Emotional Support Animals Research Articles

The effects of assistance dogs on psychosocial health and wellbeing: A systematic literature review.

Beyond the functional tasks that assistance dogs are trained for, there is growing literature describing their benefits on the psychosocial health and wellbeing of their handlers. However, this research is not only widely disparate but, despite its growth, has not been reviewed since 2012. Our objective was to identify, summarize, and methodologically evaluate studies quantifying the psychosocial effects of assistance dogs for individuals with physical disabilities. Following PRISMA guidelines, a systematic review was conducted across seven electronic databases. Records were independently screened by two authors. Studies were eligible for inclusion if they assessed outcomes from guide, hearing, medical, or mobility service dogs, if they collected original data on handlers' psychosocial functioning, and if the outcome was measured quantitatively with a validated, standardized measure. Studies on psychiatric service dogs, emotional support dogs, and pet dogs were excluded. Of 1,830 records screened, 24 articles were identified (12 publications, 12 theses) containing 27 studies (15 cross-sectional, 12 longitudinal). Studies assessed the effects of mobility (18), hearing (7), guide (4), and medical (2) assistance dog partnerships with an average sample size of N = 83. An analysis of 147 statistical comparisons across the domains of psychological health, quality of life, social health, and vitality found that 68% of comparisons were null, 30% were positive in the hypothesized direction, and 2% were negative. Positive outcomes included significant effects of having an assistance dog on psychological wellbeing, emotional functioning, self-esteem, and vitality. However, it is of note that several methodological weaknesses of the studies make it difficult to draw any definitive conclusions, including inadequate reporting and a failure to account for moderating or confounding variables. Future research will benefit from stronger methodological rigor and reporting to account for heterogeneity in both humans and assistance dogs as well as continued high-quality replication.

A Multilevel Intervention Framework for Supporting People Experiencing Homelessness with Pets.

Simple SummaryApproximately one in 10 people experiencing homelessness have pets. Despite pets having psychosocial benefits for their owners, pets can also present challenges for people experiencing homelessness related to meeting their basic needs and obtaining housing. This article proposes a framework of policy, public, and service interventions for improving the health and well-being of pet owners experiencing homelessness. At the policy level, the framework proposes an increase of pet-friendly emergency shelters, access to market rental housing and veterinary medicine, and the use of a Housing First approach. At the public level, educational interventions are needed to improve knowledge and reduce stigma about the relationship between homelessness and pet ownership. At the service delivery level, direct service providers can support pet owners experiencing homelessness by recognizing their strengths, connecting them to community services, being aware of the risks associated with pet loss, providing harm reduction strategies, documenting animals as emotional support animals, and engaging in advocacy. By targeting policies and service approaches that exacerbate the hardships faced by pet owners experiencing homelessness, the framework is a set of deliberate actions to better support this vulnerable group.Approximately one in 10 people experiencing homelessness have pets. Despite the psychosocial benefits derived from pet ownership, systemic and structural barriers can prevent this group from meeting their basic needs and exiting homelessness. A multilevel framework is proposed for improving the health and well-being of pet owners experiencing homelessness. Informed by a One Health approach, the framework identifies interventions at the policy, public, and direct service delivery levels. Policy interventions are proposed to increase the supply of pet-friendly emergency shelters, access to market rental housing and veterinary medicine, and the use of a Housing First approach. At the public level, educational interventions are needed to improve knowledge and reduce stigma about the relationship between homelessness and pet ownership. Direct service providers can support pet owners experiencing homelessness by recognizing their strengths, connecting them to community services, being aware of the risks associated with pet loss, providing harm reduction strategies, documenting animals as emotional support animals, and engaging in advocacy. By targeting policies and service approaches that exacerbate the hardships faced by pet owners experiencing homelessness, the framework is a set of deliberate actions to better support a group that is often overlooked or unaccommodated in efforts to end homelessness.

What to Do If Patients Want Service or Emotional Support Animals

Back to table of contents Previous article Next article Government & LegalFull AccessWhat to Do If Patients Want Service or Emotional Support AnimalsAnne Huben-Kearney, R.N., B.S.N., M.P.A.Anne Huben-KearneySearch for more papers by this author, R.N., B.S.N., M.P.A.Published Online:28 Sep 2020https://doi.org/10.1176/appi.pn.2020.10a24AbstractHere are some tips and information on how to handle patient requests for a support animal or emotional support animal.A patient asks the psychiatrist for a letter advocating for a service animal or for an emotional support animal. What is the difference between them? What is the psychiatrist’s responsibility when receiving such a request?Service DogsUnder the Americans With Disabilities Act (ADA), a service animal is defined as a dog (or miniature horse) that has been individually trained to perform tasks for an individual with a disability. The task(s) performed by the dog or horse must be directly related to the person’s disability. The disability may be physical, sensory, psychiatric, or intellectual. Psychiatric service dogs (PSDs) require extensive training to work specifically with people whose disability is due to mental illness. PSDs might be trained to remind patients to take their psychiatric medications, turn on lights for patients with posttraumatic stress disorder (PTSD), or interrupt self-mutilation by patients with dissociative disorder. Under the ADA, service animals can go anywhere the public can go.Emotional Support AnimalsEmotional support animals (ESAs) provide support through companionship. ESAs (generally dogs) have no special training and are not given the same accommodations as service animals. Regulations regarding ESAs are primarily set by individual states, but under the Federal Fair Housing Amendments Act and the Air Carrier Access Act, individuals who meet the proper criteria are entitled to an emotional support dog to assist them with their daily life.Generally, a regular pet can be an ESA if a mental health professional writes a letter saying that the owner has a mental health condition and needs the animal’s help for their health or treatment.Disorders that qualify for a PSD or ESA must be specified in DSM-5. Examples of disorders that could qualify a person for a service dog or emotional support animal include the following:ADHDAnxiety disordersDepressionPTSDBipolar disorder/mood disorderSchizophreniaRisk Management Tips for LettersFor a PSDDetermine that the patient is psychiatrically disabled to the degree that the person is unable to perform at least one major life task without assistance of a PSD on a daily basis.For an ESADetermine whether an ESA can indeed provide emotional support, but also understand how the animal assists with support.Consider meeting and observing the ESA, especially prior to patients’ airplane travel if they do not have their ESA with them. However, patients’ not bringing their ESA to sessions may be a flag that an ESA is not necessary.Resist classifying different species of animals, such as peacocks, iguanas, pigs, and other unusual animals as an ESA for air travel.State that you are not vouching for the ESA’s behavior, but only how the ESA helps your patient.For either a PSD or ESAState that your patient has a DSM-5 diagnosis for which the PSD or ESA is a necessary accommodation but do not give your patient’s specific diagnosis. ■ResourcesU.S. Department of Justice, Civil Rights Division, Disability Rights Section, Frequently Asked Questions about Service Animals and the ADAADA National Network, Service Animals and Emotional Support AnimalsADA National Network, Service AnimalsThis information is provided as a risk management resource for Allied World policyholders and should not be construed as legal or clinical advice. This material may not be reproduced or distributed without the express, written permission of Allied World Assurance Company Holdings, Ltd, a Fairfax company (“Allied World”). Risk management services are provided by or arranged through AWAC Services Company, a member company of Allied World. © 2020 Allied World Assurance Company Holdings, Ltd. All Rights ReservedAnne Huben-Kearney, R.N., B.S.N., M.P.A., is a risk management consultant in the Risk Management Group of AWAC Services Company, a member company of Allied World. Risk Management services are provided as an exclusive benefit to insureds of the APA-endorsed American Professional Agency Inc. liability insurance program. ISSUES NewArchived

Laws and Ethics Related to Emotional Support Animals.

The use of animals for therapeutic benefit is well-established. For example, for individuals with a disability such as blindness, trained service dogs can enhance the ability to live independently and participate fully in society. An emotional support animal (ESA) is an untrained animal that is used to support a person disabled by an emotional or mental disorder. For an animal to qualify as an ESA, a mental health or medical professional needs to write a letter saying that the animal is needed for the mental health of the person with the disability. This article describes the legal framework for service animals and ESAs, as well as the differences between them. We summarize information about the Americans with Disabilities Act, the Fair Housing Act, the Air Carrier Access Act, and other laws governing an individual's right to be accompanied by a support animal. We also summarize the clinical research on ESAs and argue that, although there are few studies on the clinical effectiveness of ESAs, a broader body of research indicates that animals may have positive clinical effects on medical and mental illness. Finally, we suggest there is a need for further research and provider education on ESAs.

Inclusion of Emotional Support Animals as Service Animals Under the ADA: Creating the Right to Use Dogs to Assist People Living with Mental Health Issues

This article asserts that Congress should amend the Americans with Disabilities Act (“ADA”) to recognize emotional support animals as service animals. The article analyzes laws and policies from other arenas such as transportation and higher education to demonstrate the need for and potential structure of such change. Indeed, the article proposes specific amendment language based upon this analysis. Providing clarity for all Americans, this expanded, clear language will benefit our society and its goals for inclusion and breaking the stigma of mental illness. The use of emotional support animals to alleviate or mitigate symptoms associated with mental health issues has been a topic of debate since its inception. On one hand, there is the community of people who have expressed a need to use support animals to help them to participate in society, including while traveling by airplane. On the other hand, the Department of Transportation has had to assess whether allowing support animals on airplanes would pose a direct threat to the safety or health of others. In the air travel context, support animals have been treated as service animals and special rules have been created to manage the situation. Nonetheless, in most other contexts, support animals are not treated as service animals, so therein lies the confusion. Between the ongoing debate, the need for clarification under the laws, and people’s desire to use emotional support animals to facilitate their participation in society on a daily basis, the law in this area is in a state of flux. Section II of this article provides the legal background on this issue and describes the current controversy over how to treat service animals and emotional support animals under federal law. Section III is an overview of the alternative approaches to defining service animal. Specifically, this section looks at the broader definitions of service animal in the contexts of transportation, higher education, and cities and states. Section IV of this article proposes language that can be used to redraft the ADA’s definition of service animal through the lens of the alternative approaches discussed in this article. This new definition includes the foundational pieces of the current definition regarding traditional service animals plus the inclusion of emotional support animals to provide parity among people with physical disabilities and people with mental health issues. Section V provides predictions for the future and how the inclusion of emotional support animals as service animals under the ADA may affect society at large. Broadening the ADA’s definition of service animal to include emotional support animal will have both positive and negative consequences. Nonetheless, the risk that comes with positive change will be worth it in the end. The biggest issue will most likely be how to ensure that users of emotional support animals are legitimate, meaning there needs to be a mechanism in place to handle issues of fraudulent behavior. With the carefully crafted definition of emotional support animal and the robust fraud mechanisms outlined in this article in place, people with mental health disabilities can have the promise of the ADA fulfilled and be fully integrated into society while still protecting the interests of businesses and others.

Emotional Support Animals: How to Accommodate All Students

This case study is designed for use in graduate courses in student affairs and higher education administration. This case presents some of the challenges that higher education professionals face concerning policies and laws as they relate to student mental illness and emotional support animals. Requests for emotional support animals are becoming more common, and institutions must determine how to accommodate such requests as required by law, while also ensuring a safe educational environment for all students. This case highlights the complex issues that administrators must confront as well as provides students the opportunity to evaluate important issues via the deconstruction of this complex case.

Are emotional support animals prosthetics or pets? Body-like rights to emotional support animals

Many philosophers have argued that prosthetic limbs are the subjects of some of the same rights as traditional body parts. This is a strong argument in favour of respecting the...

Sustainability, social marketing, veterinarians and United States veterans

ABSTRACT This marketing case study highlights an innovative nonprofit organization (Veterinarians To Veterans United, Inc.) whose mission is to provide service, therapeutic, and emotional support animals, and discounted veterinary care to United States veterans suffering from post-traumatic stress and related conditions. Through the work of this organization, the lives of veterans are positively impacted and the number of animals euthanized at animal shelters is also expected to decline. The case study requires students to reflect on the unique needs of the US veteran population and highlights the diverse segments that exist among the veteran population. This case study provides an opportunity for marketing students to apply concepts related to sustainability and social marketing in developing strategies and tactics to address the challenges faced by Veterinarians To Veterans United, Inc.

Service Animals in PreK-12 Schools: Legal and Policy Implications for School Leaders

Despite increasing animal prevalence in public spaces, few districts have proactively developed policies to integrate assistance, therapy, service, and emotional support animals that are both legally sound and support the needs of individual students. Federal legislation defines a variety of animals that could accompany students, but only those trained to perform a specific disability-related task are considered service animals. Policy development to address the increasing prevalence of service animals on school campuses has not been widely examined. This article uses standard legal analysis to gather data from court rulings in the United States; uses secondary sources such as peer-reviewed journals, special education journals, and professional organizations; and provides recommendations on how to develop a sound service animal policy and procedures.

Managing emotional support animal letters in clinical practice.

The purpose of this brief report is to inform clinical practice and decision making in addressing the increased number of individuals requesting and receiving emotional support animal (ESA) waivers. It is important for providers including nurse practitioners to carefully consider the diagnostic and legal implications of endorsing ESAs. Nurse practitioners should be aware of the legal implications of writing ESA letters before providing them to their patients, understanding that a letter constitutes a determination of a disability. The literature on this topic is sparse, making it difficult to support the evidence-based practice of writing ESA letters. The therapeutic effects and benefits from human-animal interactions warrant further study in the case of ESAs to further support their use. Ultimately, it is up to the individual provider's clinical judgment supported by due diligence on a case-by-case basis should they decide to provide an ESA letter to their patient.

Emotional support animals in the dental office

Emotional support animals in the dental office

Emotional Support Animal Assessments: Toward a Standard and Comprehensive Model for Mental Health Professionals.

Growth in the presence of Emotional Support Animals (ESAs) in our society has recently garnered a substantial amount of attention, both in the popular media and the professional literature. Public media abounds with stories focusing on the increasing number of animals claimed as ESAs, the impact of this growth on society, the industry claiming to certify ESAs, and the various types of animals described as "certified." The authors propose an assessment model for ESAs certification comprising a four-pronged approach for conducting these types of assessments: (1) understanding, recognizing, and applying the laws regulating ESAs, (2) a thorough valid assessment of the individual requesting an ESA certification, (3) an assessment of the animal in question to ensure it actually performs the valid functions of an ESA, and (4) an assessment of the interaction between the animal and the individual to determine whether the animal's presence has a demonstrably beneficial effect on that individual. This model aligns with professional ethics, standards of professional practice, and the law and seeks to provide clear guidelines for mental health professionals conducting ESA evaluations.

Know how to properly address situations involving potential ESA, service animal fraud

Occasionally, students deliberately misrepresent their pets as emotional support animals, service dogs, or both. The internet is rife with scam sites that offer ESA letters for a fee, and some students have purchased letters from those sites. Adding to the problem, students living in residence halls with already approved ESA dogs sometimes claim they have trained their dog to be a psychiatric service dog, allowing them to take it to classes and meals. These students may simply show up with their dog in classrooms or campus food services with rehearsed but fraudulent answers to the two approved Department of Justice questions.

Know how to properly address situations involving potential ESA, service animal fraud

Occasionally, students deliberately misrepresent their pets as emotional support animals, service dogs, or both. The internet is rife with scam sites that offer ESA letters for a fee, and some students have purchased letters from those sites. Adding to the problem, students living in residence halls with already approved ESA dogs sometimes claim they have trained their dog to be a psychiatric service dog, allowing them to take it to classes and meals. These students may simply show up with their dog in classrooms or campus food services with rehearsed but fraudulent answers to the two approved Department of Justice questions.

(Emotional Support) Peacocks on a Plane: Revising Federal Reasonable Accommodations Laws for Emotional Support Animals

In an era of increased healthcare and medication costs, using the comfort of an emotional support animal as a disability mitigation presents a valuable alternative to an overtaxed healthcare system. The rise in use of emotional support animals has outpaced the regulation of them, however. Four key federal statutes affect the legal rights and obligations for assistive animals under federal law — the Americans with Disabilities Act, the Rehabilitation Act, the Fair Housing Act, and the Air Carrier Access Act. While all four require accommodations for service animals, only the latter two require the same for emotional support animals. Even so, there is no consensus on how to define emotional support animals — the Americans with Disabilities defines them by exclusion, while the Air Carrier Access Act defines them by inclusion into a broader “service” animal category, and the rest merely defer to the latter. The resulting gap and confusion in federal regulation produce rather absurd results: peacocks on planes, alligators in apartments, and plenty of confusion regarding whether anyone can do anything about either. This Article argues for eliminating this gap in federal regulations with clear, prescriptive revisions to key disability laws and their reasonable accommodation requirements as applied to emotional support animals. Namely, it proposes that Congress should amend select reasonable accommodations laws so that the definition of “emotional support animal” mirrors the definition for “service animal.” These proposed revisions address three main problems plaguing the emotional support animal landscape: (1) fraudulent misrepresentation of pets as emotional support animals, (2) misrepresentation of absurdly untenable, wild, or exotic pets as emotional support animals, and (3) lack of accessibility to emotional support animals for disabled individuals who could greatly benefit from them. An emotional support animal under the proposed framework would be dog, cat, or miniature horse whose presence — or a task it performs — provides comfort or emotional support to a disabled individual. Moreover, this Article calls for eliminating the statement of need, which would further align the emotional support animal framework with that of the service animal. In doing so, it clarifies accommodation provider responsibilities with regard to these animals, and fair use of a valuable accommodation option for those disabled individuals seek to benefit legitimately from it.

Homelessness and Animal Companionship in Bloomington, Indiana

Abstract This study is the first to examine Bloomington, IN’s subpopulation of people experiencing homelessness with animals. To understand this subpopulation’s basic demographics, social service needs, and existing resources, eight families were recruited for the study from a service fair offering free veterinary care, pet supplies, and grooming to companion animals of people experiencing homelessness. The event was intended to be an isolated kick-off for a pilot year of capacity building programming in partnership with local homeless service providers. This article presents information which was collected from the first service fair through semi-structured interviews and the administration of the Lexington Attachment to Pets Scale. The data from this study reveal participants’ high attachment to their animals and a need for more pet-friendly overnight shelters. Other themes that emerge include homeless animal guardians’ restricted access to day-time services, a struggle to find temperature controlled places to sleep in extreme weather, and an absence of documentation supporting emotional support animal claims. Bloomington’s homeless advocates, direct service professionals, and program developers can ground efforts to assist people experiencing homelessness with companion animals using findings from this study.

Reducing ESA and service animal fraud

Occasionally students deliberately misrepresent their pets as emotional support animals, service dogs, or both. The internet is rife with scam sites that offer ESA letters for a fee, and some students have purchased letters from those sites. Adding to the problem, students living in residence halls with already approved ESA dogs sometimes claim they have trained their dog to be a psychiatric service dog, allowing them to take it to classes and meals. These students may simply show up with their dog in classrooms or campus food services with rehearsed but fraudulent answers to the two approved Department of Justice questions.

The ethics of emotional support animals in the dental office

The ethics of emotional support animals in the dental office

Faculty and Student Perceptions of the Presence of Emotional Support Animals on a College Campus

Abstract Colleges are experiencing an increase in requests for Emotional Support Animals (ESAs) to live on campus. However, misconceptions about policies pertaining to ESAs are pervasive. No formal, published study has yet examined the opinions of those who are most impacted—faculty and students. In the present study, 45 faculty and 228 students (49 living with an ESA) were surveyed about their understanding of ESAs and ESA-related policies. Participants were asked about the perceived benefits and disadvantages of having an ESA at college. Results indicate that the majority of faculty and students are supportive of ESAs on campus generally. However, opinions about permitting ESAs into academic spaces are considerably more mixed. Among both faculty and students, there is much confusion about the rules which govern their presence on campus. The survey also revealed support for increased accountability measures for ESAs in the form of training qualifications and welfare considerations.

Emotional Support Animals in the United States: Emergent Guidelines for Mental Health Clinicians

The role of Emotional Support Animals (ESAs) in facilitating mental health recovery is gaining increasing attention internationally. Within the United States, ESAs are companion animals without any special training, who are denoted in writing by a licensed mental health professional to be a therapeutic necessity for someone living with chronic mental health symptoms and who has a condition that meets the legal definition of a disability. ESAs are recognized within federal disability legislation, with limited rights to those who have ESAs as accommodations for their disabilities. The aim of this article is to present ESAs as a valid psychosocial rehabilitation intervention, consistent with the tenets of mental health recovery. Empirical literature is discussed, and a theoretical foundation is applied to explain the mechanism within the theory of change for how and why ESAs benefit people living with chronic mental health issues. To advance the current literature and practice, emergent best practices and guidelines for mental health clinicians for designating and documenting ESA need for clients who request such are provided.