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The Differences Between an Emotional Support Animal and a Service Animal

July 8th, 2022


Human-animal interactions are growing in popularity as a modality for psychiatric treatment as they have been known to provide multiple health benefits. Empirical evidence for decades has shown that animal therapies not only assist in physical health but can also produce positive changes in social and psychological contexts.

However, the terminology surrounding these animal treatments has vastly changed throughout the years. Service dogs, therapy dogs, and emotional support animals are commonly used and often interchanged. While each of these types of animals can fulfill important roles for their human counterparts, the legal limitations, training, and function of these animals vary greatly.

What is an Emotional Support Animal?

What is an Emotional Support Animal?

An emotional support animal (ESA) is typically the easiest to acquire and requires the least amount of training, upkeep, and education for the animal and owner. However, they also provide fewer interventions and are not given as many rights under the law. Here are a few facts about ESAs:

  • Purpose: To provide comfort through companionship to individuals with mental health issues.
  • Owner Requirements: One must have an identified mental health diagnosis such as PTSD or General Anxiety Disorder before being issued an accommodation letter by a licensed clinician.
  • Training: No training is required. Emotional support animals are most often prior pets of the owner.
  • Legality: After receiving a letter from a licensed mental health clinician stating the need for an ESA, these animals are protected under the Fair Housing Act (FHA) and Equal Employment Opportunity Commission (EEOC). Under FHA, animals are permitted to live with their owner regardless of their residence’s pet policy. The EEOC takes the position that an emotional support animal can be considered a reasonable accommodation in the workplace.
    • Of note, in 2020, the Department of Transportation ruled to allow airlines to recognize emotional support animals as pets, rather than service animals. Therefore, the airline can refuse to board an ESA, which in previous years was required to recognize it as a service animal.

Regarding additional considerations, an ESA is not limited to dogs. This category of animals has been known to include cats, birds, hamsters, pigs, and even a horse. Unfortunately, more uncommon animals or exotic pets can cause undue hardship to the public or even the individual. Thus, clinicians should practice caution and understand if the benefit of the ESA would cause further stress and difficulty to the patient.

What is a Therapy Dog?

A therapy dog is often interchangeable between emotional support animals and service animals. However, these animals are in their own specific category in terms of role and intervention.

  • Purpose: To provide therapy and comfort to those in public or living facilities, often with patients with severe illnesses, physical disabilities, and/or mental health concerns.
  • Owner Requirements: The owners or handlers do not need to have an identified disability or disorder. Rather, they provide aid to others with these concerns.
  • Training: Therapy dogs receive obedience and behavioral training. Many organizations require the dog to pass the American Kennel Club (AKC) Canine Good Citizen test. This ensures they can follow basic commands and do not cause harm to others through jumping or biting. Further certifications are also available to receive titles such as The AKC Therapy Dog certification.
  • Legality: Currently there are no major laws or enforcement for the purpose of therapy dogs. However, they are allowed in public places such as hospitals or nursing homes when invited.
What is a Service Animal?

What is a Service Animal?

A service animal is typically the highest form of animal intervention as these dogs require additional training and education for their owners, and they provide the most integrated services to patients.

  • Purpose: To perform tasks for or with an individual who has a documented physical or psychiatric disability.
  • Owner Requirements: Ownership is unique in that many dogs are not originally the pet of the patient. The original owner may represent an organization that conducts thorough training for these animals before ownership is transferred to an individual with a disability defined under the American Disabilities Act (ADA).
    • The term psychiatric service dog is often interchanged with a service dog to include owners who have documented mental health diagnoses causing functional impairments, also recognized under the ADA.
  • Training: Significant training is required for a service dog. This often includes basic command training such as learning to sit, come, and wait on command. Their behavior must also be trained in which they relieve themselves in appropriate areas, tolerate crowds, and walk along their owner in a calm fashion. Additional training depends on the documented disability but can include alerting the individual or family member to a medical emergency such as an oncoming seizure or low blood sugar. Mobility and guide dogs are specifically trained to assist in navigation or balancing.
  • Legality: In addition to the FHS and EEOC as allowed with emotional support animals, service dogs also are given additional public accommodations through the ADA and the Air Carriers Access Act (ACAA). These allow service dogs to accompany their owner in any public area or travel with the individual even in places that restrict animals.
    • It should also be noted that only dogs are currently allowed to be considered in the aid of disability services.

There are some special considerations to understand with service dogs as it pertains to clinicians and handlers. First, handlers are given protection regarding inquiries about their service dog. Staff in public areas, such as in transportation, restaurants, or medical offices, may only ask two questions of trained service animals.

  1. Is the dog required because of a disability?
  2. What work or task has the dog been trained to perform?

All other questions such as what type of disability, request to see credentials or identification cards, or demonstration of such tasks are not allowed.

However, establishments may refuse the service dog or ask to remove the dog from the premises if the dog is out of control or not housebroken.

Which one do I need?

Determining your need for animal assistance is a personal and often collaborative decision between you and your mental health professional. This usually begins with an overview of current symptoms and their impact on functionality. In addition, while ESA and service dogs provide great comfort and multiple treatment benefits, owning and taking care of an animal takes a great amount of care and involvement.

There are no legislations or certifications to be an owner of an animal, so individuals must decide for themselves if they have the time, finances, and emotional capacity to take care of an animal. Furthermore, regardless of the type of treatment animal, owners must abide by all state, local, and county laws. These often require owners to register, pay taxes and fees, and obtain certain shots required by the ordinance in their living area.

What are the next steps?

What are the next steps?

If you believe an animal will be of service to your physical and/or mental health, the next step would be to discuss options with a mental health professional. Often, individuals with pre-existing mental health conditions or physical disabilities already have resources in place such as attending weekly therapy with a licensed clinician or obtaining prescription medication with a psychiatric prescriber. These individuals are typically the first step as they will provide documentation and assess your need for treatment regarding animal therapies.

Written By: Dr. Ashley Head, PsyD.

Clarity Clinic

At Clarity Clinic, we have highly trained staff who specialize in therapy and psychiatry services. To learn more about how we can support your mental health, call Clarity Clinic at (312) 815-9660 or schedule an appointment today.

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