Why therapists shouldn't approve their own patients' emotional support animals

A growing number of therapists arecertifying their patients' pets as emotional support animals,allowing people to taketheir cats, pigs and birds on planesand into rental homes even though it may not be medicallynecessary, a recent study suggests.

Researchers asked 87 mental health professionals to reviewcurrent laws and policies for determining when animals may qualify as emotional support animals in the U.S., includingfederal transportation requirements for air travel. Then,researchers questioned these professionals about how supportanimals should be certified.

Overall, about 31 per cent of the survey participants saidthey had previously recommended emotional support animals forpeople. However, 36 per cent of them said they didn't feelqualified to make these recommendations, including twopractitioners who had done so in the past.

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Study co-author Jeffrey Younggren of the University ofMissouri explained the difference between service animals andemotional support animals.

I believe there is no evidence yet that emotional supportanimals benefit people's health.-Dr. PaulCherniack

"Service animals are formally trained to perform specifichealthcare duties/function and their training matches thepatients'needs and they are not considered pets,"he toldReuters Health by email. "This is a formal process."

"However, emotional support animals do not have any trainingrequirements under the law nor are these certifications limitedto dogs,"Younggren said. "Ducks, turkeys and potbelly pigs haveall been certified by somebody as emotional support animals."

Unconditional support

Federal and state laws regulating emotional support animals(ESAs) often are convoluted and constantly changing, Younggrenand his colleagues note in a report of their study, which isscheduled for publication in the journal ProfessionalPsychology: Research and Practice.

For example, landlords who normally prohibit pets must allowESAs and waive any fees or pet deposits.

Airlines are required to allow ESAs to accompany theirowners in the main cabins of aircraft.

The mental health professionals in the survey believedcertifying emotional support animals can sometimes beappropriate, the survey found.

But to sidestep potential legal and ethical problems,clinicians should not certify animals for patients they arealready treating, the researchers argue. Mental healthprofessionals who work in courts of law and who don'thave aprior relationship with a patient may be better able to make animpartial decision on whether an emotional support animal mightactually benefit that person.

These evaluations should be done with the same thoroughnessand impartiality that is found in evaluations for anydisability, the researchers also argue. This may require thedevelopment of professional guidelines for what assessments aredone, who conducts them and how they are completed.

Many mental health professionals may not understand that aconflict of interest exists when a patient asks for an animal tobe certified because they want to make the patient satisfied andkeep the patient engaged in therapy, said Dr. Paul Cherniack, aresearcher at the University of Miami Miller School of Medicinewho wasn't involved in the study.

Another issue is that clinicians may rely on subjectivereports from patients about how animals help them, especially inthe absence of objective ways to measure the therapeuticbenefits of these animals, Cherniack said by email.

"I believe there is no evidence yet that emotional supportanimals benefit people's health,"Cherniack said. "Other serviceanimals like seeing eye dogs are different."

While better guidelines and standards for certifyingemotional support animals is needed, there is some evidence tosuggest that pets do have the potential to comfort people withmental health problems, said Dr. Helen Brooks of the MentalHealth Research Group at the University of Manchester in the UK.

"Pets helped their owners manage feelings by distractingthem from symptoms and upsetting experiences such as hearingvoices and suicidal ideation and provided a form ofencouragement for activity,"Brooks said, who wasn'tinvolved inthe current study, said by email. "Pets provided securerelationships and unconditional support which were often notavailable elsewhere."