Human-Animal Interaction in the Program Structure: A Case Study of Recuperation Process among Persons who used Drugs (PWUDS)

Human-Animal Interaction in the Program Structure: A Case Study of Recuperation Process among Persons who used Drugs (PWUDS)

Nihaya P. Modiaba, Rsw

Faculty of Graduate School, Lourdes College Capistrano St., Cagayan de Oro City

INTRODUCTION

Substance use is a widespread social concern among an estimated number of 279 million individuals involved (Lui et al., 2022).  Approximately 1.8 million Filipino individuals have abused drugs (Gershman, 2016). Three thousand eight hundred sixty-five (3,865) were admitted in seventy (70) treatment and rehabilitation facilities wherein sixty-two (62) are residential and eight (8) are for outpatient (Dangerous Drugs Board, 2022).

Excessive substance use led to substance use disorder, a chronic and recurring illness that is manifested by a persistent dependence on addictive drugs, despite their detrimental effects on the user and the community (Koob et al., 2010). Exposure and experience with substance use pose threatening risks that increase the possible emergence of physical illnesses and contribute to the existence of dysfunctional society that would eventually manifest in criminal acts. To address this, organizations and governments have made extensive effort to research various treatments, approaches and intervening modalities against substance use disorder.

Common approaches in rehabilitation centers are multidisciplinary approach and therapeutic community approach. Multidisciplinary approaches offer skills of mental health professionals such as psychiatrist, clinical psychologist, social worker, occupational therapist, or other practitioners from similar disciplines in mutual interest with the families for the benefit of the drug dependents. Therapeutic community approach sees addiction as a symptomatic manifestation of a more complex psychological problem where emotional, social, physical and spiritual values are considered to address what effectuates the presenting problem. It is a program with structure where the community is used as the primary approach to facilitate behavioral and attitude change. The individual is provided with information and the importance to change from being a part of the community (Dangerous Drug Boards, 2022). However, no single approach was proven to be the best fit in treating substance use. Emerging approaches in addiction recovery are considered, adapted, and utilized to bring forth the best service in reconciling addiction problems ending its detrimental effect to the society at large.

Human-Animal Interaction in the field of psychology is a fascinating and growing trend in human psychopathology.  It is an approach where animals are used to relieve human stress, alter mood, elicit affection, and produce positive emotion (Beetz, et al., 2012). Animals were already used in the treatment and rehabilitation of patients’ way back in 1980’s mostly in penology and psychiatric settings. Existing literature suggests its possible potent efficacy during that time. Florence Nightingale, the founder of modern nursing, said that “A small pet animal is often an excellent companion for the sick”. She made a significant discovery regarding Animal Assisted Therapy (AAT) and it was observed that pets showed decreased anxiety in children and adults living in psychiatric institutions. Furthermore, AAT became a treatment for anxiety and as a method to relax (Ernst, 2014). The potential of human-animal approach in treating substance use addiction was initiatively applied by Dr. Melhammid C. Tomawis, Chief of hospital in Department of Health Drug Abuse Treatment and Rehabilitation Center-Agusan del Sur. He believes that animal and human interaction create a pathway that reset the human mind to its roots and nature. Exposing a person with addiction to nature and animals enables the human essence to flourish and find meaning to every happening and purpose to life’s upbringing. Hence, his vision to addiction treatment paved opportunities to generate and explore the role of animals in drug treatment and rehabilitation.

To explore the role and effects of animals as part of the treatment structure in the rehabilitation center, the present study employed a case study approach. It explored the contribution of integrating human-animal interaction in the treatment structure of drug dependents.  It is expected to foster self-discipline and develop a sense of responsibility. More so, this present study provided further understanding and examination to human-animal interaction as an approach in substance use intervention and potentially be a promising treatment modality.

BACKGROUND OF THE STUDY

Drug addiction has been a global problem for many years. According to the report of the United Nation Office on Drugs and Crime, approximately two hundred eighty-four million (284,000,000) individuals aged fifteen (15) to sixty-four (64) globally were engaged in drug use. The prevalence of drug use has notably increased by twenty six percent (26%), surpassing levels observed in the previous generation in many countries from ten (10%) as baseline (UNODC, 2020). In the Philippines, there are three thousand eight hundred sixty-five (3,865) admissions from the seventy (70) treatment and rehabilitation facilities. The increase in admission is attributable to the operation by varying rehabilitation facilities and the volunteerism of the Persons Who Use Drugs (PWUDs) to undergo treatment and rehabilitation as substantiated by almost forty-one percent (40.78%) of submission and twenty-nine percent (29.00%) cases who availed of plea bargaining (Dangerous Drugs Board, 2022).

The incidence of drug use in the international and local community has led to the establishment of many drug treatment and rehabilitation centers. In the Philippines, during the administration of President Rodrigo Duterte, there were several abuse treatment and rehabilitation centers that were established including the Mega DATRC located at Nueva Ecija which was envisioned to cater up to ten thousand (10,000) patients.

Today there are forty-four (44) drug treatment and rehabilitation centers in the country accredited by the Department of Health. The biggest is located in Mindanao in terms of land area which is located in Malaybalay, Bukidnon covering up to five hectares.

Problem Statement

Drug use affects physical and mental health of a person (Nick, 2023). Persistent use poses a damaging effect. As such, second-hand smoking was seen to increase cardiovascular disease and lung cancer to people who are not smoking by merely inhaling the smoke residue coming from the smoker. To add, alcohol addiction posits the majority of vehicle-related fatalities as the driver tested for positive in both substance and alcohol use (Nick, 2023). Parents with substance use disorder often raise their children out of neglect and abandonment, this situation could lead to the child’s mental health issues and possible emergence of drug use addiction. Drug use was also seen as the top leading problem in commission of major crimes (Nick, 2023).

This present study has identified three major gaps: evidence, knowledge, and population (Miles, 2017). Previous studies focus more on animals such as dogs and cats as therapy animals in penology or psychiatric settings. In this study, as observed, equine assisted therapy, livestock animal engagement, and social responsibility reflection are factors to consider in the human-animal interaction in addiction recovery.  It addressed the knowledge gap by providing substantial information to the limited studies involving human-animal interaction. By selecting both male and female Person Who Used Drugs (PWUDs) as recovering drug dependents, this research offered adequate data on the under-studied population. Lastly, this research had established interest in human-animal interaction and propagated its usability in rehabilitation facilities and community-based rehabilitations.

Purpose of the Study

The purpose of this qualitative case study was to explore the implementation of human-animal interaction (HAI) as a treatment modality embedded in the recuperation program structure for individuals with substance use disorders (SUDs) at an inpatient rehabilitation center. Human-animal interaction is generally defined as a structured engagement between PWUDs and animals to foster emotional, psychological, and physiological healing.

Theoretical Perspectives

This research is anchored with Urie Bronfenbrenner’s (1980) Bioecological theory of development and Murray Bowen’s (1966) Family System’s Theory. Bioecological theory of development is widely recognized and has had a significant impact on various disciplines, especially in the social sciences and fields related to human development. The theory posits that human development is not solely determined by internal factors or genetics but is shaped by the dynamic and reciprocal interactions between individuals and their environment. The bioecological theory emphasizes the transactional nature of human development, where individuals actively engage with and are influenced by their environment, and vice versa. It’s a bidirectional process where both the individual and their environment contribute to developmental outcomes. The theory introduces the concept of ecological systems, ranging from the immediate microsystem (family, peers) to broader meso-system (interactions between microsystems), ecosystem (settings indirectly affecting the individual), macro system (cultural beliefs and societal norms), and the chronosystem (changes over time). These systems collectively shape the individual’s development (Bronfenbrenner et al., 2007).

At the microsystem level, animals provide nonjudgmental companionship, which can reduce feelings of isolation, anxiety, and stress. For example, in rehabilitation settings, interacting with an animal creates a safe and supportive space for individuals, allowing them to express emotions and process difficult experiences. Essentially PWUDs fosters trust and emotional regulation, helping them develop healthier coping mechanisms. Additionally, caring for animals introduces structure and responsibility into daily routines, which can be especially beneficial for PWUDs as it promotes accountability and purpose.

Human-animal interaction aligns to the mesosystem level because it fosters interconnections by serving as a relational tool that strengthens bonds across systems. For instance, animals in therapeutic settings can enhance communication and trust between participants and counselors, bridging gaps in understanding and creating a neutral, calming space for engagement. Human-animal interaction also strengthens family involvement in recovery by providing a shared focus that fosters cohesion between home and therapy environments. Additionally, animals can serve as social facilitators in community-based activities, helping individuals in recovery build connections with peers, staff, and broader support networks. By linking these microsystems, human-animal interaction promotes collaboration, trust, and emotional support, making it an effective intervention for holistic recovery and social reintegration.

The theory acknowledges the importance of recognizing individual differences and the unique qualities that individuals bring to their developmental context. The same environment may impact individuals differently based on their characteristics and experiences. Dysfunctional family relationships, peer pressure, neglect, and parenting styles are common factors affecting the development of substance use disorder (Zimic & Jakic, 2012). The bioecological theory posits that individuals’ interaction with the environment underwent a bidirectional process where the interaction contributes to the developmental outcomes of the person. Personal experiences from society will collectively shape the person.  A neglectful family, experienced trauma and negative situations greatly affects a person’s worldview thus positively or negatively resulting in the development of substance use related addiction problems.

Moreover, the theory was complemented by Family Systems theory by Murray Bowen. The theory states the importance of the family as a crucial environment for the development of individual character traits and behavioral patterns. It suggests that the family plays a central role in shaping an individual’s personality and actions. The family was considered a primary or fundamental social unit where individuals first learn about relationships and social interactions. It is within the family that people typically form their initial bonds and connections. The family serves as a learning environment where individuals acquire and reinforce their character traits and behaviors. This process can involve observing, imitating, and internalizing the attitudes and actions of family members. Family members contribute significantly to the socialization of individuals. Socialization is a lifelong process through which individuals learn the values, norms, and behaviors of their culture. The family is a key agent in this process. Positive behaviors are likely to be reinforced through encouragement and support within the family, while negative behaviors may face correction or consequences. This reinforcement process can contribute to the establishment and perpetuation of certain behavioral patterns such as in substance use addiction (Johnsons, 2016).

Bioecological and family system’s theory integrate the assumption of the present study by explaining how disruption of one’s subsystem in the family can affect the whole system. Similarly, if one family member was not able to perform the task due to the perceived negative effect of substance use disorder it could greatly affect the entire family’s social functioning. The goal of this study was to explore and unfold the effects of relationship dimension through qualitative approach.

Research Questions

The study aimed to address the following:

• What is the experience of PWUDs in the recuperation program?
• What is the experience of PWUDs in interacting with animals as part of their program structure?
• How do the PWUDs relate their interaction with animals to enrich their sense of responsibility?
• How does the PWUDs’ interaction with animals enhance their sense of human dignity?

Significance of the Study

The present study would significantly contribute to the understanding, role, and effects of animals in the treatment and rehabilitation of recovering drug dependents. It recognizes the applicability of human-animal interaction as a treatment modality in addiction recovery and in mental health. More so, the present study had provided substantial information in consonance to the possible catalyzing-efficacy of human-animal interaction in substantiating holistic and therapeutic community approaches. To the rehab professionals and clinicians, the present study had generated intervention programs utilizing the animals as a form of therapy and to hopefully adopt Human-animal interaction as possible treatment modality for Substance Use Disorder (SUD).

Definition of Terms

This portion of the paper describes the definition of some words that were used in the study. This is to ensure that readers have a clear and common understanding of key concepts and terminologies used in the study.

 Recovering drug dependents.  This term refers to persons or individuals with drug dependency or clinically diagnosed with substance use disorder that are undergoing rehabilitation treatment programs for recovery.

Human-animal interaction.  This term refers to the mutual and dynamic exchanges between human and animal and its psychophysiological effects on humans (Griffin et al., 2011).

Therapy.  This term refers to a series of treatment modality intended to relieve or heal substance use disorder.

PWUDs (Persons Who Use Drugs). This term refers to any person who is using illegal substances.

LITERATURE REVIEW

This chapter provides an overview of Substance Use Disorder and the Therapeutic Community approach, offering insights into the evolution of understanding Substance Use Disorder over time. It also explores the integration of human-animal interaction within correctional facilities as part of the treatment and rehabilitation efforts.

Substance Use Disorder History and Current Situation

Substance abuse and addiction are complex issues that have affected societies throughout history with the use of psychoactive substances having deep historical roots. While some substances have been used for medicinal or ceremonial purposes, the misuse and addiction to these substances have led to significant public health concerns (Gahlinger, 2004). The understanding of addiction as a medical condition has developed over time. Addiction is often stigmatized and viewed as a moral letdown. It was not until the 19th and 20th century where medical and scientific communities began recognizing addiction as a complex disorder with biological, psychological, and social components (Gahlinger, 2004).

A study conducted by Levinstein on morphine addiction (1875) liberated the stigma associated with drug abuse. During his time, the phenomenon of addiction was not well understood. Levinstein’s work contributed to the evolving understanding of the nature of opioid dependence. His observations highlighted key aspects of morphine addiction, including the prioritization of obtaining and using the drug, even when users were facing adverse life situations. This intense preoccupation with the substance, often to the detriment of personal and social well-being, is a characteristic feature of addiction (Musto, 1996). Additionally, he noted the curious phenomenon of withdrawal associated with opioid addiction. Withdrawal symptoms, which include physical and psychological distress, occur when an individual dependent on opioids suddenly reduces or stops using the drug. The discomfort of withdrawal can be a powerful motivator for continued drug use (Musto, 1996).

“Early humans discovered that eating some plants gave a feeling of relaxation, happiness, drowsiness, or peace, and some gave a feeling of increased energy, alertness, and stamina. While others cause strange sensations, terrifying visions, or a profoundly different awareness” (Gahlinger, 2004). The historical use of various psychoactive substances, including alcoholic beverages and plants with mind-altering properties, is well-documented across different cultures and regions. Mead, an alcoholic beverage made from fermented honey, has a long history and is often associated with early cultures. It predates the cultivation of grapes for wine and grains for beer (Durant & Thakker, 2003; Page & Singer, 2010). The production and consumption of beer and various fruit wines are traced back to ancient times. The Sumerians, for example, had a well-established beer culture. Indigenous cultures in South America, particularly in the Andean region, have a long tradition of chewing coca leaves. Coca leaves contain stimulant alkaloids, including cocaine. Cannabis has a long history of use in ancient China for medicinal and possibly ritualistic purposes. It was valued for its various properties (Durant & Thakker, 2003; Page & Singer, 2010). The use of psychoactive substances, or drugs, has been a nearly universal phenomenon throughout human history and across various societies. People have ingested substances for a wide range of reasons, including medicinal, religious or spiritual, recreational, and social purposes. The historical and cross-cultural prevalence of drug use reflects its multifaceted roles and significance in human societies (Goode, 2008).

In the Philippine, President Rodrigo R. Duterte launched an aggressive and controversial anti-drug campaign. His campaign was often referred to as the “war on drugs” which aimed to address what Duterte perceived as a severe illegal drug problem in the country. As president, he argued that drug abuse was causing considerable harm to Filipino families and was a threat to the future of the youth (Simbulan, et al., 2019). Duterte has been known for his vocal and forceful advocacy against illegal drugs. He has consistently emphasized the urgency of the issue and called for strong measures to eradicate the drug trade. The campaign involved intensive law enforcement operations targeting drug users, peddlers, producers, and suppliers. Police forces were given significant authority to conduct anti-drug operations, resulting in thousands of arrests (Simbulan, et al. 2019). Although the intention of the campaign was good, it was being questioned by the international community because of alleged multiple human rights violations and extra-judicial killings. Despite the negative feedback and questionable implementation of the campaign, the administration was able to put many drug users, drug pushers and drug personalities behind bars. It also encouraged voluntary submission among drug users and most importantly, the establishment of many DOH accredited treatment and rehabilitation centers.

Therapeutic community approach

Therapeutic Communities (TCs) are typically in-house settings where the communal structures and interactions serve as catalysts for change, and individual recovery is guided by twelve (12) step self-help programs. The typical duration of stay in these communities ranges from 6 to 24 months, with an average length of about 12 months. Within these communities, members navigate through different phases in their recovery, marked by evolving roles and responsibilities (De Leon, 2020).

In the DOH Drug Abuse Treatment and Rehabilitation Center, there are certain stages in the program structure that every resident must pass. There are various activities that need to be completed in order to proceed to the next level of treatment. The first phase is called the crew phase, the second phase is the junior phase, third is the senior phase and the final phase is the Re-entry phase. The residents were given specific functions in the community which will also serve as their evaluation to continue to the next phase of the recovery program. Other than that, the residents were also given examinations, and case defense, if they pass these, then they are allowed to proceed to the next phase. The head of the community which are called Officers collectively ensures day-to-day functioning of the community. Days were highly structured which involved group and individual sessions, as well as time for community and personal chores and self-development, such as exercise, vocational time, and educational time. The officers, with the aid of the facility staff, were given authority to give sanctions to the residents who do not follow the structure and the rules and regulations of the community. TCs have been successfully adapted to serve special needs populations, such as adolescents, patients with mental health disorders, patients with HIV infection, and women with children. Successful completion of the TC program has shown to lead to a significant decrease in Substance Use Disorder. Nonresidential TCs are also available and may be more cost-effective for patients with less severe social problems to address (NIDA, 2002). In DOH Drug Abuse Treatment and Rehabilitation Center, there was an Outpatient program targeting PWUDs with less severe drug dependency.

Origins of animal facilitated interventions

Numerous studies have explored the positive effects of companion animal ownership and interaction on human well-being, encompassing both physiological and psychological dimensions. Companion animals, such as dogs and cats, have been shown to contribute to the reduction of stress levels in their owners. Dog owners, in particular, may benefit from increased physical activity through activities like walking their dogs, leading to better heart health.

The calming effect of petting or spending time with a companion animal may contribute to these positive cardiovascular outcomes (Hosey, et al., 2014). The companionship provided by animals can be particularly beneficial for individuals dealing with stress, depression, or loneliness. Companion animals, especially therapy animals, have been used to help individuals cope with fear and anxiety. The presence of a trusted animal companion can provide a sense of security and comfort (Hosey, et al., 2014). Emotional support animals are animals that are not trained to perform specific tasks but provide comfort and emotional support to individuals with mental health conditions they are often prescribed by mental health professionals as part of a therapeutic treatment plan. Service animals are specifically trained to perform tasks or work that assists individuals with a disability. The tasks that are performed by the animal and are directly associated with the person’s disability. Therapy animals are trained to provide comfort and affection to people in settings such as hospitals, nursing homes, schools, and disaster areas. They are not owned by the individuals they visit but rather by handlers who take them to specific locations to provide therapeutic benefits (Dizon, 2023).

Human- animal Interaction in correctional facilities

Several studies showed the people who are in correctional facilities often feel loneliness, uncertainty and lack of social support exacerbated with struggles of incarceration. Correctional facilities face various challenges, such as overcrowding, limited resources, and security concerns. These conditions can make it difficult to create an environment that fosters meaningful interpersonal connections among inmates and between inmates and staff (Smith, et al., 2023). Individuals in prison who experienced mental illness are more prone towards having insecure attachment style; they may exhibit a higher likelihood of engaging in violent behavior towards others (Smith et al., 2023). Rehabilitation often emphasizes the positive impact of supportive and caring relationships on the rehabilitation of prisoners. These connections can contribute to a sense of belonging, emotional support, and motivation for positive change. In the last ten years, various rehabilitative programs within prison settings, incorporating animals have been implemented in Canada and several other countries (Smith et al., 2023).

In the study conducted to six (6) incarcerated males at Regional Psychiatric Center in Canada, it was found out that human and animal bond established between prisoner and therapy dog can function as alternative empathic relationship, aiding in the rehabilitation of prisoners. Aligned with attachment theory, this suggests that prisoners form a connection with therapy dogs which is built on trust and unconditional love as the dogs serve as substitute attachment figures (Smith, et.al, 2023). In this research, four key themes (safety, physical touch, reciprocity, and acceptance) were delineated to illustrate the formation of Human-Animal Bond (HAB) for Animal-Assisted Therapy (AAT) to the participants within the psychiatric facility or prison. The study underscored therapy dogs can effectively function as secure and surrogate attachment figures for the participants, alleviating feelings of withdrawal and facilitating the establishment of meaningful interpersonal connections (Smith et al., 2023).

Impact of drug addiction in the social responsibility

Drug use is intervened by both genetic and environmental factors and the interconnection of these aspects determine the likelihood that a person shall develop drug use related disorder (Strickland et al., 2014).

Substance use disorders (SUDs) can have widespread and profound impacts on various aspects of an individual’s life, as well as on the broader community (Daley, 2013). Families often experience a range of emotions such as fear, anxiety, anger, and frustration when dealing with a member who has a substance use disorder. Children may be particularly vulnerable to emotional distress, confusion, and feelings of abandonment. SUDs can disrupt the normal functioning of a family, leading to strained relationships, communication breakdowns, and lack of trust among family members. Roles within family may be altered, with children sometimes taking on responsibilities beyond their age. Individuals with SUDs may struggle to fulfill their roles as parents or caregivers, leading to neglect of their children’s needs. The risk of physical, emotional, or verbal abuse may increase within families affected by SUDs (Daley, 2013). Aside from that, there are also financial and legal concerns that the family will face such as job loss, legal expenses, and the cost of supporting the addicted family member’s habits. These financial strains can impact the family’s ability to meet basic needs and maintain a stable living environment. Legal troubles arising from the individual’s substance abuse can have direct consequences on the family, such as legal fees, potential imprisonment, and the associated stress (Daley, 2013).

Alignment to the RVM Pedagogical Perspective

This study on human-animal interaction as a therapeutic interaction for the PWUDs recuperation process is aligned with the RVM Pedagogical Perspective in it’s goal of transformative education for the welfare of the participants. The Pedagogical Perspective takes into account the social realities in it’s instructional processes and highlights the development of values. This study contributes to the enhancement of the school’s core values of service, faith and excellence, especially on service.

Alignment of the Study to the Graduate School Research Agenda

This study is in line with the Graduate School Research Agenda which is to improve and enhance the ability and research capability of personnel and students.  Furthermore, this study is aligned with SDG No. 3 which the Good Health and Well-being.

METHODOLOGY

The techniques and methodology employed in this study are covered in this chapter. It discusses the study’s research design, the primary setting of the study, research respondents, sampling techniques, data gathering procedures, and data analysis framework.

Qualitative Study

Creswell and Poth (2016) stated that a qualitative study is used because a problem or an issue must be explored. Qualitative research is chosen when the goal is to explore, understand, and interpret complex phenomena, especially those that involve subjective experiences, diverse perspectives, and variables that are not easily quantifiable. It allows researchers to engage with the richness and depth of the studied subject, capturing the nuances that might be missed by more quantitative approaches (Tenny et al., 2022)

Case Study

A case study is one of the most commonly used methodologies in social research. Case studies involve in-depth examination and analysis of a particular individual, group, event, or phenomenon within its real-life context. Researchers use case studies to gain insights into complex issues, understand unique situations, and explore the intricacies of social interactions and behaviors (Yin, 2014).

The study is grounded in PWUDs encounter with animals.  Their present experiences with animals in the rehabilitation center are assumed to have a more meaningful impact to them personally due to its emphasis compared to how they see their prior interaction with animals before undergoing substance use treatment and rehabilitation.

By collecting data, qualitative research brings attention to current issues or challenges, providing a more nuanced characterization of the circumstances. It goes on to elaborate on the experience through the identification of themes. Descriptive in nature, this form of research essentially outlines the phenomenon and its characteristics, relying entirely on data. This means that data gathering and analysis happen concurrently. Rather than delving into the reasons behind an occurrence, this study places more emphasis on understanding what has happened and how it unfolded.

Research Setting

The study will be conducted in one of the Treatment and Rehabilitation centers in Caraga Region.  The researcher conducted the data gathering at the premises of the facility where the participants were most comfortable. This include the counselling room or the classroom or activity area which is located inside the facility. As for the petitioner/their family / representative, the Focused Group Discussion (FGD) was conducted through online platforms such as Googlemeet and Zoom for immediate access and convenience.

Participants of the Study

The participants of this study were the PWUDs that are in the road to recovery, and therefore considered vulnerable. The researcher ensured that their rights are properly uphold by providing avenue to avenue and choice to participate and not participate in the study. The study was purposely chosen to help the agency improve the program and services for the clientele group. The participants of this study are Persons Who Used Drugs (PWUDs) specifically those who are in their Senior and Re-entry phase of the rehabilitation center. The center’s TC Modality consists of four phases in the treatment, namely: Crew, Junior, Senior and Re-entry phase. Purposely, Senior and Re-entry phases are selected due to their longer stays in the rehabilitation program. Human-animal interaction was frequently observed as part of the rehabilitation center’s unique incorporation of animal assisted approach in their program structure. The Senior and Re-entry phase were the advanced stages of treatment recovery. The researcher recruited the participants based on their position in the community, the researcher had purposely chose the clients that are in Senior and Re-entry phase because of their longer stay in the program.

The researcher purposefully selected participants in senior and re-entry phase to be included in the study. Petitioners and family members were selected among the family of ACP clients. As for the staff as participants, the researcher identified and selected one staff per area of specialization. The researcher selected staff directly involved in the patients.  These are case managers (social worker, psychometrician, nurse (who also served as dormitory manager), and two houseparents from both male and female dormitory. The inclusion criteria include the length of year (2-3 year) as an employee in the rehabilitation center. This is to make sure that the selected staff had rendered longer time with the patients.

The researcher conducted the Focus Group Discussions (FGDs) with the petitioners (spouses, parents, or siblings) of the PWUDs. It provided additional insights into the situations and perceptions of PWUDs regarding their interactions with animals prior to rehabilitation. The frontline of the treatment for People Who Use Drugs (PWUDs) in the center consisted primarily of a program team comprising case managers, social workers, house-parents, nurses, dorm managers, and psychometricians. These professionals were interviewed to gather their perceptions and observations regarding PWUDs’ interactions with animals within the center. The duration of the interview for each participant was from 1 hour to 1 hour and 30 minutes per session.

If there is withdrawal, prior to the withdrawal, the researcher asked the participant/s of the reason/s that made him/her decide to withdraw. This is to probe and identify what made the respondent withdraw for possible course of corrective or preventive action. If the reason given is due to personal and uncontrollable factors, the respondent/s were then given a brief termination discussion from participating in the study. The collected information was kept and was not included in the presentation of results.

Sample and Sampling Procedures

The research participants in this study were male and female PWUDs in the rehabilitation center who are in the senior and re-entry phase of their treatment program. According to Creswell (2007), qualitative inquiry requires 10 to 15 participants. The participants were purposely chosen because of their longer stay and exposure to the rehabilitation program. The researcher employed a purposive sampling method to gain a thorough knowledge about the phenomenon of human-animal interaction in the rehabilitation center.  As per Campbell et al. (2020), purposive sampling stands out as the most appropriate sampling method for qualitative research. Thus, based on specific population anchored from the inclusion criteria, the researcher selected at least six (6) participants from the senior and re-entry phase PWUDs. Aside from the PWUDs, the researcher interviewed representatives from the program team, one (1) social worker, one (1) nurse, one (1) psychometrician, and two (2) house-parents. Five (5) family members were interviewed for Focus Group Discussion (FGD). Overall, the total number of participants are sixteen (16).

The participants were selected among the residents who are in senior and re-entry phase. The family members for FGD were purposefully selected among the PWUDs who already graduated. They were contacted and informed through phone and video call. The researcher selected representatives from the program team in within specified areas of specialization. The participants received information regarding the study’s purpose.  They were explicitly informed that their participation in the research project is entirely voluntary and they have freedom to decline involvement at any point during investigation through informed consent. Additionally, participants were provided with instructions on completing the questionnaire, accompanied by a clear explanation of the purpose and nature of the study.

Data Collection

Adhering to the conventional approach in instrumentation, this study employed an interview guide questionnaire to gather qualitative data. Purposive sampling was utilized in this qualitative research (Palinkas et al., 2013) to identify and select information regarding the nuisance effect of human-animal interaction in substance use addiction as the phenomenon of interest. The data were collected in the DOH DATRC. In collecting the data, the researcher used semi-structured interview. In order to understand the relationship between human and animal in the rehabilitation center, the researcher employed multiple techniques for data collection. These methods include in-depth interviews to the PWUDs and key informants such as case managers/social workers, nurses, psychometricians, house-parents and dorm managers. The researcher also conducted in-depth interview to the family/petitioner of the PWUDs.

The first step in data collection was done through observation. The animal-human interaction of the PWUDs was carefully observed. By utilizing a combination of these approaches, the researchers gathered diverse perspectives and rich information, contributing to a more thorough understanding of the subject matter without undue bias.

Prior to conducting the survey, the researcher distributed consent forms, ensuring participants of the confidentiality of their responses. A comprehensive overview of the survey’s purpose and the study in general would be presented to the participants. A preliminary letter outlining the research study’s objectives along with a consent form was issued. To capture insights of the PWUDs encounters with animals in the rehabilitation center, the researcher employed an interview protocol. The interviews were conducted in English, Tagalog, and the blended local dialect of Bisaya, Cebuano and Meranao. Note-taking, audio recording and other means of data collection were utilized to document the essential aspects of the discussions granted with permission by competent authority involved.

Adhering to the Data Privacy Act of 2012, the data gathered in the research process were treated with utmost confidentiality. The data were transcribed and anonymized to ensure that the participants in the study shall kept their identity.

Data Analysis

The researcher made used of Braun and Clarke’s 6-step of thematic data analysis. The initial stage of qualitative analysis involves thoroughly reading and reviewing the transcripts, which served as the foundation for further analysis. Taking notes and recording initial impressions can be beneficial for the analysis process. In step two, the data were structured in a coherent and organized manner. Coding allows the researcher to condense large amounts of data into concise units of meaning. The specific coding method employed depends on individual perspectives and the research objectives at hand. The step three of the process includes searching for themes. A theme is defined by its importance or meaning. The researcher reviewed the codes to find clear alignment to form a theme (Maguire et al., 2017). In step four, the researcher evaluated the themes that were identified. The relevant question asked during this phase was “Does the theme make sense and does the data support the themes?” Braune and Clarke suggested that the data associated with each theme is color-coded (Maguire et. al, 2017). In step five, the researcher defined the themes. This represents the ultimate polishing of the themes, with the goal being to pinpoint the ‘core’ or ‘essence’ of each theme. In the presence of subthemes, the researcher must know the interactions and connections to the primary theme and how these themes interrelate with one another. The sixth and final step of data analysis is the writing-up or summarization. The researcher provided context and representation for the findings, integrating the analytical narrative with vivid data excerpts to enrich the understanding of the results (Braun and Clarke, 2006).

Trustworthiness

This study established four aspects of trustworthiness and credibility such as: credibility, transferability, conformability, and dependability according to Lincoln and Guba (1985).

Credibility. It refers to the degree of confidence in the validity of the investigation and its conclusion (Polit and Beck, 2014). The participants for this study are the Persons Who Used Drugs (PWUDs) who are residents in DOH Drug Abuse Treatment and Rehabilitation Center-ADS. The researcher, together with the panel members made use of triangulation method to get multiple data sources, methods, and for researcher to cross-verify findings. The researcher also prolonged her engagement with the participants by spending enough time with the participants to build rapport and deeper understanding while sharing and clarifying the data with the participants to confirm accuracy. The research narrative includes the participant’s experiences ensuring that the researcher’s ideas and opinions are the only stated to ensure no personal biases.

Transferability. Lincoln and Guba (1985) noted that the researcher’s responsibility is to provide sufficient descriptive data that readers can evaluate its applicability of that data to other contexts. The researcher guaranteed transferability of the data ensuring that if the study will be repeated, the same conclusions will be reached. To ensure this, the researcher provided thick, rich descriptions of the context, participants, and findings and allow readers to determine whether the results are applicable to their own situations or study.

Confirmability. It refers to ensuring that the data represents information the participants provided and that interpretations of those data are not imagined by the inquirer (Alexander, 2019). The researcher’s role in this study includes interviewer, transcriber and data analyst. The researcher learned about the participant’s experiences and ensured that the responses that they have provided was the way they stated per statement. The researcher ensured correctness of data and carefully record the information collected. Although the researcher maintained reflexivity and acknowledged potential biases, the researcher chose not to include her own observations and employed independent audit findings. Finally, the researcher reviewed and categorized the data and information by themes leading to overall conclusions.

Dependability. It refers to the stability, reliability of data over time and over conditions (Alexander, 2019). The research data was recorded to address the dependability issue. The researcher made use of Code-Recode Strategy wherein the researcher analyzed data, took a break, and then revisited the analysis to check for consistency in coding and interpretation.

Reflexivity Statement

In the capacity of the data gatherer, the researcher engaged at gathering reliable information from numerous research papers depicting human-animal interaction. Within this study, the researcher assumed multiple roles, serving as an interviewer, transcriber, and data analyst. In the role of an interviewer, the researcher acquired insights into participants’ experiences, ensuring the interviews adhered to the designated design. As transcribers, the researchers verified the accuracy of transcripts, meticulously documenting all collected information. Lastly, the researcher reviewed the data, identifying and categorizing them according to their themes, ultimately culminating in an overarching analysis or conclusion.

The researcher stood on the ground of setting aside all preconceived ideas to clearly see the naturally emerging phenomenon this research study had tried to uncover.  This was done by acknowledging the diversity of cultural backgrounds, perspectives, stances, viewpoints, and assumptions influenced by personal experiences. The researcher recognized the potential for subjective influence on data gathering thus, to countermeasure biases and preconceived notions, the researcher had implemented bracketing strategy.

Ethical Consideration

Prior to conducting in-depth interviews with study participants, precautionary measure was done to ensure ethical integrity and compliance of this study. Each participant received a consent form, and the interviews commenced only after everyone has provided informed consent. Participants were explicitly informed about the assured confidentiality and voluntary nature of their participation, emphasizing that leaving the study at any point will have no repercussions. Maintaining the utmost confidentiality, each participant was assigned a pseudonym for use in all research reports, and their real identities were known only to the researcher, ensuring the privacy of their backgrounds. The participants were not in direct supervision of the researcher because they were not belonging to her caseloads.

The researcher utilized the ethical framework outlined in the Belmont Report to ensure the integrity and effectiveness of the study. The three core principles of the Belmont Report—respect for persons, beneficence, and justice—guided this study (1979). Respect for persons was upheld by obtaining informed consent from participants, ensuring they fully understood the purpose of the study. The principle of justice shaped the efforts to provide equitable participation. This ethical foundation allowed this research to explore the profound therapeutic potential of human-animal interaction while safeguarding the dignity and welfare of all involved.

Additionally, all participants who consented to take part in the study underwent a pre-debriefing session. During this session, the study’s purpose, goals, objectives, and clear, straightforward instructions about the study’s direction were explained to the participants. They were informed that they have the right to withdraw if they feel uncomfortable with the data gathering process. Furthermore, this study was subjected to the Lourdes College Research Ethics Committee before the data gathering.

FINDINGS AND DISCUSSION

This chapter outlines the process of data collection, the operational data analysis, the profile of the participants of the study, and the presentation of the findings of the study.

This case study was driven by the need to explore the role of Human-animal interaction into the program structure for clients of rehabilitation center. As Stake (1995) explained, “A case study is the study of the particularity and complexity of a single case, coming to comprehend its activity within significant circumstances. We study a case when it itself is of very special interest. We look for the detail for interaction with its context.” This design enabled the researcher to gain understandings into how human-animal interaction could serve as a potential treatment intervention for PWUDs (Persons Who Use Drugs).

Operational Data Collection

This study employed In-depth Interviews (IDI), Key Informant Interviews (KII), and Focus Group Discussions (FGD) to collect data. To ensure comprehension, the questions were translated into the local dialect. Several consultations with the mentor were conducted to ensure the reliability of the research materials. The study adhered strictly to a case study protocol throughout its implementation. According to Yin (2009), a case study protocol is “a formal document capturing the entire set of procedures involved in the collection of empirical material.” Yin (1994) further explained that it provides guidance to researchers for collecting evidence, analyzing empirical materials, and reporting findings in a structured manner.

Preparations were made before conducting the in-depth interview, key informant interview, and focus group discussion to establish a better relationship with the participants. Letters were given to the dormitory managers and head of the After Care Section to help in contacting the participants for the facilitation of the Focus Group Discussion.

During the in-depth interview, the researcher made schedule to the dormitory manager and houseparent on duty to interview the participants. The interview was conducted at female and male classroom for good ambiance and convenience of the participant.

During the Focus Group Discussion (FGD), initiating the session by asking participants how they were feeling helped establish a comfortable and relaxed atmosphere, facilitating open conversation. Emphasizing confidentiality encouraged participants to share their thoughts and experiences freely. Prior to recording, they were briefed on the purpose of the discussion to ensure clarity and understanding. The interviews were conducted in a well-ventilated and comfortable room, providing a conducive environment for the participants’ ease and engagement.

Operational Data Analysis

Data analysis is a systematic process of interpreting and visualizing data to uncover answers and insights. Utilizing data analysis tools streamlined the process, enabling more precise and effective analysis. However, the tasks of collecting and transcribing data were challenging, demanding patience and a thorough understanding to accurately interpret participants’ responses. Coding these responses was particularly complex, highlighting the importance of using HyperResearch to ensure reliable data interpretation. Despite the challenges, it has been rewarding to see the direction of the research becoming clearer through this process.

Profile of the Participants

There were six (6) Persons Who Used Drugs (PWUDs) who participated in the In-depth interview, two were married, one separated, and one with common law partner, and two are single. Five of the participants rendered ten (10) months stay in the rehabilitation center, and only one rendered eight (8) months. Their former jobs before rehabilitation include caregiver, online seller and viand vendor for the female PWUDs, while male PWUDs worked as soldier (army), project manager and radiologic technologist.

Out of the five participants in FGD, two of them are married, and three are single with common-law partner. Three of them were self-employed and two are housewives. Moreover, five staff were interviewed as Key informants. Out of five participants, three of them are employed for four years, one employed for five years and one employed for two years in the rehabilitation center.

Presentation of Findings

This section presents the answers to the main question: “What is the effect of Human-Animal interaction in the recovery process among PWUDs of DOH DATRC-ADS?” The answers to this overarching question are arranged according to themes based on the categories supported by several codes. The five themes described the recuperation process in the program.

Based on the participants’ narratives, five themes emerged. These themes are Holistic self-improvement, Therapeutic engagement with animals, Transformation and Sustainability and Regaining self-worth.

Themes Book
Theme	Category	Sample codes	Significant statement
olistic self-improvement	Self-improvement	Growth through humility	“Pero dere nako natun-an ang pag apply sa humility and acceptance sa mga sala, mga kina-iya nako” (PWUD participant No. 5, IDI, transcription lines 501-502)
		Healthy mind diversion	‘’Then ang uban nga activity sama sa counselling, kailangan jud para ma divert ang sick mind sa isa ka adik sama nako’’ (PWUD participant No. 5, IDI, transcription lines 533-535)
		Improved time management	“Yes maam uyy, dako kaayo na tabang, diha ko naka balo ug time management, kay dere baya mam, sakto ra kaayo ato oras sa tana butang. Maong nakatoon kog budget sa ako oras.’ (PWUD participant No. 5, IDI, transcription lines 506-508)
	Heightened awareness	Deep connection	‘Kung baga naa name connection mam ba, ilaha na naandan pag abot nako, naa name theme song’ (PWUD participant No. 2, IDI, transcription lines 183-184)
		Reflection	“Kana ako sila ma hawed haweran, kay mahinumduman nako akoa ge atiman na iro. Ge unsa nako sya ge atiman, ug napasagdan.” (PWUD Participant No. 1, IDI, transcription lines 34-35)
		Self-inventory	“Daghan ko na process sa ako kaugalingon samot na kato pinaka dako nako nga sekreto maam, dere ra jud nako na sulte, ug dere rapod nako na ila ako kaugalingon kay sa gawas dele.Participant No. 2, IDI, transcription lines 78-80)
	elf-reformation	Self-account	“Mao nang ma appreciate nako ang evening wrap, ma summary nako akoa day, ma evaluate nako unsay feeling nako ana nga time, unsay ako ge huna huna ana nga time, mao makatabang sya maam.” (PWUD Participant No. 4, IDI, transcription lines 408-410)
		Stress reliever	“Dako jud tabang sa akoa rabbit maam kay katunga sa akoa pag rehab naa man sa ila ako focus atong na assign ko sa rabittan, sila ang kumbaga makawala sa ako stress ug kahuyang. Dako sila nahatag na kalipay maam (cries)”. (PWUD Participant No. 2, IDI, transcription lines 189-192)
		Behavioral transformation	Maka ingon ko nga mas mayo ra jud diay nga naa sya dere kay daghan jud nausab sa iya batasan. Dele na sya musingka, sauna singkahan ko niya besan gamay ra nga sayop. (FGD participant No. 2, FGD, transcription lines 131-133)
	Structured homelife	Activities for reformation	“Dako na tabang sa ako maam, sa morning meeting maam, sa TCUP, Food for the soul, kana maam, kanang NA.” (PWUD Participant No. 2, IDI, transcription lines 90-91)
		Avoiding triggers	“Sa ERS nako nakita maam nga dere nako na learn unsaon paglikay sa triggers para dele ma relapse pag gawas, nya and maka focus ko sa ako recovery para mapalayo or mabalik sa addiction. “(PWUD Participant No. 6, IDI, transcription lines 537-539)
		Expressing talents	“Sa activity maam dapat perme busy ang huna huna kay dapat mapagawas ang talent.” (PWUD Participant No. 6, IDI, transcription lines 536-537)
Therapeutic engagement with animals	Challenges with animal engagement	Accidents with animals	“Si Jabbar (goat) maam gesungag ko nya maam kay nanguwag man gud to sya mao iya ko gisungag, nalaguman ko.” (PWUD Participant No. 3, IDI, transcription lines 300-301)
		Least preferred animals	“Mahadlok ko sa Pabo maam kay gapang lakag pero malingaw japon ko. Kay naa to kas-a nga gilakag ko. Ang akoa lang jud maam.” (PWUD Participant No. 1, IDI, transcription lines 41-43)
		Improper handling	“Ang na assign ato Kay wala sya hanaw unsaon gyud paghandle properly and hayop. Siya gyud Mismo wala niya gitarong ug handle ang hayop.” (Staff participant No. 2, KII, transcription lines 64-65)
	Treating animals like people	Maternal substitution	“Makatabang sa ako maam kay kanang wala nako nabuhat sa gawas maam, pag atiman, pag love sa mga hayop dere nako na kwan, kanang dele man jud ko hilig ug hayop pero dere ma estor-estorya nako mam, mawala sa kamingaw sa mga anak. Makatabang sa akoa jud.” (PWUD Participant No. 3, IDI, transcription lines 313-316)
		Non-judgmental connection	“Other than that, siguro yung time na binibigay sa kanila with the ano, atsaka yung no judgment na quality time with animals, na parang ito, kailangan ko tong e treasure na mga moments yung ganyan.” (Staff participant No. 4, KII, transcription lines 158-160)
		Personification of animals	“Sa akong nabantayan na pasyente, nag long daw sya sa iyang anak, nya livestock incharge sya ato na day, iyaa sab giisip na anak ang kanding pagbantay niya.” (Staff participant No. 2, KII, transcription lines 87-88)
	Expressing care and affection	Affection for animals	“Sauna dele ko modool pero karon modool nako mam. Ang kanding jud mam kay naanad naman gud ko mam, ug atiman sa kanding bahala mag gukod gukod ko maam.” (PWUD Participant No. 3, IDI, transcription lines 319-321)
		Becoming responsible	“Pagka responsible sa usa ka hayop kay wala na sa akoa sa gawas.” (PWUD Participant No. 1, transcription lines 10-11)
		Care for animals	“Pero wherein basta maka kita ko sa uban na brothers na ga dula ug iring, mag bahog sa mga hayop, kana in-ana bitaw maam nga, ang dating nya sa akoa kay dele man diay intero dautan kay naa ma pay care sa mga animals, naga kwan syag concern ba, dele man diay ing-ana me ka dautan.” (PWUD Participant No. 1, transcription lines 90-93)
	Looking forward	Possible income generation	“Mao sab silay makuha na benefits in sense of responsibility ug sa ilang focus sab makagenerate silag income.” (Staff participant No. 3, KII, transcription lines 123-125)
Transformation and sustainability			“Gusto pod ko mamuhi ug manok, ang pinaka kwan jud nako kay baboy jud, sa baboy baya kay dali ra mabuhi ug makapadako ana kay feeds man, mga 3 months dali ra kaayo mudako.” (PWUD Participant No. 5, transcription lines 519-521)
		Farming and rehabilitation plans	“Ok raman pod maam, atong wala pa sya na rehab, plano naman jud namo naa nay gi andam nga patangkalan sa baboy, piggery, ana. Naa nay area namo.” (FGD Participant No. 4, FGD, transcription lines 64-65)
	Developing personal accountability	Becoming responsible	“Pagka responsible sa usa ka hayop kay wala na sa akoa sa gawas.” (PWUD Participant No. 1, transcription lines 10-11)
		Develop self-discipline	“Kay strict sya pero grabe syag natabang kay naka develop syag discipline sa kaugalingon.” (PWUD Participant No. 4, transcription lines 351-352)
		Growth through responsibility	“Ako mga anak akoa gipanghatag kay dele ko gusto og obligasyon maam ba. Pag abot nako derea maam kaya diay nako diay. Kay dele pod baya lalim akoa tahas maam derea kay kinabuhi pod baya akoa ge atiman dba..” (PWUD Participant No. 2, transcription lines 206-208)
Regaining self-worth	Valuing one’s self	Rebuilding trust	“Since ang mga hayop walay judgments, pwede nga sa ila pag atiman, makatabang ni nga ma rebuild ilaha trust, sa ila kaugalingon, and eventually maka rebuild og ilangs trust sa other people..” .” (Staff participant No. 3, KII, transcription lines 57-59)
		Personal transformation	“Yes maam, para sa ako maam kay dako na syag tabang sa ako kaugalingon na makatabang sa akoa, mulikay nako tanan sa mga bisyo ug tanan aspeto sauna.” (PWUD Participant No. 2, transcription lines 136-138)
		Restored self-worth	“Nga makatabang nga mabalik ilaha pagkatao, isip isa ka inahan, mabalik ilak self-worth bitaw maam, and trust sa ilaha self.” (Staff participant No. 2, KII, transcription lines 35-37)
	Self-regulation	Controlled anger	“Siguro maam sa akoa behavior, kana bitaw maulit naka sa mga kanding nga ga away mga siruot kaayo, ako mam imbes na masuko ko, mu ingon ko nga oopps kanding na, kanding na, ing ana bitaw.” (PWUD Participant No. 2, transcription lines 6-8)
		Improved patience	“Dele ko dapat ma kwan ane kay hayop ni. Deha nako ma kwan maam, parehas atong kabayo nga nasipaan ko. Naulit ko sa ako kaugalingon, kay ingon pa ni sir Yunos nga kabayo man na dele man na nimo ma estorya nga ana ka nga isbog sad era, ako kay ako man gihilam iya tiyan, ana ko nga kabayo excuse sa, abe pod nako ug ok rato, pero gisipa man diay ko nya.” (PWUD Participant No. 1, transcription lines 8-12)
		Sense of purpose	“Sa pag butang ug livestock sa ila structure, nakita nako nga naka play sya og vital role sa recovery sa patients ug pag balik sa ila dinidad tungod kay ma renew nila ilang sense of purpose.” (Staff participant No. 3, KII, transcription lines 50-53)

Model of Findings   

                                     

Theme No. 1. Holistic Self-Improvement

For the participants, holistic self-improvement means self-improvement, heightened awareness, self-reformation and learning through structured home life at the center.

Holistic self-improvement plays a central role in the experience of Persons Who Use Drugs (PWUDs) within the rehabilitation center’s program structure. The program utilizes the Therapeutic Community (TC) modality alongside the 12-Steps Program to Recovery, combining structured methodologies to address addiction and mental health challenges. TC model employs a variety of approaches to assist PWUDs in their recovery journey. One of its key components is the daily morning meeting, which serves as a cornerstone for community building. These meetings include public announcements, reflections on prior sessions, and activities such as personal sharing to foster a sense of connection, awareness, and collective spirit.

The 12-Steps Program to Recovery focuses on mutual support to help PWUDs achieve and maintain abstinence from substances. Central to its philosophy is the concept of surrendering to a Higher Power, which is interpreted broadly—it could refer to a traditional God, familial support, or simply the sense of belonging within a 12-Steps meeting. The program is tailored to meet the specific needs of participants at various stages of recovery. Early Recovery Skills (ERS) are taught to new patients (referred to as Crew and Junior), while advanced concepts like Relapse Prevention (RP) are provided to those nearing graduation (Senior and Re-entry levels).

In addition to lectures, the morning meeting remains a vital daily ritual, allowing participants to absorb valuable insights from shared experiences. Complementing this are activities like the midweek showdown, which encourages individuals to showcase their talents, fostering self-confidence and personal growth.

The day starts with devotional prayer and Sambayang (prayer) for Muslims to encourage PWUDs to start their day with the presence of God Almighty. To ensure discipline and accountability, the program incorporates Facility Runs and Behavioral Shaping Tools (BST), focusing on addressing and managing behavioral lapses. Evening activities, including Leveling-Off and Evening Wrap-Up, provide PWUDs with opportunities to reflect on their day, engage in discussions, and resolve any conflicts in a supportive environment. These sessions emphasize personal responsibility, with participants encouraged to conduct self-inventory before bed to evaluate their progress and challenges. The goal of self-inventory is to encourage PWUDs to evaluate their actions and behaviors over the course of the day, allowing them to reflect on what went well and identify areas where things may have gone wrong.

The program also integrates therapeutic elements such as gardening and animal engagement, which offer unique benefits for mental well-being. These activities promote relaxation, responsibility, and a deeper connection to nature, enhancing the holistic recovery process for PWUDs.

Bioecological theory posits that human development is a transactional process in which an individual’s development is influenced by his or her interactions with various aspects and spheres of their environment (Rosa et al., 2013). The program structure in the rehabilitation center encourages the PWUDs interactions with different people, co-residents, staffs and even animals. The result of these interactions influences and helps shape the PWUDs perspective. The term Holistic Self-improvement primarily relates to the goal of the rehabilitation program which is to provide a Holistic treatment approach addressing different domains such as physical, mental, social/family problems, legal problems and other problems verbalized by the patient while on their recovery treatment. Bioecological theory and Holistic approach both prioritize a comprehensive and contextual understanding of development. The bioecological theory explains the systemic influences on individuals (Rosa et al., 2013), while the holistic approach in the rehabilitation center ensures care is multidimensional and person-centered. Together, they highlight the importance of addressing all aspects of an individual’s life and environment to support their overall well-being and growth.

Category 1. Self-improvement

Self-improvement for the participants means behavioral change, capable of responsibility, challenging personal boundary, commitment to care, developed time management, empowerment through teamwork, enhanced focus, enhanced responsibility, fosters understanding, fulfillment, full of knowledge, growth embraced, growth through humility, healthy mind diversion, helpful program structure, hobby for engagement, improved time management, improvement related activities, joy in growth, perseverance, perseverance over struggles, personal growth, positive behavioral change, positive behavioral transformation, prioritizes recovery, progressive growth, responsibility development, restores concern, significant behavioral transformation, teamwork makes easier, transformation,    understands life existence, fondness of animals, future animal engagement, future animal venture, future animal ventures, future livestock venture, genuine joy, growth embraced, growth through humility, and healing through connection.

Self- improvement is a fundamental principle that aligns the program structure, as it emphasizes personal growth, accountability, and mutual support. The TC model fosters holistic self-improvement through community-based activities like morning meetings, behavioral shaping tools, and midweek showdowns, which help PWUDs develop discipline, self-esteem, and positive habits. Similarly, the 12-Steps Program provides a structured framework for self-reflection, acceptance, and action, guiding PWUDs to take responsibility for their actions, make amends, and maintain ongoing self-inventory. Both approaches emphasize continuous growth, with the TC focusing on reshaping behavior through daily routines and communal support, while the 12-Steps Program offers a spiritual and emotional roadmap for recovery. Together, they create a comprehensive environment where PWUDs can build resilience, foster meaningful relationships, and embrace the lifelong journey of recovery and self-improvement.

As PWUD Participant No. 4 stated:

For me maam, ang program structure nag focus sa amo maam, sa mga pasyente or resident individually, kwan kaayo sya maam, grabe kaayo sya ka helpful and although the program is very strict kaayo sya pero dere nako na realize maam nga kinahanglan namo ug ing-ane, labe na para sa ako ing-ane ka strikto nga program. For me, ma’am, the program structure focuses on us, the patients or residents, individually. It’s very helpful, and although the program is very strict, I realized here, ma’am, that we really need this kind of strict program. (PWUD Participant No. 4, IDI, RQ1, Transcription lines 333-336).

The program structure focuses on the improvement of every aspect of PWUDs mainly targeting all domains and aspects in their life that needs to be improved for a lifetime.

Bronfenbrenner expressed, “the forces that have shaped human development in the past, but . . . those that may already be operating today to influence what human beings may became tomorrow” (Bronfenbrenner & Evans, 2000). Similarly, the PWUDs experience within the bioecological framework involves recognizing and enhancing the factors that support positive outcomes at every level. For example, improving the microsystem might involve strengthening family relationships or creating supportive educational environments. At the mesosystem level, fostering collaboration between family could enhance consistency in the individual’s support network.

PWUD Participant 4 added:

Sa morning meeting mam, diha na nako nakita nga I have to be concern sa mga panghitabo sa akoa palibot, nga sa community, in my own family naa diay sila mga pangenahanglanun nga kailangan nako e address, which is dele nako gena address sauna labe na sa ako wife, nga mao to maghilak ako wife maam kay ma feel nya nga pag maka drugs ko kay mu detach ko sa iyaha…. Ako na realize sa morning meeting na mga tao, parehas ra japon sa ako wife na naa syay mga needs nga kailangan nako e address. “In the morning meeting, ma’am, that’s where I realized that I need to be concerned about what’s happening around me—in the community and within my own family. I saw that they have needs that I need to address, which I didn’t pay attention to before, especially with my wife. Back then, my wife would cry because she felt that when I used drugs, I would detach from her. I realized during the morning meeting that people, just like my wife, have needs that I must address.” (PWUD Participant No. 4, IDI, RQ1, Transcription lines 359-372).

Category 2. Heightened awareness

Heightened awareness for the participants means deep connection, deep realization, inventory, more mindful, positive distraction, reflection, reflection and fulfillment, reflection and regret, reflection through program, reflective expression, regret and realization, improvement related activities, increased mindfulness, increased responsibility, innocence, inspires effort, interest in livestock, joy in growth, and lifestyle commitment change.

Heightened awareness and therapeutic community (TC) approach are closely related, as both focus on fostering self-awareness, emotional regulation, and personal responsibility, which are essential for personal growth and recovery. Mindfulness, the practice of being fully present and aware of one’s thoughts, emotions, and surroundings, enhances an individual’s ability to reflect on their behaviors and reactions without judgment.

In rehabilitation center where it makes use of TC, mindfulness supports the community’s emphasis on accountability and self-examination. By cultivating mindfulness, PWUD became more attuned to their emotions and behaviors, enabling them to recognize patterns that contribute to destructive habits or strained relationships. This awareness helped them make thoughtful, deliberate choices aligned with their recovery goals. Staff Participant No. 2 suggested: “Ilahang attention sa details mas aware sila sa ilang palibot. Mas careful sila sa ilang actions.” “Their attention to details makes them more aware of their surroundings. They are more careful with their actions.” (Staff Participant No. 2, KII, RQ2, Transcription lines 126-127). The program structure teaches PWUDs the importance of being mindful of their actions to prevent mistakes and avoid sanctions. By consistently practicing mindfulness, they develop this habit, enabling them to apply it effectively when they reintegrate into society.

Bronfenbrenner’s explanation on the Microsystem pertains to the layer of the model that represents the people, groups, and institutions that have the most immediate and direct influence on a person’s development (Rosa et al., 2013). In connection, when an individual practices mindfulness, they become more aware of their thoughts, emotions, and reactions in their immediate environment. This heightened awareness helps them respond more thoughtfully to situations, especially in close relationships instance, a mindful person is less likely to react aggressively in conflict situations, allowing for more positive, constructive interactions within their family or workplace.

PWUD No.4 described the program structure and stated,

Everytime naay mahitabo, nga ibutang sa structure nato ginapangetaan jud nako syag something na makat-unan nako, mao to nindot kaayo sya maam, helpful kaayo sya para sa amo nga mga residents labe na sa ako nga kanang abusado kaayo ko sa gawas then pag abot dere makat-unan nako unsaon pag pugong sa akoa kaugalingon.” “Every time something happens that is included in our structure, I always look for something I can learn from it. That’s why it’s really good, ma’am, and very helpful for us residents, especially for me, since I used to be very reckless outside. But when I came here, I learned how to control myself.” (PWUD No. 4, IDI, RQ1, Transcription lines 338-342).

Based on PWUD participant 4 response, he would always relate whatever he experienced in the rehabilitation center as deeply as possible to every aspect of the program structure and see to it that he learns from it.

Category 3. Self-reformation

Self-reformation means acceptance, self-account, self-awareness, self-inventory, self-observation, self-reflection, self-reformation, self-observation, self-reflection, sensitive to emotions, significant behavioral transformation, staying mentally engaged, strength and nutrition, strength in determination, stress relieve and structured program.

A holistic approach to recovery emphasizes addressing the physical, emotional, mental, social, and spiritual aspects of an individual’s well-being. This comprehensive method recognizes that recovery is not just about overcoming substance abuse or behavioral challenges but also about fostering personal growth, self-awareness, and a sense of purpose. One essential tool in the recovery process is self-inventory, a reflective practice where individuals examine their thoughts, feelings, actions, and motivations. PWUD Participant No. 2 stated: “Naga start kog inventory sa akoa kaugalingon maoy ginabuhat sa evening wrap up, akoa gena ask ako kaugalingon ngano nabilin man to nako unsay nasulod sa ako ako huna huna nga ngano nawala ako awareness.” “I started doing self-inventory, which is what I do during the evening wrap-up. I ask myself why I left something behind, what was on my mind, and why I lost my awareness.” (PWUD Participant No. 2, IDI, RQ1, Transcription lines 395-397). Activities such as evening wrap-up and journal writing helps the PWUDs summarized having emphasized on what went wrong and what went right in their whole day.

Physical activities like exercise or meditation can support mental clarity for self-reflection, while emotional support from counselors or peers can help individuals process their findings. Spiritual practices, such as mindfulness or connecting with a higher purpose, can inspire individuals to align their actions with their values. PWUD Participant No. 3 added: “Kanang sa devotional mam, gaan kaayo ako paminaw nga kadlawon palang mag worship.” “During the devotional, ma’am, I feel so light because early in the morning, we are already worshiping.” (PWUD Participant No. 3, IDI, RQ1, Transcription lines 262-263).

Together, the holistic approach and self-inventory empower individuals to achieve lasting recovery by promoting self-awareness, balance, and resilience, ensuring they address the root causes of their challenges and cultivate sustainable well-being.

Category 4. Structured home-life

Structured home life at the center was described by the participants as activities for reformation, applying recovery concepts, avoiding triggers, becoming used to, beyond physical activities, building social confidence, calmness, determined growth, expressing talents, facilitates/helps recovery, healthy activity, family focused, learned structures, learning through care, lifestyle commitment change, manageable task, positive lifestyle changes, program strict implementation, reconciliation with family, recreation, reformation-related activities, responsible lifestyle shift, rest fuels recovery, restore spirituality, self-change, share learnings, staying mentally engaged, teaches responsibility, teaching responsibility, unity over competition, willingness to learn, support fosters recovery, teamwork makes easier, therapeutic enjoyment, time management, transformation, and trusting partnership.

Based on narratives of the participants, the structured home life has helped them a lot because every activity is specifically designed to improve their overall well-being.

PWUD Participant No.6 stated:

…sa ERS nako nakita maam nga dere nako na learn unsaon paglikay sa triggers para dele ma relapse pag gawas, nya and maka focus ko sa ako recovery para mapalayo or mabalik sa addiction, kini pod music therapy maam, para naay harmony and peace of mind, ma relax ang pang huna huna. Then kani pod proper rest maam, kailangan nako jud ang 8 hours of sleep ug ang 1 hour to 3 hours siesta para ma condition ang huna huna, then dere sa community maam, paki halobilo sa uban parehas sa ako maam nga introvert ko maam dere nako na practice ang mu interact nako sa tao, labe na sa pag host maam, maulawon baya ko maam mu atubang sa tao, karon naa nakoy confident sa ako kaugaligon muatubang sa laen tao. Labe na sa behavior maam, ang pag counselling sa social workers, psychometrician ug psychologist, kailangan nako maam kay para mas maka huna huna ug tarong, mubalik ang confidence sa kaugalingon ug maka recover mapalayo sa addiction. Number one ang pagsunod sa house rules para ma disiplina, maka sunod ta sa balaod, para ma ready inig face sa reality sa real world. Through ERS, I’ve learned how to avoid triggers to prevent relapse once I leave, and I’ve been able to focus on my recovery to stay away from addiction. Music therapy has also been beneficial, bringing harmony and peace of mind, relaxing my thoughts. Proper rest is also emphasized, ma’am. I ensure I get 8 hours of sleep and a 1 to 3-hour siesta to keep my mind conditioned. In the community here, I’ve learned to socialize with others. As an introvert, I’ve practiced interacting with people, especially through hosting. I used to be very shy when facing people, but now I have gained confidence in myself to engage with others. When it comes to behavior, counseling sessions with social workers, psychometricians, and psychologists are essential for me to think clearly, regain self-confidence, and recover fully to avoid falling back into addiction. Following the house rules is the top priority, as it teaches discipline and helps us adhere to laws, preparing us to face the realities of the outside world.” (PWUD Participant No.6, IDI, RQ1, Transcription lines 527-549).

PWUD Participant No. 3 added:

Kanang sa devotional mam, gaan kaayo ako paminaw nga kadlawon palang mag worship na kay sa gawas, mulabay rako simbahan igo rako manguros dele ko musulod kay maulaw ko sa ako kaugalingon nga mu simba simba ka dha nga tama ka. Exercise pod diay maam kay para buyag ko maam, besan inani na ako edad laskig japon ko.” “During the devotional, ma’am, I feel so light because, even early in the morning, I already worship. Before, when I passed by the church, I would just make the sign of the cross and not go inside because I felt ashamed of myself to be worshipping there when I’m far from perfect. I also do exercise, ma’am, to stay healthy. Even at my age, I’m still strong.” (PWUD Participant No. 3, IDI, RQ1 Transcription lines 263-267). The activities within the program is viewed as their structured home life in the rehabilitation center.

Theme No. 2. Therapeutic Engagement with Animals

For the participants, therapeutic engagement with animals means treating animals like people, expressing care and affection and challenges in animal engagement. The relationship between human-animal interaction and therapeutic awareness is rooted in the profound emotional and physiological benefits that animals provide. Interacting with animals promotes emotional regulation by reducing stress hormones like cortisol and increasing oxytocin, fostering relaxation and emotional resilience.

The nonjudgmental and loyal presence of animals helps creates a safe space for the PWUDs to explore their feelings, enhancing self-reflection and personal growth. Animals such as goats and rabbits who are mothers encouraged empathy and mindfulness, as their care requires attentiveness and compassion, helping PWUDs stay present and attuned to others’ emotions. Additionally, the trust and confidence built through these interactions are particularly impactful for those recovering from trauma or emotional challenges, teaching the value of secure connections. Therefore, engaging in structured human-animal interaction furthers promote physical, cognitive, and emotional well-being, making it a powerful tool for cultivating therapeutic awareness and holistic healing.

The bioecological theory, developed by Urie Bronfenbrenner, emphasizes how different environmental systems influence human development (Rosa et al., 2013) and this can be applied to understanding human-animal interactions. In the microsystem, animals, such as pets, play a crucial role by providing companionship, emotional support, and teaching responsibility. These interactions can improve mental well-being and social skills, learning empathy and nurturing behavior. In the mesosystem, the relationship between family dynamics and pet care can further influence behavior and social interactions. For example, a family that values kindness toward animals may encourage children to exhibit similar empathy in other areas of life.

Human-animal interaction in the rehabilitation center has maintained its therapeutic benefit to the PWUDs, however, it has also a fair share of challenges on its implementation. Under this theme are the three categories namely- Challenges with animal engagement, treating animals like people, and Expressing care and affection.

Category 5. Challenges with animal engagement

For the participants, challenges with animal engagement means, accidents with animals, animal preference, challenges, improper handling, least liked animal, least preferred animal, negligence of duty, and varied engagement reasoning.

While many of them enjoy engaging with and caring for certain animals, they also express clear preferences, favoring specific species over others. Some animals naturally appeal to them such as (rabbits and goats), fostering a stronger connection and a greater willingness to take responsibility for their care. On the other hand, there are animals they are less inclined to interact with, either due to fear, discomfort, or lack of familiarity. These varying preferences emphasized the importance of considering individual inclinations and comfort levels when incorporating human-animal interaction programs, ensuring that the experience is both beneficial and enjoyable for everyone involved.

As PWUD Participant No. 3 stated,

Ang ako paborito maam kay kaning kanding, dele ko anang sa gansa kay mahadlok ko kay makurat ko, sauna dele ko modool pero karon modool nako mam. Ang kanding jud mam kay naanad naman gud ko mam, ug atiman sa kanding bahala mag gukod gukod ko maam. “My favorite, ma’am, is the goat. I’m not a fan of geese because they scare me, and I get startled. Before, I wouldn’t go near them, but now I do, ma’am. I prefer the goat because I’ve gotten used to taking care of them, even if it means chasing them around, ma’am.” (PWUD Participant No. 3, IDI, RQ1, Transcription lines 318-321).

Furthermore, individuals with less experience in interacting with animals may face difficulties in properly caring for or handling them, which can lead to unintentional mishandling. This lack of experience may increase the risk of accidents or injuries, not only to the animals but also to the participants themselves. Inadequate knowledge about animal behavior, safety protocols, or proper care routines can result in the animals being treated in ways that cause them harm, or in some cases, leading to casualties. This highlights the importance of providing proper training and guidance for participants, especially those with limited experience, to ensure both the safety and well-being of the animals as well as the effectiveness of the human-animal interaction program.

PWUD Participant No. 2 stated:

Mao to lisod ko kay akoa nasundan maam kay dele kabalo, nalumos ang baby rabbit sa planggana mam ba, sakit kaayo nalooy ko. Maong pagka ugma ato nag suggest jud ko nga ma oni buhaton, mao ni, mao na kay mao pod nakita nako sa ako tatay (grandfather). “That’s why I struggled, ma’am, because the one I was following didn’t know what to do. The baby rabbit drowned in the basin, ma’am, and it was so painful—I really felt sorry for it. That’s why the next day, I suggested what should be done, explaining step by step, based on what I learned from my grandfather. (PWUD Participant No. 2, IDI, RQ4, Transcription lines 33-36).

Aside from that, based on some responses of the PWUDs, there were concerns that they raised such as the lack of food supply for animals, especially the rabbits. PWUD Participant No. 2 added: “Masukod jud sya maam, labe na usahay walay bahog ang mga rabbit mam, mabalaka jud ko maam musogot gane ko maam wala koy siesta maam basta maka kuha lang kog bahog sa rabbit maam.” “It’s really difficult, ma’am, especially when the rabbits sometimes don’t have food. I get really worried, ma’am, and if I agree to it, ma’am, I won’t take a break as long as I can get food for the rabbits, ma’am.” (PWUD Participant No. 2, IDI, RQ1, Transcription lines 170-172).

Category 6. Treating animals like people

Treating animals like people to the participants means perceiving animals as therapeutic, bonded connection, happiness, innocence, maternal care, maternal substitution, motherhood and responsibility, motherly sacrifice, motherly substitution, non-judgmental connection, parental connection, past time, peace in simplicity, personification of animals, pet longing, profound relationship, relating experience, resilient animal caring, sensitive to emotions, simple care routine, worries for animals, understands life existence, value of expression, and verbalized thoughts.

Based on the participants’ responses, they perceived their time spent with the animals as deeply meaningful, often likening it to the cherished moments they would spend with their own families. For many female patients, animals such as small rabbits and goats held a special significance, as they symbolized the children they missed dearly. This connection highlights the emotional bond these patients form with the animals, viewing them as a source of comfort and a way to fill the void left by their longing for their loved ones.

PWUD Participant No. 3 stated:

Makatabang sa ako maam kay kanang wala nako nabuhat sa gawas maam, pag atiman, pag love sa mga hayop dere nako na kwan, kanang dele man jud ko hilig ug hayop pero dere ma estor-estorya nako mam, mawala sa kamingaw sa mga anak. Makatabang sa akoa jud. “It helps me, ma’am, because the things I couldn’t do outside, like taking care of and loving animals, I can do here. I wasn’t really fond of animals before, but here, I can talk to them, and it eases the loneliness I feel for my children. It really helps me a lot.” (PWUD Participant 3, IDI, RQ1, Transcript lines 315-318).

PWUD Participant No. 2 added:

“Kana mag bahog ko sa rabbit maam nga ako ra maam, akoa sila estoryahon mam, mag tan aw sila sa akoa, pag mu abot pod ko akoa sila kantahan maam, ‘Naa na si mama, naa na si mama’. Kung baga naa name connection mam ba, ilaha na naandan pag abot nako, naa name theme song. Mao pod akoa kanta sa akoa anak maam, ‘anak ni mama, anak ni mama’.” “When I feed the rabbits, ma’am, and it’s just me, I talk to them, ma’am. They look at me, and when I arrive, I sing to them, ‘Mama is here, Mama is here.’ It’s like we have a connection, ma’am. They’ve gotten used to me, and when I come, we already have a theme song. It’s also the same song I sing to my child, ma’am, ‘Mama’s child, Mama’s child.”. (PWUD Participant No. 2, IDI, RQ1, Transcription lines 181-185).

This statement highlights the connection between human dignity and meaningful relationships, emphasizing the intrinsic value of nurturing and caring roles. By engaging with the rabbits through conversation and song, the individual demonstrates empathy and creativity. The act of singing and creating a “theme song” not only reflects a personal bond with the animals but also reflects participant’s relationship with her own child, reinforcing her identity as a caregiver. This nurturing behavior affirms their self-worth and underscores the human capacity for kindness and connection, both of which are central to dignity (Nordenfelt, 2004).

In a rehabilitation setting, such acts of caregiving allow PWUDs to experience respect, purpose, and belonging, which are fundamental to maintaining dignity. The ability to establish meaningful bonds, even with animals, serves as a reminder of their inherent value and the importance of their contributions to the lives they touch (Edlund et al., 2013).

Caring for animals as if they were children can provide therapeutic value, instilling purpose and emotional fulfillment. As for the PWUDs in the rehabilitation center, they personify the animals as their own family member which leaves the animals extra care and love from the PWUDs. These behaviors enhance empathy and strengthen the bond between species, creating a sense of shared existence.

In addition, Family systems theory focuses on understanding how family members interact and influence one another, viewing the family as an interconnected system rather than a collection of individuals. The theory seeks to identify existing patterns of behavior and communication within the family, especially those that may be unhealthy or dysfunctional (Johnson, 2016).

The way they personified animals as their own children demonstrated a deep level of empathy and understanding toward animals. It highlights their recognition of animals as living beings with needs that must be met with care and responsibility. This perspective reflects not only their emotional connection but also their commitment to ensuring the animals is properly nurtured and looked after, much like they would care for a child. Caring for animals serves as a reflection of their maternal instincts, particularly for female PWUDs, as it allows them to connect with the responsibilities and challenges associated with motherhood. Through their interaction with and care for animals, they gain a deeper understanding of the commitment, patience, and nurturing required to raise and care for another living being.

Category 7. Expressing care and affection

For the participants, expressing care and affection means, animal care skills, animal lover, animal rearing plans, animal-loving, care for animals, compassionate care, livestock enjoyment, becoming responsible, behavioral change, bonded connection, building social confidence, capable of responsibility and care for animals.

PWUDs interaction with animals foster emotional well-being, alleviate stress, and provide a sense of companionship that can be transformative for them who are undergoing rehabilitation. The bond formed between the PWUDs and the animals is often characterized by affection, which plays a critical role in the healing process. For example, one participant shared she was more becoming affectionate with animals now that she was integrated in the program. Previously, she was not fond of animals but now that she was introduced to animals’ engagement, she became affectionate with animals.

In a rehabilitation setting, individuals may feel isolated or disconnected from their family and loved ones, leading to emotional challenges such as loneliness or sadness. This is true with the PWUDs because of the long period of time that they were away from their loved ones.

PWUD Participant No. 3 stated on learning she gained with animal interaction:

Daghan mam uyy, kane pag atiman aning mga hayop maam, kani sa mga kanding maam, sa kanding jud kay ma storya storya nako ba, maka ingon nga ako anak, siguro sa kamingaw lang guro maam, ako pa gani hungitan maam, kaning tahop, ihunget nako sa ilaha tapos estoryahon nako. Na kwan nako mam ba, besan hayop mam imo atimanon, magaan imo dughan, mao nang dakog tabang sa ako ang pag atiman sa mga hayop kay nawala ako kamingaw sa ako mga anak (cries). “Ma’am, there are so many animals to take care of, especially the goats, ma’am. It’s with the goats that I really talk, as if they were my children. Maybe it’s just because of the loneliness, ma’am. I even feed them, ma’am. I give them the tahop (rice bran) and hand-feed them while talking to them. You know, ma’am, even if they’re just animals, when you take care of them, it lightens your heart. That’s why taking care of the animals has helped me a lot, because it eased the loneliness I feel for my children (cries).” (PWUD Participant 3, IDI, RQ1, Translation lines, 250-255).

The act of feeding, grooming, or simply spending time with animals encouraged mindfulness and provided a distraction from personal struggles. Over time, these affectionate interactions can lead to improved mood, reduced anxiety, and a more positive outlook, ultimately supporting the overall goals of rehabilitation.

Theme No. 3. Transformation and Sustainability

Therapeutic engagement and sustainability for the participants means looking forward and developing personal accountability. The implication of human and animal interaction in the recuperation programs in the rehabilitation center have shown to have a profoundly positive impact on People Who Use Drugs (PWUDs). According to the narratives shared by the PWUDs themselves, engaging with animals has played a significant role in restoring and enriching their sense of responsibility. Their interactions with animals helped them reconnect with a part of themselves they had lost during their substance use. Responsibility, which often takes a backseat during periods of drug use, became a key theme in these interactions. By caring for animals, PWUDs were reminded of the importance of being accountable not only for their actions but also for the well-being of others, in this case, the animals they cared for.

Based on the study of Claypool et.al, (2023) they examined animal-assisted therapy (AAT) program implemented in a Canadian forensic psychiatric facility. The program centered on developing a human-animal bond (HAB) between prisoners and animals, aiming to enhance rehabilitation outcomes. Participants reported increased feelings of empathy, responsibility, and improved social interactions, suggesting that engaging with animals can positively influence behavior and attitudes.

The goal of human-animal interaction in the rehabilitation of PWUDs extends beyond restoring a sense of responsibility and fostering companionship. While these are significant benefits, the program is also designed with a broader, forward-looking objective: to promote sustainability and equip them with practical skills that they can carry with them upon reintegration into the community. By engaging with animals, PWUDs not only learn the value of care and accountability but also gain hands-on experience in managing and interacting with livestock. This practical exposure is intentional, as it aims to prepare them for potential income-generating opportunities in the future.

For many, this means developing the skills and confidence needed to work with animals in agricultural or small-scale farming settings, which can serve as a sustainable livelihood. This aspect of the program ensures that the lessons learned in the rehabilitation center have real-world applicability, empowering PWUDs to build stable, productive lives after completing their treatment. Additionally, these interactions foster an appreciation for the importance of sustainable practices, as working with animals often involves an understanding of resource management, environmental care, and community engagement. By aligning therapeutic goals with economic and environmental sustainability, engaging with animals not only supports the immediate recovery of PWUDs but also lays the foundation for a future where they can contribute meaningfully to their communities.

Category 8. Looking forward

For the participants looking forward means economic support, farming and rehabilitation plans, focused future plans, possible source of income, progressive livestock plans, source of income, strength in determination, sustainable livestock preparation, motherhood and responsibility, perseverance over struggles, positive lifestyle changes, prioritizes recovery, and responsibility development.

Most PWUDs are looking forward to integrate what they have learned in the rehabilitation center to their life upon reintegration. In fact, PWUD Participant No.4 stated:

Siguro maam, ang kalahian kay dere sa rehab center, pag enagage nako ug animals, dele lang animals akoa tan-aw sa ilaha kundi something importante para sa ako recovery, siguro sa paggawas nako maam ang kalahian kay gena tudloan ko nya nga dele lang about sa pang warta, maka earn ko ug profit, ipakaon sa ako pamilya, but it’s about, apil na ako recovery ana, kung mahimo kung responsible sa mga hayop, mahimo pod kong responsible sa ako recovery. “Maybe, ma’am, the difference here at the rehab center is that when I engage with animals, I don’t just see them as animals, but as something important for my recovery. Perhaps, when I leave the rehab center, the difference will be that I’ve been taught it’s not just about making money or earning profit to feed my family, but also about including my recovery in the process. If I can be responsible for the animals, I can also be responsible for my recovery.” (PWUD Participant No.4, IDI, RQ4, Transcription lines 109-114).

From this response, the participant expressed a strong sense of optimism and anticipation for the future as he looked forward to his new life after completing the program. He highlighted his eagerness to apply the knowledge and skills he had gained through the Human-animal interaction program at the center. Specifically, he was excited about the prospect of continuing to engage with animals as a significant part of his ongoing recovery journey. This reveals his recognition of the positive impact that these interactions have had on his personal growth and his intention to integrate this aspect of his learning into his life moving forward.

Apart from that, the participants were also looking forward to take care of animals as a possible source of income that could help them with their livelihood upon reintegration. As PWUD Participant No. 1 stated: “Gusto pod nako nga mahimo syang Negosyo pagbuhi mga hayop, ing ana bitaw maam.” “I also want to turn it into a business, raising animals, that’s what I mean, ma’am.” (PWUD Participant No. 1, IDI, RQ1, Transcription lines 25-26). FGD Participant No. 3 added: “Oo maam, nag plano me nga mamuhi ug kanding sa ilang lugar baboy, didto lang kay peaceful. Mag negosyo dayun.” “Yes, ma’am, we are planning to raise goats and pigs in their area because it’s peaceful there. We will start a business.” (FGD Participant No. 3, FGD, RQ3, Transcription lines 156-157). These responses showed their willingness to take care of animals to show they are responsible enough, thus challenging themselves through taking care of animals.

Category 9. Developing personal accountability

For the participants, developing personal accountability means becoming responsible, commitment and accountability, concern for well-being, control and acceptance, dedication, develops self-discipline, genuine concern, growth through change, growth through responsibility, heightened accountability, and improved behavior.

Personal accountability refers to PWUDs commitment to take responsibility for their actions, decisions, and behaviors. This is something that the PWUDs has failed to acknowledge to themselves because of the unmanageability in their life during drugging days, owning up to their mistakes and acknowledging accountability for their actions.

Developing accountability through interaction with animals provides a meaningful and effective approach with PWUDs. Caring for animals inherently requires individuals to take responsibility for another living being, fostering self-discipline, empathy, and a sense of duty. One FGD Participant stated:

Mag gahin na syag oras maam, nga bahugan niya, mag maintain na syag huna huna sya nga wala pato nabahugan ang baboy, ang iro. Ma focus iya oras, mabalaka sya kinsay mabilin, kinsay mag bantay. Mao pod nga dele na sya kaayo ga gawas. “He will now set aside time, ma’am, to feed and take care of the animals. He will start thinking about whether the pig or the dog has been fed. His time will be focused on this, and he will worry about who will stay behind and who will look after them. That’s also why he doesn’t go out as much anymore.” (FGD Participant No. 5, FGD, Translation Lines 199-201).

This statement highlights the relationship between personal accountability and the development of responsibility, particularly in caregiving roles. The petitioner describes a shift in her partner’s priorities, as they now allocate time and effort to ensure the well-being of animals under their care. Personal accountability involves recognizing one’s duties and taking ownership of tasks, which is evident in the way this person proactively manages feeding schedules and plans for the animals’ needs (Schlenker et al., 1994). In this context, personal accountability fosters a sense of purpose and discipline, as the PWUDs focuses his time on meaningful responsibilities rather than external distractions like social outings. This behavior reflects an internal commitment to fulfilling obligations, which is a key component of accountability. The following responses indicate self-regulation, FGD Participant No. 2 added:

Parehas pod sa iya maam, nga maminaw napod sya sa akoa, dele na sya muadto sa iyang barkada, naa ra sya sa balay, naa man me tindahan na sari-sari store, deha ra sya, sya ang magbantay, kung hagaron sya dele na sya mu adto. Maminaw sya unsay gusto nako.” “It’s the same with her, ma’am; he listens to me now. He doesn’t go out with his friends anymore and just stays at home. We have a sari-sari store, and he stays there to watch over it. When someone invites him out, he doesn’t go. He listens to what I want.” (FGD Participant No. 2, FGD, Transcription lines 121-123).

This statement illustrates how developing personal accountability fosters responsibility and strengthens relationships. The petitioner describes a shift in her partner’s behavior, highlighting how listening and making responsible choices align with mutual respect and shared goals. Personal accountability involves recognizing one’s actions and their impact on others, which is evident in the partner’s decision to prioritize staying home and supporting their family by managing the sari-sari store. This behavior demonstrates an understanding of their role in maintaining trust, stability, and partnership within their relationship (Tillema, 2001).

In rehabilitation settings, promoting personal accountability is crucial, as it empowers individuals to take ownership of their actions, make constructive choices, and contribute positively to their communities and families. By fostering accountability, individuals develop a sense of agency and responsibility that benefits both their personal growth and their interpersonal relationships (Zimmerman & Schunk, 2011).

PWUD Participant No. 4 added:

Ang livestock ang man naga tudlo sa ako na mahimo kong responsible na e cater ang needs sa mga hayop. Siguro maam mao nay kalahian, I’ll be more responsible. Kato ako negosyo sauna, nasagulan man to droga mao to nawala sya, siguro pag mu engage ko sunod dele lang sya animal engagement lang kundi part sa ako recovery as RDD. “The livestock teaches me to be responsible in meeting the needs of the animals. I think, ma’am, that’s the difference—I’ll be more responsible. My previous business failed because it got involved with drugs, which is why it was lost. Maybe if I engage again, it won’t just be about animal engagement but also a part of my recovery as an RDD.” (PWUD Participant No. 4, IDI, RQ4, Transcription lines 114-118).

The daily tasks of feeding, grooming, and monitoring the well-being of animals teach the importance of routine and consistency, as animals depend entirely on their caretakers. These responsibilities highlight the cause-and-effect relationship between actions and outcomes, allowing individuals to see the direct impact of their care—or neglect—on the animals. Claypool et.al., (2023) found out that participants developed a sense of responsibility and improved self-regulation through their interactions with the animals, contributing to their rehabilitation process.

Theme No. 4. Regaining Self-worth

Regaining self-worth based on the responses of the participant means Valuing one’s self and self-regulation. PWUDs regains self-worth through animal engagement by fostering adaptability, perseverance, and a focus on learning through experience. Interacting with animals often involves unpredictable situations that require patience and problem-solving, encouraging individuals to view challenges as opportunities for growth rather than setbacks. The PWUDs were encouraged to see animal engagement as a way of improving their character, building and restoring human dignity. A study on Equine-Facilitated Prison-based programs found that the relationships formed between inmates and horses in these programs foster transformative experiences for both. These interactions help inmates prepare for life after incarceration while enhancing their sense of self-worth and restoring their dignity (Bachi, 2014).

By highlighting responsibility with animals, the PWUDs were able to understand the process of caring for or training animals which reinforces the value of persistence and incremental progress, as small successes, such as earning an animal’s trust or teaching it a new behavior, highlight the rewards of effort and dedication. Additionally, understanding and responding to an animal’s needs develops empathy and emotional regulation, which are essential for maintaining a positive outlook and reframing setbacks constructively.

Overall, these experiences of PWUDs in the center helps boost confidence by demonstrating that skills and relationships can improve over time with effort, reflecting the core principles of a growth mindset. Through these interactions, PWUDs learn to embrace challenges, adapt to obstacles, and celebrate progress, fostering a mindset focused on continuous learning and self-improvement.

Under this theme, there are two categories that emerged, namely- Valuing one’s self and self-regulation.

Category 10. Valuing one’s self

For the participants, valuing one’s self means challenging stigma, emotional healing, restoring self-worth, rebuilding trust, personal transformation, reflects own behavior, renewed purpose, self-value, improved patience, recovery support, being hopeful and self-determination.

Animal engagement in the rehabilitation center was integrated in the program structure to play a vital role in rehabilitation and character development by fostering emotional healing, building trust, and promoting personal growth. PWUDs caring for animals teaches responsibility and accountability. This interaction also enhances social skills, resilience, and patience, which are essential for reintegration and personal development. In fact, when asked how are their experiences with animals in the rehabilitation center has helped them towards stretching their patience.  It is clear that through the routine and discipline required for animal care which instills self-discipline, time management and bonding with animals boosts confidence and self-worth. By encouraging compassion, animal engagement not only aids in healing but also nurtures essential character traits such as empathy, kindness, and respect for others. This holistic approach is widely used in therapy, education, and community programs to help PWUDs rebuild their lives and strengthen their character.

Most PWUDs responded how the community viewed them as people with stigma and stain due to their previous cases and that they are PDL, people might see them as irresponsible thereby affecting their inherent worth as a person. When asked how interacting with animals in the center has restored or enhanced their sense of human dignity, most of them responded that they do not care how people see them, they want to change because they wanted to show their changes through actions. One participant said: “Basta ipakita lang nako sa ako action nga pina age sa ako pag atiman sa hayop, maka build nako ako dignidad isip isa ka tao kay usahay baya ang panlantaw sa uban tao sa amo RDD kay dele maayo.” “I just show through my actions that by taking care of the animals, I can rebuild my dignity as a person because sometimes, the way other people view us RDDs is not good.” (PWUD Participant No. 6, IDI, RQ4, Transcription lines 151-153).

PWUD Participant No. 2 added:

Pag abot nako derea maam kaya diay nako diay. Kay dele pod baya lalim akoa tahas maam derea kay kinabuhi pod baya akoa ge atiman dba, ma proud ko sa ako kaugaligon labe na pag naay buntis nga rabbit maam, akoa jud na sya e priority sa tanan maam kay sa ako pod nga part atong buros ko dele pod baya lalim. “When I arrived here, ma’am, I realized that I can do it. My task here isn’t easy because I’m taking care of lives, right? I feel proud of myself, especially when there’s a pregnant rabbit, ma’am. I really prioritize it above everything else because, from my own experience of being pregnant, I know it’s not easy.” (PWUD Participant No.2, IDI, RQ1, Transcription lines 208-211).

This statement reflects the concept of valuing oneself in the rehabilitation center, as the PWUDs acknowledges their ability to handle challenging tasks and derives a sense of pride and purpose from their responsibilities. By caring for pregnant rabbits, they connect with their own experiences, fostering empathy and a deeper understanding of their worth. This process of recognizing personal strengths, such as nurturing and prioritizing others’ well-being, helps build self-esteem and reinforces a sense of identity and capability (Deci & Ryan, 2000). In rehabilitation, engaging in meaningful activities like caring for animals promotes intrinsic motivation and self-efficacy, which are essential for personal growth and recovery (Faver, 2009). This alignment of personal experiences with caregiving tasks enables individuals to see themselves as capable and valuable contributors, enhancing their overall well-being.

Category 11. Self-regulation

Self-regulation for the participants means improved commitment, engaging with purpose, compassion through hardship, compassion through responsibility, controlled anger, empathy development, self-reflective growth, sympathy, sense of purpose, and embracing responsibility.

In a rehabilitation setting, self-regulation and human dignity are deeply interconnected, working together to foster recovery and personal growth. Self-regulation empowers individuals to take control of their actions, emotions, and decisions, building resilience and accountability in their journey toward independence. At the same time, upholding human dignity ensures that individuals are treated with respect, compassion, and recognition of their intrinsic worth.

Based on the responses of the participants, self-regulation and self-discipline is an important aspect of recovery because it prepares them for the life outside rehabilitation. PWUD Participant No. 6 stated: “Number one ang pagsunod sa house rules para ma disiplina, maka sunod ta sa balaod, para ma ready inig face sa reality sa real world.” “Number one is following house rules to develop discipline, comply with the law, and be prepared to face the realities of the real world.” (PWUD Participant No. 6, IDI, RQ1, Transcription lines 548-549). Another participant stated:

Kay sa tinood lang maam, atong pag assign nako dera maam, nag ampo jud ko sa ginoo mam nga lord, dele man jud ko diyosnon maam, talagsa rako mag ampo maam, pero nag ampo ko sa ginoo nga tabange ko sa ako tahas lord, mabuhian kog rabbit.” “To be honest, ma’am, when I was assigned there, I truly prayed to God. I’m not really a very religious person, ma’am, and I rarely pray, but I prayed to God, saying, “Lord, please help me with my responsibilities. Lord, let me succeed in taking care of the rabbits.” (PWUD Participant No. 2, IDI, RQ4, Transcription lines 30-33).

Spirituality also plays a vital role in recovery by providing individuals with a sense of purpose, hope, and connection. It encourages self-reflection, helping PWUDs align their goals, which fosters motivation and clarity. Human-animal interaction enhances self-regulation and spirituality in rehabilitation by fostering emotional stability, reducing stress, and promoting mindfulness. Interacting with animals, such as through petting or companionship, has been shown to lower cortisol levels and activate the parasympathetic nervous system, which reduces anxiety and supports emotional regulation (Beetz et al., 2012).

Animals also encourage present-moment awareness, helping individuals develop mindfulness and patience. Spiritually, nurtures a sense of connection and purpose, the bond with an animal can enhance feelings of compassion and interconnectedness, which are essential elements of spiritual well-being (Fredrickson & Anderson, 2019). These interactions provide a non-judgmental and supportive environment, making them valuable in rehabilitation settings.

Human-animal interaction can foster self-regulation by encouraging emotional awareness, taking perspective, and adaptive responses to stress.

PWUD Participant No. 1 stated,

Siguro maam sa akoa behavior, kana bitaw maulit naka sa mga kanding nga ga away mga siruot kaayo, ako mam imbes na masuko ko, mu ingon ko nga oopps kanding na, kanding na, ing ana bitaw. Dele ko dapat ma kwan ane kay hayop ni. Deha nako ma kwan maam, parehas atong kabayo nga nasipaan ko. Naulit ko sa ako kaugalingon, kay ingon pa ni sir Yunos nga kabayo man na dele man na nimo ma estorya nga ana ka nga isbog sad era, ako kay ako man gihilam iya tiyan, ana ko nga kabayo excuse sa, abe pod nako ug ok rato, pero gisipa man diay ko nya, kana feeling close kaayo ko. Dele man diay sya ganahan sa babae maam, ana si sir Yunos kay selosa man daw to na kabayo.” “Maybe, ma’am, it’s about my behavior. For example, when I get annoyed with goats fighting and being rowdy, instead of getting mad, I just say, “Oops, they’re goats, just goats.” Like that. I shouldn’t let it get to me because they’re animals. I think I’ve learned something from it, ma’am, like with that horse that kicked me. I was annoyed with myself because Sir Yunos said, “It’s a horse; you can’t just tell it to move like you would a person.” I was rubbing its belly and saying, “Excuse me, horse,” thinking it was fine, but it ended up kicking me. I was acting too friendly with it, but it turns out it didn’t like women. Sir Yunos said it was a jealous horse.” (PWUD Participant No. 1, IDI, RQ4, Transcription lines 6-14).

This statement illustrates the PWUDs reflections demonstrate growth in managing frustration and cultivating patience by recognizing the natural behaviors of animals, such as goats fighting or a horse kicking. Instead of reacting impulsively, the participant No. 1 reframes her emotional response, attributing the animals’ actions to their instincts rather than personalizing the situation. This cognitive reappraisal aligns with self-regulation strategies used in therapy, where individuals learn to adapt their thoughts and behaviors to navigate challenges effectively (Gross, 2015). Moreover, engaging with animals in this manner promotes mindfulness and emotional balance, critical skills for rehabilitation, as they enable individuals to remain calm and purposeful in response to stressors (Beetz et al., 2012).

SUMMARY OF FINDINGS, CONCLUSIONS, RECOMMENDATIONS, LIMITATIONS, AND REFLECTIONS

This chapter summarizes the study’s findings, present the conclusions, and provide recommendations based on the data gathered. The objective of the study is to provide insights into its effectiveness, impact, and sustainability, and to generate recommendations for improving the implementation of Human-animal interaction as a possible treatment for Substance Use Disorder (SUD).

This case study analyzed the implementation of Human-animal interaction in the rehabilitation center. It explored the challenges encountered during its execution and ultimately evaluated its effectiveness in achieving its goals which is to become recognized as possible treatment to help the PWUDs in their continued battle for recovery.

Summary of Findings

Four themes emerged from the narratives of the participants.  These are:  Holistic self-improvement, Therapeutic engagement with animals, Transformation and sustainability, and Regaining self-worth.

The program structure of DOH Drug Abuse Treatment and Rehabilitation Center employed Holistic self-improvement practically targeting all domains that needs to be address such as physical, emotional, mental, and social dimensions of well-being. Through Human-animal interaction, these domains were addressed because of the unwavering affection from the animals, which played a significant role in building emotional resilience, alleviating stress, and encouraging personal growth. The loyal companionship that is created between the animals and the PWUDs creates a comforting presence that helps them navigate emotional challenges, fostering a sense of stability and security. Additionally, interacting with animals nurtured empathy and trust, as their genuine and nonjudgmental nature inspires deeper connections and emotional understanding. Through these profound interactions, animals contributed positively to overall well-being and emotional development of the PWUDs.

Human-animal interaction and therapeutic engagement with animals are deeply grounded in the significant emotional and physiological benefits that animals offer. By engaging with animals, it helped them to reduce stress.  By fostering a calming and nurturing environment, human-animal interaction played a crucial role in enhancing emotional resilience and overall well-being, laying a foundation for deeper therapeutic self-awareness and healing.

Human-animal interaction fostered therapeutic engagement and sustainability for Persons Who Use Drugs (PWUDs).  It served a purpose that goes beyond merely companionship and instilling a sense of responsibility. The inclusion of animals in the rehabilitation process served as a dynamic tool to address not only their immediate therapeutic needs but also their self-reliance and stability. Through their engagement with animals, PWUDs developed a deeper understanding of the importance of care, compassion, and accountability. This bond with animals nurtured their ability to form meaningful connections, fostering empathy and emotional growth. Beyond these emotional and psychological benefits, the program emphasized hands-on experience in managing and interacting with livestock.

These experiences are intentional and strategic, aiming to prepare PWUDs for potential income-generating opportunities once they reintegrate into society. By equipping them with knowledge and expertise in animal husbandry or related fields, the program empowers them to explore livelihood options that can provide financial stability and reduce the likelihood of relapse. Ultimately, human-animal interaction in this setting serves as a comprehensive rehabilitation tool, addressing the holistic needs of individuals while setting them up for a future marked by independence and resilience.

Human-animal interaction helped individuals regain self-worth and human dignity. Caring for animals provides individuals with meaningful responsibilities, such as feeding or grooming, which promoted a sense of competence and self-efficacy. These tasks helped individuals witness the positive impact of their actions, reinforcing their value and capability. Animals, offering unconditional acceptance, created a safe and non-judgmental space that allowed the participants to feel valued. Moreover, engaging with animals nurtured empathy, accountability, emotional, and self-regulation.  These are essential for restoring dignity. The structured routines and caregiving roles in animal-assisted programs empower individuals to rebuild trust in themselves and others, supporting recovery and reintegration into society with a renewed sense of worth and purpose.

Implications

The study’s conclusion highlighted key elements and offered a comprehensive, subjective interpretation informed by the participants’ experiences and additional data. The researchers gained a deeper understanding of how human-animal interaction was integrated into the program structure, providing valuable insights into its implementation and impact.

In addition to established structured programs for Persons Who Use Drugs (PWUDs), human-animal interaction has gained recognition as an effective supplementary intervention. By fostering bonds between PWUDs and animals, the intervention encouraged empathy, patience, and accountability, which are critical in the recovery journey.

However, despite its promising benefits, certain challenges have been identified. One such challenge is the preferences among PWUDs for specific animals, as some may feel more comfortable or connected with particular species. Additionally, concerns about the ability of participants to adequately care for the animals have arisen, emphasizing the need for proper guidance and support in this aspect. Furthermore, while relatively rare, incidents such as animals kicking or biting have been reported, highlighting the importance of implementing safety measures and providing thorough training for both PWUDs and staff involved in the program. Addressing these challenges is crucial to maximizing the positive impact of human-animal interaction as a valuable component of holistic recovery programs.

Conclusions

Thus, the study provides a framework for understanding how human-animal interaction is therapeutic to Persons Who Used Drugs (PWUDs) contributing to their rehabilitation. This confirm the Bioecological Theory of Development of Urie Bronfenbrenner.  Human-animal interaction contributes to the emotional, social, and psychological growth, shaping human development throughout the lifespan.  Furthermore, this intervention demonstrates its positive impact on PWUDs including its benefits to the broader community upon their reintegration. It helps the PWUDs process their thoughts and emotions without the fear of judgment, while also aiding in the restoration of their sense of responsibility and human dignity. Ultimately, it emphasizes the importance of fostering compassion and care for all living beings.

Recommendations

Based on the findings and conclusions presented, the following recommendations are suggested:

• That the Dormitory Managers. May consider assigning PWUDs to animals with which they have prior experience and familiarity in handling. This strategic approach helps to reduce the likelihood of accidents or injuries resulting from improper handling techniques. By pairing PWUDs with animals they have successfully interacted with before, both the safety of the individuals and the well-being of the animals can be ensured. This method fosters a sense of confidence and competence in the PWUDs while minimizing the potential for mishaps, creating a more secure and supportive environment for therapeutic animal interactions.
• That Case Managers. May assign PWUDs the task of writing a reflective paper based on their experiences during their interactions with animals. This reflective exercise serves multiple purposes: it allows the PWUDs to process and articulate their thoughts and emotions about the activity, fosters self-awareness, and helps them to identify any personal growth or insights gained through the interaction. Additionally, such reflective writing can provide valuable feedback for the program, offering a deeper understanding of how these experiences impact the participants. Encouraging this practice can enhance the therapeutic benefits of the intervention while promoting critical thinking and emotional expression among the PWUDs.
• That House-parents. May ensure the safety and security of PWUDs is of utmost importance, particularly during therapeutic activities that involve interactions with animals. It is essential to closely monitor and supervise these interactions to prevent any potential incidents that could harm either the individuals or the animals. This supervision not only helps to create a safe and controlled environment but also fosters positive and meaningful engagement between the PWUDs and the animals, maximizing the therapeutic benefits while mitigating risks.
• Those Future Researchers. May consider investigation of other PWUDs experiences in various recuperation centers to in the region to establish a fuller grasp of the case of human-animal intervention.

Limitations

The study faced certain limitations, including the potential for sampling bias, as it focused on a specific group of participants, making the findings less generalizable to other contexts or populations. Additionally, the reliance on self-reported data from PWUDs and staff introduced the possibility of response bias, as participants might have provided socially desirable answers or inaccurately recalled information. To address these limitations and enhance understanding of human-animal interaction, future research could incorporate other qualitative methods, allowing for a broader range of insights and a deeper exploration of the topic.

Reflections and Utilization

During my time as MSSW student, research writing was not my strong suit, but I recognized its importance for my professional growth and development. Encouraged by the perspectives of my friends and family, I found myself gradually engaging in the process of working on my research. By the grace of the Almighty Allah, I was fortunate to have supportive instructors who guided and supervised me throughout my thesis journey. The path was not without its challenges—there were moments when my time, patience and knowledge were tested as I worked to complete my writing. As a researcher, I also struggled with organizing my ideas, fearing the risk of bias or losing focus on the direction of my paper. Despite these adversities, self-doubt and hesitation, I chose to finish this paper in dedication to our agency, Department of Health Drug Abuse Treatment and Rehabilitation Center, our clients, Persons Who Used Drugs (PWUDs) and to the future researchers.

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