Emotional Support Animals Research Articles

Barriers to finding and maintaining pet-inclusive affordable housing: Tenant experiences in Houston, Texas

The city of Houston, Texas has a growing deficit of available and affordable rental units for low-income residents. Due to pet policies, the shortage of affordable housing potentially puts renters who own pets at greater risk of housing insecurity. In this qualitative study, we use a community-engaged approach to document the lived experiences of finding and maintaining affordable housing among 24 current, former, and aspiring pet owners. The majority of the participants identified as female, were aged 44–60 years, identified as Black, had a high school education, and were employed full-time or on disability or government assistance. Many expressed having experienced homelessness in the past and/or having lived in several different types of affordable housing over their lifetime. Participants highlighted challenges in finding pet-inclusive affordable housing, emphasized its importance, and discussed issues faced, such as high pet charges, size and breed restrictions, and confusion surrounding pet policies. Landlord relationships and living conditions varied, with safety concerns prevalent. Having one’s pet designated as an Emotional Support Animal made tenants feel safe and secure, knowing they could not be refused, evicted, or otherwise charged extra. Participants shared what is working well and what could be improved. This study concludes with recommendations for fair application and awareness of pet policies in affordable housing, drawing on participating tenants’ experiences and existing efforts for policy and practice improvements.

Travelling together: exploring the impact of support and service animals on travel experiences

ABSTRACT The phenomenon of multi-species families is increasingly linked to the growing awareness of the benefits of emotional support and service animals. As more people adopt various animals into their homes, it becomes crucial to understand how these family arrangements influence travel experiences. The presence of these animals during travel directly impacts the well-being and safety of travellers, contributing to the emotional and behavioural dynamics of multi-species families in transit. Consequently, the hospitality, tourism, and transportation industries must adapt to accommodate the growing number of tourists travelling with their animals, whether for work or leisure. The United States is the focus of this research due to its significant role in regulating emotional support and service animals, allowing for comparisons with the diverse regulations across European countries. This study aims to: (1) investigate current U.S. legislation regarding emotional support and service animals; (2) explore the challenges faced by owners of these animals during travel; and (3) highlight the practical experiences of owners travelling with emotional support and service animals. The methodology used is an exploratory qualitative review. The research highlights the experiences of Em and Jennifer, Brazilian students who travelled to the USA with their animals, illustrating the variations in travel experiences with emotional support and service animals. In conclusion, while acceptance and accommodation of these animals are evolving, particularly in the US hospitality industry and tourist attractions, challenges and a lack of understanding still exist in some establishments. This underscores the importance of studies like this to raise awareness and educate about the needs of families that rely on their animals. The increasing prevalence of multi-species families positively influences the availability of pet-friendly services, which can significantly impact travellers’ choice of accommodation when accompanied by their pets.

Supporting Rights to Emotional Support Animals as an Accommodation: A Scoping Review of Professional Guidelines for Verifying Eligibility

ABSTRACT When the emotional support provided by a person’s animal helps to mitigate an aspect of a disability, that person has a right to have their animal, typically referred to as an emotional support animal (ESA), within their housing as a disability accommodation under the Fair Housing Act (FHA) in the United States. Health and mental health care professionals (henceforth referred to as “health-care professionals”) are considered a reliable source for verification of eligibility for ESAs as a disability accommodation, and guidelines have emerged within and across professions to help guide assessment and documentation. These guidelines are published in the form of peer-reviewed journal articles and position statements from professional groups, such as primary care physicians, nurse practitioners, psychologists, counselors, social workers, and psychiatrists. We used scoping review methods to identify guidelines across psychiatry, medicine, nursing, counseling psychology, and social work, then analyzed the guidelines using a competency-focused framework. and compared them to the legal requirements of ESA documentation. Guidelines often reflected the values underlying the profession, but agreement was generally seen in most areas of knowledge, skills, and attitudes. Recommendations for integrative best practice guidelines, across professions, are proposed along with specific recommendations for writing ESA letters.

Service and emotional support animals in pediatrics

There is a growing body of evidence of the positive psychological and social impacts animals can have on individuals with chronic conditions and disabilities. Service animals have been used primarily in the adult population. Recently they have become more prevalent in pediatric care to improve the quality of life and emotional well-being of children with physical and mental health challenges. Studies have shown that both service animals and emotional support animals (ESAs) improve physical, psychological, and social health of children with chronic medical conditions and neurodevelopmental disabilities. Due to the increasing use of service animals and ESAs in pediatrics, providers need to be aware of which children may benefit from having a service animal or ESA, the process to obtain them and recognize the practical, financial, and ethical considerations or challenges children and their families may encounter. This article aims to provide guidance on the differences between service and emotional support animals and considerations for their use in pediatric care.

The ethical perspectives of using animals in pediatric health

While there are ethical standards for human biomedical research, animals have historically not benefitted from the same levels of protection. Cultural shifts in response to studies demonstrating animal capacity to suffer have resulted in laws defining minimum ethical standards for the treatment of various animal populations. However, none of these pertain to service or therapy animals nor do they define ethical considerations regarding training, placement, environment, and duty limitations specific to this population. The potential for harm and inability to provide consent should raise ethical questions of animal assisted interventions (AAI), including how to best balance the risk: benefit ratio for both animal and human participants.While service animals have specific definitions, therapy and emotional support animals are much less clearly defined and therefore have far less standardized practices regarding their training, certification, and process for matching to handlers. This can lead to animals being inadequately trained to cope with the stresses of their jobs or being placed in incompatible environments. Meanwhile, service animals’ duties are constant, and the animal has little ability to consent to or withdraw from participation, leading to overwork, without the opportunity to engage in activities that align with the animals’ natural preferences. Emotional support animals are the least defined of these populations, receive no formal training, and are at increased risk of inadequate care, unstable housing, and abuse from handlers who may also be poorly prepared to properly handle their needs.To uphold our moral obligations to the animals that serve to improve our own mental wellness and physical independence, urgent actions are needed to improve the protections in place for these populations.

Animals as healers: A historical journey through the impact of animals on human health across the ages

Animals have had a profound impact on health throughout the course of human history. Beginning with zootherapy in the ancient world, where animals were used as sources of mystical healing, animals have been crucial in the scientific discovery of human health and disease. In the modern world, the therapeutic application of emotional support animals serves as recognition for the symbiotic relationship between animals and humans. Appreciating the continued application of animals in human health serves as a reminder of the connectivity between humanity and the animal kingdom.

Learn how to distinguish between service animals, emotional support animals, and assistance animals

In the past few years, an increasing number of college students have expressed interest in bringing their service animals, emotional support animals, or assistance animals to campus to help them manage a variety of physical and mental health issues. Although most institutions have policies and procedures regarding animals on campus, colleges and universities should be prepared to handle complex or unique requests. Recently, some of the more unexpected ESA requests from individuals with disabilities have involved some particularly exotic animals — including a beehive, a baby kangaroo, and a large peacock.

Clinician’s Beliefs, Practices, and Attitudes Regarding Emotional Support Animal Recommendations

ABSTRACT The landscape regarding the public’s use and mental health professionals’ recommendation of emotional support animals has recently undergone significant changes. This study analyzes current practices for emotional support animal (ESA) recommendations among mental health professionals and aims to explore best practices for compliance with ethical and legal standards when using emotional support animals in treatment. The researchers surveyed 106 mental health professionals using a Likert-style questionnaire to determine their beliefs, practices, and attitudes regarding ESAs. Participants included LPCs/LMHCs, LMFTs, social workers, psychologists, and student interns. Results showed that most participants believed in the healing power of human-animal interactions and were well versed in legal requirements regarding ESAs. Results also indicated that many mental health professionals recommend ESAs without appropriate continuing education or coursework. Results also showed discrepancies between practitioners’ purported knowledge about ESAs and actual procedures regarding ESA recommendations. These findings yield important information for clinicians, counselor educators, and clinical supervisors who are likely to face inquiries about ESAs.

Points to Consider When Asked to Write Emotional Support Animal Advocacy Letter

Points to Consider When Asked to Write Emotional Support Animal Advocacy Letter

Learn how to distinguish between service animals, emotional support animals, and assistance animals

In the past few years, an increasing number of college students have expressed interest in bringing their service animals, emotional support animals (ESAs), or assistance animals to campus to help them manage a variety of physical and mental health issues. Although most institutions have policies and procedures regarding animals on campus, colleges and universities should be prepared to handle complex or unique requests. Recently, some of the more unexpected ESA requests from individuals with disabilities have involved some particularly exotic animals — including a beehive, a baby kangaroo, and a large peacock. To help higher education professionals navigate this complex area, I’ve answered some frequently asked questions:

Learn how to distinguish between service animals, emotional support animals, and assistance animals

In the past few years, an increasing number of college students have expressed interest in bringing their service animals, emotional support animals (ESAs), or assistance animals to campus to help them manage a variety of physical and mental health issues. Although most institutions have policies and procedures regarding animals on campus, colleges and universities should be prepared to handle complex or unique requests. Recently, some of the more unexpected ESA requests from individuals with disabilities have involved some particularly exotic animals — including a beehive, a baby kangaroo, and a large peacock.

Considerations for the Writing of Certification Letters Endorsing Use of Emotional Support Animals.

Emotional support animals (ESAs) are different from service animals, therapy animals, and other disability-related assistance animals. Although pet ownership may confer psychological benefits, limited research has supported the use of ESAs to realize such benefits. If clinicians are asked to write a letter of support for use of an ESA, they need to be familiar with relevant federal, state, and local laws that regulate ESAs and with the essential components of an ESA evaluation. This article provides an overview of terminology; federal, state, and local laws related to ESAs; and clinical and ethical considerations for clinicians who decide to write these letters. The authors also review liability issues related to writing these letters, including those related to ESA aggression.

Emotional Support Animal Partnerships: Behavior, Welfare, and Clinical Involvement

ABSTRACT The present study gathered information about the characteristics of individuals and dogs in Emotional Support Animal (ESA) partnerships, instances of service-animal misrepresentation, animal welfare and behavior, dimensions of bond quality, and health professional involvement. Seventy-seven adults (53 female, 24 male) with a canine ESA were surveyed via Qualtrics panel services. Data were analyzed for descriptive data, as well as correlational analyses among variables. Participants reported high frequencies of misrepresentation of emotional support animals, access law violations, and problematic instances including ESAs with a history of aggression and times when participants were unable to care for their dog. The majority of participants reported mental illness diagnoses, seeking ESA documentation from mental health providers; however, levels of health professional involvement in the ESA-procuring process were varied. Several dimensions of bond quality between participants and their ESA were reported to be consistently high across participants. Correlational data brought forth questions about the roles that health professionals and animal welfare could play in preventing harm to clients, animals, and communities, discouraging unlawful and problematic behavior, and strengthening the human–animal bond between their clients and ESAs. For example, welfare concerns were correlated with problematic animal behaviors and perceived costs to the participants. Additionally, as professional involvement increased, so too did rates of misrepresentation of ESAs as service animals and access law violations. These data provide a first picture of ESA partnerships and can be a springboard for future research toward protecting individuals with disabilities, their animals, and communities.

Therapeutic and Economic Benefits of Service Dogs Versus Emotional Support Dogs for Veterans With PTSD.

This work aimed to assess the therapeutic and economic benefits of service dogs versus emotional support dogs for veterans with posttraumatic stress disorder (PTSD). Veterans with PTSD (N=227) participating in a multicenter trial were randomly assigned to receive a service or emotional support dog; 181 veterans received a dog and were followed up for 18 months. Primary outcomes included overall functioning (assessed with World Health Organization Disability Assessment Scale II [WHODAS 2.0]) and quality of life (Veterans RAND 12-Item Health Survey [VR-12]). Secondary outcomes included PTSD symptoms (PTSD Checklist for DSM-5), suicidal ideation, depression, sleep quality, health care costs and utilization, medication adherence, employment, and productivity. Participants paired with a dog had a mean±SD age of 50.6±13.6 years (range 22-79), and most were male (80%), White (66%), and non-Hispanic (91%). Adjusted linear mixed repeated-measures models indicated no difference between the two groups on WHODAS 2.0 or VR-12 scores. Participants with service dogs had a 3.7-point greater reduction in PTSD symptoms versus participants with emotional support dogs (p=0.036). No reduced health care utilization or cost was associated with receiving a service dog. Veterans with service dogs had an increase of 10 percentage points in antidepressant adherence compared with those with emotional support dogs (p<0.01). Both groups appeared to benefit from having a service or emotional support dog. No significant differences in improved functioning or quality of life were observed between the groups. Those in the service dog group had a greater reduction in PTSD symptoms and better antidepressant adherence, improvements that should be explored further.

Current Perspectives on the Challenges of Implementing Assistance Dogs in Human Mental Health Care.

The prevalence of mental health disorders, driven by current global crises, is notably high. During the past decades, the popularity of dogs assisting humans with a wide spectrum of mental health disorders has significantly increased. Notwithstanding these dogs' doubtless value, research on their legal status, certification processes, training and management practices, as well as their welfare status, has been scarce. This scoping review highlights that in contrast to other assistance dogs such as guide dogs, there exists no consistent terminology to mark dogs that assist humans with impaired mental health. Legal authorities monitoring the accreditation process, training and tracking of mental health supporting dogs are broadly lacking, with only few exceptions. This review emphasizes the need to address several topics in the promotion of progress in legal and welfare issues related to assistance dogs as well as emotional support dogs for humans with a mental health disorder. The current body of knowledge was assessed in three different areas of focus: (1) the legal dimension including definitions and certification processes; (2) the dimension of performed tasks; and (3) the dog welfare dimension including aspects of the relationship with the handler and risks associated with children recipients. Considering the challenges associated with a mental health diagnosis, collaborations of dog provider organizations and health care professionals would be desirable to continuously assess the efficiency of the human-dog dyad regarding their overall compatibility, general satisfaction and mutual well-being.

The Department of Transportation’s Failures in Regulating Emotional Support Animals

In the past decade, the number of emotional support animals being used to treat a wide array of mental and emotional disorders has multiplied exponentially. This increase has been met with mixed reactions in the context of air travel. While some passengers are thrilled to sit next to a dog on their flight, others are frustrated due to the belief passengers with emotional support animals are exploiting a loophole to travel with their pet for free. Regardless of the differing perceptions, emotional support animals are a valid, affordable way to treat mental health illnesses without incurring negative side effects associated with medication. The Department of Transportation (DOT) recently amended the regulations on emotional support animals to reflect grievances related to potential abuses of the system. These amendments unfairly discriminate against individuals with mental health illnesses while doing little to prevent exploitation and misrepresentation of service and emotional support animals. DOT should revert to the previous system of recognizing emotional support animals in a category distinct from service animals. Furthermore, implementing stricter regulations for the registration of emotional support animals, reducing pet fees, and keeping records of such in a robust database would allow those with mental disorders to rightfully obtain emotional support animals while curbing abuse of the system.

“It Almost Makes Her Human”: How Female Animal Guardians Construct Experiences of Cat and Dog Empathy

Understanding how humans perceive and construct experiences of non-human animal empathy (hereafter, 'animal/s') can provide important information to aid our understanding of how companion animals contribute to social support. This study investigates the phenomenology of animal empathy by examining how humans construct sense-making narratives of these experiences, with the hypothesis that anthropomorphic attributions would play a key role in these constructions. Comprehensive, semi-structured interviews were conducted with six participants, using established interpretative phenomenological analysis methodology to facilitate deep examination of how they interpreted and reacted emotionally. Participants were consistent in reporting changes to their companion animals' normal behaviour as the key to the identification of animal empathy experiences, yet they were highly paradoxical in their constructions of perceived internal drivers within their dogs and cats. Explanations were highly dichotomous, from highly anthropomorphic to highly anthropocentric, and these extremes were combined both within individual participant narratives and within some thematic constructs. This research demonstrates that experiences of companion animal empathy can be powerful and meaningful for humans, but the inconsistent mixture of anthropomorphic and anthropocentric reasoning illustrates the confused nature of human understanding of animals' internal states. Insight into how humans construct animal empathy has implications for the moral status of these animals and an application for companion animals used explicitly for social support, such as in animal-assisted therapy and emotional support animals.

APA Board Looks to Future of Psychiatry, Importance of Measurement-Based Care

APA Board Looks to Future of Psychiatry, Importance of Measurement-Based Care

Exploring Benefits of Emotional Support Animals (ESAs): A Longitudinal Pilot Study with Adults with Serious Mental Illness (SMI)

While anecdotal accounts describe mental health recovery-related benefits of having Emotional Support Animals (ESAs), to date there have been no studies on such within peer-reviewed journals. This pilot study yields data on how ESAs may facilitate mental health recovery and related benefits for persons with Serious Mental Illness (SMI).Through an ESA placement program, the Hope and Recovery Pet program (HARP), shelter dogs and cats were placed as ESAs with adults (N=11) with SMI. A longitudinal mixed method research design was utilized to explore potential ESA impact. Pre- and post-placement data from participants was collected on depression, anxiety, and loneliness. Biomarker data (saliva analytes assessing oxytocin, cortisol, alpha amylase) were collected before and after ten-minute interactions with ESAs at 1, 3, 6, 9, and 12 months. Qualitative data was collected twelve months post-placement. Significant reductions in anxiety, depression, and loneliness scale scores via the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and UCLA Loneliness Scale (UCLA), respectively, were found. While not significant, there was a pattern of oxytocin increase and cortisol decrease after ten minutes of ESA interaction. Qualitative data indicated participants attributed their improvements in mental health and well-being to their respective ESAs. Findings underscore the need for continued research on ESA companionship as a mental health recovery support.

Defining Terms Used for Animals Working in Support Roles for People with Support Needs.

Simple SummaryAlthough animals are being employed for a growing number of roles to support people, the terms used to describe those animals (e.g., “therapy animal” and “emotional support animal”) can be confusing. The same term may be used to describe different types of work, or the same role can be described with different terms. This paper presents the results of a collaboration between over 100 researchers, practitioners, and end users of animal-based supports from all over the world. We created working definitions for the following nine terms: “assistance animal”, “companion animal”, “educational/school support animal”, “emotional support animal”, “facility animal”, “service animal”, “skilled companion animal”, “therapy animal”, and “visiting/visitation animal”. In this paper, we describe the defining characteristics of each animal type and how it is different from the other types. We recommend phasing out the terms “skilled companion animal” and “service animal”, because they are similar to other terms. We discuss how our definitions may be received in different parts of the world.The nomenclature used to describe animals working in roles supporting people can be confusing. The same term may be used to describe different roles, or two terms may mean the same thing. This confusion is evident among researchers, practitioners, and end users. Because certain animal roles are provided with legal protections and/or government-funding support in some jurisdictions, it is necessary to clearly define the existing terms to avoid confusion. The aim of this paper is to provide operationalized definitions for nine terms, which would be useful in many world regions: “assistance animal”, “companion animal”, “educational/school support animal”, “emotional support animal”, “facility animal”, “service animal”, “skilled companion animal”, “therapy animal”, and “visiting/visitation animal”. At the International Society for Anthrozoology (ISAZ) conferences in 2018 and 2020, over 100 delegates participated in workshops to define these terms, many of whom co-authored this paper. Through an iterative process, we have defined the nine terms and explained how they differ from each other. We recommend phasing out two terms (i.e., “skilled companion animal” and “service animal”) due to overlap with other terms that could potentially exacerbate confusion. The implications for several regions of the world are discussed.