I agree. The first few times a patient asked me for this, I thought they were being sincere and just assumed I had missed a personality disorder diagnosis. Then I talked to a friend of mine who said he's approached people in airports who had dogs with them which were obviously not service animals, asked them "excuse me, do you mind if I ask how you're able to get the airline to allow your dog in the cabin with you?" and without fail, their reply was "oh, it's really easy, you just ask your doctor for a letter saying it's an emotional support animal!"
There is no liability. You aren’t writing for the animal but for the patient. It is the airline that would be liable they are still supposed to exercise care in deciding what animals to let on. You are merely expressing your opinion that the patient needs an ESA. Personally I don’t write ESAs for flying only housing.
The apartment issue is one that hits too close to home for me to be objective on. I currently live in an apartment and the neighbor below me has a dog who barks incessantly, when presumably they're not even home, and it's a deep-voiced bark that bellows through the floor.
That's my approach as well. It's something of a cop-out, but it's a good compromise of not pissing a patient off while retaining some shred of my own self-respect.
It is another symptom of our society's dysfunction. The VA is just a microcosm of the whole so it can be easier to see. The disability compensation, need for medications, dependency, and entitlement parade keeps growing. In the poker of online forums, I will match your cynicism and then raise it.
It seems to me that almost all apartments allow pets. My college age son is truly afraid of dogs and among 80 apartment complexes near his college campus only 2 stated a no pet policy, but they are required to allow service dogs. We thought that would be great until his apartment turned out to be between 2 tenants with dogs. One said "I'm just dog sitting it for a friend". I turned her in, dog was gone in one day. The other, who clearly did not need a service dog, claimed he was "training it as a service dog for my little cousin, who is blind". Hmm. But you don't need a service dog. The apartment manager allowed him to keep it. At least it was quiet and well trained and always on a leash. This didn't help my son who cringed every time he saw it in the hallway. But hey, they are not required to take phobias into consideration for tenants.
probably going to seek that out once he graduates from college (one more semester)
and neither seem causal.
Was he mauled by a dog? Or are you from a dog-phobic culture?
Knocked down by a dog while biking when younger, it affected him.
Short answer - sort of yes.
I am surprised that you think this practice isn't maladaptive. What kind of benefit does a patient get from using an animal as a way of escaping their scary feelings? Doesn't that just reinforce the false believe that said feelings are dangerous or that the person is unable to deal with them? Seems to me that it's little more than classic avoidance.
Not a bad idea. I'm envisioning a big German Shepherd or Rottweiler, trained to start growling whenever someone requests a controlled substance.
“But doc, you don’t understand, I need my adderall and xanax for my mental illness. How else am I going to stand sitting home all day doing nothing productive with my life.”
petting cats is a DBT skill. petting said cat as a way to use your senses to help regulate your emotions is adaptive. using a dog to scan the perimeter because of your PTSD related hypervigilance is maladaptive. finding the company of an animal therapeutic, healing and restorative is adaptive. not being able to go anywhere without said animal is maladaptive.
A bit worried for the cat
you needn't worry - cats know how to manage borderlines perfectly. http://gomerblog.com/2016/03/borderline-personality-disorder/
OMG, I was only mildly curious to read this Gomer Blog piece, but this one made me laugh out loud.
I agree with the idea of charging for letters, but this amount sounds like a lot to me.
