People with communication difficulties have an increased risk of mood and anxiety disorders. This often means that speech and language therapists must actively engage in counselling as part of their intervention. It is not surprising, therefore, that the active components of any therapeutic relationship outlined by the authors of this paper are empathy, congruence, and unconditional positive regard. The authors also advocate that speech and language therapists may provide counselling to support clients in a range of roles such as exploring and processing emotional reactions, thoughts, feelings, and behaviours in connection to the communication, swallowing disorder or underlying diagnosis. The authors of this paper go on to provide a case for the use of animal-assisted therapy (AAT). They define AAT as the use of the human–animal bond in a goal-directed intervention, and emphasise that most often AAT is used as an adjunctive or complementary intervention to enhance the influence on therapeutic outcome. The article then provides an overview of the recent literature on AAT and a series of case examples highlighting how this approach can enhance social engagement in children, provide a space to share feelings and build confidence in adult clients. They outline counselling activities including empowerment, education, support, skills building, discussions, evaluating and addressing negative thoughts and emotions and referral, and describe how AAT techniques can address these issues. This innovative approach should be considered as an adjunct for the speech and language therapist when working with people with communication and swallowing difficulties.