Animal-Assisted Interventions for Trauma-Exposed Children and Adolescents: A Systematic Review

Purpose: Animal-assisted interventions (AAIs) are widely used with trauma-exposed youth, yet whether the animal adds benefit beyond the accompanying therapy is unclear. Methods: Five databases were searched from inception to August 2026. Eleven studies yielded 73 effect sizes; uncontrolled pre–post and controlled between-condition effects were modeled separately. Results: Most studies were at serious or critical risk of bias. During participation, youth improved from posttraumatic stress ( g = 0.70, 95% confidence interval [CI] [0.20, 1.20]) and internalizing symptoms ( g = 0.59, 95% CI [0.24, 0.94]); other domains were positive but imprecise. In four controlled comparisons, no domain showed a detectable AAI advantage; the posttraumatic stress point estimate favored the comparators ( g = −0.30, 95% CI [−1.47, 0.87]) but did not establish a difference. Discussion: Improvement during participation was observed, but incremental benefit was not. AAIs are best considered potential engagement adjuncts requiring direct evaluation rather than stand-alone trauma treatments.