Service Dogs and PTSD: How Service Dogs Support Military Veterans with Post-Traumatic Stress Disorder

Post-traumatic stress disorder, commonly known as PTSD, is a significant issue among military veterans. A recent study published in JAMA Network Open suggests that trained psychiatric service dogs can help alleviate some symptoms of PTSD. The study found that veterans partnered with these service dogs experienced reduced PTSD symptoms and improved psychosocial functioning compared to those receiving usual care alone.

Understanding PTSD Service Dog and Its Impact on Veterans

PTSD is a mental health condition triggered by experiencing or witnessing a traumatic event. Symptoms include intrusive memories, avoidance of trauma reminders, negative changes in thoughts and mood, and heightened arousal and reactivity. These symptoms can cause substantial distress and impair various aspects of daily life. Among veterans, PTSD is particularly prevalent, affecting about 23% of those who served after the September 11 attacks.

Service Dogs for PTSD: A Complementary Treatment

Existing treatments for PTSD include therapy and medication, but they are not effective for everyone, and many veterans struggle to stick with these treatments. Increasingly, veterans are turning to psychiatric service dogs as a complementary intervention. These dogs are trained to perform specific tasks that help mitigate PTSD symptoms, such as interrupting anxiety attacks or providing a sense of security in public spaces.

Despite their growing popularity, the effectiveness of service dogs for PTSD had not been thoroughly studied until now. This new research highlights how service dogs can significantly impact the lives of veterans living with PTSD.

Veterans' Experiences with Psychiatric Service Dogs

“When I reflect on why this research matters, I think about the veterans that I’ve spoken with and the things they have shared with me. A common theme is that for many of them, they’re in a dark place. When they find out that a service dog is an option, there is hope. Then they find out that it’s going to be a two-year wait,” said Maggie O’Haire, the principal investigator on the study and Associate Dean for Research at the College of Veterinary Medicine at the University of Arizona.

“Two years is a long time when you’re in a dark place. Our group’s mission is to conduct the largest, most comprehensive set of studies on service dogs for veterans with PTSD, and this study represents a major milestone in this process.”

Sarah Leighton, a PhD candidate and first author of the paper, added: “I spent a decade working at a nonprofit service dog organization. I heard and saw first-hand how these partnerships were changing people’s lives. One of our clients went from rarely leaving his room, for months at a time, to having the confidence to visit Disneyland with the assistance of his service dog.”

Emotional Support Dogs and PTSD: Implications for Veterans

The study was a nonrandomized controlled trial involving veterans who received a trained service dog in addition to their usual care and those who were on a waiting list for a service dog but had unrestricted access to usual care. Participants were recruited from K9s For Warriors, a nonprofit organization that provides service animals to veterans.

Eligibility and Training for Service Dog Placement

To be eligible for the study, veterans had to have served on or after September 11, 2001, been honorably discharged, and have a current posttraumatic stress disorder (PTSD) diagnosis confirmed by independent clinicians. They also had to meet the criteria set by K9s For Warriors and be at least 18 years old.

Participants in the intervention group received a service dog after a thorough training process. These dogs, primarily from shelters and rescues, underwent extensive training to perform specific tasks related to PTSD symptoms. The veterans and their dogs spent three weeks at the K9s For Warriors campus, receiving over 40 hours per week of instruction. After this training, the trained service dogs and veterans were assessed to ensure they could safely and effectively operate as a team in public.

Practical Tips for Assessing PTSD Symptom Severity

The study measured PTSD symptom severity, depression, anxiety, and psychosocial functioning at baseline and three months after the intervention. PTSD symptoms were assessed using self-reported questionnaires and clinician-administered scales, ensuring a comprehensive evaluation.

The study found that veterans partnered with service dogs reported significantly lower PTSD symptom severity after three months compared to those on the waiting list. This improvement was observed in both self-reported measures and clinician ratings. Specifically, the intervention group showed a marked reduction in PTSD symptoms, as measured by standardized scales.

“These findings are particularly notable given the relatively short time frame,” Leighton said. “Service dog partnerships can last a decade, and we’re seeing these significant differences after just three months. We’re excited to learn how these outcomes evolve over a longer period; in our current study, we follow veterans for over a year.”

Benefits and Challenges of Service Dog Partnerships

In addition to reduced PTSD symptoms, veterans with service dogs experienced lower levels of depression and anxiety. They also reported better overall quality of life, including less social isolation and greater companionship. However, the study noted that social activity levels were lower for those with service dogs, possibly due to negative public reactions or the stigma associated with having a service animal.

“Overall, we found evidence supporting service dog partnerships for veterans with PTSD,” O’Haire told PsyPost. “We saw significantly better outcomes in the service dog group in nearly every area we measured. Service dog placements were associated with 66% lower odds of an expert PTSD diagnosis; lower PTSD severity, anxiety, and depression; less social isolation and higher companionship, but lower participation in activities; and higher quality of life.”

Barriers to Accessing PTSD Service Dogs: Waitlists, Costs, and Eligibility

While the therapeutic benefits of dogs for PTSD are well-documented, veterans with posttraumatic stress disorder often face significant obstacles in obtaining a PTSD service dog. From long waitlists for a service dog to the financial burden of training, these barriers can delay or prevent access for many individuals who could benefit.

The Waitlist Dilemma: Why Veterans Wait Years for a Service Dog

The use of PTSD service dogs has increased in recent years, but demand far outweighs availability. Many service dog training programs operate on limited funding, leading to waitlists for a service dog that can extend beyond two years. For veterans with severe PTSD symptoms, the long wait can be overwhelming. Some may turn to alternative treatments or attempt to train their own dog as an emotional support animal. However, these options often lack the structured training and psychiatric support that service dogs provide

Nonprofits such as K9s For Warriors and the Department of Veteran Affairs work to provide service dogs to veterans, but eligibility criteria and funding constraints continue to be obstacles. For military veterans with PTSD, these delays can impact their ability to reintegrate into civilian life and manage symptoms effectively.

Financial Barriers: The Cost of Service Dog Training

Even when veterans are approved for a PTSD service dog intervention, the cost of acquiring and training a PTSD service dog can be overwhelming. While some programs cover the full cost, others require veterans to fundraise or contribute out-of-pocket expenses. The cost of service dogs for military veterans can exceed $25,000, depending on the service dog tasks required.

Some veterans already have a dog and wonder whether their pet dog can be trained as a service dog or emotional support dog. While some organizations allow veterans to work with their existing dog trained for service, most require dogs to meet strict temperament and training standards before being classified as PTSD service dogs.

Expanding Access: The Future of PTSD Service Dog Programs

To assist veterans more efficiently, initiatives are underway to streamline the service dog training program process and increase funding for service dogs for veterans experiencing PTSD. The National Center for PTSD continues to research the impact of service dogs as a complementary treatment option for PTSD, to make these services more broadly applicable to PTSD symptoms across diverse populations.

For military members and veterans struggling with PTSD, increasing funding, improving service dog training programs, and expanding veteran mental health support services are critical steps in reducing the risk of developing PTSD and ensuring that those in need receive timely care.

Conclusion

While the study’s findings are promising, there are several limitations. First, the study was nonrandomized, meaning veterans received service dogs based on their position on the waiting list rather than random assignment. This approach could introduce bias, although the researchers adjusted for various baseline characteristics to mitigate this.

“This study was nonrandomized, meaning we cannot say (yet) that service dogs cause these outcomes,” O’Haire explained. “The great news is that we’re currently midway through the next study, a gold-standard NIH-funded clinical trial to confirm these findings in a randomized design. This will help us establish causation.”

“Next, we’ll investigate how service dog partnerships combine with evidence-based, frontline PTSD treatments through a Department of Defense (DOD)-funded randomized clinical trial,” O’Haire continued. “Specifically, we’ll learn whether trained service dogs can help veterans overcome the stresses and challenges that are involved in Prolonged Exposure therapy, to increase treatment completion and achieve better health outcomes. Ultimately, the future of our research is to move beyond the binary of whether or not service dog partnerships work to understand for whom and under what circumstances service dog partnerships are most effective.”

“Of course, each individual’s care needs are unique; service dogs aren’t a cure, and they won’t be right for everyone,” Leighton noted. “At the end of the day, we’re thrilled to be building the evidence base underlying the service dog intervention and hope that our work will increase access to those who might benefit.”

The study, “Service Dogs for Veterans and Military Members With Posttraumatic Stress Disorder: A Nonrandomized Controlled Trial,” was authored by Sarah C. Leighton, Kerri E. Rodriguez, Clare L. Jensen, Evan L. MacLean, Louanne W. Davis, Erin L. Ashbeck, Edward J. Bedrick, and Marguerite E. O’Haire.

Jun 27, 2024