Running head: PTSD

Service Animals as Treatment for Posttraumatic Stress Disorder:

An Idea for a More Peaceful Society

Samantha Riedl
PTSD 2

Service Animals as Treatment for Posttraumatic Stress Disorder: An Idea for a More Peaceful
Society

Introduction

Service animals have been used for centuries, and are becoming more widely used today

for people who are blind, deaf, mentally ill, autistic, diabetic, and for individuals who have

seizures. One of the most promising uses of service animals is to help those who have

posttraumatic stress disorder (PTSD). PTSD is a very common disorder among returning

veterans. Traditional treatments of PTSD include medication and therapy, but there doesnt seem

to be much improvement with patients (Yambo, 2016). Service animals are an alternative to

traditional therapy methods that seems to be improving the lives of many individuals with PTSD

(Stern et al., 2013).

Posttraumatic Stress Disorder

PTSD can develop within any person at any age for any reason. The disease can be

brought on by any type of trauma, but is more common among people who have had a traumatic

brain injury and is complicated by mood disorders and substance abuse (Stern et al., 2013). In

2013, reports showed that over half a million veterans were suffering from the disorder (Stern et

al., 2013). Common symptoms of PTSD are usually avoidance of social activities, fear of

harming ones self or ones family, and marked irritability. These symptoms make it increasingly

difficult for these individuals to maintain relationships, receive social support, and maintain a job

which will ultimately cause loneliness. PTSD symptoms can also negatively affect psychosocial

adjustment and development. These mental health symptoms can significantly increase an

individuals chances of unemployment, poverty, criminality, domestic violence, homelessness,

and suicide (Ferruolo, 2015). Individuals with PTSD are also at a higher risk to develop other
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general medical problems such as elevated blood sugar, abdominal obesity, heart disease, and

other metabolic symptoms (Stern et al., 2013).

Many veterans who return after active duty go home to their children, husbands, or

wives. The spouses of veterans are usually major support systems in their lives, especially if

they are experiencing signs of PTSD (Yambo, 2016). A key problem is that the spouse usually

isnt familiar with the signs and symptoms of PTSD. This lack of knowledge about the disease

usually contributes to a weakened family bond, hostility towards family members, and marital

problems (Yambo, 2016). Most treatment plans for PTSD involve medication and individual or

group therapy. Patients who receive medication are usually prescribed anti-depressant or anti-

anxiety medications. These types of medications take about 4-6 weeks to take into effect, but

many people start to lose hope in medications when they do not start working as fast as they

would like. Sometimes it takes people years of trying different drugs and different combinations

to find the right brand and dosage that works for them. Since the number of veterans returning to

civilian life with PTSD is increasing, it is becoming vital for society to come up with better ways

to treat this disease in order to help the people and their families.

Animal Assisted Therapy

Cognitive behavioral therapy (CBT) has always been thought to be the most successful in

reducing psychological symptoms and for many people it still is the most effective treatment, but

some PTSD clients have found that this approach does not work for them (Stern et al., 2013).

CBT is a type of talk therapy that helps a person change the way they think. By changing a

persons way of thinking, it will ultimately change the way they behave. Animal Assisted

Therapy (AAT) and Equine Facilitated Therapy (EFT) is now being used as an alternative for
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people who dont seem to respond to traditional CBT methods (Signal, Taylor, Botros, Prentice,

& Lazarus, 2013).

When people think of AAT, they often picture service animals, which have been around

for centuries. The earliest service animals were dogs in law enforcement and military settings.

In 1992, service animals began to work with those who experienced stress from combat under

the Combat and Operational Stress Control (COSC) program (Rubenstein, Debboun, & Burton,

2012). In this program, military dogs were used to provide education and therapy to the soldiers

(Ritchie & Amaker, 2012). After the 9/11 attacks, service animals were brought in to address the

stress and anxiety of the victims and the rescue and recovery workers (Rubenstein et al., 2012).

Today, traditional service dog organizations are now providing dogs to soldiers with

PTSD (Ritchie & Amaker, 2012). Service dogs, or emotional support dogs are an extremely

important part of PTSD therapy and recovery. The dogs are trained to wake veterans up from

nightmares, comfort them, and help bring them back to reality when they have flashbacks, along

with many other tasks that work to minimize anxiety, depression, panic attacks and phobias

(U.S. Dog Registry, n.d.).

As mentioned earlier, many people with PTSD tend to isolate themselves. They have

difficulty connecting with and trusting others. Many of these people connect more easily with

animals because animals hold no judgement, cannot talk back, and enjoy being touched

(MacLean, 2011, p. x). The bond that forms between the animal and the patient has powerful

therapeutic effects that help in reducing the symptoms of anxiety, irritability, depression, and

emotional numbing (Epstein, Yount, Wilson, Ellen-Netting, & Quinlan, 2014). Dogs also tend to

bark when they hear a stranger or a strange noise, so that might give the individual a sense of

safety and security (Stern et al., 2013). Sufferers report that they feel calmer, less lonely, less
PTSD 5

depressed, and less worried about their safety. With a dog, they also exercise more. The exercise

helps these individuals get out of the house and helps them fight their higher risk of diseases

(Stern et al., 2013).

Along with dogs, horses are also being used as a means of therapy for people with

symptoms of PTSD. Horses require humans to work with them to gain their trust (MacLean,

2011). Veterans with PTSD can understand and relate to the horse because they also have a hard

time trusting others. Horses communicate primarily through body language so if veterans with

PTSD become more aware of their bodies and their body language, it helps them become more

aware of other peoples body language (MacLean, 2011). Horses are significantly larger than the

average pet, so if a veteran has a problem controlling his impulses he realizes that if he expresses

his anger too violently, a horse is big enough to hurt him (MacLean, 2011). The horse is

essentially used as a metaphor for problems in life (Ferruolo, 2015). The common goals of

equine therapy include improving verbal and nonverbal communication, decreasing anxiety,

handling frustration, building confidence and self-esteem, completing tasks, and becoming more

aware of feelings (MacLean, 2011).

Many equine facilities use an activity called the Come with Me, Please activity. In this

activity, participants are handed a halter and a lead line and asked to earn the horses trust enough

so that the participant can lead the horse to the gate. If trust is not built between the horse and

the participant, the horse will most likely refuse to walk. In one instance, a participant could not

get his horse to move. Frustrated, he brought his face close to the horses face, growled at the

horse, and threw the lead on the ground. Seeing this, facilitators used CBT and mindfulness

techniques to help the participant see that he routinely used fear and intimidation to get what he

wanted. He was then able to look more closely at his actions and begin to change how he
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interacted with people, animals, and the world. After the activity, the participant stated that

during the exercise it was the first time in years that he had looked at himself as a person and not

as a sergeant in the army. This activity helped the veteran start to create a new identity for

himself based on who he was and who he wanted to be in the civilian world (Ferruolo, 2015).

According to Ferruolo, equine facilitated mental health (EFMH) has shown significant promise

in helping to treat depressive and anxiety disorders. It also helps raise self-confidence, self-

esteem, self-concept, and overall well-being. The individuals with PTSD in Ferruolos study

also reported taking less medication than individuals who did not participate. With more

experimentation, EFMH may significantly help more veterans than traditional CBT methods. If

there is significant research and a large amount of success stories, insurance companies might

begin to look at EFMH as an effective option for the treatment of PTSD and other combat-

related mental health issues (Ferruolo, 2015).

Although service animals seem like a great idea all around, there are many road blocks

regarding laws and regulations protecting the people and their animals. Service animals are

covered under the Americans with Disabilities Act (ADA), but its definition of a service animal

is very limited (Topinka, Nichols, & Brooks, 2016). This makes it very difficult to put laws and

restrictions in place for what a service animal is supposed to be, what certifications it has to

have, and who can have them. Thus, potential for abuse exists.

Recently there have been an increasing number of fake service dogs. Service animals are

not required to have any registration, certification, or documentation of any sort to prove that

theyre legitimate. The ADA places all of these animal owners on the honor system, but a large

amount of people are abusing it. Fake service animals cause legitimate service animals harm

because they may not be well trained and that can create a backlash against people with
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disabilities who actually need service animals (Buhai, 2016). There have been many instances

where fake service dogs have started dog fights with real service dogs in public areas. Since

legitimate service dogs are well trained, most of them just stand there and look confused because

they are supposed to be working. Anybody can get a fake vest and certificate online to certify

that their dog is an emotional therapy dog just so that they can take them in public areas or on

airplanes (Anything Pawsable Staff, 2016). There needs to be a change in government regulation

of service animals so that people with disabilities who actually need them can live their lives

safely with the services their animals provide them.

Conclusion

Animal-assisted therapy is becoming increasingly more common. While more research

needs to be done to figure out how effective animals are in helping to treat PTSD as compared to

medications and CBT, there seems to be great promise in the exploration of alternative therapies

that better assist veterans and others with their psychological illnesses (Ferruolo, 2015, p. 59).

Through the ADA, the government also needs to step in and help create new regulations on what

certifications animals need to have to be considered legitimate so as to eliminate fake service

animals. Last, insurance companies need to start accepting that animal-assisted therapy is in the

best interest of the patient and they should start covering it more often. With more strict

regulation and training, service animals could do so much more for people with PTSD.
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References

Anything Pawsable Staff. (2016, July 22). The hidden complications of fake service dogs.

Anything Pawsable. Retrieved from http://www.anythingpawsable.com/fake-service-

dog-complications/#.WOZ1Rme1vIU

Buhai, S. (2016). Preventing the abuse of service animal regulations. New York University

Journal of Legislation & Public Policy, 19(4), 771-796.

Epstein, N. B., Yount, R., Wilson, C. C., Ellen Netting, F., & Quinlan, J. (2014). Service dog

training by service members/veterans: Reflections on the need for empirical evidence.

Reflections: Narratives of Professional Helping, 20(2), 8-16.

Ferruolo, D. M. (2015). Psychosocial equine program for veterans. National Association of

Social Workers, 61(1), 53-60. doi: 10.1093/sw/swv054

MacLean, B. (2011). Equine-assisted therapy. Journal of Rehabilitation Research and

Development, 48(7), ix-xii.

McGovern, M. P., Lambert-Harris, C., Xie, H., Meier, A., McLeman, B., & Saunders, E. (2015).

A randomized controlled trial of treatments for co-occurring substance use disorders and

post-traumatic stress disorder. Addiction, 110(7), 1194-1204.

Ritchie, E. C., & Amaker, R. J. (2012). The early years. U.S. Army Medical Department

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Rubenstein, D. A., Debboun, M., & Burton, R. (2012). Canine assisted therapy in military

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