. Current perspectives on therapy dog welfare in animal-assisted interventions. Animals. 2017;7(2):7. source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    Therapy dogs and their handlers undergo specialized training to ensure that interactions are beneficial and secure.

    “Therapy dogs and their handlers undergo specialized training to ensure that interactions are beneficial and secure [15].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15] Marcus DA. The science behind Animal-Assisted therapy. Curr Pain Headache Rep, 2013. 17(4). source

  • It may state two separate claims as one.

    Interpretationown data

    The adjusted effect size after trim-and-fill remains a moderate and statistically significant effect of canine-assisted therapy in reducing stress and anxiety among university students.

    “Although this adjusted effect size is slightly smaller in magnitude, it still reflects a moderate and statistically significant effect of canine-assisted therapy in reducing stress and anxiety among university students.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Egger's test has low power to detect small-study bias when there are few studies.
    • The authors state this as an assumption: The trim-and-fill procedure assumes that funnel plot asymmetry is solely due to publication bias.

  • It may state two separate claims as one.

    Premisecitation

    Canine-assisted therapy is relatively inexpensive and cost-effective for university-based interventions.

    “Practically, canine-assisted therapy is relatively inexpensive, as dogs are easily transportable and can engage with a larger number of people during a single drop-in session, making it a cost-effective option for university-based interventions [19].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] Narvekar HN, Narvekar HN. Canine-assisted therapy in neurodevelopmental disorders: A scoping review. Eur J Integr Med. 2022;50:102112. source

  • It may state two separate claims as one.

    Interpretationcitation

    The findings align with social support theory: interactions with therapy dogs and handlers may serve as a source of social support, resulting in reduced students' anxiety and stress levels.

    “From a theoretical standpoint, our findings align with social support theory. That is, interactions with therapy dogs and handlers may serve as a source of social support, resulting in reduced students’ anxiety and stress levels [22].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] Thoits PA. Stress, coping, and social support processes: where are we?? we?hat next?? J Health Soc Behav. 1995;35:53. source

  • It may state two separate claims as one.

    Premisecitation

    Canine-assisted therapy is based on social support theory, offering a source of social connectedness and combating feelings of loneliness and isolation.

    “Theoretically, canine-assisted therapy (CAT) is based on social support theory, offering a source of social connectedness and combating feelings of loneliness and isolation [21].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [21] Binfet J-T, Green FL, Draper ZA. The importance of client–canine contact in canine-assisted interventions: A randomized controlled trial. Anthrozoös. 2021;35(1):1–22. source

  • It may state two separate claims as one.

    Study design and conductnone given

    A substantial number of included studies lacked pre-registration, meaning analyses were not always conducted according to a pre-specified plan finalized before unblinded outcome data were available, raising concerns about outcome reporting flexibility.

    “Third, a substantial number of studies lacked pre-registration, meaning analyses were not always conducted according to a pre-specified plan finalized before unblinded outcome data were available, raising concerns about outcome reporting flexibility.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Premisecitation

    Therapy dogs can experience stress or burnout if not properly managed, which may reduce the therapy's effectiveness and negatively impact animal welfare.

    “Research shows that therapy dogs can experience stress or burnout if not properly managed, which may reduce the therapy’s effectiveness and negatively impact animal welfare [39–41].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [39] Mignot A, et al. Handlers’ representations on therapy dogs’ welfare. Animals. 2022;12(5):580. source
    • cites [40] Glenk LM. Current perspectives on therapy dog welfare in animal-assisted interventions. Animals. 2017;7(2):7. source
    • cites [41] Haubenhofer DK, Kirchengast S. Physiological arousal for companion dogs working with their owners in animal-assisted activities and animal-assisted therapy. J Appl Anim Welfare Sci. 2006;9(2):165–72. source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Interpretationreasoning

    Other factors, such as clinical diversity or methodological variability across studies, may also contribute to the initial funnel plot asymmetry.

    “Other factors, such as clinical diversity or methodological variability across studies, may also contribute to the initial asymmetry.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Interpretationreasoning

    CAT facilitates emotionally safe, low-stakes social interactions, which may serve as an important buffer against stress and anxiety.

    “In particular, CAT facilitates emotionally safe, low-stakes social interactions, which may serve as an important buffer against stress and anxiety.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation

    Having a supportive social network has a direct impact on wellbeing, especially when it is large and perceived to offer support, which can improve quality of life and reduce stress.

    “Furthermore, having a supportive social network has a direct impact on wellbeing, especially when it is large and is perceived to offer support, which can improve quality of life and reduce stress [25].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [25] Panayiotou G, Karekla M. Perceived social support helps, but does not buffer the negative impact of anxiety disorders on quality of life and perceived stress. Soc Psychiatry Psychiatr Epidemiol. 2013;48(2):283–94. source

  • It may state two separate claims as one.

    Interpretationown data

    Although Egger's test was not significant, the fact that one of the smallest trials produced the largest effect size points to possible small-study effects.

    “Although Egger’s test was not significant, the fact that one of the smallest trials produced the largest effect size points to possible small-study effects and calls for cautious interpretation.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. It may state two separate claims as one.

    Premisecitation

    Prior research suggests that both brief (5 min) and longer (20 min) sessions can significantly reduce stress [59], and one study found no significant differences in outcomes between sessions lasting 2, 5, and 10 min [70].

    “However, prior research suggests that both brief (5 min) and longer (20 min) sessions can significantly reduce stress [59], and one study found no significant differences in outcomes between sessions lasting 2-, 5-, and 10 min [70].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [59] Binfet J-T. The effects of Group-Administered canine therapy on university students’ wellbeing: A randomized controlled trial. Anthrozoös. 2017;30(3):397–414. source
    • cites [70] Manville K, Coulson M, Reynolds G. An exploratory randomised controlled trial comparing the effectiveness of different duration of canine-assisted interventions in higher education students. Human-Animal Interactions, 2023. 2023(2023). source
    • Rests on an assumption: There are no standardized thresholds for session length in canine-assisted interventions.

  • It may state two separate claims as one.

    Premisecitation

    The dogs and handlers involved in CAT play a crucial role in engaging individuals in social interactions and offering social support, thereby buffering them from stress and anxiety.

    “Consequently, the dogs and handlers involved in CAT play a crucial role in engaging individuals in social interactions and offering social support, thereby buffering them from stress and anxiety [21].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [21] Binfet J-T, Green FL, Draper ZA. The importance of client–canine contact in canine-assisted interventions: A randomized controlled trial. Anthrozoös. 2021;35(1):1–22. source

  • Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.

    Premisecitation

    The standardization of incorporating professionally trained, certified dogs and requiring the presence of a handler during CAT is crucial for the safety, therapeutic efficacy, and ethical treatment of the therapy dog.

    “The standardization of incorporating professionally trained, certified dogs and requiring the presence of a handler during CAT is crucial for the safety, therapeutic efficacy, and ethical treatment of the therapy dog [39].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [39] Mignot A, et al. Handlers’ representations on therapy dogs’ welfare. Animals. 2022;12(5):580. source

  • It may state two separate claims as one.

    Premisecitation

    On-campus counseling services are often strained under high demand, leading to long waiting times for students and increased counselor burnout and turnover.

    “On-campus counseling services are often strained under high demand, leading to long waiting times for students and increased counselor burnout and turnover [12].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [12] ME F. The Mental Health Crisis on College Campuses 2023; Available from: https://www.nea.org/nea-today/all-news-articles/mental-health-crisis-college-campuses

  • It may state two separate claims as one.

    Interpretationown data

    Intervention length might influence outcomes, but no specific duration emerged as definitively superior.

    “This implies that, while intervention length might influence outcomes, no specific duration emerged as definitively superior.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    CAT primarily provides emotional support, which involves expressions of sympathy, caring, esteem, value, or encouragement.

    “CAT primarily provides emotional support, which involves expressions of sympathy, caring, esteem, value, or encouragement [23].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23] Kort-Butle L. Social support theory: the encyclopaedia of juvenile delinquency and justice. Wiley Blackwell; 2017. source

  • It may state two separate claims as one.

    Premisecitation

    Even briefly interacting with therapy dogs can lower stress hormones like epinephrine and norepinephrine, increase endorphin and oxytocin levels, leading to decreased stress, anxiety, and pain, improved mood, and better social bonding.

    “Even briefly interacting, such as hugging, petting, and sitting next to therapy dogs, can lower levels of stress hormones like epinephrine and norepinephrine, increase endorphin levels and oxytocin, leading to decreased stress, anxiety, and pain, improve mood, and better social bonding [15].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [15] Marcus DA. The science behind Animal-Assisted therapy. Curr Pain Headache Rep, 2013. 17(4). source

  • It may state two separate claims as one.

    Interpretationown data

    There were no significant differences in effect sizes between passive control groups and active control groups, suggesting that the observed benefits of CAT are not solely due to novelty or attention effects.

    “Additionally, there were no significant differences in effect sizes between passive control groups (e.g., waitlist) and active control groups (e.g., attention-matched activities), suggesting that the observed benefits of CAT are not solely due to novelty or attention effects.”
    Quote in the paperSubstantial claim
84 of 84

  • The authors state this as an assumption.

    For studies included in the analysis, if the presence of a handler was not explicitly stated, a handler was assumed to be present because this is standard practice in CAT.

    “For studies included in our analysis, if the presence of a handler was not explicitly stated, we assumed a handler was present since this is standard practice in CAT.”

  • The paper relies on this without support.

    Egger's test has low power to detect small-study bias when there are few studies.

    “Even though we did not find significant results for small study bias, it is still important to note that Egger’s test has low power to detect this bias when there are few studies.”

  • The paper relies on this without support.

    There are no standardized thresholds for session length in canine-assisted interventions.

    “Currently, there are no standardized thresholds for session length in canine-assisted interventions.”

  • The authors state this as an assumption.

    The trim-and-fill procedure assumes that funnel plot asymmetry is solely due to publication bias.

    “the trim-and-fill procedure assumes that funnel plot asymmetry is solely due to publication bias and may not perform well when substantial heterogeneity exists.”

  • The paper relies on this without support.

    There is no standardized theoretical framework for evaluating the effectiveness of AAT/CAT.

    “Currently, there is no standardized theoretical framework for evaluating the effectiveness of AAT/CAT, leading to wide variations in intervention protocols, treatment goals, and outcome measures.”
5 of 5

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Consistentz = -5.99reported p < .001 · recomputed p < .001

    “z = -5.99, p < .001”

  • Consistentz = -1.27reported p = .21 · recomputed p = .204

    “(z = -1.27, p = .21”

2 of 2

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Ward-Griffin effect is called significant and nonsignificant

    Minor

    The main-effect paragraph calls Ward-Griffin's effect significant, but also lists study [68] among those without statistically significant effects. Its reported confidence interval includes zero.

  • Trammell's Table 2 citation points to a different study

    Minor

    Table 2 labels Trammell as reference [68], whereas reference 68 is Ward-Griffin.

  • Risk-of-bias ratings do not total 75

    Minor

    The three reported rating counts sum to 72, not 75, leaving three outcomes unaccounted for.

    Reported 75 · recomputed 72

3 of 3

Citations

Cites

Flagged first, then by citations

Research works printed but not linked: 3

  1. McNicholas J. G.M. Collis 2006 Animals as social supports: insights for Understanding animal-assisted therapy. Handb animal-assisted Therapy: Theoretical Found Guidelines Pract 2 49–72.
  2. Animal-Assisted Psychotherapy Theory, Issues, and Practice, ed. N. Parish-Plass. 2013: Purdue University Press.
  3. Haefelin N, et al. Anxiety reduction in college students after brief interaction with a therapy dog or animatronic dog. North Am J Psychol. 2020;22(3):411–411.

Cited by

Sorted by citations

Related

Metadata

Authors
Sim, S. Q., Liu, Z., Wu, Z., Wang, S., & Nisa, C.
Affiliations
  • Duke Kunshan University (CN)
  • Duke University (US)
  • Boston College (US)
Corresponding author
Nisa, Claudia
ORCID
Venue
BMC Complementary Medicine and Therapies
Publisher
Springer Science and Business Media LLC
Published
2025-08-12
Volume
25
Issue
1
Pages
303-303
ISSN
2662-7671 (ISSN-L)
DOI
10.1186/s12906-025-04955-2
PMC
PMC12341270
OpenAlex
W4413113383
Semantic Scholar
11e2d3487dda6dcee1d4ad7d577beb5e305a8319
Cited by
14
References
65
Citations by year
2026: 12 · 2025: 2
FWCI
1.54
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Complementary Medicine and Therapies (publishedVersion, cc-by-nc-nd)
  • Research Square (acceptedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Life Sciences › Agricultural and Biological Sciences › Animal Science and Zoology › Human-Animal Interaction Studies
  • Social Sciences › Psychology › Social Psychology › Music Therapy and Health
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
dog-assisted therapy, human-animal interaction, university students, stress, anxiety, mental health, student psychological well-being
MeSH terms
Animals, Anxiety, Dogs, Humans, Stress, Psychological, Students, Universities, Randomized Controlled Trials as Topic, Animal Assisted Therapy

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

A language model drew the claims from the paper on 2026-11-10, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).

A second model labelled each claim on 2026-11-10 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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