Mitigating a World
of Hurt ― Psychiatric Service Dogs Stepping up to the Challenge By Rochelle Lesser, School Psychologist
Founder, Land of PureGold Foundation
My first love in life was being with and protecting children. Having
been teased unmercifully due to my being extremely short and almost
completely enveloped by freckles, I grew up with much empathy for the plight
of others who were easily intimidated by or ruled by others. It was easy to
then understand my advocacy for the disabled as a special educator and then
school psychologist. But, my greatest joy was when I came to utilize my
beloved Goldens as psychotherapeutic assistants. Our first Golden Retriever, Ollie, grew to be an exemplary therapist’s
helper. He was the most cherished of teachers, so gallantly fine-tuning my
awareness of the substantial role that canines play in our lives. Children
could easily feel Ollie’s love as his face would beam and his tail would
swing nonstop. And wanting desperately to be accepted, he listened and
followed their lead without pause.
Ollie has touched so many, including myself. I never thought of
Ollie as just a dog, he was and still is my sun that will be
shining over me and all of us for the rest of our lives. ...
Ollie is a free spirited, loving, and full of forgiveness person
and that is how I will ALWAYS remember him. He made a watermark
in my life and will never be forgotten.
from young client after learning of Ollie's death
In the early 90's often working with youngsters in my home or within the setting of my
private practice, it was always a struggle to keep boys, in particular,
engaged in the therapeutic process. It was not surprising that they struggled over having to spend
their free time inside working with me. Yet, with Ollie added to the
picture, these sessions became must-attend events! He easily calmed my
anxious patients, bolstered the insecure, and lifted the spirits of the
depressed. And, while it’s tough to admit—on more than one occasion—it was
this four-footed therapist rather than his mom who in fact scored the
My academic background in both special education and school psychology,
coupled with the extensive dog training that I completed with my Goldens,
allowed me to create quite able child therapy assistants. However, this was
not an overnight achievement. A foundation of 2 years of obedience work from
puppyhood was provided, along with extensive real-life practice, before any
of my furry companions was able to assist at my private practice or when
seeing clients at my home.
I believe there is so much to be gained by the canine members of our
society, and that we only just begun to realize how powerful their influence
can be. Our own personal hero in this area is Dr. Bonnie Bergin, the incredible
woman who in 1975 originated the concept of the mobility type "service dog"
and went on to establish
the world's very first service dog program. After seeing waiting
lists for service dogs extending to 10 years, and the low percentage of dogs
making it through the program, she continued her research and founded the
Assistance Dog Institute and Bergin
University of Canine Studies.
"The dog, we now realize, thinks, feels and reacts in ways very much
like humans, which explains its unique ability to fit into human
society. And the plasticity, the versatility, the adaptability of the
canine species is very much aligned with ours. So the time has come to
elevate the dog to take its place beside humans, equines, bovines and
other mammalian species as a specific subject of study at the college
and university level. No animal does more for us, none share a more
intimate relationship with us, nor can any claim more years of alliance
with us – than the dog – our partner, our friend, our helpmate."
It has taken decades, however, to expand the reach of canine helpers for
other medical, psychological, and socially impacting disabilities. And,
while much anecdotal evidence demonstrates the success that such dogs can
provide, the research world clearly lags behind with respect to the
scientific efficacy for working dogs.
In the October 2009 New York Times article, Good Dog, Smart Dog,
by Sarah Kershaw, we learn about Jet, a seizure-alert and psychiatric service
dog who has been trained to detect impending seizures, panic attacks, and
blood sugar decline. Reportedly, he alerts his owner to such events by
staring intently at her until she does something about the particular
difficulty. For example, Jet will drop a toy in her lap to snap her out of a
dissociative state or position himself so that his body is under her head to
cushion a fall from an anticipated seizure. The author questions, though, whether this is due to brain smarts or
The matter of what exactly goes on in the mind of a dog is a tricky
one, and until recently much of the research on canine intelligence has
been met with large doses of skepticism. But over the last several years
a growing body of evidence, culled from small scientific studies of
dogs’ abilities to do things like detect cancer or seizures, solve
complex problems (complex for a dog, anyway), and learn language
suggests that they may know more than we thought they did. Their
apparent ability to tune in to the needs of psychiatric patients,
turning on lights for trauma victims afraid of the dark, reminding their
owners to take medication and interrupting behaviors like suicide
attempts and self-mutilation, for example, has lately attracted the
attention of researchers.
He argues that it is dogs’ deep sensitivity to the humans around
them, their obedience under rigorous training, and their desire to
please that can explain most of these capabilities. They may be deft at
reading human cues — and teachable — but that doesn’t mean they are
thinking like people, he says. A dog’s entire world revolves around its
primary owner, and it will respond to that person to get what it wants,
usually food, treats or affection.
“I take the view that dogs have their own unique way of thinking,” Dr.
Wynne said. “It’s a happy accident that doggie thinking and human
thinking overlap enough that we can have these relationships with dogs,
but we shouldn’t kid ourselves that dogs are viewing the world the way
When it comes to many disorders, service dogs are not a perfect, or
even, best solution. But, they do have a place within the overall repair
kit that those in the helping professions utilize in treatment decision
making. However, the approximate 2-year training time is long and
costly, and only a small percentage of the disabled population is ever in
receipt of an assistance or service dog, whether
for sensory (visual, hearing),
mobility, psychiatric (e.g., depression, post-traumatic stress disorder,
bi-polar disorder, anxiety, panic attacks, autism), or medical alert (seizure,
diabetes hypoglycemia) impairments.
I have been fascinated by the increased interest in Psychiatric Service
Dogs. Anecdotal evidence supports positive changes that these dogs can bring
about, such as reduced symptomatology and medication use, as well as
increased social skills and independence. Yet, much assistance is sometimes
necessary to enable the human part of the service dog team to provide
Psychiatric disorders, as delineated in the Diagnostic and Statistical
Manual of Mental Disorders (DSM-IV), include those related to psychosis,
mood, anxiety, dissociation, sleep, cognition, and child development.
And diagnosis is dependent on symptoms sufficient enough to cause clinically
significant distress, as well as moderate to severe impairment in social,
occupational, or other important areas of functioning. Such disorders are
complex, typically presenting with additional co-morbid conditions. In this
regard, a multidisciplinary determination is critical before a
psychiatric service dog, per se, is prescribed.
In Drs. Doherty and Haltiner's 2007 Neurology article, Wag the
dog: Skepticism on seizure alert canines, reports of dogs that can predict their owners' epilepsy seizures have
been anecdotal and not objectively confirmed by doctors and researchers. And,
oftentimes, the success of these dogs depended primarily on the handler's
awareness and response to the dog's alerting behavior. The article
also looked at the controversy regarding
NonEpileptic Seizures (PNES), with dogs thought to be responding more to
psychological seizures, rather than epilepsy seizures. PNES may look like
epileptic seizures, but are not caused by abnormal brain electrical discharges.
Instead, they are a manifestation of psychological distress. By definition, PNES
are a physical manifestation of a psychological disturbance and are a type of
Somatoform Disorder called a conversion disorder.
Pseudoseizure Dogs, a 2007 article In the American Academy of Neurology
from Dr. Gregory L. Krauss, MD, of Johns Hopkins University School of Medicine,
concludes that those with psychogenic seizures need psychiatric evaluation and
appropriate treatment, not a specially trained dog for epileptic seizures. "This
is important because the treatment is very different for a person with epilepsy
and one with psychological seizures, which stem from emotional difficulties,"
said Krauss. "Epilepsy drugs are not effective for psychological seizures, and
they often have side effects. And with proper treatment and counseling,
psychological seizures can often be eliminated."
Krauss said it's possible that people with psychological seizures may seek out
service animals for support. He noted that some people with epileptic seizures
may benefit from seizure response dogs. "Seizure response dogs can help people
during seizures and stay by them when they are unconscious and provide
companionship that aids them in dealing with a chronic disorder," Krauss said.
"People with nonepileptic seizures require psychiatric evaluation and behavior
therapy. This study demonstrates the importance of establishing an accurate
diagnosis of epilepsy before obtaining a seizure response dog."
The think tank RAND report in 2008 had revealed 300,000 veterans
returning home from Iraq and Afghanistan had been diagnosed with severe
depression or post traumatic stress disorder (PTSD). It said more
soldiers were going AWOL to find treatment from PTSD. RAND further
reveals that rates of PTSD and traumatic brain injury among troops
taking part in war on terror have been excessively high, with a third of
returning troops reporting psychic problems and 18.5% of all returning
service personnel battling either PTSD or depression. Marine suicides
doubled between 2006 and 2007; army suicides are at highest rate since
records were kept in 1980. There has been 80% increase in desertions
since 2003. Over 150 GIs refused service while about 250 war resisters
are taking refuge in Canada. 1700 strong GI resistance is gaining
momentum. The veterans have signed up for anti-war Oath Keepers (an
association of serving military officers, reserves, National Guard,
veterans, fire fighters). Longer war drags on more resistance from
within ranks. Hundreds of letters have been written to Obama by serving
and retired servicemen, urging him to bring back US troops. Long absence
from homes is escalating divorce rates. ...
Mental state of those on duty on scattered posts is worst since they
feel scared. Many suffer from mental disorders. Sleeplessness and bouts
of anger are common. Many are found broken down and weeping since the
faceless enemy frustrates them. Seeing their comrades blown up shatters
them. They feel irritated that in their bid to help the population by
giving them humanitarian assistance, they do not cooperate and often lie
and tend to protect Taliban. Recent rules of engagement to minimize
civilian casualties are seen as fighting with one arm tied behind backs.
Most demoralizing thing is that soldiers are not getting killed in
combat actions but by roadside bombs on routine journeys. In 2009, most
casualties were from IEDs and still are. All combat missions are
accepted with a heavy heart. There is no sense of pride or
accomplishment in them. None want to die or get crippled. All they
desire is complete their tenure and return home safely in one piece.
Therapist Jane Miller is seen here with Goldens
Ahava (in bandanna) and Simcha (in T-shirt), outside the Oberlin Inn. Photo
by Lonnie Timmons III, The Plain Dealer
Despite the ever-pressing need for Psychiatric Service Dogs, I have been
somewhat disheartened by the lack of information on this area of assistance
at the American Psychological Association or
American Psychiatric Association.
And, there are no respective organizations formed by interested
psychiatrists, psychologists, or clinical social workers.
That is why I was so excited to discover the work of Jane Miller LISW CDBC,
a fellow therapist and Golden Retriever lover.
an October 5, 2005 article from the Chronicle-Telegram, Paws and take a deep
breath, Jane Miller speaks to the comfort and verbal ease that came
about her patients when her Golden Retriever Umaya was present. And, she
detailed how a Psychiatric Service Dog came to make a difference for a
barely functioning client named Tracy, who had been diagnosed with a
Post-traumatic Stress Disorder and accompanying depression and anxiety. When
first meeting Jane, Tracy could not even leave her home, and had trouble
talking with anyone.
Tracy Corso, left, Baron, and clinical
social worker Jane Miller. Photo by Chuck Humel/Chronicle Photos
"You have to make sure the client is able to take care of the dog
while taking care of themselves," Miller said. "It's really an added
responsibility, but sometimes that's what the person needs." ...
She was paired with a golden Labrador retriever named, Baron, who would
be trained to react to Tracy and certain situations. Whether she's
crying or spending too much time in bed, Baron's been trained to gently
paw at her.
"I never could eat in a restaurant before Baron," Tracy said. "Baron
will lie across my feet, and sort of anchors me there. He helps to keep
me calm and centered."
Baron also helps to keep Tracy composed in countertop transactions at a
bank or store, where he's been trained to press up against her.
When Sgt. Raymond Hubbard returned from the
war in Iraq, his post-traumatic stress disorder was sometimes so bad he
couldn't function. He'd wake, screaming, in the middle night, dreaming
about the blast that tore off his leg. He'd yell at his two little boys.
He couldn't remember where he'd left the medication he needed for his
attention-deficit disorder and his pain.
All that's changed. Now, as soon as Hubbard starts tugging at his covers
or hollering in his sleep, Dace wakes him. When he starts ranting at the
boys, Dace gives him a gentle nudge to remind him to calm down. And when
he can't find his pills, Dace hunts them down and brings them to him.
"She has a lot of different hats that she wears," Hubbard says from his
home in Wisconsin. "She's a partner. She's a friend when I need her.
She's an extra set of limbs for stabilizing me when I'm walking. She's
like a conscience sometimes. She's a gift --something to bring me back
to the person I was before my injuries."
Dace is a dog. Not any old dog, but a psychiatric service dog.
In this fabulous 2010 article by Diane Suchetka,
we learn about how Jane actually helps her clients with the training of
their dogs, accompanying them with their PSDs to drugstores, restaurants,
groceries, theaters, libraries and doctor appointments. Of course, they need
to be able to behave, no matter the situation, so trained to cope with all
the stresses that they will meet along the way. And, we again catch up with
Tracy Corso, initially featured five years ago
Tracy Corso says service dogs transformed
her life. When the 44-year-old, Cleveland-area woman started therapy for
post-traumatic stress disorder, she couldn't look Miller in the eye
― her abusers made her do that before she was
beaten. She was afraid to go out in the community, couldn't shop or go
out to eat and certainly couldn't talk about the abuse she endured as a
"Really, I didn't start making any progress at all until she started
bringing her dog," Corso says now, seven years later. "Once the dog
came, I was a whole different person."
Instead of looking at and talking to Miller, her therapist, Corso told
her story to the dog, which would lie on the floor or next to her on the
couch. "Dogs to me were less threatening," Corso says. "They weren't
going to hurt me; they weren't going to abuse me. It was easy to build
trust with them. I knew I was safe."
With Miller's help, she ended up with a service dog herself. Now, she
not only goes shopping and out to eat, but she speaks publicly about the
benefits of psychiatric service dogs. "They gave me independence, and
I'm more grateful for life," Corso says. "Now I get up and I'm happy to
Ahava, Jane & Simcha Miller.
2009 Fur in Focus Photo Photography
Jane Miller works in private practice as a licensed
psychotherapist /clinical social worker, with a particular
interest in holistic modalities of healing. She currently
focuses on educating others about the legal, ethical, and
practical criteria of working with Psychiatric Service Dogs (PSDs).
Jane has additionally consulted with the
NEADS Canines for Combat Veterans
Program. She also recently was approached by the VA Hospital to present
for their Departments of Psychiatry & Psychology Grand Rounds
focusing on PSD’s for soldiers returning from combat with PTSD
and to speak for the Veteran’s Administrations PTSD Consortium.
She appeared in the PBS program “Health Visions – Animals As
Healers” on the healing power of animals and joined
world-renowned veterinarian/author Dr. Allen Schoen to present a
workshop on the topic of animals as healers at a national
conference for medical professionals (See
She is also a practitioner of
QiGong and Reiki
and teaches stress reduction techniques to her clients and their
Jane Miller’s lifelong passion for healing has
emphasized the human-animal bond, culminating in certifications
as a Canine Massotherapist and as a Consultant for Therapy and Service
Animals by the International Association of Animal Behavior Consultants (IAABC).
The book features some wonderful dogs who have helped their partners improve their lives in profound and
unexpected ways, allowing them to gain self-esteem and self-confidence. And
while these dogs provide emotional support, as all
dogs do, they are specifically trained to perform certain tasks unique
to their disabled partner's needs.
The book effectively addresses the following areas:
Criteria to consider when choosing the right
The kind of training
How PSDs compliment other forms of
What to expect and how to respond when you take a
out in public
How PSDs may impact other members of the family
How to navigate the procedural regulations that
apply to a PSD
Strategies for helping PSDs better able to cope
How to recognize the needs of PSDs, thus providing them with
Handling the PSD's "Golden Years" in order to effectively
Healing Companionsis a must-have,
book for so many reasons. My bookshelves are filled with dog-themed books.
Some are collections of amazing dog-people relationships. Others are
detailed guidebooks or training manuals. And, finally, there are books are
various philosophical issues and topics important to those in our huge dog
Chapter 1 Mindy's Story: Umaya Leads the
Chapter 2 Canine Rx: Finding the Right
Chapter 3 The Good Fight: Prison Puppies Free
Veterans from Combat
Chapter 4 Sit, Stay, Soothe: Training your
Chapter 5 Member of the Family: Helping
Everyone Get Along
Chapter 6 Dogs Have Issues, Too: Helping your
Dog Cope With Stress
Chapter 7 The Golden years: When to Hang Up
Appendix 1 Sample Service Dog Cards
Appendix 2 Delta Society Service Dogs Welcome
Appendix 3 ADA Business BRIEF Service Animals
Appendix 4 Breed Types: What's In A Name?
Appendix 5 Assistance Dog Tasks
Appendix 6 Service Dog Tasks for Psychiatric
Resources (Books and Internet Links)
Jane's book, however, cannot be so easily catalogued. In the same breath,
this compelling publication is informative, practical, inspirational, and
Healing Companions includes the
passionate stories of those helped by a Psychiatric Service Dog, showing
clients dealing with bi-polar or post-traumatic stress disorders, for
example. More critically, though, it provides almost 100 pages of truly
valuable appendixes and book & online resources.
But, what truly sets this book apart is Jane's emphasis on the dog
member of the partnership. I cannot imagine that there are many
psychotherapists proficient in Reiki, QiGong, and canine massage, which
allows her to teach all of her clients stress-reduction and relaxation
techniques that they can utilize with their PSDs. Jane Miller so perfectly
speaks to the fact that PSDs have issues too, their needing to be in sync
with their partners' mental state, mood shifts, environment, and practical
needs, but not so intuitive that they are negatively impacted.
"Because the handler may be suffering from stress-related
difficulties, a dog that is too empathic or intuitive may also begin to
show signs of increased stress. ... Perhaps more than any other type of
service dog, PDSs must have a balanced life filled with time for work,
play, and relaxation."
Learn more about Service Dogs for
Medical, Psychological, and Physical Disabilities more
Service Golden Teddy: First
Facility Dog in the US to serve as VA Hospital
Staff Member Mary MacQueen is a proud member of Kinzua Search Dogs, a non-profit, all volunteer group
that endeavors to locate missing persons in New York State as well as Pennsylvania.
We follow Mary's incredible work here where you
can learn about the makings of a true working dog. Mary has also been working hand-in-hand with Rick Yount and the Veterans
Administration in an effort to develop national standards for service dogs
as there is currently no national certification testing.
In 2010, along with
Behesha Doan of Extreme K-9, she saw a need for service dogs to be
placed with returning veterans who had received either physical or
psychological injuries as a result of their service to our country. Their
dream came to fruition with the launching of
This Able Veteran.
This nonprofit's mission is to provide quality dogs trained by experienced
Certified trainers, at no charge, to these veterans.
One of the first tasks for this not-for-profit organization was to be
able to provide a facility service dog to the Veterans Administration
hospital located in Marion, Illinois. This dog will actually be a staff
member there, and be able to interact with the military veterans that are
housed at this facility. Mary donated Teddy to
This Able Veteran
for this role. He is a Golden from one of her breedings.
A highly stable dog with a phenomenal temperament, Teddy is now highly
obedience trained, trained to turn lights on and off, can open doors and
pull wheelchairs, and is also trained not to react to extreme emotional
outbursts that some of these patients can experience. He has also trained to
pull covers off of beds in the event that a resident is experiencing night
terrors, and to stay away from flailing arms and legs if someone were to
unknowingly strike out at him during one of these outbursts.
Teddy will be going home every night with the same staff member, so he
won't actually be staying at the facility at night. During the day, the
residents of the facility will be
responsible for taking him out for walks, feeding him, brushing him, hugging
him, and loving him.
IL (KFVS) - After experiencing the horrors of war, the newly constructed
Residential Rehabilitation Treatment Facility will be a safe place for veterans.
It'll be a one-of-a-kind program in the U.S. with a very unique member of the
staff that doctors hope will help veterans reclaim their lives from PTSD and
A dog named Teddy will be their guardian, their friend, and in a way - their
"Teddy's on staff, just like the physiologists, psychiatrists," Dr. Thomas
Kadela, a recovery coordinator with the Marion V.A. "Teddy will be in group
therapy, teddy will be other places in the facility, he'll be in veterans rooms
Teddy will live in the new facility - but he'll be much more than a pet to the
veterans who'll go there for treatment.
"They went to war, and they came back different than now they left. And we know
we can help," said service dog trainer Behesha Doan with the organization This
non-profit group, This Able Veteran, donated Teddy to help veterans through
their darkest days as they work toward recovery.
"Teddy is primarily trained to deal with people with PTSD and traumatic brain
injury, his specialty and what we've worked with him on is to identify the bio
markers that are associated with high anxiety," said Doan.
Soldiers have been in Iraq for more than eight years and in Afghanistan for
nearly to 10 years. It's the longest U.S. troops have been in combat since
Vietnam and the human cost of these conflicts has been high.
According to the Department of Veterans Affairs - research shows between 10 and
18 percent of soldiers serving in Iraq and Afghanistan are likely to have post
traumatic stress disorder when they get back.
"PTSD is actually an anxiety disorder. You're hyper vigilant, hyper alert, they
constantly have intrusive thoughts they're constantly scanning what's around
them because they're concerned there's a danger," said Kadela.
Service men and women are also reportedly at higher risk of other mental health
problems including depression, addiction, and anger issues.
The new rehabilitation center aims to change those statistics.
a veteran is depressed, Teddy will be there to let them know they're not alone.
If a veteran is angry, upset, or anxious, Teddy's there to listen and calm their
nerves. If a veteran just needs a hug - Teddy's more than happy to oblige.
"A lot of times people with PTSD isolate, and say I don't want to deal with
anybody else," said Kadela. "You can yell at Teddy, you can cry in front of
Teddy, you can make a fool out of yourself in front of Teddy and he doesn't
judge, he doesn't care, he just loves you unconditionally."
Teddy's mission is to help veterans in any way he can so they can leave the
battle field behind and return to real life.
"By treating it, you can move on with your life, knowing it's part of who you
are, it becomes a memory and you move on with your life instead of a demon that
you battle every day," said Kadela.
The Residential Rehabilitation Treatment Program will open later this summer.
FAIR USE NOTICE
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and educational purposes.
This video comes from Vancouver Island Assistance Dogs. Nanaimo,
have a great series of instructional videos that
Please note that the star (*) indicates when the
clicker marks the behavior.
Also, barking is not a behavior that is desirable for an alert
for assistance dogs. In public it is disruptive and is only used for
emergencies to call attention to a person that needs help.
Although one would typically believe this skill is only critically
for Hearing Dogs, it is one that can be a lifesaver for those
various medical conditions. For example, medications can provoke
sleep such that a person would sleep through the warning sounds from
Luis had been an intelligence officer in Iraq, rooting out corruption
in Anbar Province. In 2005, Capt. Montalván was the target of an
assassination attempt. Now he walks with a cane and suffers from severe
post-traumatic stress disorder. Luis explained that he couldn't have
made it to the inauguration if it weren't for his dog. As someone who's spent time with our troops in Iraq and Afghanistan
on USO tours and met wounded warriors at Walter Reed and Bethesda, I
feel a deep obligation to the men and women who have risked life and
limb on our behalf.
After I met Luis, I did some research. Service dogs like Tuesday can
be of immense benefit to vets suffering from physical and emotional
wounds. Yes, they provide companionship. But they can also detect
changes in a person's breathing, perspiration or scent to anticipate and
ward off an impending panic attack with some well-timed nuzzling. They
are trained to let their masters know when it's time to take their
medication and to wake them from terrifying nightmares.
Service dogs raise their masters' sense of well-being. There is
evidence to suggest that increasing their numbers would reduce the
alarming suicide rate among veterans, decrease the number of
hospitalizations, and lower the cost of medications and human care. Veterans report that service dogs help break their isolation. People
will often avert their eyes when they see a wounded veteran. But when
the veteran has a dog, the same people will come up and say hi to pet
the dog and then strike up a conversation.
Like any other golden retriever seeking a treat, Tuesday nudged his
owner's hand with his snout one recent morning and waited expectantly.
Luis Carlos Montalván got up from a chair in his small Brooklyn
apartment and walked to the kitchen. Tuesday followed close behind, eyes
fixed on a white cabinet. The retriever sat alertly as Mr. Montalván, an
Iraq war veteran with severe post-traumatic stress disorder, reached for
a vial of pills, lined a half-dozen on the table and took them one by
The dog had gotten what he wanted: When the last pill was swallowed,
he got up and followed his master out of the kitchen, tail wagging.
Tuesday is a so-called psychiatric-service dog, a new generation of
animals trained to help people whose suffering is not physical, but
emotional. They are, effectively, Seeing Eye dogs for the mind.
Tuesday is with Mr. Montalván at all hours. Taught to recognize
changes in a person's breathing, perspiration or scent that can indicate
an imminent panic attack, Tuesday can keep Mr. Montalván buffered from
crowds or deliver a calming nuzzle. Other dogs, typically golden
retrievers, Labradors or Labrador retriever blends, are trained to wake
masters from debilitating nightmares and to help patients differentiate
between hallucinations and reality by barking if a real person is
"Tuesday is just extraordinarily empathetic," said Mr.
years old, a retired Army captain who received a Purple Heart for wounds
he suffered in Iraq. "In bad moments, he'll lay his head on my leg, and
it'll be like he's saying, 'You're OK. You're not alone.'"
Senator Franken’s bill, the Franken-Isakson Service Dogs for Veterans
Act, was passed unanimously in July 2009, tacked onto the Defense
Authorization, later passing in September 2009 to become law.
The Franken-Isakson Service Dogs for Veterans Act will:
Pair a minimum of 200 veterans and dogs, or the minimum number
necessary to produce scientifically valid results on the benefits of the
use of the dogs (whichever is greater).
Ensure that 50 percent of veterans participating in the pilot
program will be those who suffer primarily from mental health
disabilities, and fifty percent those who suffer primarily from physical
injuries or disabilities.
Direct VA to partner exclusively with non-profit agencies who do not
charge for their animals, services, or lodging.
Require VA to provide seed money to pay for the first 50 service
dogs, and match its non-profit partners’ contributions for the rest of
the service dogs.
Continue the pilot program for at least three years; the Secretary
of the VA must make annual reports to Congress on its implementation;
the National Academies of Science is directed to study and report on the
program’s effectiveness at the end of three years.
The scientific study of the pilot program will study both the
therapeutic benefits to veterans, including quality of life benefits
reported by the veterans; and the economic benefits of using service
dogs, including savings on health care costs, such as reduced
hospitalization and prescription drug use, and productivity and
employment gains for the veterans.
Why We Did This Audit
The Conference Report to accompany Public Law 111-117,
Consolidated Appropriations Act, 2010, directed the OIG to
review the Guide and Service Dog Program. VHA is authorized to
provide financial support for guide dogs to assist visually
impaired veterans and service dogs to assist veterans with
mobility, hearing, or mental impairments. The audit evaluated
VHA’s progress in providing guide and service dogs to qualified
What We Found
VHA faces challenges implementing the Guide and Service Dog
Program in the absence of implementing criteria. VHA assisted
visually impaired veterans in obtaining guide dogs for several
decades. VHA only started assisting mobility and hearing
impaired veterans with service dogs in 2008—6 years after being
authorized to do so. Since FY 2009, VHA provided financial
support to over 230 veterans for guide dogs. However, VHA
provided financial support to only eight veterans for service
dogs. VHA personnel told us the actual demand for service dogs
This occurred because VHA had not provided sufficient guidance
to VA medical center personnel to ensure consistent decisions on
veterans’ requests for service dogs. Also, VHA had not made
their personnel fully aware of these potential benefits and the
application process involved. VHA Handbook 1173.05 only
prescribes policies and procedures applicable to providing guide
dogs to visually impaired veterans. VHA is in the process of
determining the appropriateness of using service dogs to assist
veterans with mental impairments.
What We Recommended
We recommended the Under Secretary for Health issue
comprehensive interim guidance to ensure VA medical center
personnel are aware of and better understand the qualifying
criteria for service dog benefits and the process required to
apply for them.
Agency Comments The Under Secretary for Health agreed to develop clinical
criteria to determine whether a veteran would benefit from a
service dog. The Under Secretary also stated that immediately
after the formal regulations exercising VHA’s authority are
published, scheduled for July 2011, VHA will issue a directive
defining VHA’s policy on issuing service dogs. We will monitor
implementation of the planned actions.
Autumn offers a paw-of-thanks to
John, an Iraq War combat veteran.
University's Paws for Purple Hearts (PPH) program
is the only one of it kind in the world.
Building on the time-honored
tradition of veterans helping veterans, Paws for Purple
Hearts engages servicemen diagnosed with PTSD in a
mission to train service dogs as part of their
rehabilitative therapy. Training service dogs provides a
way for veterans with PTSD to practice emotional
regulation and give their days focus and purpose. The
dogs help to facilitate social relationships with
members of the community since a critical element of
training is properly socializing the puppies and
practicing their training skills in public.
The service dogs are trained to
assist in activities of daily living by opening doors,
retrieving dropped items and pulling wheelchairs. These
are just a few of the many benefits that a service dog
provides. Plus the dog also offers unconditional love
and acceptance. The service dog accompanies their
partner everywhere – home, work, anywhere their lives
take them. In many cases, service dogs perform tasks
that were previously performed by an attendant or family
member; thus reducing the veteran’s dependence on other
John, a powerful and gentle man,
sees the power of service dog puppies like Underdog.
In PPH's Warrior CARE Program, also known as Canine Assisted Reintegration
Experience (CARE), the servicemen and women are first trained to train
service dogs in over 90 commands. Using this expert knowledge and their
honed training skills, they move onto training dogs that will be partnered
to assist comrades with physical injuries.
The process of training a service dog for a fellow veteran can help address
many of the symptoms associated with psychological injuries including PTSD.
It also creates a positive sense of purpose and reinforces military values.
The soldiers who are trainers experience the unconditional love and support
of the dogs in training. This connection offers stress relief as these
servicemen and women reintegrate back into their community. Training the
dogs enhances self worth, and provides an opportunity to practice emotional
regulation and a reason for participating in new social relationships
PPH has been integrated into the Veterans Affairs Palo Alto Health Care
Service’s Menlo Park location under the direction of their Recreation
Therapy Services. Strong observations by the medical staff underscore the
areas of impact that the dogs and the dog training exercises have made with
the servicemen and women include: increased patience, impulse control and
emotional regulation, increased positive social interactions, less
isolation, decreased depression, increase in positive sense of purpose,
improved sleep, decreased startle responses, decreased need for pain
medications, increased sense of belonging and acceptance, increased
assertiveness skills and improved parenting skills and family dynamics.
On November 18, 2008, Brian Williams did a MSNBC TV report on Paws
for Purple Hearts. With NBC's Robert Bazell
reporting, the segment was filmed at the VA Hospital in Menlo Park, CA,
featuring soldiers training dogs as a treatment for PTSD.
Bergin's Bay Area program to help veterans suffering from Post Traumatic
Stress Disorder has continued to spark interest, as noted in the November
11, 2009 ABC TV report,
Man's best friend helps vets with PTSD.
The PPH program’s second location was launched in March 2009 at the Walter Reed
Army Medical Center. Documentation of the results of the Menlo Park PPH
program encouraged Walter Reed Army Medical Center to move ahead with the
program. Legislation has been introduced in Congress that would set up three
tests sites modeled on the Menlo Park program, to study the effectiveness of
using service dogs in training to treat PTSD.
Amanda (left) and Ashley, among the first Paws for Purple Hearts trainers
at Walter Reed Army Medical Center, help Owen refine his retrieve. Photo:
Dogs from the Bergin University of Canine Studies are now being taught to
heel by soldiers from the Warrior Transition Unit of Walter Reed Army
Medical Center (WRAMC). After a long process of drafting proposals and
gaining JAG legal approval, the Paws for Purple Hearts (PPH) program at
Walter Reed launched in February 2009! What have we learned since February?
It was well worth the time and effort.
It was wonderful to watch the soldiers arrive on their first day to work
with their new dogs. They patiently listened to the staff talk to them about
what they could expect from their participation in the program. Then, the
magic happened. Three five-month-old Golden Retrievers were introduced to
their new significant Humans. Owen, Nathan and Ortiz took over from there
with tails wagging. A shift was felt throughout the room. These young
uniformed Wounded Warriors, some struggling with both physical and
psychological injuries from the conflicts in Iraq and Afghanistan seemed
different. Literally, you could see and feel the stress lift.
Nathan, Ortiz and Owen (top to
bottom). Photo by Augusta Westland.
Imagine a typical day spent attending medical appointments and counting the
days and months before you are either discharged from military service or
placed back into active service. Now, in the midst of that daily routine,
you have the mission of training a service dog that will one day help your
fellow comrades live a more fulfilled and independent life.
Now, every day holds a bright spot knowing you will be greeted by a pup that
knows you’re the greatest and most loveable person who ever lived. He greets
you, not caring if you have facial scars or scars that others can’t see. He
just loves you and that’s what you needed! Because of your efforts, you
watch your dog learn success. When you’re having a hard day, he knows how to
help. He is there for you and listens. He doesn’t allow you to isolate
because that is a violation of dog values. He is an expert at living in the
moment, a skill that will make all the difference in the world for you.
He’ll teach you if you let him in and oh yes, he’s good at getting in! Who
is teaching whom to heel/heal?
Thanks to all who support our efforts. With your help, we’re opening new
doors to allow our dogs to work their miracles!
Project HEAL® Service Dogs are specially
trained dogs who pick up dropped objects, open and close doors, open
refrigerators, pull wheelchairs, prevent overcrowding in public, interrupt
nightmares and flashbacks, remind to take meds, warn of approaching
strangers and reduce anxiety and stress, all the while providing
unconditional love and comfort.
ECAD does not charge our Wounded Warriors for these very special Service
Dogs. Each veteran is provided with 13 days of Team Training instruction
either in their New York or Florida facility at a cost of $500. Housing is
provided at no cost.
Puppies begin their training in the
NEADS Nursery Nwhere they
learn housebreaking and basic obedience skills. The majority of the dogs
then go to live in a prison cell with an inmate who completes their
Due to the more intensive training, it can take
almost half the time to train service dogs in prison than it does in foster
Ut Oh, Emotional Support Animals are not Psychiatric
emotional support animal (ESA) is a legal term for a pet which provides
therapeutic benefit to its owner through companionship and affection.
Emotional support animals are not specially trained to alleviate the
symptoms of a disability
as Psychiatric Service Dogs (PSDs) are. They require only as much training as
is necessary to live among humans without being
a nuisance or a danger. Two US federal laws grant rights to some owners of
ESAs, as related to housing and airflight. As noted at
Service Dog Central,
An Emotional Support Animal is a dog or other common domestic animal
that provides therapeutic support to a disabled or elderly owner through
companionship, non-judgmental positive regard, affection, and a focus in
life. If a doctor determines that a patient with a disabling mental
illness would benefit from the companionship of an emotional support
animal, the doctor write letters supporting a request by the patient to
keep the ESA in "no pets" housing or to travel with the ESA in the cabin
of an aircraft.
ESAs are not task trained like service dogs are. In fact little
training at all is required so long as the animal is reasonably well
behaved by pet standards. This means the animal is fully toilet trained
and has no bad habits that would disturb neighbors such is frequent or
lengthy episodes of barking. The animal should not pose a danger to
other tenants or to workmen. But there is no requirement for fancy
heeling or mitigating tasks since emotional support animals are not
generally taken anywhere pets would not ordinarily go without permission
(the exception being to fly in the cabin of an aircraft, even if the
airline does not ordinarily accept pets).
It is important to note that having a diagnosis of a mental illness,
by itself, is not sufficient to qualify a person for an ESA unless that
illness is so severe it disables them. Only a judge can truly determine
whether a person is legally disabled. However, a doctor can probably
make a medical determination of a person's disability and on that basis
prescribe an ESA. To qualify as disabled under federal disability rights
laws, a person must experience substantial limitations on one or more
major life activities because of their mental illness.
The issue of disabling conditions was one that was a daily occurrence in
my former time in the school system as a school psychologist. Like it or
not, there is no one with a perfect brain, our makeup being the summation of
various cognitive strengths and weaknesses. No matter the person, I could
find a test to tap into an area that was poorly developed. In fact, I
sometimes presented tasks to others that I myself was unable to complete.
However, many of us are able to overcome obstacles and function quite well
despite them. It is only when a weakness becomes debilitating and so effects
overall functioning in a major life area (such as school, work, or social
functioning) that it truly becomes disabling.
Central sees the difference between emotional support animals and service animals
To have a service animal, a person must be so impaired as to have a
disability. For example, needing glasses for poor vision is an impairment,
but being unable to see with or without glasses is a disability. Having a
mental illness is an impairment, but being unable to function on a minimal
level because of a mental illness is a disability. Folks may have an
emotional support animal due to a mental impairment if they are also
otherwise disabled or elderly or they may have an emotional support animal
because of a mental illness disability. Only those actually disabled by a
psychiatric impairment would qualify to use a psychiatric service dog.
Service animals are task trained to actually do something which mitigates
the person's disability. Their defined function is not to provide emotional
support (affection on demand or a security blanket) but to do something the
handler cannot do for themselves which allows that handler to overcome or
ameliorate an inability to perform major life activities. Emotional support
animals don't have to be trained, so long as they do not disturb neighbors
or pose a threat to public safety.
A person with a disability has a right to be accompanied by a trained
service dog which is assisting them in most public accommodations (places of
business). A person with an impairment or a disability does not have a right
to be accompanied by an emotional support animal unless individual state
laws specifically grant this right, in which case it applies only in that
Some folks confuse Emotional Support Animals (ESAs) with Psychiatric Service
Animals (PSAs). They think that "training" a dog to kiss on command or jump
in their lap, or be hugged is a task qualifying the animal as a service
animal. Real tasks for PSDs (psychiatric service dogs) include
counterbalance/bracing for a handler dizzy from medication, waking the
handler on the sound of an alarm when the handler is heavily medicated and
sleeps through alarms, doing room searches or turning on lights for persons
with PTSD, blocking persons in dissociative episodes from wandering into
danger (i.e. traffic), leading a disoriented handler to a designated person
or place, and so on.
If you look at the tasks just described (and those listed below), you will
see that PSD tasks are actually very similar to tasks for persons with other
disabilities. Guiding to a place and blocking from danger are common Guide
Dog tasks. Signaling for an alarm is a common hearing dog task.
Balancing/bracing and turning on lights are common Mobility Dog tasks.
That's because they are real service dog tasks for persons whose disability
happens to be due to mental illness.
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