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.

― Note 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 victory.

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 sniffing smarts:

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.

Dr. Clive D. L. Wynne, of the U of Florida Canine Cognition & Behavior Lab, provides further perspective given the current efforts to compare human and canine brains.

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 we do.”
 



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 necessary care.

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 Psychogenic 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 concept of the Psychiatric Service Dog has received an increased emphasis in the media, their status elevated due to the concerns regarding the huge numbers of war veterans suffering with Post-Traumatic Stress Disorder (PTSD) as well as Traumatic Brain Injury due to the use of the improvised explosive device (IED). Some estimates show greater than one third of vets returning home from war in Iraq and Afghanistan are suffering from PTSD, this article on declining morale of US troops in Afghanistan revealing the significant societal impact:

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.

In 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.

In the January 26, 2010 article from The Plain Dealer, Giving comfort, courage to heal: Psychiatric service dogs offer patients new life outlook, we learn about a returning war veteran:

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 child.

"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 be alive."
 

 


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 NICABM). She is also a practitioner of QiGong and Reiki and teaches stress reduction techniques to her clients and their service dogs.

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).

 


 
 

Jane has now published a groundbreaking new book [January 2010] on Psychiatric Service Dogs Healing Companions: Ordinary Dogs and Their Extraordinary Power to Transform Lives. And, I'm sure that you would agree that it could not have come at a better time. The book is informative, practical, and inspirational.

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 PSD
  The kind of training PSDs require
  How PSDs compliment other forms of therapy
  What to expect and how to respond when you take a PSD 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 with stress
  How to recognize the needs of PSDs, thus providing them with proper care
  Handling the PSD's "Golden Years" in order to effectively move on

Healing Companions is a must-have, empowering 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 loving world.

Chapter 1 Mindy's Story: Umaya Leads the Way
Chapter 2 Canine Rx: Finding the Right Companion
Chapter 3 The Good Fight: Prison Puppies Free Veterans from Combat
Chapter 4 Sit, Stay, Soothe: Training your New Companion
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 the Leash
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 Disabilities
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 life-altering. Yes, 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
       ● Inspiration for & Creation of Franken-Isakson Service Dogs for Veterans Act
       ●
Paws for Purple Hearts
       ● NEADS Canines for Combat Veterans Program
       ● Puppies Behind Bars & Project Heal from East Coast Assistance Dogs
       ● Importance of Training a PSD to alert to sounds (w/video)
       ● Ut Oh, Emotional Support Animals are not Psychiatric Service Dogs
       ●
Related Service Dog Materials, Organizations and Online Links

 

Facility Dog


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 nonMary and Willow-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.

 

Service dog will help veterans at new Marion VA PTSD facility
By Carly O'Keefe , 12KFVS Heartland NEWS, June 29, 2011

MARION, 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 depression.

A dog named Teddy will be their guardian, their friend, and in a way - their therapist.

"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 working one-on-one."

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 Able Veteran.

The 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.

If 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
This article contains copyrighted material, the use of which has not always been specifically authorized by the copyright owner. I am making such material available in my efforts to advance understanding of democracy, economic, environmental, human rights, political, scientific, and social justice issues, among others. I believe this constitutes a 'fair use' of any such copyrighted material as provided for in section 107 of the US Copyright Law. In accordance with Title 17 U.S.C. Section 107, the material in this article is distributed without profit for research and educational purposes.



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Importance of Training a PSD to alert to sounds

This video comes from Vancouver Island Assistance Dogs. Nanaimo, BC. They have a great series of instructional videos that can be accessed here.

Please note that the star (*) indicates when the clicker marks the behavior. Also, barking is not a behavior that is desirable for an alert behavior 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 needed for Hearing Dogs, it is one that can be a lifesaver for those suffering various medical conditions. For example, medications can provoke quite deep sleep such that a person would sleep through the warning sounds from a smoke detector.


 

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Inspiration for & Creation of Franken-Isakson Service Dogs for Veterans Act

The first goal for new Senator Al Franken (a huge dog lover) was to provide Service Dogs for war veterans. He had obviously done his homework and knew how dreadfully expensive (~$25,000 per dog) it is to train these types of service dogs. This idea was spurred by his chance meeting with Luis Carlos Montalván and his Service Golden Retriever Tuesday at an inaugural event, as noted in AL's OpEd: Al Franken: A wounded veteran's best friend: A chance encounter inspires my first bill -- Legislation making the service dog program more affordable for our troops.

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.

 



 

In the article, Sit! Stay! Snuggle!: An Iraq Vet & his Service Golden Retriever Tuesday, we learn more about Captain Montalván.

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 one.

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 nearby.

"Tuesday is just extraordinarily empathetic," said Mr. Montalván, 36 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.
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JULY 2010 UPDATE
The latest information from the Veterans Health Administration's Guide and Service Dog Program Audit is quite disappointing. Below are the report's highlights:

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 veterans.

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 is unknown.

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.
 

 


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Paws for Purple Hearts

 

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Autumn offers a paw-of-thanks to John, an Iraq War combat veteran.
 

Bergin 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 people.


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: Carolyn Ford
 
 

Paws for Purple Hearts Expands to Serve Warriors in Transition at Walter Reed Army Medical Center
By: Rick Yount, Director PPH, Veterans Affairs Palo Alto Health Care System & Walter Reed Army medical Center

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!

 

 


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Puppies Behind Bars & Project Heal from East Coast Assistance Dogs
 

Puppies Behind Bars coordinates with Project Heal from East Coast Assistance Dogs (ECAD), to honor and empower Wounded Warriors by providing specially trained Service Dogs to increase independence and make a difference in their lives.

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.

 

 

 

 

 

 

 


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NEADS Canines for Combat Veterans Program

 

The NEADS Canines for Combat Veterans Program involves the training of service dogs by prison inmates.

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 training.

Due to the more intensive training, it can take almost half the time to train service dogs in prison than it does in foster homes.
 
 

 

 

 

 

 

 

 

 

 

 


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Ut Oh, Emotional Support Animals are not Psychiatric Service Dogs

An 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.

Service Dog Central sees the difference between emotional support animals and service animals as being threefold:

  1. 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.
     
  2. 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.
     
  3. 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 state.

    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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Service Dog Materials, Organizations, and Online Links

  Helpful Resources   Service Dog Issues   Training Standards / Tasks
Nationwide Service Dog Groups Listing
Frequently Asked Questions
Emergency Preparedness
Working Like Dogs Service Dog Site/Guidebook
 
Is it an emotional support animal or a psychiatric service dog?
What is the difference between a psychiatric service dog and an emotional support animal?


 

Service Dog Standards
Traditional Service Dog Tasks
Psychiatric Service Dog Tasks
Dog Partner Standards
Public Access Test
  Organizations   Medical Response Service Dogs   American with Disabilities Act (ADA)
Assistance Dog International
Delta Society National Service Dog Center
International Association of Assistance Dog Partners (IAADP)
Assistance Dog United Campaign
   
Diabetes: Medical Alert Dogs
Epilepsy: Seizure Alert Dogs
Service Dog Central: Psychiatric SDs
Americans with Disabilities Act
ADA Information Line
FAQ on Service Animals in Business Places
EEOC: ADA and Psychiatric Disabilities
Dept. of Justice Nondiscrimination on Basis of Disability: Proposed Rules June 2008
 


 


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FAIR USE NOTICE
Some of the articles here contain copyrighted material, the use of which has not always been specifically authorized by the copyright owner. I am making such material available in my efforts to advance understanding of social justice and human bond issues, among others. I believe this constitutes a 'fair use' of any such copyrighted material as provided for in section 107 of the US Copyright Law. In accordance with Title 17 U.S.C. Section 107, the material in this article is distributed without profit for research and educational purposes.

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