Psychiatric Service Dogs
How much would a patient's life improve if their psychiatric symptoms decreased? Would they be better off physically? Mentally? Or perhaps financially or socially? Maybe even all of the above? All these problems can then lead to missed opportunities, increased medical costs, co-morbidity with other conditions, fear, and even despair.
Pawsitivity trains Psychiatric Service Dogs for both children and adults (as well as both veterans and non-veterans). Like Guide Dogs for the blind, Psychiatric Service Dogs are not covered by insurance. With our nonprofit, we require the recipient to contribute at least half the cost (see our F.A.Q. for details).
- The biggest benefit most handler’s find that having a service dog helps with is the ability to go to public places with the service dog.
- A Service Dog can help you deal with crowded places. For crowds, the most important tasks are usually sitting behind you in line (if needed), and blocking others who would otherwise intrude on your space. An elevator is a good example of one of the many places where these tasks are helpful.
- It can be nice when visiting places other than the hotel where you stay (Mall of America, IKEA), to see how the dog could be a positive bridge (as well as a blocker of crowds). To do this, we practice interactions, starting with me playing the stranger (asking questions), and practice common replies for the common questions. Such as: “Are you the trainer? Is that a service dog? What breed is she?” If these Q&A can become rote or automatic, the hope is that you’ll actually enjoy these encounters. If that hope is too optimistic, we can, at least, help make the encounters nice and easy (I’m really hoping that in the long term, you’ll be looking forward to getting out and about with Lexi...between her blocking for you and then also serving as a social bridge, my hope is that the experiences will slowly build and accumulate, creating a “virtuous circle” (as opposed to a vicious circle), where, 1% improvement by 1% improvement, your ease at going into public gets better and better.
- Regroup Before Entering. Before going into a house or public building, the handler should regroup and get all set. They should make sure their treat-bag and waist-leash are set up correctly, and ensure that the dog is calm. Do “figure eights” if necessary (a “figure eight” is a strict heel, walking in double-loops that make a figure eight–this exercise is great at getting the dog to focus on the handler).
- Find “Safe Zones”. When the handler enters a public building, the first thing you should do is find any areas that are quiet and free from people. These “safe zones” will be spots where the handler can pause and regroup if needed, which will help to keep stress levels down for both the handler and the dog.
- While this isn’t a task, the two men with PTSD who got a Pawsitivity dog would use the dog as an excuse to leave and take a break (as if the dog needs to potty).
Calming Team Member
While in crowds, the handler can calm themselves in public with their Service Dog.
- Having the dog do “Lap” can bring calming relief because of the weight and pressure of the dog.
- The tactile stimulation a dog can bring, combined with focusing outwardly on the dog (instead of inwardly at one’s panic) can soothe the handler back down to a state in which they can handle the situation better.
Nama-stay/Partnering in Mindfulness
- The US military uses mindfulness training (a secular form of meditation) to help mental resilience in a war zone. Mindfulness training, also known as meditation, has also been proven to be effective in treating trauma and anxiety, but unfortunately, hypersensitivity to one’s own feelings can make traditional methods difficult.
- However, by sitting down with the dog, closing one’s eyes most of the way, and focusing on the dog’s breathing for twenty minutes twice a day, you can immediately start to get the beneficial effects of this kind of grounding.
- This kind of focusing on the meditation object/anchor (the dog) is used to center/re-anchor yourself.
- This method comes without experiencing the difficulty of focusing on yourself, which can be too intense.
- The process:
- Put on your belt-leash, best, and harness, as if you were going to do public access with the service dog.
- Sit comfortably like you’re watching television. Check your watch, and calculate twenty minutes from now. Cue the dog for a down-stay.
- Close your eyes most of the way.
- Become aware of the dog’s breathing. Your mind will start wandering. When you become aware that your mind has wandered, then...
- Go back to Step 1.
- You can check your watch whenever you want. After twenty minutes, open your eyes fully and take a couple minutes to notice how much calmer the dog is.
- This kind of “bottom-up” regulation:
- Recalibrates the autonomic nervous system.
- Decreases the activity of the amygdala thus decreasing reactivity to triggers. The amygdala (often referred to as the fear center of the brain) literally shrinks[.5].
- "Nama-stay" is a play on words, based on the word "Namaste" and asking the dog to Stay ("Doga" is another fun way to refer to this practice).
By focusing on the dog’s arousal level (which is easier to read than one’s own), the dog serves as a “canary in a coal mine”. Being aware of the dog’s arousal level helps you use that information as a warning of your own arousal level getting higher. With that information, you can go and take the dog to a calming place (before you get to a high arousal level).
“Arousal” is an important concept—only when the dog is not overly aroused will they respond to cues properly (and only when not overly aroused will you be able to function well). If a dog is too aroused (or excited), he won’t be able to focus.
We teach the handler this ten-point scale to help you understand this idea in reference to their dog:
- Arousal rate is 7 = Ready to play, but too high for working. If the dog’s mouth is open but he’s probably not hot, he might be showing that he’s ready to play. If you can’t see the whites of his eyes, but the dog’s excited enough that he’s starting to get hard to control, don’t try to work with him. Give him a nice long break on his mat until his arousal rate is at 4 or below.
- Arousal rate is 6 = Happy dog. At an arousal level of 6 the dog is still easy to control, but having him do a down-stay will calm him down to a nice 4 or less. Put him on the mat, if possible.
- Arousal rate is 4 = Alert. If the dog’s ears are up, the dog is alert and ready to work. At the arousal level of 4, the dog has got a little breathing room. He should be ready to work, but even if he starts to get excited, you’ve got some leeway before reaching a hard-to-control level 7.
Friend, Partner, and Safeguard
- When people are too anxious, shut down, dysregulated to find comfort in people, a deep (but less complicated) relationship with a service dog can be very effective in their healing.
- If exercise was a pill, it would be the best-selling pill ever. Dogs cannot be happy without exercise, and when the handler who loves their dog goes out for walks, the handler benefits, too.
- Engaging with the dog is much safer than connecting with other people, and once a person feels safe, then they can eventually build relationships with other people.
A 2002 study of the effects of a person getting a Service Dog found that:
Self-esteem was enhanced significantly, as measured by the Rosenberg Self-Esteem Scale.
Participants reported that their service dogs had a positive effect on going out in public, feeling needed, feeling independent, feeling safe, and socializing, including more people approached them when in public.
Family caregivers benefited, too, by being able to pursue other activities, and having more peace of mind.
- Note: Participants reported that their actual experience with the service dogs met the participant's expectations, which is good to know.
A 2010 study concluded that Service Dogs:
Alleviate the mental burden of daily activities.
Improve the physical functioning of their handlers.
Have positive functional and mental effects on their disabled handlers.
Studies show that a Service Dog can:
Lessen perception of physical pain.
Decrease agitation and aggression.
Increase social interaction and ability to manage daily living.
Lower blood pressure and heart rate.
Ease anxiety or depression.
Remind the handler to take medication.
Remind the handler to perform her or his daily routines.
Wake the handler to prevent him or her from sleeping too much..
Assist handler in creating a safe personal space in public, serving as a physical buffer to calm handler and reduce feelings of emotional distress in crowded places.
Reorient and "ground" handler to current place and time when struggling with PTSD episodes.
During a panic attack, a psychiatric service dog can assist the handler by providing tactile stimulation.
Assist the handler when he or she tries to relax (self-soothe) in order to complete uncomfortable tasks.
Accompany while in stores and other environments to reduce stress associated with daily activities, as well as facilitate social interactions and reduce fear associated with meeting new people.
Alert when the handler is starting to experience anxiety problems reminding the handler to take his or her medication.
Remind the handler to take walks, which encourages the handler to be more social and increases the amount of exercise the handler gets. This also helps the handler keep a constant schedule and will be a reason to get out of bed in the morning.
More info about what a Psychiatric Service Dog does can be found on our page about PTSD.
[.5]Fox, Kieran CR, Savannah Nijeboer, Matthew L. Dixon, James L. Floman, Melissa Ellamil, Samuel P. Rumak, Peter Sedlmeier, and Kalina Christoff. "Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners." Neuroscience & Biobehavioral Reviews 43 (2014): 48-73.
Human-Animal Bond Resource Center research abstract on the effects of service dogs, Rintala, Diana H; Sachs-Ericsson, Natalie; hart, Karen A. SCI; Psychosocial Process, 15(2): 2002 Summer; 69-72.
The Effect of Service Dogs on the Improvement of Health-related Quality of Life, Shintani M, Senda M, Takayanagi T, Katayama Y, Furusawa K, Okutani T, Kataoka M, Ozaki T. Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama.
Complementary Therapies in Clinical Practice, Braun, C., Stangler, T., Narveson, J., & Pettingell, S. (2009). 15(2), 105-109. Also, Journal of Holistic Nursing: Official Journal of the American Holistic Nurses' Association Sobo, E. J., Eng, B., & Kassity-Krich, N. (2006). 24(1), 51-57.
Western Journal of Nursing Research, McCabe, B. W., Baun, M. M., Speich, D., & Agrawal, S. (2002). 24(6), 684-696.
International Psychogeriatrics/IPA. Filan, S. L., & Llewellyn-Jones, R. H. (2006). 18(4), 597-611.
Psychosomatic Medicine, Allen, K., Blascovich, J., & Mendes, W. B. (2002). 64(5), 727-739.
The Journals of Gerontology, Series A, Biological Sciences and Medical Sciences. Banks, M. R., & Banks, W. A. (2002). 57(7), M428-M432.
American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses. Cole, K. M., Gawlinski, A., Steers, N., & Kotlerman, J. (2007). 16(6), 575-585; quiz 586; discussion 587-588.