When thinking of service animals, most of us would probably picture a vested German Shepherd carefully leading its blind or sight-impaired caretaker down a busy sidewalk or curled up at its handler's feet while on a plane or at a restaurant. But that's not necessarily the case anymore, according to Assistance Dogs International (ADI), which provides training and accreditation to assistance dog programs around the world.

Dogs are now recognized as valuable in new service roles such as hearing dogs for the hearing impaired and service dogs. Service dogs may offer emotional and psychiatric support, monitor for epilepsy and seizures, aid families with autistic children, provide hypoglycemic detection for diabetes sufferers1.

You can teach a dog new tricks

The last decade has seen the numbers of dogs trained in the relatively new role of providers of psychiatric, medical and emotional support surpass those trained for more traditional forms of mobility assistance2. The tasks assigned to animals trained in psychiatric care is wide, from reminding a handler to take medication and providing safety checks and room searches, to turning on lights for a PTSD or anxiety disorder sufferer, and interrupting potential self-mutilation and keeping disoriented individuals from danger3.

Be it through anecdote or lived experience, the emotional and therapeutic benefit of having a dog seems self-evident: they didn't become our best friends by being haughty and disagreeable. Animal-assisted interventions (AAI), which utilize specially trained non-pet animals trained to achieve therapeutic gains and improved health and wellness education4, have been shown to provide tremendous relief to those suffering from stress related disorders.

Canine companionship can help reduce stress

A recent study indicates that the presence of novel dogs was a more effective means of reducing the risk of stress related illnesses in subjects than in those who had been paired with a human friend, perhaps due to the risk of negative evaluation by the other person and the dogs' inherently more 'unconditional' type of support5. Another recent study showed the presence of a dog companion was an effective means of controlling hypertension in older adults when facing a daunting

engagement6, and another survey revealed that 95% of students who brought therapy dogs into university libraries while studying for final exams reported significant reductions in stress during finals7.

With the stress-reducing effects of having a canine companion well established in both clinical and less formal home-based settings, dogs have also been shown to be an effective presence in relieving various forms of depression and anxiety. A study using the AAI strategy known as animal-assisted activity (AAA) assigned companion dogs to the elderly residents of a long-term care facility as a means of exploring the effect of a companion dog on residents' depression and anxiety levels. The results of this study confirmed that AAA visits made a difference in the depression levels of residents in such facilities, although the difference between the anxiety scores for the AAA group was non-significant8.

A study following the effects of canine companionship on those undergoing cognitive behavioral therapy (CBT) yielded similar results: as participants used writing to recall traumatic events, the presence of a dog companion lessened acute anxious arousal than those who wrote about their ordeals without a dog present. Moreover, those who had the dog present as they relived their trauma wound up having less depressive symptoms in follow-up consultations9.

A real-life success story

Sometimes, however, the trained effectiveness of service dogs and the reliable warmth of a beloved pet can dovetail in the most unexpected and graceful ways. After taking his own dog Shiva with him to work and allowing her to be in the room during sessions, Dr. Victor Cohen observed a striking transformation take place with one of his more troubled clients, "Steve." A highly gifted, socially anxious and emotionally withdrawn teen, Steve often hid his fear behind a sneering contempt for those whom he did not consider his intellectual peers, yet when his hostility was countered by Shiva's unconditional warmth and affection, Steve's defenses were slowly disarmed: "It is just hard to be aloof with an animal that is being that friendly," Dr. Cohen states. "I observed that Steve seemed to relax in response to her affection, in a way that I had not seen in several years of interacting with him." And of course, contempt for Shiva's intellect seemed out of the question: her animal status seemed to create an opportunity for a different kind of connection, the absence of a perceived threat that Steve dealt with by being contemptuous. Steve seemed more relaxed, even when Shiva was not present, eventually sharing more of his inner world and leading to an increased openness and insight that would soon lead to transformative epiphany and breakthrough for the teen.

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Cinzia Roccaforte, Ph.D.

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Sources

1. Walther, S., Yamamoto, M., Thigpen, A. P., Garcia, A., Willits, N. H., & Hart, L. A. (2017). assistance Dogs: historic Patterns and roles of Dogs Placed by ADI or IGDF accredited Facilities and by non-accredited Us Facilities. Frontiers in Veterinary Science, 4.

2. Yamamoto, M., Lopez, M. T., & Hart, L. A. (2015). Registrations of Assistance Dogs in California for Identification Tags: 1999–2012. PloS one, 10(8), e0132820.

3. Muramatsu, R. S., Thomas, K. J., Leong, S. L., & Ragukonis, F. (2015). Service dogs, psychiatric hospitalization, and the ADA, Psychiatric Services (66)1, 87-89. doi: 10.1176/appi.ps.201400208

4. Pet Partners. (n.d.). Terminology. Retrieved from https://petpartners.org/learn/terminology/. (Accessed 25 February 2017).

5. Polheber, J., & Matchock, R. (2014). The presence of a dog attenuates cortisol and heart rate in the Trier Social Stress Test compared to human friends. Journal Of Behavioral Medicine, 37(5), 860-867. doi:10.1007/s10865-013-9546-1

6. Friedmann, E., Thomas, S. A., Cook, L. K., Tsai, C. C., & Picot, S. J. (2007). A friendly dog as potential moderator of cardiovascular response to speech in older hypertensives. Anthrozoös, 20(1), 51-63.

7. Daltry, R. M., & Mehr, K. E. (2015). Therapy dogs on campus: Recommendations for counseling center outreach. Journal of College Student Psychotherapy, 29(1), 72-78.

8. Le Roux, M. C., & Kemp, R. (2009). Effect of a companion dog on depression and anxiety levels of elderly residents in a long-term care facility. Psychogeriatrics, 9(1), 23-26. doi:10.1111/j.1479-8301.2009.00268.x

9. Hunt, M. G., & Chizkov, R. R. (2014). Are therapy dogs like Xanax? Does Animal-Assisted Therapy impact processes relevant to cognitive behavioral psychotherapy?. Anthrozoös, 27(3), 457-469.

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