The subversiveness of dog training prison programs

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ABSTRACT Prison Dog Programs (PDPs) have quickly grown as rehabilitative opportunities across the United States; estimates project between 230 and 290 currently active programs. These programs pair up incarcerated individuals with dogs from local shelters for 8–12 weeks and either train them as service dogs or work on basic obedience in preparation for adoption. In this paper, we propose that these programs subversively undermine prison logic in three main ways: (1) by allowing for ontological expansion – of the self, with other humans, and with other nonhumans–(2) by rearranging masculine socialization, and (3) by providing incarcerated individuals to participate in caretaking. We argue this with various supporting interviews from participants in two programs: the Madison Correctional Facility for Women in Indiana, USA and the North Central Unit in Arkansas, USA.

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  • Research Article
  • Cite Count Icon 5
  • 10.3390/healthcare11222987
Benefits of Being Teamed with a Service Dog for Individuals Living with Visible and Invisible Disabilities.
  • Nov 19, 2023
  • Healthcare
  • Joanne K Singleton

Over 61 million people in the United States are living with disabilities. Less than one percent are teamed with service dogs. A service dog is a type of assistance dog specifically trained to perform a disability-related task(s) to assist the person and support their independence. Service dogs may also provide valuable secondary benefits. The aim of this survey research is to add empiric data on benefits of being teamed with a service dog. Two hundred and four individuals teamed with service dogs responded to demographic and survey questions that included the benefits they experience from being teamed with a service dog. Overwhelmingly, respondents agreed or strongly agreed to benefits of emotional connection (96%), community participation (97%), physical activity (96%), psychological wellbeing (98%), quality of life (97%), a reduction in prescribed medications (78%), and a decrease in paid or unpaid assistance hours (83%), which extend beyond their primary disability need. It is clear that many others may benefit from being teamed with a service dog. Greater evidence is needed to increase tangible support for those who desire to be teamed with a service dog and can meet the Americans with Disabilities requirements. Additionally, to support individuals with service dogs now and in the future, healthcare professionals need to be knowledgeable about and culturally competent in caring for patients teamed with service dogs. Service dogs, when indicated, may benefit individuals living with disabilities by meeting primary and secondary needs that support independence.

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  • Cite Count Icon 25
  • 10.1016/j.applanim.2019.104864
Fear/Reactivity in working dogs: An analysis of 37 years of behavioural data from the Mira Foundation’s future service dogs
  • Aug 30, 2019
  • Applied Animal Behaviour Science
  • Nicolas Dollion + 6 more

Fear/Reactivity in working dogs: An analysis of 37 years of behavioural data from the Mira Foundation’s future service dogs

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  • 10.1371/journal.pone.0313864
Obstacles to inclusion and threats to civil rights: An integrative review of the social experiences of service dog partners in the United States.
  • Mar 19, 2025
  • PloS one
  • Sarah C Leighton + 6 more

Service dogs, trained to assist people with disabilities, are known to impact their human partners' social experiences. While service dogs can act as a "social bridge," facilitating greater social connection under certain circumstances, many service dog partners also encounter challenges in social settings because of the presence of their service dog - despite legal protections. Among the most common challenges reported are experiences of stigma, discrimination, and access or service denials. This preregistered integrative review sought to synthesize empirical, theoretical, and legal literature to understand better the social experiences reported by service dog partners in the United States, including (1) civil rights experiences; (2) experiences of stigma and discrimination; and (3) broader social experiences. Following database searches and article screening, a total of N = 43 articles met the eligibility criteria for inclusion. Analyses were conducted in two stages: first, synthesizing quantitative and qualitative findings to explore the magnitude of social experiences reported by empirical articles and second, narrative synthesis to integrate findings across all article types. Analyses identified three themes: Adverse Social Experiences, Contributing Factors, and Proposed Solutions. Overall, we found consistent reports of stigma, discrimination, and access denials for service dog handlers. Additionally, these adverse experiences may be more common for service dog partners with disabilities not externally visible (i.e., invisible disabilities such as diabetes or substantially limiting mental health conditions). This integrative review highlights a pattern of social marginalization and stigmatization for some service dog partners, exacerbated by inadequate legal protection and widespread service dog fraud. These findings have implications for the individual well-being of people with disabilities partnered with service dogs and highlight a need for collective efforts to increase inclusion and access. Effective solutions likely require a multi-component approach operating at various socio-ecological levels.

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  • Cite Count Icon 4
  • 10.1515/jom-2020-0280
A survey on health professionals’ understanding of federal protections regarding service dogs in clinical settings
  • Feb 10, 2021
  • Journal of Osteopathic Medicine
  • Alexander Merk + 7 more

Research has been scarce on health professionals' knowledge about guidelines regulating service dogs in a clinical setting. Gaining insight into health professionals'understanding of Americans with Disabilities Act (ADA) regulations concerning service dogs is critical for navigating compliance and reducing risk. Misinformation about service dogs could influence decisions affecting policy and care, leading to poor treatment and suboptimal health outcomes for patients with service animals. To assess health professionals' knowledge about ADA regulations and beliefs about workplace protocols and training related to service dogs. The study used snowball sampling to distribute surveys to health professionals from around the United States. Initial outreach occurred using mailing lists, investigators' personal networks, and social media. The survey contained 24 items. True and false questions were used to test ADA knowledge and then coded as correct or incorrect. Most closed-end questions were measured on a 5-point Likertscale using frequencies and descriptive statistics. A one-wayanalysis of variance (ANOVA) was conducted to test whether variables, such as encounters to service dogs, affected knowledge of ADA requirements. The survey was completed by 441 health professionals from around the country. Most (234; 53.1%) worked in a hospital and came from a range of professional backgrounds (nurses, 155 [35.2%]; physicians, 71 [16.1%]). While nearly three-quarters (318 [73.1%]) of participants said their workplace had a policy on service animals, 113 (34.9%) of those said they were unfamiliar with the policy and 236 (54.5%) said they had not received adequate training on the topic. Most participants did not know basic ADA policy requirements related to service dogs. Only those who were extremely familiar with policy (F=4.613; p=0.001) and those who strongly agreed that they knew the differences between service dogs and other classes of animals (F=5.906; p=0.000) scored higher on the knowledge test than those who disagreed. Our results suggest that increased familiarity and training leads to higher knowledge about servicedogs and ADA policy. Health professionals need additional education on ADA service dog regulations andhospital policy in order to minimize risk and ensure patientswith service dogs receive optimal care.

  • Research Article
  • 10.32755/sjcriminal.2022.01.078
УМОВИ РЕЗУЛЬТАТИВНОГО ВИКОРИСТАННЯ КІНОЛОГІЧНИХ КОМАНД
  • Sep 2, 2022
  • Scientific journal Criminal and Executive System: Yesterday. Today. Tomorrow
  • V.P Matviichuk

The conditions for the effective use of Junior Canine Inspectors with service dogs of remand centers and penal institutions of the State Criminal and Executive Service of Ukraine while performing their assigned tasks are clarified in the article. The essence and content of the proposed principles of using dog commands are revealed. The basic principles of application of canine commands while performing their tasks on purpose are offered the following: – the use of service dogs, taking into account their physiological characteristics and physical capabilities; – high efficiency of dog training; – activity and timeliness of actions of canine teams during the performance of purpose tasks; – the use of dog commands in combination with technical means; – continuous improvement of training methods and tactics of cynologists’ actions with service dogs. The responsibilities of the junior canine inspector to create favorable conditions for the effective use of service dogs is clarified. Namely, they are obliged to: – to improve their knowledge, study according to an individual program and systematically train a service dog assigned to them constantly; – to be able to use a service dog in accordance with the requirements of the law; – to show determination, agility and physical endurance while performing official tasks; – to keep a diary of education (training) of a service dog; – to qualitatively fulfill the requirements for storage, keeping and feeding of service dogs; – to clean and protect the fixed dog from diseases and various injuries; – to know the most common diseases and signs of dogs, as well as ways to provide them with the first aid; – to clean the premises for a service dog, keep in proper condition and constant readiness of equipment and care items; – to report to the Senior Canine Inspector of the remand center (penal institution) about the dog's disease immediately; – to follow the rules of personal hygiene when working with a service dog. The factors that ensure the smooth operation of canine teams are proposed and the factors that affect the performance of a service dog are specified, taking into account the specifics of service activities of remand prisons and penal institutions, among which the following should be noted: – general condition of the body of a service dog; – degree of preparedness (training) of a service dog; – dog trainer’s knowledge, skills, abilities and experience to manage the behavior of a service dog during its use in specific circumstances; – odorous situation in the area (place) of a service dog use; – peculiarities of the odor trail (antiquity, wind, precipitation, atmospheric pressure); – time of the year, time of the day; – terrain (relief, vegetation, etc.); – distracting environmental stimuli. Key words: Junior Canine Inspectors, service dogs, effective use, principles, factors.

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  • Research Article
  • Cite Count Icon 9
  • 10.3389/fvets.2019.00179
Professionally- and Self-Trained Service Dogs: Benefits and Challenges for Partners With Disabilities
  • Jun 11, 2019
  • Frontiers in Veterinary Science
  • Mariko Yamamoto + 1 more

It has been widely reported that service dogs offer benefits to their human partners, however, it is unclear whether the expanding methods of training and roles of service dogs for their partners with various disabilities also provide similar benefits. This study aimed to investigate the self-reported experience of service dog partners to understand whether three different factors influence the benefits and drawbacks associated with partnering with a service dog: (1) different methods of training service dogs; (2) different severities of human partners' disabilities; (3) different roles of service dogs. Partners of service dogs were recruited to the web survey through service dog facilities and networking groups. Answers from 19 men and 147 women participants (91.8% living in the U.S.) were analyzed in this study. Participants experienced the expected benefits of service dogs, including increased independence, social relationships, self-esteem, and life satisfaction, and decreased anxiety, stress, and loneliness. However, the perceived benefits, concerns, and burdens differed depending on the partners' disabilities and the training history of the dogs. When first living with their service dogs, people who had self-trained their service dogs experienced more burdens than those living with professionally trained service dogs. No major reduction in expenses for assistance after acquiring a dog was reported. Personalized team training based on each person's disabilities and situation is required to optimize the benefits and minimize the burdens and concerns of living with service dogs.

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  • Cite Count Icon 4
  • 10.3389/fvets.2022.886941
Quantifying canine interactions with smart toys assesses suitability for service dog work.
  • Sep 2, 2022
  • Frontiers in Veterinary Science
  • Ceara Byrne + 2 more

There are approximately a half million active service dogs in the United States, providing life-changing assistance and independence to people with a wide range of disabilities. The tremendous value of service dogs creates significant demand, which service dog providers struggle to meet. Breeding, raising, and training service dogs is an expensive, time-consuming endeavor which is exacerbated by expending resources on dogs who ultimately will prove to be unsuitable for service dog work because of temperament issues. Quantifying behavior and temperament through sensor-instrumented dog toys can provide a way to predict which dogs will be suitable for service dog work, allowing resources to be focused on the dogs likely to succeed. In a 2-year study, we tested dogs in advanced training at Canine Companions for Independence with instrumented toys, and we discovered that a measure of average bite duration is significantly correlated with a dog's placement success as a service dog [Adjusted OR = 0.12, Pr(>|z|) = 0.00666]. Applying instrumented toy interactions to current behavioral assessments could yield more accurate measures for predicting successful placement of service dogs while reducing the workload of the trainers.

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  • Cite Count Icon 15
  • 10.1080/20008198.2022.2062997
Posttraumatic stress disorder service dogs and the wellbeing of veteran families
  • May 9, 2022
  • European journal of psychotraumatology
  • Leanne O Nieforth + 3 more

Background Benefits and challenges associated with service dogs for veterans with posttraumatic stress disorder (PTSD) may extend beyond veterans to their families. Objective The purpose of the current study is to evaluate the impact of veterans’ PTSD service dogs on spouses and families in a parallel-group, longitudinal design with assessments at baseline and three months follow-up. Method A total of 88 United States military veteran spouses completed a survey composed of multiple standardized measures at baseline and three months later. In the intervention group (n = 48), veterans received service dogs shortly after baseline while the waitlist control group (n = 40) did not. Results Linear regression analyses demonstrated significantly lower caregiver satisfaction, higher caregiver burden and higher participation in life activities among spouses who had service dogs in their homes compared to those on the waitlist. Though not significant, small effect sizes were present among additional measures. Conclusion Results suggest that although previous literature demonstrates service dogs may offer significant improvements for veterans, spouses and children may not experience those same benefits. Clinicians should consider how to prepare veteran spouses and families for integrating service dogs into their home. Future studies should explore family-focused approaches for service dog integration, defining an optimal strategy for the benefit of the entire family. HIGHLIGHTS Though service dogs may improve wellbeing for veterans with posttraumatic disorder, families of veterans may not experience those same benefits. Researchers and clinicians should consider how to best prepare veteran families for integrating service dogs into their homes. Though posttraumatic stress disorder (PTSD) service dogs are trained specifically for veterans, recent studies have demonstrated that their impact may go beyond veterans themselves (McCall, Rodriguez, Wadsworth, Meis, & O’Haire, 2020; Nieforth, Craig, Behmer, MacDermid Wadsworth, & O’Haire, 2021). PTSD service dogs may provide both benefits and challenges for veteran families.

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DOGS WITH A PURPOSE SAINT FRANCIS SERVICE DOGS: ASSISTING PEOPLE WITH DISABILITIES
  • Jun 30, 2013
  • Medical Science Pulse
  • Carol B Willoughby

Formed in 1996, Saint Francis Service Dogs is a non-profit organization working to improve the lives of children and adults with disabilities through partnership with a service dog. The organization is also committed to promoting the use and acceptance of service dogs through public and professional education, providing advocacy for service dog partners, and supporting the growth of the service dog industry on a national level. The organization’s training center is located in Roanoke, Virginia USA, and is the largest service dog organization in the state. The Saint Francis Training Center includes a state-of-the-art kennel facility to house young dogs that are going through the training program. A recently-established program places service dogs with United States military veterans who have combat-related injuries. Co-founder Carol Willoughby credits her first service dog, Booker, with changing her life. He ultimately inspired her to form Saint Francis Service Dogs so that others in need could benefit from professionally trained service dogs. Today, Carol’s life is brightened by her Saint Francis Service Dog, Midas. While providing valuable assistance, Midas also helps Carol promote awareness and appreciation for service dogs and the amazing difference they make in so many lives.

  • Research Article
  • Cite Count Icon 50
  • 10.1037/prj0000294
Benefits and challenges of using service dogs for veterans with posttraumatic stress disorder.
  • Jun 1, 2018
  • Psychiatric Rehabilitation Journal
  • Bobbi Jo H Yarborough + 4 more

Veterans with posttraumatic stress disorder (PTSD) are increasingly seeking service dogs to help them manage trauma-related symptoms, yet literature describing service dog use in this population is scant. The goal of this study was to document the benefits and challenges experienced by veterans with service dogs trained to assist with PTSD-related needs. Participants were veterans (N = 41) with service dogs, and their caregivers (n = 8), recruited through community-based service dog training agencies. We conducted in-depth interviews and observed training sessions as part of a larger study, and used thematic analysis to characterize data. Veterans reported that service dogs reduced hypervigilance by alerting and creating boundaries, and disrupted nightmares, improving sleep quality and duration. Dogs also helped veterans turn their attention away from invasive trauma-related thoughts. Additional reported benefits included improved emotional connections with others, increased community participation and physical activity, and reduced suicidal impulses and medication use. Demands of training, adjustment to life with a service dog, and delayed benefits were challenging for many veterans and caregivers. Veterans report that service dogs help reduce PTSD symptoms and facilitate recovery and realization of meaningful goals. Service dogs may be a reasonable option for veterans who are reluctant to pursue or persist with traditional evidence-based treatments. Additional rigorous research on the effectiveness of service dogs for this population is warranted. (PsycINFO Database Record

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  • Cite Count Icon 2
  • 10.1080/09687599.2023.2227336
‘Fake Dogs Hurt Real Dogs’: boundary work and discrimination in the Service Dog Community
  • Jun 16, 2023
  • Disability & Society
  • Meghan L Mills

This article examines the relationship between the use of “fake” Service Dogs and the discrimination of Service Dog handlers using interview data from 25 adult Service Dog handlers in the United States. Most Service Dog handlers interviewed reported the use of “fake” or inadequately trained Service Dogs is the main cause for the discrimination they experience. This research finds many Service Dog handlers engage in boundary work, the ongoing process of creating and maintaining a division between those with a shared sense of identity as a “good” legitimate handler from “bad” or “fake” handlers to reduce discrimination. However, this boundary work ultimately supports internalized ableism with the main aim of keeping disability hidden. Changes in the current civil rights of people with disabilities to use a Service Dog should be based on the everyday lived experiences of Service Dog handlers.

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  • 10.3373/jssdr.12.32
The Current Situation and Challenges of Accepting Foreigners with Unapproved Service Dogs According to the Act of Assistance Dogs for Person with Physical Disabilities in Japan
  • Oct 1, 2018
  • Nippon Hojyoken Kagaku Kenkyu
  • Tomoko Takayanagi

Established in 2002 with the objective to advance and foster accessibility for challenged individuals, The Act on Assistance Dogs for Persons with Physical Disabilities stipulates, in accordance with the physical disability certificate, that guide dogs, service dogs, and hearing dogs be legally accepted as assistance dogs, and that they require legal certification and ID. The demands and uses of guide dogs and hearing dogs are the same between Japan and the Western world, but there has been increasing variation in the Western world for the demand and uses of service dogs. In contrast to Japan, the Western world uses service dogs for mental and emotional challenges, such as developmental disorders and post-traumatic stress disorder (PTSD), none of which are legally accommodated in Japan; there are no regulations requiring the certification, identification, or accountability of these types of service dogs and their users. While emotional support animals are becoming a social issue in the United States, due to its difficulty in distinguishing between “invisible” and “fake” disabilities, Japan is facing the same problem; of the 7,000 dogs that enter Japan each year, 20 are assistance dogs. Japanese airlines operating international flights between North America and Japan have reported that they have over 30 cases of U.S. “service dogs” aboard annually, and that they are facing complaints regarding noise and behavior problems. Heading into the 2020 Tokyo Olympics and Paralympics, it is important that we promote and publicize information concerning the Act on Assistance Dogs, so that we can accept and accommodate for those with dogs that comply with the Act, and to caution those with dogs that do not.

  • Research Article
  • 10.1176/pn.45.2.psychnews_45_2_019
Some Service Dogs Appear More Equal Than Others
  • Jan 15, 2010
  • Psychiatric News
  • Rich Daly

Back to table of contents Previous article Next article Government NewsFull AccessSome Service Dogs Appear More Equal Than OthersRich DalyRich DalySearch for more papers by this authorPublished Online:15 Jan 2010https://doi.org/10.1176/pn.45.2.psychnews_45_2_019AbstractMental health advocates have launched an effort to get federal aviation officials to reverse a new order that places special requirements on people who use trained psychiatric service dogs and want to take them on commercial flights.The effort aims to roll back regulations by the Federal Aviation Administration (FAA) in effect since May 2009 that require people who use psychiatric service dogs to provide documentation from a clinician that the animal assists with a psychiatric illness. Other types of service dogs are allowed on flights if their owners simply state that their dogs are service dogs.“It just creates an onerous set of burdens for people with psychiatric illness if they want to travel,” said Jennifer Mathis, an attorney at the Bazelon Center for Mental Health Law, in an interview with Psychiatric News.Bazelon has joined other mental health advocates, including the National Alliance on Mental Illness (NAMI) and the Psychiatric Service Dog Society (PSDS), in urging federal officials to reverse the regulations that were promulgated during the George W. Bush administration.The FAA is considering a PSDS “petition for rule making” that, if approved, would reopen the regulations for public comment and change. If the FAA consents to revise the regulations, it could take another year for those changes to move through the review process and become effective.Joan Esnayra, Ph.D., and Craig Love, Ph.D., are accompanied by two trained psychiatric service dogs, Kenji and Rainbow.Photo courtesy of Joan Esnayra, Ph.D.The new travel regulations have already had a large impact on people who use psychiatric service dogs, Joan Esnayra, Ph.D., president and founder of PSDS, told Psychiatric News. She has been told by dog trainers that many of the estimated 5,000 people with psychiatric service dogs who wanted to travel during the last Christmas season were unable to do so because they lacked insurance and had no clinician to write the required documentation. Others balked at having to admit to airline personnel that they had a psychiatric illness. Some simply pretended that the dog was for a physical ailment and gave assurances to airline staff to that effect, which airlines are required to accept under federal law.The impact of the regulations could increase in future years since use of psychiatric service dogs has expanded among people with mental illness, including posttraumatic stress disorder (PTSD). A growing number of veterans with PTSD, in particular, have found trained psychiatric service dogs helpful in waking them from violent nightmares and reorienting them when they begin to suffer combat flashbacks, Esnayra said.Psychologist Carmen Davis, Ph.D., has had several patients in recent years who have used such service dogs and considers them as important as medication in the health of her patients.“The dogs are absolutely essential in terms of keeping people grounded and present in reality,” she told Psychiatric News.Davis described the requirement for people with psychiatric disorders to disclose their conditions to airline personnel as “discriminatory.” “There is so much shame and stigma attached to mental illness, anyway,” Davis said.Mental health advocates are hoping to reverse the travel requirements quickly through an executive order from Obama. They have been told by members of the Obama administration that it is open to reversing the regulations, but so far no action has been taken.“If it's a concern about the certification of psychiatric service dogs we can address that, but otherwise it seems like a violation of the Americans With Disabilities Act,” Ron Honberg, director of policy and legal affairs at NAMI, told Psychiatric News.Neither the White House nor FAA responded to requests for comment.More information on psychiatric service dogs is posted at </www.psychdog.org>. ISSUES NewArchived

  • Research Article
  • 10.1080/08927936.2025.2568291
Veterans With Post-Traumatic Stress Disorder (PTSD): Does Participating in a Service Dog Training Program Reduce Their Symptoms?
  • Oct 28, 2025
  • Anthrozoös
  • Erika Friedmann + 3 more

Post-traumatic stress disorder (PTSD) affects 20–30% of US veterans. Greater PTSD symptom severity (PTSDSS) produces emotional dysregulation, impulsive behavior, and family/societal dysfunction. The frequency and insidiousness of PTSD demand empirically validated treatment. Service dogs are used to reduce PTSD symptoms in veterans. Anecdotal reports suggest training service dogs for other veterans also reduces PTSDSS for the veterans who train them, but data are lacking. Studies without comparison interventions also suggest that training service dogs would reduce veterans’ PTSDSS. This two-armed parallel randomized clinical trial examined the efficacy of a service dog training program (SDTP) versus a dog training video control intervention (CIG) for improving PTSDSS in veterans with PTSD (n = 60). Both interventions consisted of eight sessions and included instruction in training service dogs. The SDTP included hands-on service dog training. The CIG did not include any contact with service dogs. PTSDSS was assessed at baseline, after four sessions, and after eight sessions. In linear mixed models with random intercepts and slopes, veterans’ PTSDSS decreased significantly (F (1, 53.850) = 17.210, p < 0.001, ES = 0.45) from baseline to the end of the intervention. Decreases did not differ between interventions (F (1, 53.850) = 0.319, p = 0.575) and were greater for women than for men (F (1, 53.895) = 5.216, p = 0.026, ES = 0.47). Results indicate that the SDTP was not more effective than the CIG for reducing PTSDSS among veterans. Findings suggest that the support provided through participation in a study, placebo effects, and gender influenced PTSDSS reductions. Differences in the responses of men and women require further investigation.

  • Research Article
  • Cite Count Icon 10
  • 10.1080/08927936.2021.1898219
The Effect of a PTSD Service Dog on Military Veterans’ Medication Regimens: A Cross-Sectional Pilot Study
  • Apr 23, 2021
  • Anthrozoös
  • Kerri E Rodriguez + 3 more

Recent research suggests that service dogs may have clinically relevant benefits for military veterans with posttraumatic stress disorder (PTSD). However, the effects of PTSD service dogs on veterans’ medication use have been largely unexplored. The objective of this study was to quantify the effect of PTSD service dogs on medication use among a population of military veterans with PTSD. In a cross-sectional design (n = 96), United States post-9/11 military veterans with PTSD were recruited from a single service dog provider including veterans living with a PTSD service dog (n = 52) and veterans on the waitlist (n = 44). Both populations of veterans received treatment as usual. Participants completed an online survey of self-reported medication regimens and medication changes. Regression models quantified the effect of having a service dog on physical health, mental health, pain, and sleep medications while controlling for confounding variables (age, gender identity, relationship status, traumatic brain injuries, and physical health). Results indicated that there were no significant effects of having a service dog on overall self-reported medication use nor any specific medication category (p’s > 0.06). However, veterans with a service dog were more likely than those on the waitlist to report that their doctor had decreased dosage or removed medications since getting their service dog. The results of this preliminary cross-sectional research should be interpreted with caution, as future within-subject and pharmacy-verified research is necessary to understand the causality of these findings.

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