Download behavioral health assistance dogs

Behavioral Health
Assistance Dogs
A Guide for Mental Health Providers
 Director of ASPIRE Assistance Dogs
Presenter:
Elizabeth
Givens, MA,
CPDT-KA
 Certified Professional Dog Trainer
 25 years of experience as a trainer of companion and
assistance dogs
 Behavior consultant and specialist in the treatment of
anxiety-related disorders in dogs
About you?
 Please share a little about yourself
 What made you interested in learning about behavioral
health assistance dogs?
 Private training of behavioral health assistance dogs
About ASPIRE
Assistance
Dogs
 Team training approach – owner/handler and dog
trained together
 Committed to defining and upholding standards of
training and performance of Psychiatric Service Dogs
and Emotional Support Animals
 www.aspiredogs.org
 What is a behavioral health assistance dog?
 How do assistance dogs benefit people with mental
illness?
Presentation
Topics
 What rights do people with behavioral health
assistance dogs have?
 How to identify good assistance dog owner/handler
candidates
 Ways to integrate your patient’s assistance dog into
treatment
 The first documented, therapeutic use of animals
to treat the mentally ill occurred in York, England in
the late 18th century. This was part of a systematic
reform of the mental health system
History
 In the United States, during World War II, animals
were first used therapeutically at an Army Corps of
Engineers hospital to treat patients with
“operational fatigue”, which would probably be
considered post-traumatic stress disorder today.
 The therapeutic value of assistance dogs is now
recognized worldwide.
 Assistance dogs reduce symptoms of mental
illness.
Today
 Assistance dogs reduce the need for and use of
medication.
 Assistance dogs promote healing, empowerment,
quality of life and independence.
 Because of the profound impact mental illness has
on society - financially and otherwise – assistance
dogs may be part of a solution to a very big social
problem.
What is a Behavioral
Health Assistance Dog?
Assistance Dogs vs. Therapy Dogs
THERAPY DOGS
ASSISTANCE DOGS
Trained to work for the benefit of others
Trained to work for the benefit of the owner/handler
The Assistance Dog Universe
THERAPY DOGS
ASSISTANCE DOGS
•
Animal Assisted Therapy
SERVICE ANIMALS
•
Animal Assisted Activities
•
Psychiatric Service Dogs
OTHER ASSISTANCE DOGS
•
(Canine) Emotional Support Animals
BEHAVIORAL HEALTH ASSISTANCE DOGS
OTHER ANIMALS
•
Guide Dogs
•
Hearing Dogs
•
Other Therapy Animals
•
Mobility Assistance Dogs
•
Other Service Animals
(e.g., Miniature Horses)
•
Seizure Response Dogs
•
Medical Alert Dogs (e.g., Diabetes)
•
Other Emotional Support
Animals
How are
assistance
animals
defined?
By what they are trained to do or the
benefits they provide
By the needs of the owner/handler
Behavioral Health Assistance Dogs at a Glance
(Canine) Emotional Support Animals - ESAs
Psychiatric Service Dogs - PSDs
Needs of Owner/Handler:
Needs of Owner/Handler:
• Someone with a DSM-IV mental health
disorder
• Someone with a DSM-IV mental health disorder
Function/Training:
• May or may not be trained to perform tasks
that alleviate symptoms
• Presence alone alleviates symptoms
• Someone who is considered disabled according to the
Americans with Disabilities Act definition
Function/Training:
• Must be trained to perform tasks that alleviate symptoms
of a disability
• Must independently recognize need for task to be performed
• Tasks must facilitate activities that owner/handler could
not otherwise do on his/her own
 Legal rights of ESA and PSD-owners are different
 Training standards are different
 When rights are defined, reduces abuse
Why are the
definitions
important?
 Better public acceptance leads to higher probability
that people will continue to benefit from assistance
dogs in the future
How does
someone obtain
an assistance
dog?
 From an assistance dog training organization
 Dogs are raised in volunteer homes
 Dogs are returned to organization at a certain age to receive training
 Dogs are placed with owner/handler after training is complete
 Necessary when an owner/handler cannot manage an untrained dog
 Owners benefit from expertise of trainers
 Long waiting lists
 Self-training
 Advantage - little to any wait
 Most people are not qualified to train an assistance dog
 When poorly trained dogs are represented as well-trained dogs, it erodes the
perception of legitimate assistance dogs
 Team training guided by professional assistance dog organization
 Develops stronger bond between owner/handler and dog
 Allows for customized task training targeting the needs of the individual
 Avoids re-homing the dog at the sensitive age of 12-24 months (rehoming at this
age can be stressful and may contribute to lower success rates)
 Participating in training provides immediate benefits to owner/handler
What about
cost?
 Working with a professional trainer or training
organization, it costs over $30,000 to train an
assistance dog.
 This includes cost of care and training.
 People may pay privately for the training.
 Cost may be offset by a non-profit organization
that is funded by donations.
How do Assistance
Dogs Benefit People
with Mental Illness?
ESAs and PSDs help people with mental and behavioral
health disorders including:
Who benefits
from Behavioral
Health
Assistance
Dogs?
 Generalized anxiety disorder
 Panic disorder
 Phobic anxiety disorders (including agoraphobia and social
phobia)
 Post-traumatic stress disorder (PTSD)
 Obsessive compulsive disorder
 Depression
 Bipolar affective disorder
 Substance use disorder and addiction
People with other types of brain/neurological disorders
may also benefit from an assistance dog including
people with:
People with
Other Types of
Brain/
Neurological
Disorders
 Epilepsy/seizure disorder
 Alzheimer’s disease
 Parkinson’s disease
 Motor neuron disease (MND)
 Huntington’s disease
 Multiple sclerosis (MS)
 Cerebral palsy (CP)
Dogs that assist people with these disorders are not
Psychiatric Service Dogs, but simply “Service Dogs”
How Behavioral
Health
Assistance Dogs
Help
When someone is part of an assistance
dog team, their dog helps them by:
 Providing general benefits of owning a pet
 Performing tasks in response to a crisis
 Performing tasks that mitigate life-limiting symptoms
of a disability
 Performing other non-task functions
Owner-centered training provides
inherent benefits to owner/handlers:
How
Participation in
Training Helps
 Development of a stronger bond between owner
and dog
 Engages owner/handler in stimulating and
challenging activity
 Provides opportunity for personal achievement
 Is an empowering system of self-help
Pets are beneficial in and of themselves :
 Provide companionship/reduce isolation
General benefits
of pet ownership
 Improve physical health by reducing blood
pressure, heart rate, cholesterol; and by promoting
physical activity.
 Presence of dogs increases the “happy” brain
chemicals, in particular, oxytocin
 Bring objects to an immobilized person (medication, beverage,
emergency phone)
 Go get help – bring a person at home or in workplace, escort back to
owner/handler
Examples of
tasks performed
in response to a
crisis
 Activate a K9 Rescue Phone
 Bring emergency information card to emergency personnel and escort
back to owner/handler
 Alert owner/handler to smoke/fire alarm
 Alert owner/handler to someone in distress
 Revive owner/handler if sedated
 Guide to emergency exit
 Interrupt dangerous compulsive or self-destructive behaviors
 Provide regular medication reminders
 Disrupt repetitive and/or self-destructive behaviors/behavior sequences
 Wake a sleeping person at set times (if alarm clocks fail)
Examples of
tasks that
alleviate lifelimiting
symptoms of a
disorder
 Initiate walks or exercise at set time every day
 Alert sedated person to doorbell or telephone
 Block or alert to approaches from the rear to prevent owner/handler
from being startled
 Facilitate social interaction by approaching others when appropriate
 Act as a “brace”, in the event of loss of balance, weakness or disorientation
 Orient to reality by providing feedback about the environment (e.g., in
response to possible hallucinations)
 Do a “safety check” of rooms and give “all clear” or alert to threat
 Turn lights on for a “safety check”
 Help owner/handler find his/her way back to car or home if disoriented
Other examples
of non-task
assistance
 Reduce self-consciousness by acting as a “social buffer” by being object of
attention in public (note: this may have the opposite effect, depending on
the individual)
 Potentially facilitate activities not otherwise possible, such as going out in
public or entering social settings
 Provide general sense of security
 Presence may function as real or perceived deterrent against threats
 Provide owner/handler with something to do with nervous energy
(Canine) Emotional Support Animals
 ESAs alleviate symptoms simply by being there; they may or may
not be trained to perform tasks
 An owner of an ESA has been diagnosed with a disorder, but need
not be disabled.
Remember that
PSDs and ESAs
are different
 Owners of ESAs are generally NOT entitled to bring their dogs into
public places (there are exceptions)
Psychiatric Service Dogs
 PSDs are for people who are disabled
 PSDs alleviate life-limiting symptoms by performing trained tasks
 PSDs independently recognize need for a task to be performed
 PSDs facilitate activities that could not otherwise be accomplished
 PSDs have greater public access rights
What Are the Rights of
People with Behavioral
Health Assistance Dogs?
To benefit from their dogs unrestricted by rules
that normally exclude pets and other animals.
What are the
general
entitlements of
owner/handlers
of assistance
dogs?
 To be accompanied by the dog into certain public places
 Entitled to needed modifications to accommodate
accompaniment by dog
 To be able to live in residences that do not normally
allow pets without financial penalties
The specific rules, regulations and limitations are
extremely complex and vary from state to state.
Owner/Handler Rights at a Glance
(Canine) Emotional Support Animals - ESAs
Federal Rights:
• To live in a residence that does not normally allow
pets
• Residence may not charge pet deposit or pet rent
(though owner/handler is financially responsible for
damages)
• To be accompanied on domestic flights by
assistance dog in cabin irrespective of airline rules
regarding pets. (This applies only if the ESA owner
is disabled – owner/handlers of both ESAs and PSDs
must furnish a letter documenting the disability)
State Rights:
• Vary by state
• May only expand owner/handler rights
afforded by federal law
Psychiatric Service Dogs - PSDs
Federal Rights:
• All rights afforded to owner/handlers of ESAs
• To be accompanied by dog into public places, including
commercial or government enterprises or organizations
where the public is generally allowed.
• Are entitled to reasonable accommodation or alteration
when accompanied by their service dog.
State Rights:
• Vary by state
• May only expand owner/handler rights
afforded by federal law
U.S. Department of
Justice Code of Federal
Regulations
Title 28 Section 36.302 Link
Laws protecting
owner/handlers
of assistance
dogs
The Americans with
Disabilities Act of 1990
Revised 2010 Link
The Air Carrier Access
Act Link
Title VIII of the Civil
Rights Act of 1968 (Fair
Housing Act) Link
Section 504 of the
Rehabilitation Act of
1973 Link
Texas Consolidated
Assistance
Animal/Guide Dog Law
Link
Additional Texas
state laws
 Employees of the state of Texas are entitled to a 10day paid leave of absence to become acquainted with
their trained service dog.
 Assistance animals in training may not be denied
access to public places and owner/handlers or trainers
are entitled to the same rights as owner/handlers of
trained dogs.
 Violations are punishable by fines up to $1,000
 A person who interferes with or injures an assistance
animal commits a misdemeanor
 A person who kills an assistance animal commits a
class A felony.
Owners of Psychiatric Service Dogs generally have access to places
like restaurants, hospitals, hotels, theaters, shops, and government
buildings.
Inquiries: The
“Two Questions”
businesses may
ask
owner/handlers
Business owners, employees or agents are entitled to ask two
questions if an owner/handler requests public access.
 Is the dog needed for a disability?
 What tasks is the dog trained to perform?
If the need for the dog is obvious and the tasks the dog is trained to
perform are obvious (as with a Guide Dog), then the
business/organization may not ask anything.
In any case, they may never ask the nature of the disability.
Responsibilities
of the
owner/handler
 The dog must be under control at all times
 The dog must be on-leash or tethered
unless the disability makes this impossible
 The dog must be housebroken
Resources for
answers to legal
questions
 The U.S. Department of Justice Hotline:
1-800-514-0301
 ASPIRE Assistance Dogs: 1-866-348-1820
 www.animallaw.info
How to Identify Good
Assistance Dog
Owner/handler
Candidates
Who makes a
good candidate?






Must be qualified
Must be motivated
Must be able to commit to a 12-24 month project
Their disability must not inhibit care or training of the dog
Must have a support system
Must be able to treat the dog responsibly and humanely,
committing to the ownership of the dog, regardless of
training outcome
 Must have a relatively high degree of insight about nature of
disability and symptoms
What Type of Dog Does a Patient Qualify For?
1
BEHAVIORAL HEALTH
CONCERNS?
YES
DIAGNOSED WITH
DSM-iV DISORDER?
YES
DISABLED
BY ADA DEFINITION?
PSYCHIATRIC SERVICE
DOG CANDIDATE
YES
NO
2
EMOTIONAL SUPPORT
ANIMAL CANDIDATE
WILL THE DOG’S PRESENCE
ALONE ALLEVIATE SYMPTOMS?
2
YES
NO
NO
YES
EMOTIONAL
SUPPORT ANIMAL
CANDIDATE
NO
PSYCHIATRIC
SERVICE DOG
CANDIDATE
WILL THE DOG INDEPENDENTLY
RECOGNIZE NEED TO PERFORM
TASKS?
YES
NO
COMPANION DOG
(PET)
WILL THE DOG BE TRAINED TO
PERFORM SYMPTOMMITIGATING TASKS?
YES
WILL THE DOG FACILTATE
ACTIVITIES THAT COULD NOT
BE DONE OTHERWISE?
NO
NO
“Concentric Support Teams”
 The Assistance Dog Team
ASPIRE’s
Concentric
Support Team
System
 Owner/handler
 The Assistance Dog
 The Training Team
 The Assistance Dog Team
 The Trainer
 The Family Support Team
 The Training Team
 Family and friends who are willing to help care for
the dog when the owner/handler is unable and to
support training practices
 The Advocacy Team
 The Family Support Team
 Health care and community services providers
ASPIRE’s
Concentric
Support Team
System
Ways to Integrate Your
Patient’s Assistance
Dog Into Treatment
Engage in a
preliminary
discussion with
patient
 Discuss the value of behavioral health assistance
dogs with the patient
 Together with patient, examine the nature of
symptoms and discuss how a dog might be helpful
 Discuss the qualifications for being an
owner/handler of an assistance dog
 Discuss the rights and responsibilities of assistance
dog owner/handlers (refer to outside experts if
needed)
 Make a preliminary determination about what type
of assistance dog might be appropriate
Recommend
next steps to
patient
 Provide materials for patient to read and direct to
outside resources
 Recommend that patient discuss all aspects of
owning and training an assistance dog with family
and friends
 Recommend that patient begin developing a
potential support system
 If patient has no experience with dogs, recommend
that they spend some time volunteering at an
animal shelter
 Recommend that patient consider cost of care and
training
Consider being
part of the
patient’s
advocacy team
 Help training organization design a program that
meets individual needs of the patient
 Together with the patient, begin measuring how
participating in training and benefiting from the
dog’s training impact symptoms
 Together with the patient, provide feedback to the
training organization about progress, challenges
and new ideas
Help people
with mental
health disorders
continue to
benefit from
Assistance Dogs
 Provide your patients with documentation that
verifies that s/he has a disability and what tasks the
dog will be trained to perform (this information can
be obtained from the trainer)
 Clearly state the type of dog the patient uses –
either an Emotional Support Animal or Psychiatric
Service Dog
 Be sure that this documentation is never more than
12 months old
 Consider very carefully if patients genuinely qualify
for an assistance dog and do not provide
documentation without due diligence
Welcome your
patient’s
assistance dog
 Don’t forget that your patient has a legal right to
bring a Psychiatric Service Dog to your place of
business
 Share this information with colleagues!
Finally…
Visit our website at www.aspiredogs.org
Facebook.com/aspiredogs
Twitter: @aspiredogs
1-866-348-1820
[email protected]