Emotional Support Animals in the United States: Emergent Guidelines for Mental Health Clinicians

Abstract

The role of Emotional Support Animals (ESAs) in facilitating mental health recovery is gaining increasing attention internationally. Within the United States, ESAs are companion animals without any special training, who are denoted in writing by a licensed mental health professional to be a therapeutic necessity for someone living with chronic mental health symptoms and who has a condition that meets the legal definition of a disability. ESAs are recognized within federal disability legislation, with limited rights to those who have ESAs as accommodations for their disabilities. The aim of this article is to present ESAs as a valid psychosocial rehabilitation intervention, consistent with the tenets of mental health recovery. Empirical literature is discussed, and a theoretical foundation is applied to explain the mechanism within the theory of change for how and why ESAs benefit people living with chronic mental health issues. To advance the current literature and practice, emergent best practices and guidelines for mental health clinicians for designating and documenting ESA need for clients who request such are provided.

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References

  1. 1.

    U.S. Department of Health & Human Services. Recovery is possible. https://www.mentalhealth.gov/basics/recovery-possible (2019, March 19). Retrieved 22 May 2019.

  2. 2.

    Ellison ML, Belanger LK, Niles BL, Evans LC, Bauer MS. Explication and definition of mental health recovery: a systematic review. Adm Policy Ment Health Mental Health Serv Res. 2018;45(1):91–102. https://doi.org/10.1007/s10488-016-0767-9.

    Article  Google Scholar 

  3. 3.

    Wisdom JP, Saedi GA, Green CA. Another breed of “service” animals: STARS study findings about pet ownership and recovery from serious mental illness. Am J Orthopsychiatry. 2009;79(3):430–6. https://doi.org/10.1037/a0016812.

    Article  PubMed  PubMed Central  Google Scholar 

  4. 4.

    Zimolag U, Krupa T. Pet ownership as a meaningful community occupation for people with serious mental illness. Am J Occup Ther. 2009;63(2):126–37. https://doi.org/10.5014/ajot.63.2.126.

    Article  PubMed  Google Scholar 

  5. 5.

    Jacob KS. Recovery model of mental illness: a complementary approach to psychiatric care. Indian J Psychol Med. 2015;37(2):117.

    Article  Google Scholar 

  6. 6.

    Brooks H, Rushton K, Walker S, Lovell K, Rogers A. Ontological security and connectivity provided by pets: a study in the self-management of the everyday lives of people diagnosed with a long-term mental health condition. BMC Psychiatry. 2016;16(1):1–12.

    Article  Google Scholar 

  7. 7.

    Brooks HL, Rushton K, Lovell K, Bee P, Walker L, Grant L, Rogers A. The power of support from companion animals for people living with mental health problems: a systematic review and narrative synthesis of the evidence. BMC Psychiatry. 2018;18(1):31.

    Article  Google Scholar 

  8. 8.

    Fine AH, editor. Handbook on animal-assisted therapy: foundations and guidelines for animal-assisted interventions. Pomona: Academic press; 2019.

    Google Scholar 

  9. 9.

    Beetz A, Uvnäs-Moberg K, Julius H, Kotrschal K. Psychosocial and psychophysiological effects of human–animal interactions: the possible role of oxytocin. Front Psychol. 2012;3:234.

    PubMed  PubMed Central  Google Scholar 

  10. 10.

    Odendaal JS, Meintjes RA. Neurophysiological correlates of affiliative behaviour between humans and dogs. Vet J. 2003;165(3):296–301. https://doi.org/10.1016/S1090-0233(02)00237-X.

    Article  PubMed  Google Scholar 

  11. 11.

    Hoy-Gerlach J, Wehman S. The relevance of human–animal interaction for social work practice. Washington: NASW Press; 2017.

    Google Scholar 

  12. 12.

    Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977;196(4286):129–36.

    Article  Google Scholar 

  13. 13.

    Freund LS, McCune SE, Esposito LE, Gee NR, McCardle PE. The social neuroscience of human–animal interaction. Washington: American Psychological Association; 2016.

    Google Scholar 

  14. 14.

    American Veterinary Medical Association (AVMA). Assistance animals: rights of access and the problem of fraud (2017). https://www.avma.org/KB/Resources/Reports/Pages/Assistance-Animals-Rights-of-Access-and-the-Problem-of-Fraud.aspx. Retrieved 22 July 2019.

  15. 15.

    U.S. Department of Justice. Service animals, ADA requirements (2019). https://www.ada.gov/service_animals_2010.html. Retrieved 22 July 2019.

  16. 16.

    American Veterinary Medical Association (AVMA@Work). AVMA, United Airlines reach agreement on veterinary health form (2018). https://atwork.avma.org/2018/03/02/avma-united-airlines-reach-agreement-on-veterinary-health-form/. Retrieved 22 July 2019.

  17. 17.

    Ng ZY, Pierce BJ, Otto CM, Buechner-Maxwell VA, Siracusa C, Werre SR. The effect of dog–human interaction on cortisol and behavior in registered animal-assisted activity dogs. Appl Anim Behav Sci. 2014;159:69–81.

    Article  Google Scholar 

  18. 18.

    Hoy-Gerlach J, Delgado M, Sloane H, Arkow P. Rediscovering connections between animal welfare and human welfare: creating social work internships at a humane society. J Soc Work. 2019;19(2):216–32. https://doi.org/10.1177/1468017318760775.

    Article  Google Scholar 

  19. 19.

    Younggren JN, Boisvert JA, Boness CL. Examining emotional support animals and role conflicts in professional psychology. Prof Psychol Res Pract. 2016;47(4):255–60. https://doi.org/10.1037/pro0000083.

    Article  Google Scholar 

  20. 20.

    Katz J. The new work of dogs: tending to life, love, and family. New York: Random House Incorporated; 2004.

    Google Scholar 

  21. 21.

    Schlau E. Bring your dog to work day: what animal-assisted therapy is NOT. In: American Counseling Association Conference, San Francisco, CA. Vistas Online; 2017.

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Correspondence to Aviva Vincent.

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Hoy-Gerlach, J., Vincent, A. & Lory Hector, B. Emotional Support Animals in the United States: Emergent Guidelines for Mental Health Clinicians. J. Psychosoc. Rehabil. Ment. Health 6, 199–208 (2019). https://doi.org/10.1007/s40737-019-00146-8

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Keywords

  • Emotional support animal
  • Human–animal interaction
  • Human–animal bond
  • Psychosocial rehabilitation
  • Mental health recovery