Psychiatric Service Dogs Research Articles

Service Dogs for Veterans and Military Members With Posttraumatic Stress Disorder

Military members and veterans (hereafter, veterans) with posttraumatic stress disorder (PTSD) increasingly seek psychiatric service dogs as a complementary intervention, yet the effectiveness of service dogs is understudied. To estimate the associations between psychiatric service dog partnership and self-reported and clinician-rated PTSD symptom severity, depression, anxiety, and psychosocial functioning after 3 months of intervention among veterans. This nonrandomized controlled trial used standardized and validated assessment instruments completed by participants and administered by blinded clinicians. Recruitment, eligibility screening, and enrollment were conducted between August 2017 and December 2019. Veterans were recruited using the database of an accredited nonprofit service dog organization with constituents throughout the US. Participants were veterans with a PTSD diagnosis; they were allocated to either the intervention group (n = 81) or control group (n = 75). Outcome assessments were performed at baseline and at the 3-month follow-up. Data analyses were completed in October 2023. Participants allocated to the intervention group received a psychiatric service dog for PTSD, whereas those allocated to the control group remained on the waiting list based on the date of application submitted to the service dog organization. Both groups had unrestricted access to usual care. The primary outcomes were PTSD symptom severity, depression, and anxiety after 3 months, and the secondary outcomes were psychosocial functioning, such as quality of life and social health. The self-reported PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was used to measure symptom severity, and the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) was used to assess PTSD diagnosis (score range for both instruments: 0-80, with higher scores indicating greater PTSD symptoms). The 156 participants included in the trial had a mean (SD) age of 37.6 (8.3) years and included 117 males (75%), 17 Black or African American individuals (11%), 30 Hispanic individuals (19%), and 117 White individuals (76%). Compared with the control group, the intervention group had significantly lower PTSD symptom severity based on the PTSD Checklist for DSM-5 mean (SD) score (41.9 [16.9] vs 51.7 [16.1]; difference in means, -11.5 [95% CI, -16.2 to -6.6]; P < .001) and the CAPS-5 mean (SD) score (30.2 [10.2] vs 36.9 [10.2]; difference in means, -7.0 [95% CI, -10.8 to -4.5]; P < .001) at 3 months. The intervention group also had significantly lower depression scores (odds ratio [OR], 0.45 [95% CI, 0.23-0.86]; difference in means, -3.3 [95% CI, -6.8 to -0.6]), anxiety (OR, 0.25 [95% CI, 0.13-0.50]; difference in means, -4.4 [95% CI, -6.9 to -2.1]), and most areas of psychosocial functioning (eg, social isolation: OR, 0.34 [95% CI, 0.18-0.64]). This nonrandomized controlled trial found that compared with usual care alone, partnership with a trained psychiatric service dog was associated with lower PTSD symptom severity and higher psychosocial functioning in veterans. Psychiatric service dogs may be an effective complementary intervention for military service-related PTSD. ClinicalTrials.gov ID: NCT03245814.

A Preliminary Analysis of Psychiatric Service Dog Placements and Sleep Patterns of Partners of Veterans With PTSD

ABSTRACT Partners of veterans diagnosed with posttraumatic stress disorder (PTSD) are at risk of a variety of challenges, and it is unknown whether psychiatric service dogs are disruptive to their sleep or provide similar benefits that are seen in the limited literature on veterans. As part of a larger clinical trial examining the efficacy of psychiatric service dogs for veterans with PTSD and their families, this study focused on sleep patterns of veterans’ partners (n = 88), incorporating both subjective (clinically validated self-report surveys) and objective sleep measures (actigraphy). Linear regression was used to analyze differences in relation to group (intervention versus control) at follow-up, controlling for baseline score. Results revealed no significant differences between groups for both the subjective surveys (p = 0.15; p = 0.75) and the objective actigraphy measures (p = 0.06–0.98). This suggests that psychiatric service dogs are not disruptive, nor do they provide any benefits to partner sleep. Partners had sleep patterns on par with national norms at baseline and remained at such levels at follow up. Ultimately, using both subjective and objective measures, we found no impact of psychiatric service dogs on the sleep of veterans’ partners. Trial registration: ClinicalTrials.gov identifier: NCT03245814.

Psychiatric service dog placements are associated with better daily psychosocial functioning for military veterans with posttraumatic stress disorder.

Psychiatric service dog placements may benefit psychosocial functioning for veterans with posttraumatic stress disorder (PTSD), however, these effects have never been examined directly in daily life. This nonrandomized longitudinal clinical trial quantified the efficacy of psychiatric service dogs for daily psychosocial functioning among N = 168 veterans with PTSD using ecological momentary assessment (EMA). EMA data were collected twice daily for 2 weeks at each assessment period (0 and 3 months), totaling 9,408 survey responses (2 Assessments × 14 Days × 2 Prompts × 168 Participants). At follow-up, regression analysis identified associations between service dog placement and better perceived social interaction quality (β = 0.42, p < .05), better affect (negative affect: β = -2.64, p < .001; positive affect: β = 2.44, p < .001), and lower odds of panic attacks (OR = 0.68, p < .05). Social participation results were mixed: placements were associated with greater activity participation (β = 3.21, p < .001) but lower odds of being away from home (OR = 0.77, p < .05), indicating possible support for anecdotes that public stigma is an obstacle to community participation. Results further revealed that the service dog's trained tasks may be particularly important for social functioning outcomes, and the service dog's presence for emotional functioning outcomes. Findings highlight a need for education surrounding service dog etiquette and reveal potential mechanisms underlying psychiatric service dog placements. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Stigma and Stereotyping of Veterans who May Benefit from a Psychiatric Service Dog: A Test of the Stereotype Content Model and Weiner’s Attribution-Affect-Action Model

Among veterans with posttraumatic stress disorder (PTSD) and comorbid substance use disorder (SUD), stigma has been identified as a frequent barrier to help-seeking and treatment. Stigma can also lead to the activation of stereotypes and discrimination. Increasingly, veterans are relying on psychiatric service dogs (PSDs) to aid in managing their PTSD and comorbid SUD. Consumer demand currently exceeds the availability of PSDs in Canada, and very few individuals can afford a PSD independently. This study examined the stigma and stereotyping of Canadian veterans needing a PSD using two theoretical models of stereotyping and stigma. Hypotheses were mostly supported. The veteran with PTSD was positively stereotyped by participants and was considered part of the normative social &ldquo;in-group.&rdquo; Participants were more willing to support these individuals in their acquisition of a PSD. In contrast, a veteran with SUD was more negatively stereotyped and stigmatized. Societal perceptions of veterans with PTSD may be more positive than previous research findings. However, an accompanying SUD may counteract this and result in stigma, negative stereotyping, and decreased civilian support for veterans accessing PSDs. Future research on these issues is warranted, including the development and testing of interventions aimed at addressing beliefs about SUD and increasing empathy and compassion for individuals with SUD.

“My Lifeline is Gone”: An Exploration of the Experiences of Veterans Following the Loss of their Psychiatric Service Dog(s)

Abstract Canadian veterans with PTSD are increasingly accessing psychiatric service dogs as a complementary treatment for their symptoms. Due to the short life span of dogs, however, it is inevitable that these veterans will experience the loss of their PSD either through death, retirement, or relinquishment. This exploratory qualitative study shares the findings from interviews with four veterans who had experienced grief at the loss of a PSD. The themes that emerged suggest that participants experienced a grief cycle: building of a bond with their PSD, a grief response after the loss of their PSD, healing and coping, and a transitional stage when introducing a new PSD into their lives. Recommendations are made for health care professionals working with veterans with psychiatric service dogs and for service dog providers and organizations to better prepare and support their clients leading up to and after the loss of their service dog.

Characterizing veteran and PTSD service dog teams: Exploring potential mechanisms of symptom change and canine predictors of efficacy.

Psychiatric service dogs are an emerging complementary intervention for posttraumatic stress disorder (PTSD). Initial evidence suggests that partnership with a service dog may be related to less PTSD symptom severity. However, it remains unclear how or why this might occur. To address this gap, we conducted a longitudinal investigation of 82 post-9/11 military members or veterans and their PTSD service dogs to (1) evaluate service dog characteristics as potential predictors of efficacy, (2) assess dog and human characteristics as potential predictors of veteran-dog bond, and (3) explore potential mechanisms for mental health outcomes. Aim 1 results demonstrated that most service dog characteristics did not predict veterans’ mental health outcomes, but lower service dog excitability was associated with less PTSD symptom severity at follow-up. Aim 2 results showed that closer dog-veteran relationships were associated with less excitable dog temperament. Aim 3 results indicated that worse mental health at follow-up was associated with greater use of the specifically trained PTSD service dog task to initiate a social greeting (“make a friend”), whereas better mental health was related to less use of dominance-based training methods, lower perceived emotional/logistical costs of service dog partnership, and closer veteran-dog relationships. More frequent use of the trained service dog task to signal when someone approaches from behind (cover/watch back) was associated with greater anxiety, but less PTSD symptom severity. Overall, veterans spent an average of 82% of their time with service dogs (assessed via Bluetooth proximity between dog collar and veteran smartphone), and most frequently asked their service dogs to perform the trained task for calming their anxiety (calm/comfort anxiety). The present study provides subjective and objective metrics of the heterogeneity among veteran-service dog dyads while also suggesting which of the assessed metrics might be potential mechanisms involved in the intervention.

PTSD service dogs foster resilience among veterans and military families.

Military deployment and reintegration challenges permeate the lives and relationships of Veterans, their spouses, and their families. Among these challenges, 23% of post-9/11 Veterans have been diagnosed with posttraumatic stress disorder (PTSD). Psychiatric service dogs have been found to help clinically alleviate PTSD symptoms when used as a complementary intervention. However, minimal research exists that explores the role of the service dog as a mechanism for cultivating resilience within the military family system. Researchers utilized a qualitative, constant comparative approach to analyze self-reported experiences of 101 individuals, including Veterans (n = 67) and their spouses (n = 34). Analyzed through the framework of the Theory of Resilience and Relational Load (Afifi et al., 2016), findings suggest complex communication processes that facilitate relational and family adaptation. These processes encompassed (a) the role of the service dog in building emotional reserves, (b) relational load introduced when caring for the service dog, and (c) the service dog's facilitation of relational maintenance behaviors among family members that contributed to communal orientation. Based on the results of this qualitative analysis, researchers suggest educational interventions where service dog trainers and mental health practitioners can incorporate relational maintenance strategies and family-focused approaches to integrating service dogs as military family members.

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.

Service Dogs for Veterans and Military Members With Posttraumatic Stress Disorder: Replication With the PTSD Checklist for DSM-5.

Psychiatric service dogs are an emerging complementary intervention for veterans and military members with posttraumatic stress disorder (PTSD). Recent cross-sectional studies have documented significant, clinically relevant effects regarding service dogs and PTSD symptom severity. However, these studies were conducted using the PTSD Checklist (PCL) for the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The present study aimed to replicate and advance these findings using the latest version of the PCL for the fifth edition of the DSM (PCL-5). Participants included 186 military members and veterans who had received a PTSD service dog (n = 112) or who were on the waitlist to receive one in the future (n = 74). A cross-sectional design was used to investigate the association between having a service dog and PCL-5 total and symptom cluster scores. After controlling for demographic variables, there was a significant association between having a service dog and lower PTSD symptom severity both in total, B = -14.52, p < .001, d = -0.96, and with regard to each symptom cluster, ps < .001, ds = -0.78 to -0.94. The results replicated existing findings using the largest sample size to date and the most recent version of the PCL. These findings provide additional preliminary evidence for the efficacy of service dogs as a complementary intervention for military members and veterans with PTSD and add to a growing body of foundational research serving to rationalize investment in the further clinical evaluation of this emerging practice.

“A Part of Our Family”? Effects of Psychiatric Service Dogs on Quality of Life and Relationship Functioning in Military-Connected Couples

Posttraumatic stress disorder (PTSD) can have corrosive impacts on family relationships and individual functioning. Emerging evidence has shown that psychiatric service dogs may be an effective complementary treatment for military veterans with PTSD, benefiting veterans’ mental and social health. However, few studies have examined the effects of psychiatric service dogs on the family members of veterans, specifically their partners. Mixed-methods data from 60 veteran-partner dyads examined individual and relationship functioning among partners of veterans paired with a service dog (service dog group; n = 37) and those awaiting placement (waitlist group; n = 23). While there were no statistically significant differences across groups, the effect sizes for group differences suggested that partners in the service dog group (relative to those on the waitlist) may experience higher levels of resilience and companionship, and lower levels of anger, social isolation, and work impairment. A topical survey of partner qualitative data within the service dog group indicated that service dogs provided more benefits than challenges. Partners reported improvements in veteran functioning, family relationships, and partners’ quality of life. Results, although preliminary, suggest that psychiatric service dogs may provide modest positive experiences for some veteran family systems.

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

Defining the PTSD Service Dog Intervention: Perceived Importance, Usage, and Symptom Specificity of Psychiatric Service Dogs for Military Veterans.

Research suggests that psychiatric service dogs may be an effective complementary treatment option for military veterans with posttraumatic stress disorder (PTSD). Although this practice continues to increase in popularity and research has reached the rigor of clinical trials, the components of the PTSD service dog intervention remain largely undefined. This research aimed to (1) quantify the importance, usage, and PTSD symptom specificity of service dog trained and untrained behaviors, (2) explore how PTSD severity, time since receiving the service dog, and the veteran-dog relationship relate to outcomes, and (3) compare expectations of veterans on the waitlist to experiences of veterans with service dogs. In a cross-sectional design, 217 post-9/11 military veterans with PTSD were recruited from a national service dog provider, including n = 134 with a service dog and n = 83 on the waitlist. Results showed that the service dog’s trained tasks of calming and interrupting anxiety were perceived as the most important for veterans’ PTSD, the most frequently used in a typical day, and as helping the most PTSD symptoms. Trained tasks were most helpful to the PTSD symptoms of hypervigilance and intrusion, and least helpful toward the symptoms of amnesia and risk-taking. Although all trained tasks were helpful toward PTSD symptoms, veterans rated the service dog’s untrained behaviors on average as more important for their PTSD. After controlling for covariates, there was no relationship between a veteran’s PTSD severity and perceived importance or frequency of task use. However, veterans who reported feeling closer to their service dogs reported using trained tasks more often, and veterans who had their service dogs for longer reported using trained tasks less often. Finally, veterans on the waitlist reported higher expectations regarding task use and importance than described by veterans with a service dog. In conclusion, findings describe the core components of the PTSD service dog intervention by quantifying the use and value of trained and untrained dog behaviors. Overall, this study helps explain the PTSD service dog’s clinically relevant value while contributing to the scientific understanding of this emerging practice.

The Relevance of Shame in Dog-Human Relationships

Abstract The general claim behind the use of psychiatric service dogs is that the dogs, given their individual training, can provide a bigger sense of independency and safety for people struggling with mental health issues such as PTSD. Struggling with these types of mental health issues is thought to be associated with a self-undermining feeling of shame that, in turn, reinforces the mental health issue in question. This particular experience is, we believe, not present, or present in only a limited sense, in a positive emotional relationship with a dog. Thus, understanding the phenomenon of shame and its influence on the dog-human relationship may help us understand why such a relationship can be beneficiary to people struggling with PTSD and possibly a variety of other mental health issues. The concept of shame is most suitably thought of as a social and relational phenomenon. That is, as an emotion elicited by others and related to certain societal and cultural standards, ideals and norms. Shame is experienced as a painful emotion that negatively affects our self-perception and includes the risk of producing a self-undermining shame that can lead to social withdrawal and a continuous vicious circle of shame. In this article we address these psychological phenomena from within a philosophical framework, and we argue that a positive relationship between a dog and a human can provide a valuable social space in which shame becomes less present. Such a social space necessitates the presence of a connection between relational beings—i.e., beings with advanced mental and emotional capacities. Thus, we argue that the understanding of any dog-human relationship must include an approach beyond the somewhat still existing confines of objective natural science and its implied skepticism and agnosticism towards animal mind. We introduce an approach to dog life and dog-human relationships inspired by phenomenology. This approach enables an understanding of the dog as a bodily being, who lives in and experiences the world around her in co-existence with relevant similar others, including humans. We argue that such an approach is a sound way of trying to understand dog-human relationships and provides a key to a better understanding of the concept of shame in connection with such relationships.

Geographic Availability of Assistance Dogs: Dogs Placed in 2013-2014 by ADI- or IGDF-Accredited or Candidate Facilities in the United States and Canada, and Non-accredited U.S. Facilities.

Assistance dogs' roles have diversified to support people with various disabilities, especially in the U.S. Data presented here are from the U.S. and Canada non-profit facilities (including both accredited and candidate members that fulfilled partial requirements: all here termed “accredited”) of Assistance Dogs International (ADI) and the International Guide Dog Federation (IGDF), and from non-accredited U.S. assistance dog training facilities, on the numbers and types of dogs they placed in 2013 and 2014 with persons who have disabilities. ADI categories of assistance dogs are for guide, hearing, and service (including for assistance with mobility, autism, psychiatric, diabetes, seizure disabilities). Accredited facilities in 28 states and 3 provinces responded; accredited non-responding facilities were in 22 states and 1 province (some in states/provinces with responding accredited facilities). Non-accredited facilities in 16 states responded. U.S./Canada responding accredited facilities (55 of 96: 57%) placed 2,374 dogs; non-accredited U.S. facilities (22 of 133: 16.5%) placed 797 dogs. Accredited facilities placed similar numbers of dogs for guiding (n = 918) or mobility (n = 943), but many more facilities placed mobility service dogs than guide dogs. Autism service dogs were third most for accredited (n = 205 placements) and U.S. non-accredited (n = 72) facilities. Psychiatric service dogs were fourth most common in accredited placements (n = 119) and accounted for most placements (n = 526) in non-accredited facilities. Other accredited placements were for: hearing (n = 109); diabetic alert (n = 69), and seizure response (n = 11). Responding non-accredited facilities placed 17 hearing dogs, 30 diabetic alert dogs, and 18 seizure response dogs. Non-accredited facilities placed many dogs for psychiatric assistance, often for veterans, but ADI accreditation is required for veterans to have financial reimbursement. Twenty states and several provinces had no responding facilities; 17 of these states had no accredited facilities. In regions lacking facilities, some people with disabilities may find it inconvenient living far from any supportive facility, even if travel costs are provided. Despite accelerated U.S./Canada placements, access to well-trained assistance dogs continues to be limited and inconvenient for many people with disabilities, and the numerous sources of expensive, poorly trained dogs add confusion for potential handlers.

An exploratory case study of the impact of psychiatric service dogs on problematic substance use among PTSD-diagnosed veterans

ABSTRACTBackground: Post-traumatic stress disorder (PTSD) and co-occurring problematic substance use is a health concern among Canadian military veterans. There are complex pathways to their problematic use of substances, including high-risk use of licit and illicit substances both pre and post PTSD diagnosis as well as access to prescribed PTSD medication with a potential for misuse.Methods: This exploratory case study examines whether and how the introduction of a psychiatric service dog (PSD) for veterans diagnosed with PTSD assists with addressing their problematic use of substances, both illicit and licit, including prescribed medications. Veterans’ prescription histories were reviewed one year prior to and one year after their match with a PSD. Interviews were held with the veterans at the second point in time to review their substance use.Results: A PSD assisted with decreasing the veterans’ PTSD symptoms and provided a steady source of additional personalized support. The veterans decreased their problematic use of prescribed and other licit and illicit substances. The veterans also stabilized or decreased their use of prescription medication.Conclusion: Psychiatric service dogs are a potential complementary health practice for PTSD diagnosed veterans who problematically use substances. This finding supports a call for further research.

Psychiatric Service Dogs: Use and Value for Military Veterans With PTSD

Psychiatric Service Dogs: Use and Value for Military Veterans With PTSD

Service Dog Schools for PTSD as a Tertiary Prevention Modality: Assessment Based on Assistance Dogs

Psychiatric service dogs compensate in terms of social and physical cognition for people who suffer from chronic post-traumatic stress, reassuring them with their canine behavior in public places, at home and in relationships interpersonal skills with strangers. There are no certification and standards for schools that train service dogs in Canada and the United States. Does the fact that training is different from one school to another have an impact on the effectiveness of the assistance dog for his master? To identify all aspects that closely reflect tertiary prevention, this exploratory case study documents the processes and services supporting the assignment of service dogs to veterans with PTSD and the subsequent follow-up conducted at various dog training schools; and it evaluates and compares the processes and services in place. The case study included four data collection methods involving 31 veterans, 7 school delegates, 7 trainers and 23 dogs. Qualitative content analysis and all the information collected was rated according to the Theoretical Domains Framework (TDF) and Assistance Dogs International (ADI) criteria. Results indicated a TDF-scoring across 12 domains ranged from 6/24 to 16/24. The schools moderately reflected ADI-standards. Tertiary prevention recommendations were proposed for dog trainers to better address the domains that needed improving at the time of the study (knowledge about PTSD, beliefs about capabilities, behavioral regulation, environmental context and resources, beliefs about consequences, nature of behaviors).

Military Veterans and Their PTSD Service Dogs: Associations Between Training Methods, PTSD Severity, Dog Behavior, and the Human-Animal Bond.

Introduction: Psychiatric service dogs are increasingly being sought out by military veterans as a complementary intervention for posttraumatic stress disorder (PTSD). After receiving a service dog, many veterans continue training their service dog at home. Our objective was to explore the associations between training methods, PTSD severity, service dog behavior, and the veteran-service dog bond in a population of military veterans with PTSD.Methods: Post-9/11 military veterans with PTSD who had received a psychiatric service dog were recruited from a national service dog provider. A total of 111 veterans (M = 40.1 ± 8.3 years, 80% male) participated in an online survey regarding frequency of training methods, PTSD symptom severity, service dog behavior, and the human-animal bond. Service dogs were predominately Labrador Retriever purebreds or mixes of various breeds (66% male) and mostly obtained from shelters or rescues (58%). Training methods were divided into five categories: positive reinforcement (e.g., physical praise), negative punishment (e.g., ignoring the dog), positive punishment (e.g., verbal correction), dominance (e.g., alpha roll), and bond-based (e.g., co-sleeping). Data were analyzed using general linear models.Results: Veterans self-reported using all five categories of training methods at least once a month. More frequent use of positive punishment was associated with less closeness with their service dog (p = 0.02), more fear (p = 0.003), less eye contact (p < 0.0001), and less trainability (p = 0.04). More frequent use of positive reinforcement was associated with higher closeness to their service dog (p = 0.002) and perceived increased attachment behavior (p = 0.002) and playfulness (p = 0.002). More frequent use of bond-based methods was associated with higher closeness to their service dog (p = 0.02). PTSD severity was not significantly associated with reported dog behavior, temperament, or veteran-service dog closeness.Conclusion: Military veterans with PTSD service dogs reported using many training methods that were associated with different outcomes. In general, the reported use of positive reinforcement or bond-based training methods were associated with reporting more positive outcomes while the reported use of positive punishment was associated with reporting more negative outcomes. Educating service dog organizations and recipients about the impacts of training methods could be beneficial for service dog efficacy and welfare.

The effect of a service dog on salivary cortisol awakening response in a military population with posttraumatic stress disorder (PTSD)

Recent studies suggest a therapeutic effect of psychiatric service dogs for military veterans with posttraumatic stress disorder (PTSD), but are limited by self-report biases. The current study assessed the effect of PTSD service dogs on the salivary cortisol awakening response (CAR) and arousal-related functioning in a population of military veterans with PTSD. Participants included 73 post-9/11 military veterans with PTSD including 45 with a service dog and 28 on the waitlist to receive one. Saliva samples were collected on two consecutive weekday mornings at awakening and 30 min later to quantify the cortisol awakening response (CAR) and its area under the curve (AUCi) in addition to standardized survey measures of anxiety, anger, sleep quality and disturbance, and alcohol abuse. There was a significant main effect of having a service dog on both the CAR and the AUCi, with individuals with a service dog exhibiting a higher CAR and AUCi compared to those on the waitlist. Results also revealed that those with a service dog reported significantly lower anxiety, anger, and sleep disturbance as well as less alcohol abuse compared to those on the waitlist, with medium to large effect sizes. Although those with a service dog reported significantly less PTSD symptom severity, CAR was not significantly associated with PTSD symptoms within or across group. In conclusion, results indicate that the placement of a PTSD service dog may have a significant positive influence on both physiological and psychosocial indicators of wellbeing in military veterans with PTSD. Although clinical significance cannot be confirmed, a higher CAR/AUCi among those with a service dog may indicate better health and wellbeing in this population. Future within-subject, longitudinal research will be necessary to determine potential clinical significance and impact of individual differences.

Psychiatric service dogs as a tertiary prevention modality for veterans living with post-traumatic stress disorder

ObjectiveTo document the usability of psychiatric service dogs (PsySDs) as a tertiary prevention modality from the perspective of veterans who have been using a PsySD 2 to 4 years as an assistive aid for post-traumatic stress disorder symptom (PTSD) management. MethodA case series study with PsySD primary users was carried out with 10 Canadian veterans recruited from 4 different dog training schools. Researchers conducted semi-structured telephone interviews and asked questions pertaining to four domains addressing the PsySD’s ‘usability’. A content and thematic analysis were realized using an inductive and deductive approach. ResultsOur conceptual framework proposes four main themes with their associated subthemes:: 1-Service dog’s roles and tasks (8 subthemes, e.g. acting as a socializing agent, maintaining an appropriate free space around the veteran), 2-Personal advantages and Environmental impacts (8 subthemes, e.g. alleviating symptoms; increasing outings and physical activities, enabling social interactions and relationship building), 3-Obstacles (4 subthemes, e.g. high costs of dog maintenance, dog’s presence attracted unwanted public attention, prompting intrusive questions), and 4-Recommendations for PsySD programs (16 subthemes, e.g. creating a national registry for PsySD, encouraging mental health practitioners’ involvement). Conclusions and Implications for PracticeThemes 1 and 2 are positive perceptions, and theme 4 suggests relevant potential improvements. The current study offers insights into how PsySDs concretely assist primary users and can help addressing PTSD chronicity. It presents the roles professionals may play when dealing with patients using PsySDs for PTSD. The proposed conceptual framework can be useful to policy makers, dog trainers and caregivers.