'Prescribing' companion animals for patients with mental illness


Roughly 78 million, or 62% of households in the United States, have a pet, according to the American Pet Products Association. It is estimated that Americans will spend $55.53 billion on their pets in the year 2013 alone.

Over the last decade, the mental health profession has been placing an increased emphasis on the potential healing benefits of this animal companionship. In light of these trends, animal companionship can play an important role in our work with patients with mental illness and their families.

Jocelyn Augustino/FEMA Photo Library

Therapy animals may have unheralded healing benefits with mental health patients.

Froma Walsh, Ph.D., has examined both existing research and the history of animal companionship in a two-part review (Fam. Process 2009;48:462-80 and Fam. Process 2009;48:481-99). Dr. Walsh found that animals can assist in the family education of authority, boundaries, and communication. They also can become the subject of affection and attachment that provide the family with a common bond, according to Dr. Walsh, codirector and cofounder of the Chicago Center for Family Health, and the Mose and Sylvia Firestone Professor Emerita in the school of social service administration and department of psychiatry at the University of Chicago.

In addition, research has shown that a relationship exists between pets and improved outcomes within serious mental health diagnoses, such as bipolar disorder, schizophrenia, and schizoaffective disorder. For example, researchers at the New York State Psychiatric Institute found that pets provide outlets for empathy, connection, self-efficacy, and support for adults with serious illness. Their conclusion was based on surveys from 177 health maintenance organization members who had participated in the Study of Transitions and Recovery Strategies study (Am. J. Orthopsychiatry 2009;79:430-6). Interestingly, participants who owned pets were found to have a greater avoidance of isolating behaviors by providing a social outlet that helped them to connect with others.

We need to be aware of potential resources for using animal companions that can be tapped to help our patients. Within the canine species, three types of therapeutic dogs are shown to provide benefits to psychiatric patients: Emotional Support Dogs (ESDs), Mental Healthy/Psychiatric Service Dogs, and Therapy Dogs.

An ESD is a therapeutic dog that can be used to assist an elderly person or an individual with disabilities. The primary purpose of an ESD is to provide the owner with affection, companionship, and improved motivation to fulfill important tasks of daily living, such as getting a basic amount of exercise and going outside. ESDs do not qualify as service dogs under the Americans with Disabilities Act, but they are covered under the Fair Housing Amendment Act and the Amended Air Carrier Access Act. Therefore, ESDs can live in certain types of housing that have "no pet rules" and must be allowed to sit with their owners in the cabin of an aircraft.

Mental Health/Psychiatric Service Dogs undergo rigorous and specialized training in basic and advanced obedience, public access, and task performance. These dogs are found to be especially effective in the lives of people who suffer from anxiety disorders, including posttraumatic stress disorder. They can perform such tasks as providing a buffer for the handler in crowded areas by creating a physical barrier, standing behind the owner and others to increase feelings of security, and helping reduce hypervigilance on the part of their owners. They also can be trained to remind owners to take medication.

Therapy Dogs are available to provide affection and comfort for people in nursing homes, hospitals, hospices, and community centers. To be registered as a therapy dog or cat, the pet must be very social and enjoy human companionship. The dog should know basic obedience cues and be able to sit down, stay, heel, leave it, and come when called. Animals and their handlers must be registered and pass a certification exam that are offered by organizations such as Pet Partners.

The National Alliance on Mental Illness provides free, ongoing groups that offer peer support and therapeutic interaction with professionally trained pet therapy dogs. In addition, many animal shelters often look for volunteers to spend time caring for and engaging with animals. In our clinical experience, we have found that patients gain a greater sense of independence, self-worth, and purpose by not only interacting with therapy dogs but also by engaging in this type of volunteer work with their own pets.

Another useful resource, Puppies Behind Bars, is an organization that helps inmates train service dogs for veterans with PTSD. Paws and Stripes provides veterans who suffer from PTSD with a shelter dog and interactive training at no cost. Heeling Allies privately trains both mental health service dogs and ESDs to enrich the lives of individuals living with psychological, neurologic, and developmental impairments such as PTSD, depressive and anxiety disorders, autism spectrum disorders, and Tourette syndrome.

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