Emotional Support Animals

[erg923]

Has there been any empirical studies looking at "Emotional Support Animals,", specifically? Thanks?

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[DynamicDidactic]

Has there been any empirical studies looking at "Emotional Support Animals,", specifically? Thanks?

I had a student write about this research for a class once. So, there is research in the area. However, this undergrad student didn't find any controlled trials (or at least not well-controlled).

Remember, this was an undergrad student. I would love to see a single well-controlled trial.

 

[WisNeuro]

I know the VA was looking at a few service animal studies, not sure if they included "emotional support animals" too.

"ESAs, for when you're just too cheap to pay to transport your dog."
"ESAs, for when your Doctor won't prescribe you Xanax, but is still stupid enough to write you a letter for a furry benzo."

 

[FreudianSlippers]

I know the VA was looking at a few service animal studies, not sure if they included "emotional support animals" too.

"ESAs, for when you're just too cheap to pay to transport your dog."
"ESAs, for when your Doctor won't prescribe you Xanax, but is still stupid enough to write you a letter for a furry benzo."

This 100%. In my anecdotal experience emotional support animals usually serve the function as a safety behavior/experiential avoidance. I mean, who doesn't feel better when around a cute, warm, fluffy animal? However, people in therapy are usually avoidant enough, and I'm not interested in giving them more safety behaviors. I'm all for using critters to assist with exposure or behavioral activation though!

 

[PsyDr]

Brief overview:

1) ESA are specific to the fair housing act. This law covers specific types of housing. So ESAs have zero legal standing in public.

2) ESAs may also be semi covered via the air carriage act, which specifically regulates flying with an animal. Exotics are not covered. The letter used must specifically use the dsm-IV. The animal must be certified to not have to urinate or defecate for flights longer than 8hrs. There have been decent lawsuits about this. See: Portland airport lawsuit.

3) Service animals can only be dogs or mini horses under the ADA. In general they must be trained to perform a specific task. Calming someone down has been ruled to NOT be a specific task. Legally, one of the few tasks that you are allowed to ask is, “what service is that animal trained to do?”. If they say calming down, it’s not a service animal.

Jeff Younggren from the Trust has published in the area and specifically advised psychologists to not provide ESA letters, due to liability concerns and lack of efficacy.

Molly Crossman has one of the few studies on the subject which showed basically no clear benefit.

 

[Sanman]

Amusing job

American Service Pets

The above is all I have to add. Seems like a fun way to get in trouble.

EDIT: @PsyDr, I want in if you're suing them.

 

[BuckeyeLove]

My old mentor views this area strictly as something that should be evaluated by forensic psychologists (always looking for a new income stream). Greenburg and Shuman would agree though, as all I ever see are therapy providers proffering opinions on, at best I can tell, is somewhat of a psycho-legal opinion.

 

[BuckeyeLove]

He made up a fake pet and got it approved. Just like that dude that made the cat have all those fake credentials.

 

[psychlife19]

I know the VA was looking at a few service animal studies, not sure if they included "emotional support animals" too.

"ESAs, for when you're just too cheap to pay to transport your dog."
"ESAs, for when your Doctor won't prescribe you Xanax, but is still stupid enough to write you a letter for a furry benzo."

Furry benzo!!!

 

[deleted343839]

In my anecdotal experience emotional support animals usually serve the function as a safety behavior/experiential avoidance.

They also serve to get a landlord's pet fees waived, and I suspect this is a strong motivator as well. A patient once asked asked me to provide a pet letter primarily for this purpose.

 

[cara susanna]

They also serve to get a landlord's pet fees waived, and I suspect this is a strong motivator as well. A patient once asked asked me to provide a pet letter primarily for this purpose.

Or a landlord to allow an animal that wouldn't otherwise be allowed.

At our VA, our psychology service STRONGLY discourages us from writing these letters for the above discussed reasons. When you provide an ESA letter, you are making a judgment about disability and functioning that you may not even be qualified to make.

 

[erg923]

Without going into detail, this is a worker's comp case. IME and then likely going to peer review. Upon further reading:

My understanding is "ESA" is just the legalized term (so to speak) for a pet that (via some letter from some MH professional) can get the "no pets clause" waived for housing and might be able to fly on an airplane at no cost. Nothing more. Right? The person in question does not even have a designated animal/pet currently.

 

[PsyDr]

Without going into detail, this is a worker's comp case. IME and then likely going to peer review. Upon further reading:

My understanding is "ESA" is just the legalized term (so to speak) for a pet that (via some letter from some MH professional) can get the "no pets clause" waived for housing and might be able to fly on an airplane at no cost. Nothing more. Right? The person in question does not even have a designated animal/pet currently.

That is basically correct.

 

[jdawg2017]

I may not fully understand this, but aren’t public places prohibited from asking about what a service dog does/why someone has a service dog? If so, an ESA (assuming it’s a dog and not a cat, or something that clearly provides no functional value), cannot from a practical standpoint be questioned easily.

In recent years I’ve noticed a trend of more frequent appearances of animals wearing no clear service vests in places like target and the grocery store. I’m almost positive these are not service dogs but I’m wondering if management and workers don’t gamble with this given the potential for lawsuits if a truly legitimate service animal is questioned.

 

[PsyDr]

I may not fully understand this, but aren’t public places prohibited from asking about what a service dog does/why someone has a service dog? If so, an ESA (assuming it’s a dog and not a cat, or something that clearly provides no functional value), cannot from a practical standpoint be questioned easily.

In recent years I’ve noticed a trend of more frequent appearances of animals wearing no clear service vests in places like target and the grocery store. I’m almost positive these are not service dogs but I’m wondering if management and workers don’t gamble with this given the potential for lawsuits if a truly legitimate service animal is questioned.

No. You are specifically allowed to ask if the animal is a service animal required for a disability AND what the animal is trained to do. You are NOT allowed to ask what the disability is. Calming someone is NOT a trained task according to the law. So you can ask, “what’s the dog or mini horse trained to do?”. If the person says, “calm me down if I have a flashback.”, the animal does not qualify as a service animal.


ESAs have zero standing in public (outside of a plane). ESAs are NOT service animals.

Since public settings ONLY cover service animals, and since the ada only covers dogs and mini horses, you can straight up call people liars if they have other animals.

Service dogs and mini horses are not required to wear any vests or adornments. Any idiot can buy those vests off amazon.

 

[jdawg2017]

No. You are specifically allowed to ask if the animal is a service animal required for a disability AND what the animal is trained to do. You are NOT allowed to ask what the disability is. Calming someone is NOT a trained task according to the law. So you can ask, “what’s the dog or mini horse trained to do?”. If the person says, “calm me down if I have a flashback.”, the animal does not qualify as a service animal.


ESAs have zero standing in public (outside of a plane). ESAs are NOT service animals.

Since public settings ONLY cover service animals, and since the ada only covers dogs and mini horses, you can straight up call people liars if they have other animals.

Service dogs and mini horses are not required to wear any vests or adornments. Any idiot can buy those vests off amazon.

Thanks for clarifying! It’s still interesting to think, though, about how many ESAs (or heck, no certification at all) are brought into public spaces. It doesn’t bother me really, but I’ve witness people at grocery and big box stores get upset and patrons with dogs. Never really seen anything except a dog in public.

Also, to rebut ESAs being avoidance coping tools, I’m curious if there’s research on the use of ESA for behavioral activation. Conceptually I bet they could help, though “getting me active” I’m sure is not going to be an approved form of assistance, either.

 

[deleted343839]

Also, to rebut ESAs being avoidance coping tools, I’m curious if there’s research on the use of ESA for behavioral activation. Conceptually I bet they could help, though “getting me active” I’m sure is not going to be an approved form of assistance, either.

There is a whole separate literature on companion animals (i.e., pets), some of which addresses this idea. Functionally I'm not quite sure how you distinguish an ESA from a pet.

 

[futureapppsy2]

Thanks for clarifying! It’s still interesting to think, though, about how many ESAs (or heck, no certification at all) are brought into public spaces. It doesn’t bother me really, but I’ve witness people at grocery and big box stores get upset and patrons with dogs. Never really seen anything except a dog in public.

Also, to rebut ESAs being avoidance coping tools, I’m curious if there’s research on the use of ESA for behavioral activation. Conceptually I bet they could help, though “getting me active” I’m sure is not going to be an approved form of assistance, either.

In the U.S., there is no certification for either service animals or ESAs and any service animal or ESA certifications sold are scams.

 

[Spydra]

Also, to rebut ESAs being avoidance coping tools, I’m curious if there’s research on the use of ESA for behavioral activation. Conceptually I bet they could help, though “getting me active” I’m sure is not going to be an approved form of assistance, either.

I was wondering about this too. I past clients with major depression have said that having a pet at home to care for helps get them out of bed because they feel obligated to care for it. All of them were pet owners before being diagnosed so I have wondered if getting a pet later would help with behavioral activation. Thankfully none were asking for an ESA letter and I have no interest in doing that anyway.

 

[cara susanna]

That's the thing: pets are probably helpful for mental health. But with an ESA, you are saying that 1) your patient is disabled because of their mental health issue and 2) the ESA improves functioning. That's a much harder burden of proof than "petting my dog makes me feel happier."

 

[Fan_of_Meehl]

That's the thing: pets are probably helpful for mental health. But with an ESA, you are saying that 1) your patient is disabled because of their mental health issue and 2) the ESA improves functioning. That's a much harder burden of proof than "petting my dog makes me feel happier."

I always wonder what's next? If I have a client on SSDI who loves to garden (with all the attendant antidepressant effects of exercise/activation, Vitamin D, and a sense of accomplishment and healthy food) and he/she happens to live in a neighborhood with a homeowner's association that forbids having a vegetable garden in your yard...is it *really* my role/responsibility to step in and write a letter 'prescribing' a waiver to the 'no garden' rule due to 'medical necessity' of it helping mitigate his/her medical disability (clinical depression)?

Where does it end?

 

[cara susanna]

I always wonder what's next? If I have a client on SSDI who loves to garden (with all the attendant antidepressant effects of exercise/activation, Vitamin D, and a sense of accomplishment and healthy food) and he/she happens to live in a neighborhood with a homeowner's association that forbids having a vegetable garden in your yard...is it *really* my role/responsibility to step in and write a letter 'prescribing' a waiver to the 'no garden' rule due to 'medical necessity' of it helping mitigate his/her medical disability (clinical depression)?

Where does it end?

Excellent point.

I also think about people who don't like animals or pets (or perhaps even have allergies) and therefore want an animal-free building. What about their rights?

 

[WisNeuro]

What if peanuts make my kid feel more happy and calm? Can he bring them to daycare with your kid who has a peanut allergy? He needs his emotional support peanuts!!!

 

[Justanothergrad]

Any idiot can buy those vests off amazon.

And many do.

 

[Therapist4Chnge]

What if I can convince my emotional support octopus to aggressively seek out and eat all stray peanuts....who do the overly involved parents try and complain about now?! The Peanut Smuggling Kid, me with my ESA octopus who loves peanuts, or a new yet to be determined quixotic windmill from which to tilt?

 

[Therapist4Chnge]

And many do.

It *amazed* me traveling over the holidays how many stupid fake vests I saw at the various airports. I saw two legit service animals (dogs, clearly working), a couple of almost but not really ESA dogs, and countless dogs and cats in stupid vests that were as trained as an unmedicated 6yo on a sugar high.

This is one of my biggest pet peeves now bc it makes legitimate requests and accommodations harder for those who actually need and qualify for a service animal.

 

[Justanothergrad]

It *amazed* me traveling over the holidays how many stupid fake vests I saw at the various airports. I saw two legit service animals (dogs, clearly working), a couple of almost but not really ESA dogs, and countless dogs and cats in stupid vests that were as trained as an unmedicated 6yo on a sugar high.

This is one of my biggest pet peeves now bc it makes legitimate requests and accommodations harder for those who actually need and qualify for a service animal.

it makes me so angry with the MH providers who do this or make light of it because it minimizes and mocks an actual clinical service

 

[PsyDr]

I always wonder what's next? If I have a client on SSDI who loves to garden (with all the attendant antidepressant effects of exercise/activation, Vitamin D, and a sense of accomplishment and healthy food) and he/she happens to live in a neighborhood with a homeowner's association that forbids having a vegetable garden in your yard...is it *really* my role/responsibility to step in and write a letter 'prescribing' a waiver to the 'no garden' rule due to 'medical necessity' of it helping mitigate his/her medical disability (clinical depression)?

Where does it end?

At the heart of it is the argument that X person doesn’t have to abide by a contract he/she willingly entered into because they have a mental illness. But their mental illness is not of such severity to preclude their ability to enter into contracts. That’s an exceedingly fine line.

 

[AbnormalPsych]

What if peanuts make my kid feel more happy and calm? Can he bring them to daycare with your kid who has a peanut allergy? He needs his emotional support peanuts!!!

Emotional support nuts are going to be the next pet rock. Thanks for this idea. Retirement here I come. Step 1, nuts. Step 2, profit.

 

[WisNeuro]

Emotional support nuts are going to be the next pet rock. Thanks for this idea. Retirement here I come. Step 1, nuts. Step 2, profit.

It's supposed to go "Step 1, nuts. Step 2 ????. Step 3, profit!" Underpants gnomes!

 

[DynamicDidactic]

US will redefine 'service animals' flying with their owners on flights

The U.S. Transportation Department on Wednesday proposed new rules aimed at preventing passengers from falsely claiming their pets are service animals aboard U.S. airline flights.

www.cnbc.com

The administration’s proposal would consider “a psychiatric service animal to be a service animal and require the same training and treatment of psychiatric service animals as other service animals.”

Biggest concern is who decides that an animal is therapeutic (meaning will this be empirically examined with credible placebos) and what would qualify as "training."

 

[Fan_of_Meehl]

US will redefine 'service animals' flying with their owners on flights

The U.S. Transportation Department on Wednesday proposed new rules aimed at preventing passengers from falsely claiming their pets are service animals aboard U.S. airline flights.

www.cnbc.com

Biggest concern is who decides that an animal is therapeutic (meaning will this be empirically examined with credible placebos) and what would qualify as "training."

Nor have I seen a SINGLE decent written exposition (book chapter or journal article) in the professional literature that's worth a piss examining the theoretical underpinnings (or lack thereof) of this form of 'intervention' for specific mental disorders and/or proposed mechanism(s) of action. NO ONE has acknowledged that--as a safety behavior--reliance on a 'service dog' is antithetical to the two main heavily supported effective treatment elements of exposure and cognitive restructuring in empirically-supported interventions for PTSD. Our field has never even formally acknowledged these issues...let alone substantively contended with them. And yet if you asked 10 people on the street (or in Congress) about effective treatment for PTSD, 9 of them would say 'doggies' and meds (or weed) and you'd be fortunate to find 1 in 10 who'd say 'CBT.' Maybe 1 in 100 or 1 in 500 would know about CPT or PE.

 

[cara susanna]

So this would be like the VA's rule, I assume, where service animals are permitted but not ESAs?

Nor have I seen a SINGLE decent written exposition (book chapter or journal article) in the professional literature that's worth a piss examining the theoretical underpinnings (or lack thereof) of this form of 'intervention' for specific mental disorders and/or proposed mechanism(s) of action. NO ONE has acknowledged that--as a safety behavior--reliance on a 'service dog' is antithetical to the two main heavily supported effective treatment elements of exposure and cognitive restructuring in empirically-supported interventions for PTSD. Our field has never even formally acknowledged these issues...let alone substantively contended with them. And yet if you asked 10 people on the street (or in Congress) about effective treatment for PTSD, 9 of them would say 'doggies' and meds (or weed) and you'd be fortunate to find 1 in 10 who'd say 'CBT.' Maybe 1 in 100 or 1 in 500 would know about CPT or PE.

Or, worse, they'll say EMDR.

(I'm kidding... kind of).

 

[Fan_of_Meehl]

So this would be like the VA's rule, I assume, where service animals are permitted but not ESAs?



Or, worse, they'll say EMDR.

(I'm kidding... kind of).

What killed me was when the VA put out that memo/policy (I think it was like a year and a half ago) stating that 'service dogs' for PTSD were to be considered to treat a 'disorder of mobility.' The issue isn't mobility, per se. It's a behavioral issue. It is physiologically possible for them to emit the behavior of 'mobility' (unlike folks who, say, have neuromuscular issues, no legs, or other physical disabilities). It was a completely politically-motivated decision to consider 'service dogs' for a mental illness to be addressing an issue of 'mobility' and far more of a play-on-words and political 'sleight of hand/phrase' Sophistry than it was a good faith or honest classification.

Check out this flyer from the VA website (there was an official policy/procedure document but I can't find it):

 

[Justanothergrad]

https://www.washingtonpost.com/transportation/2020/01/22/department-transportation-proposes-ban-emotional-support-animals-planes/

related.

 

[Fan_of_Meehl]

https://www.washingtonpost.com/transportation/2020/01/22/department-transportation-proposes-ban-emotional-support-animals-planes/

related.

I've been wondering when the reality/sanity membrane would be stretched to the outer limits of elasticity (just before breaking) and then--finally--begin to snap back.

 

[cara susanna]

I'm impressed by how many in the comments are in favor of this decision.

 

[AcronymAllergy]

I'm impressed by how many in the comments are in favor of this decision.

If there's one thing people hate, especially while traveling, it's the idea that someone else gets something they don't.

 

[WisNeuro]

If there's one thing people hate, especially while traveling, it's the idea that someone else gets something they don't.

I'm thinking more about that guy who had to have reconstructive surgery after an animal mauled his face, or the countless reports of a support animal ****ting all over the place. Flying is bad enough, flying and having to smell animal **** for several hours, no thanks.

 

[AcronymAllergy]

I'm thinking more about that guy who had to have reconstructive surgery after an animal mauled his face, or the countless reports of a support animal ****ting all over the place. Flying is bad enough, flying and having to smell animal **** for several hours, no thanks.

And there's that, yes.

 

[MAClinician]

House passes VA funded service dogs for veterans

 

[DynamicDidactic]

Problem: suicide rates among veterans is high
Govt: I know, let’s get them dogs!

 

[Sanman]

Problem: suicide rates among veterans is high
Govt: I know, let’s get them dogs!

Hey, hey: We give them a suicide flag in the chart and ask them if they are going to kill themselves by phone daily. Then, we give them a dog.

Goal: No one should kill themselves ever! This is realistic, really it is.

 

[DynamicDidactic]

ask them if they are going to kill themselves by phone daily.

Is that accurate?

 

[cara susanna]

House passes VA funded service dogs for veterans

Oh GOD no.

 

[AbnormalPsych]

House passes VA funded service dogs for veterans

"require the VA to assess the effectiveness of dog therapy."

You VA peeps enjoy that one. Also, someone please operationalize 'dog therapy.'

"There is no question that the companionship and unconditional love offered by man's best friend can have powerful healing effects on men and women from all walks of life, including our men and women in uniform."

Welp, .... good luck VA.

 

[cara susanna]

I hope Mental Health Central Office pushes back against this one. Right now the VA doesn't even recognize service dogs for PTSD.

 

[PsyDr]

Problem: suicide rates among veterans is high
Govt: I know, let’s get them dogs!

Remember the DoD study that showed that Alcohol abuse was a much more significant risk factor for suicide than PTSD? And remember when the Annals of Epidemiology showed that non-deployed veterans had more suicides than deployed ones? And remember when the times showed that when stratified by age and gender, there wasn't an increased risk of suicide?

We just blew by that.

 

[Bayside]

A company called ESAD is recruiting psychologists PA’s, and NP's in my area to provide “Emotional Animal Support letters of recommendation”. The ad has a lot of stuff about complying with HUD guidelines and offers $80-$120/hr compensation. By recruiting locally seems they're avoiding the internet evals but still looks very sketchy to me.

 

[Therapist4Chnge]

Ugh...another company looking to leverage tax dollars to maximize profits off the backs of tax payers, science and data be damned. This will just further reinforce the wrong things for our Veterans.