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
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
and suicide (Ferruolo, 2015). Individuals with PTSD are also at a higher risk to develop other
PTSD 3
general medical problems such as elevated blood sugar, abdominal obesity, heart disease, and
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.
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
PTSD 4
people who dont seem to respond to traditional CBT methods (Signal, Taylor, Botros, Prentice,
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
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
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
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
PTSD 6
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-
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
PTSD 7
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
Conclusion
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
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.
PTSD 8
References
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Buhai, S. (2016). Preventing the abuse of service animal regulations. New York University
Epstein, N. B., Yount, R., Wilson, C. C., Ellen Netting, F., & Quinlan, J. (2014). Service dog
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
Ritchie, E. C., & Amaker, R. J. (2012). The early years. U.S. Army Medical Department
Journal, 5-7.
Rubenstein, D. A., Debboun, M., & Burton, R. (2012). Canine assisted therapy in military
Signal, T., Taylor, N., Batros, H., Prentice, K., & Lazarus, K. (2013). Whispering to horses:
Childhood sexual abuse, depression, and the efficacy of equine facilitated therapy.
Stern, S. L., Donahue, D. A., Allison, S., Hatch, J. P., Lancaster, C. L., Benson, T. A.,
with posttraumatic stress disorder (PTSD). Society & Animals, 21(6), 568-581. doi:
10.1163/15685306-12341286
Topinka, J. B., Nichols, J., & Brooks, M. (2016). Service animals: A new legal dimension
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Yambo, T. W., Johnson, M. E., Delaney, K. R., Hamilton, R., Miller, A. M., & York, J. A. (2016).