In hospital wards, the dog matters more than the handler

Doges Editorial · 2026-06-30 · 6 min read

A 2025 randomized trial — the first of its kind — compared therapy dog visits, handler-only visits, and standard care for psychiatric inpatients at VCU. Loneliness improved with the dog present. It didn't improve when the handler came alone. The center running that trial has been building toward that answer for 25 years.

A program that started with a single question

In June 2001, a psychiatrist at Virginia Commonwealth University named Sandra Barker started asking what happened to people's health when a dog came into the room. She turned that question into a research center — the Center for Human-Animal Interaction, or CHAI — and attached to it a hospital-based therapy dog program she called Dogs on Call. It was among the first of its kind in the United States. Twenty-five years later, Barker's successors have co-authored more than 200 peer-reviewed studies, published five books on animal-assisted services, and helped researchers on multiple continents build similar programs.

The program's current director, Nancy Gee, PhD, describes Barker's foundational contribution without ceremony: she "literally wrote the book on how to set up therapy dog programs, like our Dogs on Call." Those books are now used by hospitals, universities, and clinical training programs around the world.

What 300,000 interactions looks like in practice

Numbers can feel abstract, but 300,000 is the count for just the last five years: the number of times a trained volunteer handler and a certified therapy dog walked into a patient's room at one of VCU Health's locations across Virginia, sat with a nurse on a difficult shift, or spent twenty minutes with someone who had been struggling through a run of bad days in a psychiatric unit. Not in the program's full lifetime — just the last five years.

The Dogs on Call dogs are not employees. They are volunteers — accompanying trained human handlers who have gone through a rigorous certification process to enter hospital spaces. They work regular shifts, visiting patients and healthcare staff alike. They are, consistently, the most-requested form of supplemental support that patients ask for when admitted.

For many patients and their family, the visits offered a small but meaningful break from their harsh reality — a moment where the focus shifted away from illness and treatment to becoming fully present with the dog.

What the research has actually found

The question CHAI has spent 25 years trying to answer precisely is not whether dogs feel nice to be around — that's obvious — but whether the benefit is specific and measurable enough to justify the infrastructure. A study published in February 2026 in Frontiers in Psychiatry, led by Nancy Gee and funded by the Human Animal Bond Research Institute, moved that question forward in a concrete way (doi:10.3389/fpsyt.2025.1582767). It was the first randomized controlled trial to examine the impact of therapy dog visits on loneliness in adults hospitalized for acute psychiatric treatment.

The trial used three arms: visits from a Dogs on Call team (dog plus handler), visits from a handler alone, and standard care. Patients hospitalized for five or more days were enrolled. Across both older adults and adults with mental illness, loneliness and anxiety improved in the dog condition. In the handler-only condition, they did not. That gap is the finding that matters: it tells researchers the dog is not simply providing an excuse for a warm human interaction. Something the dog itself brings — the particular quality of a non-judgmental, present animal — is doing measurable work that a person alone cannot replicate.

Older program data from Dogs on Call adds texture to those trial results. In patients receiving electroconvulsive therapy — a procedure that produces significant anticipatory anxiety — a Dogs on Call visit before the session reduced fear by 37% and anxiety by 18%. In a survey of 407 patients, 99% said the visit was helpful. Healthcare workers who spent five minutes interacting with a therapy dog showed a statistically significant reduction in salivary cortisol, the body's primary stress hormone. The benefit runs in both directions through the ward.

A Danish researcher and the ripple outward

One measure of a research program's influence is who travels to study it. Lene Høeg Fuglsang-Damgaard, a PhD scholar at Aarhus University in Denmark, crossed the Atlantic specifically to spend time with Nancy Gee and observe how Dogs on Call had grown from an initial idea into a structured, evidence-based institution. Her goal was practical: dogs are not currently approved to work in Danish hospitals, and she wanted to understand what it would take to change that.

Working with researchers around the world has been an absolute pleasure because they bring unique perspectives to our understanding of human-animal interaction. It's interesting to see how different cultures interact with animals and how we might consider adapting new ways to achieve the best benefit for both humans and animals.

Fuglsang-Damgaard shadowed the dog-handler teams during their hospital shifts — watching from the doorways of patient rooms as the interactions unfolded. The experience clarified something she had understood abstractly: getting dogs into hospitals requires not just goodwill, but a solid scientific foundation that can persuade healthcare administrators and health ministries that the benefit is real and the risk is managed. She returned to Denmark with both the data and the framework.

Why the dogs have to enjoy it too

One of the less obvious findings from 25 years of research is how much the dog's own experience during a visit matters — not just ethically, but scientifically. An anxious therapy dog produces a different kind of interaction than a calm, engaged one. Dogs who are stressed, overtired, or simply not suited to hospital environments do not produce the same measurable benefits for the patients they visit. That means monitoring the dogs is not optional; it is part of the methodology.

Here at CHAI and in our Dogs on Call program, the dogs are our partners in the process. It is crucial for us to advocate for their needs to help them enjoy the process of interacting with other human beings.

CHAI's protocols include ongoing behavioral assessment of the therapy dogs themselves. Dogs that show signs of stress or disengagement during visits are not simply pushed through. The program's position is that a dog who does not want to be in the room is not a therapy dog — it is a dog in the wrong job. Matching the right dog to the right environment, and reading that match across a career of shifts, is part of what makes the program work.

The next chapter for animal-assisted research

CHAI is currently deepening a collaboration with Purdue University College of Veterinary Medicine, whose Center for the Human-Animal Bond approaches the subject from the animal welfare side. The pairing is deliberate: CHAI focuses primarily on human health outcomes; Purdue centers the animal's experience. Together, they are planning a joint conference to map research gaps in the field, and looking further ahead, a coalition of centers capable of running the large-scale multi-site studies that the existing literature has not yet been able to produce.

At 25, the program Barker started with a question has produced a body of evidence being used to shape policy, clinical practice, and hospital design in ways that would have seemed ambitious at the time of founding. The dogs on the current roster don't know any of that history. They know their handler, their route through the wards, and — apparently — that walking into a hospital room and settling at a patient's bedside is something worth getting up for.

This story was reported by Mia Stephens and Sara McCloskey-Nieves for VCU Health and published June 25, 2026.