Therapeutic and Economic Benefits of Service Dogs Versus Emotional Support Dogs for Veterans With PTSD

Richerson, Joan T.; Abrams, Thad E.; Skelton, Kelly; Biswas, Kousick; Illarmo, Samantha; McSherry, Frances; Fallon, Michael T.; Frakt, Austin B.; Pizer, Steven D.; Magruder, Kathryn M.; Groer, Shirley; Dorn, Patricia A.; Huang, Grant D.; Stock, Eileen M.

doi:10.1176/appi.ps.20220138

Cited by 9 publications

(6 citation statements)

References 33 publications

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“…The idea of service dogs is nearly universally popular, but evidence for positive effects of service dogs is lacking, and existing studies are generally of low quality (Van Houtert et al., 2018; Vitte et al., 2021). A recent large study in a veteran population showed that having a service dog did not differ from having a generally well‐behaved dog (Richerson et al., 2023). Service dogs may negatively impact the family (Nieforth et al., 2022) or interfere with the “antiavoidance” principle of trauma‐focused psychotherapy.…”

Section: Frequently Asked Questions About the Cpgmentioning

confidence: 99%

A clinician's guide to the 2023 VA/DoD Clinical Practice Guideline for Management of Posttraumatic Stress Disorder and Acute Stress Disorder

Lang,

Hamblen,

Holtzheimer

et al. 2024

Journal of Traumatic Stress

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A clinical practice guideline (CPG) is a rigorously established set of recommendations based on currently available evidence about the efficacy, safety, acceptability, and feasibility of interventions to assist with clinical decision‐making. The 2023 Department of Veterans Affairs /Department of Defense Clinical Practice Guideline for Management of Posttraumatic Stress Disorder and Acute Stress Disorder is described herein. The CPG recommendations are accompanied by a clinical algorithm, which incorporates principles of evidence‐based practice, shared decision‐making, and functional and contextual assessments of goals and outcomes. An overview of the CPG recommendations is combined with a discussion of questions that clinicians and patients may face in implementing the CPG and suggestions for how to effectively work with the CPG.

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Section: Frequently Asked Questions About the Cpgmentioning

confidence: 99%

A clinician's guide to the 2023 VA/DoD Clinical Practice Guideline for Management of Posttraumatic Stress Disorder and Acute Stress Disorder

Lang,

Hamblen,

Holtzheimer

et al. 2024

Journal of Traumatic Stress

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“…The degrees of differences among these dogs should be noted, as each type of dog is not the same and cannot carry out the same tasks as another, due to variations in training (23, 24). The results from a 2014 study conducted by the Department of Veterans Affairs showed that SDs trained to support veterans with PTSD can decrease the severity of their symptoms better than dogs classified as emotional support dogs (25).…”

Section: Study Rationalementioning

confidence: 99%

A Qualitative Exploration of the Use of Service Dogs in Veterans with Post Traumatic Stress Disorder and Traumatic Brain Injury

Shiroff

Gray

Santulli

et al. 2023

PRCP

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Objective This qualitative research was conducted to add to the body of knowledge that supports the benefits of service dogs (SDs), as a tertiary treatment modality, to veterans with post‐traumatic stress disorder (PTSD) and/or traumatic brain injury (TBI). Methods This grounded theory research design utilized open‐ended, semi‐structured interviews with veterans (n = 10) who were using SDs as a treatment modality for PTSD and/or TBI. Transcripts were analyzed using NVivo qualitative software until data saturation was achieved. Results Results from the data analysis identified 4 major themes with concurrent subthemes. The most prominent themes were functional status, impact of a SD, recognition of symptoms of PTSD and/or TBI by the SD, and barriers and challenges to the acquisition of a SD. Participants reported that the SD increased socialization and was a positive adjunct to treatment modalities for PTSD and/or TBI. Conclusions Our study highlights the benefits of using a SD as a tertiary treatment for PTSD and/or TBI in veterans. Veterans in our study articulated the benefits of using a SD as a tertiary treatment option, and the need to make this a standard treatment option for all veterans who suffer from PTSD and/or TBI.

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“… 7 Service dogs, referred to as assistance dogs internationally, are defined under US federal law as “dogs that are individually trained to do work or perform tasks for people with disabilities.” 8 Preliminary evidence indicates that service dog partnerships are associated with meaningful improvements in self-reported PTSD symptoms for veterans with PTSD. 7 However, only 1 clinical trial on their efficacy has been conducted to date, 9 which compared emotional support dogs to service dogs, precluding conclusions about service dogs compared with usual care alone. 10 Moreover, no studies of service dogs have used blinded or masked clinician ratings to evaluate PTSD severity outcomes.…”

Section: Introductionmentioning

confidence: 99%

Service Dogs for Veterans and Military Members With Posttraumatic Stress Disorder

Leighton,

Rodriguez,

Jensen

et al. 2024

JAMA Netw Open

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ImportanceMilitary members and veterans (hereafter, veterans) with posttraumatic stress disorder (PTSD) increasingly seek psychiatric service dogs as a complementary intervention, yet the effectiveness of service dogs is understudied.ObjectiveTo estimate the associations between psychiatric service dog partnership and self-reported and clinician-rated PTSD symptom severity, depression, anxiety, and psychosocial functioning after 3 months of intervention among veterans.Design, Setting, and ParticipantsThis nonrandomized controlled trial used standardized and validated assessment instruments completed by participants and administered by blinded clinicians. Recruitment, eligibility screening, and enrollment were conducted between August 2017 and December 2019. Veterans were recruited using the database of an accredited nonprofit service dog organization with constituents throughout the US. Participants were veterans with a PTSD diagnosis; they were allocated to either the intervention group (n = 81) or control group (n = 75). Outcome assessments were performed at baseline and at the 3-month follow-up. Data analyses were completed in October 2023.InterventionsParticipants allocated to the intervention group received a psychiatric service dog for PTSD, whereas those allocated to the control group remained on the waiting list based on the date of application submitted to the service dog organization. Both groups had unrestricted access to usual care.Main Outcomes and MeasuresThe primary outcomes were PTSD symptom severity, depression, and anxiety after 3 months, and the secondary outcomes were psychosocial functioning, such as quality of life and social health. The self-reported PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was used to measure symptom severity, and the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) was used to assess PTSD diagnosis (score range for both instruments: 0-80, with higher scores indicating greater PTSD symptoms).ResultsThe 156 participants included in the trial had a mean (SD) age of 37.6 (8.3) years and included 117 males (75%), 17 Black or African American individuals (11%), 30 Hispanic individuals (19%), and 117 White individuals (76%). Compared with the control group, the intervention group had significantly lower PTSD symptom severity based on the PTSD Checklist for DSM-5 mean (SD) score (41.9 [16.9] vs 51.7 [16.1]; difference in means, −11.5 [95% CI, −16.2 to −6.6]; P &lt; .001) and the CAPS-5 mean (SD) score (30.2 [10.2] vs 36.9 [10.2]; difference in means, −7.0 [95% CI, −10.8 to −4.5]; P &lt; .001) at 3 months. The intervention group also had significantly lower depression scores (odds ratio [OR], 0.45 [95% CI, 0.23-0.86]; difference in means, −3.3 [95% CI, −6.8 to −0.6]), anxiety (OR, 0.25 [95% CI, 0.13-0.50]; difference in means, −4.4 [95% CI, −6.9 to −2.1]), and most areas of psychosocial functioning (eg, social isolation: OR, 0.34 [95% CI, 0.18-0.64]).Conclusions and RelevanceThis nonrandomized controlled trial found that compared with usual care alone, partnership with a trained psychiatric service dog was associated with lower PTSD symptom severity and higher psychosocial functioning in veterans. Psychiatric service dogs may be an effective complementary intervention for military service–related PTSD.Trial RegistrationClinicalTrials.gov ID: NCT03245814

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Therapeutic and Economic Benefits of Service Dogs Versus Emotional Support Dogs for Veterans With PTSD

Cited by 9 publications

References 33 publications

A clinician's guide to the 2023 VA/DoD Clinical Practice Guideline for Management of Posttraumatic Stress Disorder and Acute Stress Disorder

A clinician's guide to the 2023 VA/DoD Clinical Practice Guideline for Management of Posttraumatic Stress Disorder and Acute Stress Disorder

A Qualitative Exploration of the Use of Service Dogs in Veterans with Post Traumatic Stress Disorder and Traumatic Brain Injury

Service Dogs for Veterans and Military Members With Posttraumatic Stress Disorder

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