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


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