Lt. Christine Supervielle, Psy.D, Naval Hospital Camp Pendleton
Service dogs for current and former military members suffering from PTSD and TBI have been in the news a lot recently. There are a multitude of feel-good stories about how a service member was helped by his or her service animal. While this can be a necessary tool for some, there also exists some misconceptions about service dogs and for whom they are appropriate.
By law, service dogs are covered under Americans with Disabilities Act (ADA) laws. This means that they are allowed to go anywhere their handlers goes – airports, restaurants, hospitals, etc. People are not permitted to ask for what the service dog is used. There is an expectation that the service dog behaves as a service dog. If they do not, business owners, etc., are allowed to ask the owner and dog to leave.
Service dogs are often confused with therapy dogs. Therapy dogs provide emotional support and are used by their handlers for outings such as hospital visits to support patients of all kinds. Most have passed a canine good citizens test. On the other hand, service dogs belong to a specific owner that must meet the legal definition of disabled and perform at least three tasks in service to their owner to assist the disability. For people with PTSD, this might include awakening the owner from a nightmare, grounding the owner by physically putting pressure on the person’s feet or legs, or maneuvering themselves between the owner and other people. Service dogs ought to be trained to the specific owner. The dogs learn their owner and are then more effective service animals. Emotional support is not considered one of the three required tasks.
There is a lack of standardization in the training of service dogs. Assistance Dogs International (ADI) is the closest to a governing body that determines the criteria for a service dog. There are certain generally accepted industry standards, for example the canine good citizen test and the public access test, that all dogs must pass.
However, the specific training, length of training, requirements for the dog owners, etc., are all up to the individual organizations or individual trainers. ADI certification appears to be the current gold standard of training. There are many individuals out there that train dogs to perform three tasks and they are then deemed “service dogs” and given what would appear to most people as credentials, a vest and tag. These items can be bought online and are not necessarily the mark of a well-trained service dog.
Because of the lack of industry standard, there is also a lack of standardization across the U.S. Department of Veteran’s Affairs (VA) and the Department of Defense (DoD) with respect to service dogs. The DoD is exempt from complying with the ADA laws and service members who are fit for full duty, by definition, do not meet criteria for a service dog. The VA has decided that service dogs are only a covered benefit if recommended by a provider and obtained through an ADI certified organization (and the VA does not currently fund service dogs for individuals who are recommended solely for mental health problems).
The Army modeled their own policy after the VA, possibly to aid in the smooth transition of their service members off of active service and into the VA system. The Navy does not have a policy on service dogs. The USMC does not have a policy, but Wounded Warrior Battalion-West, a battalion made up primarily of Marines who are transitioning out of the Marine Corps on medical retirement, has created their own policy which is mostly aligned with the Army.
From a mental health provider standpoint, there are several issues to consider with respect to service dogs. Often patients require a recommendation for a service dog, or at a minimum, for the provider to complete paperwork speaking to diagnosis and severity of symptoms. When a provider recommends a service dog they must be willing to go to court to attest to the disability of their patient. While only a judge can deem a person “disabled” under ADA, the mental health provider is essentially supporting that assertion when recommending a service dog. More often, the provider is asked to speak to the diagnosis, severity, and ability of the patient to take care of a service dog. The patient must be impaired enough to warrant a dog, but not so impaired that they are unable to care for the dog. The patient must also be able to financially support the feeding and veterinary care of the dog.
A concern about service dogs is the implication of PTSD as a permanent disability. When a service member is paired with a dog that is their dog until the dog is retired, some organizations follow-up to ensure the dog is still being used as service dog and that it does not require any upkeep training. However, some organizations do not. This can say to the patients that they are permanently disabled and there is no expectation that they will ever improve to such a degree that they no longer need the dog. This is not true in all cases.
Some patients are aware that the dog may turn into a pet after some time when their symptoms improve. Secondly, some patients do not consider the attention a service dog will draw. Some patients will say that the dog creates more interactions with people than they were prepared to handle. It is also an outward sign of disability that they must be prepared to accept and possibly address. They must also be prepared to handle encounters at airports, restaurants, etc. with individuals who may not be aware of ADA laws and the access of service dogs.
Overall, service dogs can serve as a valuable tool for a person with a disability in their road for recovery. However, there are serious implications when recommending a service dog. When a service dog is appropriate, there are considerations that must be taken into account when selecting how to obtain the service dog. In depth conversations and evaluations by mental health providers are necessary in protecting both the patients and service dogs.
Editor’s note: Click here to see the previous post about therapy dogs from Lt. j.g. Finton.