{'fraction_non_alphanumeric': 0.02245334370139969, 'fraction_numerical': 0.007484447900466563, 'mean_word_length': 5.024004683840749, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 1, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
ANIMAL ASSISTED THERAPY AND OCCUPATIONAL THERAPY

The therapeutic relationship between the therapist and the client is considered as a primarily goal for treatment and a significant factor for the programme success. In recent years, the scientific community has brought to light more and more findings concerning the human-animal bond. Many therapists are already incorporating Animal Assisted Therapy into their program as a complementary method. The Occupational Therapist, by introducing an animal to his sessions and using it as a therapeutic tool to achieve communicative, motor, mental, emotional and sensory goals can greatly benefit the patient. Scientific studies should be carried out in Greece in order to draw conclusions that will help all members of the interdisciplinary team to integrate an animal into the pre-treatment process taking into account factors that affect both one's health and ethical use of the animal.


INTRODUCTION
Animal Assisted Therapy is defined as "the incorporation of an animal into the immediate environment of a person or group as a means of interaction for a therapeutic purpose". 1 The term is also known as "Pet Therapy" and nowadays, it is applied in a wide range of therapeutic benefits, such as developmental disorder centres, special education, nursing homes, rehabilitation centres, psychiatric centres and hostels, as well as hospitals. [2][3][4][5] Occupational Therapy uses the therapeutic relationship as a key therapy. According to Cole and McLean6 there is a great connection between the therapeutic relationship and the positive effects of an intervention. The Occupational Therapist is called upon to utilize the natural bond which humans have with animals, integrating the latter into occupational therapeutic practice both on an individual and on a group basis depending on the goals and structure of the therapy, so as to promote motor, mental, sensory, social and psychological skills of the individual and to adopt functional roles and interests for the benefit of the patients. Bowlby 7 borrowed the central concept of bond or attachment from the life science. That is to say, human beings, like all mammals, are distinguished from the bond system, a behavioural and self-perpetuating system ensuring the survival of the new-born. This system acts as a genetically determined predisposition, guiding the infant's behaviours to "attach" to people who are able to provide care. An example of such behaviour is crying, which controls and gives feedback when distance to the parent increases threateningly to the infant's bonding system.

THE HUMAN-ANIMAL BOND
In recent years, researchers have shown that attachment theory can be extended to individual disciplines, providing a very useful framework for understanding the relationship between people and animals. 8 Early on, Levinson 9 argued that a pet is a natural attachment object, much more suited to lifeless or abstract or symbolic objects. The bond between an individual and a pet clearly demonstrates that it often fulfils all four criteria for an attachment relationship, namely, proximity seeking, safe haven, secure base, and stress reduction. 10 According to Bowlby, 7 a prerequisite for positive therapeutic change is the ability of the therapist to act as a means of improving safety by acting as an attachment figure. This approach assumes that a pet can facilitate the formation of an attachment bond that may be relatively free of maladaptive predictions and can therefore help therapists revise maladaptive bonding patterns. People tend to experience relationships with a pet in the same way they handle interpersonal relationships. 9 Pets are uncritical, offer unconditional love, they are faithful, and most of the time they pose no threat to humans. According to Cusack,11 ''love for an animal can be easier than love for a human being, as animal love in general does not require any decision'' (p.9). With a pet, individuals can feel safe, accepted, loved and thus unable to automatically display their maladaptive bonding patterns. Levinson 12 believed for children whose parents did not respond well to their developmental needs, that a pet might be in position to fill some of their needs: "These children have experienced so much harm in the hands of people of their immediate surroundings that when they develop a satisfying relationship with an animal they can make a new start in the development of a genuine human relationship'' (p.35).

Animals and physical health
Pet animals can improve human physical health in the short term, providing health benefits that last for seconds or even minutes. Caressing an animal has repeatedly been shown to cause transient decreases in blood pressure and heart rate. [13][14][15] Pointing in the same direction was the observation that the presence of a dog helped to lower the increased blood pressure in children who had to read aloud in front of the class. 16 It was also recorded that the presence of a pet dog or cat resulted in lower heart rate and blood pressure compared to that of a friend or spouse for people exposed to psychologically stressful factors. 17 Even movie screening with animals can serve as a viable alternative to stressful situations. 18

Animals and Mental Health
Pets can also contribute to people's psychological well-being.
Research has shown that animals can improve the effects of potentially stressful life events (e.g. mourning, divorce), help reduce levels of stress, loneliness, and depression, 20 and enhance emotions of autonomy, responsibility, and self-esteem. 21 Pets can facilitate social interaction between people. Pets, and especially dogs, have long been popular for their important role in socialization. For example, walking with a dog significantly increases the chance of having conversations with total strangers in comparison to walking alone. 22 Hunt, Hart, and Gomulkiewicz 23 found that a woman sitting in a park was approached by passers-by significantly more each time she was accompanied by an animal, such as a rabbit or a turtle, than when she was simply sitting alone. Bernstein and his col-

Animals and family function
The family as a system benefits from having a pet. Pets provide care, selfless love, respond to many human needs and provide psychological and social support. 26  Caring for of an animal is also a therapeutic functional occupation. 30 Taking care of an animal is a project that can contribute to the emotional state of an individual and to the structuring of a daily routine. It also acts as a means of social integration as it reduces 'stigma' and provides opportunities for social interaction. The social environment sees an animal owner rather than a person with a disability, and there are more opportunities for interaction, even only through eye contact. 31,32 Owners of animals have a sense of responsibility for someone else and their daily schedule is structured around routines which involve feeding, watering, cleaning equipment and space, training and medical care of the pet. 33 Even fish, birds, turtles, rabbits or hamsters can easily be used in classrooms or treatment rooms with the disadvantage of the small life span they may have. The programme ''Puppies Behind Bars'' is one of many programmes in prisons and penitentiaries which integrate animals in an effort to teach inmates the value of offering to the community. 34 In other programmes, it has been found that the care offered by inmates to rescued horses improves psychological function and reduces prison recidivism rates. 35

Animals as a means of developing skills
The positive effects of horse-riding date back to early European history, when therapists used them as a means of treatment for physical ailments and for psychological well-being. 36 Horse therapy is based on scientifically documented practice and The introduction of a dog into a psychodynamic therapeutic session as an assisted means has received particular attention. 55 The dog is an animal that can be easily incorporated into the Occupational Therapist session. In a study involving a dog in the treatment of a child in the autistic spectrum, the results showed that supervised interaction with the dog increased positive social behaviour, reduced self-absorption, and (2020), Volume 6, Issue 3 Vakrinou & Tzonichaki 89 https://ejournals.epublishing.ekt.gr/index.php/HealthResJ reduced stereotypical behaviours. 56 Similarly, children in the autistic spectrum were found to have increased intrinsic motivation for play, common attention, and social interaction in the presence of the dog in the therapeutic context. 57 In addition, dogs play such an important role in a child's social and communication development, that a carer may not be able to provide to such a degree because the child and the dog often interact in ways that are not recognizable by adults. 58 The alternative intervention in the therapy with the introduction of the dog seems to be effective in improving a child's social skills. The presence of the dog also helps to improve the physical, social, emotional and cognitive function of the child. 59  Finally, just as humans want to feel safe, so pets need protection and proper regulation of their needs for survival. In addition, they are also affected by disorders such as separation, abandonment, and loss. Therefore, they also need to feel connected with people, protected and secure.

CONCLUSION
Therapists who integrate an animal into the therapeutic process aim to improve the motor, sensory, mental, functional, emotional and social lives of the individuals they serve. We are in the midst of a change that makes it necessary for occupational therapists to educate themselves on human-animal bonding, the various issues related to animal ownership and their integration into therapeutic planning. 64 Existing studies appear to confirm the efficacy of animal assisted therapy. 5 Studies should be carried out in Greece as well, in order to draw conclusions which will help all members of the interdisciplinary team to integrate an animal into the preliminary treatment process taking into consideration factors which affect an individual's health such as allergies or injuries caused by the animals themselves or the hygiene of the environment.