Aloha Colleagues,
Below are excerpts from two previous emails sent to the list serve in response to discussions regarding Emotional Support Animals (ESA).
I hope this information might provide clarification and support to colleagues who are considering the valuable resource of animals in mental health care.
Mahalo,
Shannon Curry, Psy.D.
On the Differences Between Emotional Support Animals (ESAs), Service Animals, and Therapy Dogs:
(Listserv Post Dated 07/30/2014)
This is such a good discussion, and I felt compelled to chime in since I train service dogs through the Hawaii Canine Assistance Network, use a certified therapy dog in my own practice, and have created some educational materials for my clients who I feel may benefit from an emotional support dog.
First, a service dog, a therapy dog, and an emotional support dog are each completely different, separate things.
An emotional support dog (ESA) is NOT a "service dog," NOR a " therapy dog". An emotional support dog is simply a pet that a provider "prescribes" to the patient to provide emotional support. There is growing evidence for the significant mental and physical health benefits of even brief contact with an animal, particularly canines. An emotional support dog can be an incredibly useful treatment resource, but it's important for providers to understand their liability and potential risks in "prescribing" an ESA, as well as to be capable of educating their clients about the proper use and representation of their ESA.
A therapy dog MUST BE CERTIFIED to be called such, but at the same time is not considered a service dog. It is allowed public access rights in medical, mental health and correctional settings to provide therapeutic services to patients. In order for to be called a "therapy dog," the canine must actually be certified by the American Kennel Club's Canine Good Citizen test as well as be evaluated and pass testing for secondary criteria established by a therapy dog organization (like Therapy Dogs Incorporated). Many providers unknowingly misrepresent their dog that they use in their practice as a "therapy dog." Unless the dog is certified by an accredited therapy dog organization, it is simply the provider's pet or an ESA they are utilizing to provide emotional support to their clients.
Service dogs have the most rigorous training standards but do not actually have to be certified. They include seeing eye dogs, hearing dogs, assistance dogs (pull wheelchairs and retrieve medication), and medical alert dogs (alert the patient of an epileptic or diabetic attack).
I have developed an agreement form and educational handouts that I provide to those clients for whom I prescribe emotional support animals, and which they must sign prior to my providing a letter. I am attaching those forms to this email for any of you to review and perhaps adapt for your own practice. My aim in creating these forms for clients was to prevent misuse and false representation of an emotional support dog as a therapy or service dog. Therapy dogs are insured by their certifying organization. Service dogs are protected by the ADA. Emotional support dogs are just pets, and if you're writing a letter for your client to be taking their pet on a crowded aircraft or public housing, you want to be sure that their pet isn't going to attack another passenger or resident, defecate in the aisle way and require an emergency landing (this actually happened), or get people sick due to an untreated illness. Therefore I require that my clients provide documentation of up-to-date vaccinations and a health certification from their veterinarian. I also ensure that they review and understand the educational handout on what an emotional support animal is and what it is not. I have them sign a written agreement not to misrepresent their emotional support dog as a service or therapy dog. There is also a necessary format to writing these letters that protects your client's rights. Please email me if you would like me to send you a template at Dr.Curry@CurryPsychology.com.
On Policies for Writing ESA Letters and Keeping an Open Mind Toward Patients Who Request Letters:
(Listserv Post Dated 11/11/2014)
I realize that it can be off-putting when a potential client makes contact for the sole purpose of obtaining an emotional support animal, and there is definitely an initial question of secondary gain. However, it has been my own experience that some of my most rewarding cases have started just that way. I've found that more often than not, people who might not otherwise have had the courage or recognized a very real need for help have stepped forward initially for the primary purpose of having their pet serve as their emotional support animal (e.g., veterans who have lived decades in isolation without having ever received treatment for chronic PTSD, severe cases of panic disorder and agoraphobia, etc.). It is with this in mind that I'd like to encourage providers to adopt a more open mind to these cases.
What I've found works for me is a three-session policy, where I inform patients who initially seek treatment with questions about an emotional support animal that I do not write letters unless someone is an established patient and I have a chance to get to know them better and understand their needs. So long as they are agreeable to treatment without any guarantees about a letter, I've found that every single case that's started this way has ended with a long-term and very meaningful therapeutic relationship.
I am happy to provide consultation to any of you who have patients who you feel may benefit from an emotional support animal, such as how emotional support animals can help, whether an emotional support animal is indicated, and on the practicalities of writing the letter. I can also share some of the informational materials I have created for patients, including an agreement I have for patients to sign committing to responsible use and representation of their pet as an emotional support animal and NOT as a service animal.
If you have any questions about the issues above, please do not hesitate to contact me.
Thank you all for the good work that you do!
- Shannon Curry
