I’m so confused! Emotional Support Animals, Service Dogs, and Psychiatric Service Dog Tasks?

– by Catherine Cheng

What’s the Difference?

One of the most misunderstood concepts is the difference between an emotional support animal (ESA) versus a service dog.

You may ask: Is there even a difference? Aren’t the terms interchangeable?

And the answer is that there is a huge difference!

Here is the definition of a service dog straight from the Americans with Disabilities Act (ADA): “Service animals are defined as dogs that are individually trained to do work or perform tasks for people with disabilities.”

The key is that the animal must be a dog (miniature horses can also be service animals*), and the dog must be trained to carry out specific actions directly related to the person’s disability. Examples of this would be: If a person has trouble seeing, then the dog will guide them. If a person has a panic attack, the dog will actively climb on top of their handler to apply pressure and calm them down.

*Miniature horses are permitted to assist a person with a disability, but they are regulated under separate provisions under the ADA. More information can be found here.

In contrast, ESAs are not necessarily just dogs. Most importantly: ESAs are not trained to do specific tasks. An ESA provides comfort to the person simply by existing. If a person went into a panic attack, and the ESA instinctively licked that person’s face to comfort them, the animal would still not be a service dog.

In order to be a service dog, the dog must be trained for at least one task that directly mitigates their handler’s disability. The dog must reliably carry out the tasks it is specifically trained to do. In the case of someone with panic disorder, the dog must reliably alert (alert = react) to symptoms of an oncoming panic attack. This would help the person prevent the attack or lesson the intensity of the attack.

Under the ADA, service dogs are allowed access to virtually any public space: “State and local governments, businesses, and nonprofit organizations that serve the public generally must allow service animals to accompany people with disabilities in all areas of the facility where the public is normally allowed to go.” Service dogs must also be under control.

On the other hand, ESAs are not protected by the ADA. This means ESAs cannot freely walk into spaces like restaurants, supermarkets, schools, museums, libraries, busses, malls, banks, churches, hotels, etc.. ESAs are seen as pets.

Psychiatric Service Dogs

There are many types of service dogs such as guide dogs, hearing alert dogs, and mobility dogs. You may learn more about these different types here.

But not all disabilities or impairments are immediately obvious. “An individual with a disability is defined by the ADA as a person who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment.”A psychiatric service dog is used to help people with mental or psychiatric disabilities such as PTSD, anxiety, obsessive-compulsive disorder, panic disorder, depression, bipolar disorder, or schizophrenia.

Psychiatric Service Dog Tasks

There are many different types of tasks that a psychiatric service dog can be trained to do in response to the handler’s distress. Below are just a few examples of psychiatric service dogs in action.

In this first video, the psychiatric service dog alerts when it sees the handler exhibiting signs of anxiety or panic. The beginning of the video also demonstrates general tasks that all well-trained service dogs must know. (Psychiatric task demonstrations begin at 2:46).

This service dog does these tasks wonderfully:

  1. Alerts to anxious behaviors by putting its head on her lap when it sees her rubbing her hands or shaking
  2. Jumps on her to bring her back into the moment and to prevent her anxiety from escalating into a full blown attack
  3. Nudges its face continuously between her hands and skin to prevent her from scratching herself
  4. Jumps up to block her out from environmental stressors
  5. Places its face on her chest and maintains eye contact to calm her down

This video isn’t labeled, but the tasks are well-defined if you know what to watch for!

  1. Blocks the handler from others in public spaces by placing its body close in front of her
  2. Alerts to anxious behaviors (shaking knees or scratching) by jumping up and placing its upper body on her lap
  3. Nudges its face into handler’s arms to interrupt stress – continues to do this to prevent the onset of an attack or to mitigate the intensity of the attack
  4. Applies deep pressure therapy* by putting its whole body on handler

* Deep pressure therapy (DPT) is where a dog applies its weight and warmth on the handler. Like a weighted blanket given to trauma patients or swaddling a baby, the pressure from DPT can relax a person experiencing debilitating levels of stress, depression, or a flashback.

The way in which psychiatric service dogs carry out their tasks looks different with each handler. This service dog has clearly defined tasks:

  1. Retrieves medicine
  2. Opens fridge and brings water
  3. Nudges and jumps up to interrupt handler’s scratching
  4. Paws at the handler’s leg when it sees or senses the handler breathing faster
  5. Pushes handler’s hands out of the way when she is crying/experiencing a flashback
  6. Not Shown: Service dog can follow the person in front of the handler if she is experiencing dissociation*. Some service dogs can even be trained to lead the handler to the exit of a building.

*Dissociation is a state where the person feels disconnected with his or her surroundings.

Dissociation can be caused by trauma or PTSD. More information can be found here.

Spread the Word

The importance of emotional support animals and service dogs cannot be understated. Each animal or dog has its own special role to fill when helping its handler.

Specifically, psychiatric service dogs need more exposure. Their handlers are suffering from very real mental illnesses and disorders. People oftentimes receive criticism from outsiders or even their own friends and family for relying on a service dog.

A psychiatric service dog can interrupt harmful behavior, prevent its handler from lapsing into a panic attack, provide calming pressure if the  handler faints, guide a person out of an alarming situation, circle the handler to create personal space, use its body to block other people, turn on the lights if the  handler is afraid, or retrieve medication. The list goes on – the uses for a psychiatric service dog are as varied as the mental disorders and impairments that people struggle with.

People who have psychiatric service dogs say that their dogs give them a degree of individual freedom. They are able to accomplish things and go to places with more confidence because they have their service dog.

It is important to note that service dogs are only one part of a person’s treatment plan. Service dogs are not the cure-all solution. An affected person may still need medication or go to therapy.

Having a service dog by a person’s side also brings unwanted attention and judgment from others who may not fully understand the service dog’s purpose or the person’s disability.

Hopefully, as people continue to make videos about service dogs, write blogs, and share information with each other, we can help ourselves and others in need. Knowing more about psychiatric service dogs and “invisible disabilities” can prevent someone from making an accusation: “You look perfectly fine to me. You don’t seem to need help at all!”

The great Nelson Mandela’s words ring true: Education is the most powerful weapon which you can use to change the world.

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