By now almost everyone is familiar with the concept of an emotional support animal (ESA), and chances are, many of you have already encountered an ESA in a formerly “animal-free zone.” Or perhaps you or someone in your family or circle of friends has a dog, cat, bird, or other animal companion who serves as an ESA.

How ESAs Differ From Service Animals

Emotional support animals, according to the Fair Housing Act and Air Carrier Access Act (ACAA), can be any species of animal, who must fulfill a disability-related need and whose use is supported by a physician, psychiatrist or mental health professional.

ESAs don’t qualify as service animals under the Americans with Disabilities Act (ADA). Service animals are highly trained and can receive certifications as psychiatric service dogs to help people who suffer from depression, bipolar disorder, anxiety, panic attacks, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), schizophrenia and other mental conditions.

Emotional support animals, on the other hand, don’t require specific training to provide assistance to someone with a psychological disability. However, they may be permitted in housing facilities that would otherwise prohibit animals, and the ACAA allows some ESAs to travel on airlines at no extra cost, often with supportive documentation required.

As you might expect, there’s growing controversy surrounding the appearance of ESAs in ever-increasing numbers in locations that have traditionally been off-limits to animals. Sadly, the backlash isn’t surprising given that more than a few people have taken advantage of the special access granted to ESAs, falsely claiming their pet is necessary for emotional support.

Researchers Propose a Standard Assessment to Certify ESAs

Recently, researchers at the University of New Mexico published an article in the journal Professional Psychology: Research and Practice, outlining the ethical challenges therapists face when asked to certify emotional support animals for their patients, and offering possible solutions to better serve both people who feel they need ESAs and those who must comply with the animals, such as landlords and airlines.¹

The research team developed and is proposing a four-prong standard assessment for therapists when asked by patients to provide an ESA certificate:

1. Understanding, recognizing and applying the laws regulating ESAs.
2. A thorough valid assessment of the individual requesting an ESA certification.
3. An assessment of the animal in question to ensure it actually performs the valid functions of an ESA.
4. An assessment of the interaction between the animal and the individual to determine whether the animal’s presence has a demonstrably beneficial effect on that individual.

Assessment Will Address Whether the ESA Is Able to Do What It’s Being Asked to Do

The proposed assessment involves not just the patient, but the animal as well.

“Somebody has to certify that the animal is able to do what you’re asking it to do,” says lead article author Jeffrey Younggren, a forensic psychologist and clinical professor at the University of New Mexico’s Department of Psychiatry and Behavioral Sciences. “And there are avenues by which animals can be evaluated regarding their capacity for these kinds of experiences.”²

There’s no shortage of horror stories of encounters with emotional support animals, especially during air travel, and Younggren and his colleagues believe that implementing standardized guidelines and practices will reduce the number of incidents.

“Our research has nothing to do with service animals,” Younggren clarifies. “Seeing eye dogs and therapy dogs are animals that help individuals manage their disabilities in certain situations — but that’s not what an ESA is. An ESA is an example of a well-intended idea that has metastasized and developed into a world of nonsense.”

Proposal Answers the Need for Ethical Guidelines Around ESAs

Paper co-author Cassandra Boness, a University of Missouri Ph.D. candidate, says the proposed assessment will better align ESA certifications with professional and legal practices, while also providing guidelines for mental health therapists.

“One of our biggest goals is to disseminate this information in order to better educate mental health providers, as well as policy writers, about the need for ethical guidelines around ESAs,” Boness said.³

Importantly, mental health practitioners who aren’t knowledgeable about the law may not realize that when they write an ESA certification letter for a patient, legally it constitutes a disability determination that becomes part of the patient’s permanent medical record. Per the UNM Newsroom publication:

“Currently, in order to receive waivers for housing or travel purposes where animals are banned, the law requires patients must have a mental or emotional condition diagnosable by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

If patients are given certifications for an ESA, it means they, and the therapist signing the certification, are declaring the patient to be psychologically disabled with significant impairment in functioning.”⁴

The proposed assessment will require ESA certifiers to perform a comprehensive evaluation of the person requesting the certification to determine if they have a disability under the DSM-5, according to Younggren.

“That disability has to substantially interfere with the patient’s ability to function, which is what the ADA requires,” he explains. “And the presence of the animal has to ameliorate the condition, which means you have to see the person with the animal.”

If the proposal is adopted as an industry standard, it will become more difficult for individuals to receive ESA certifications, but will benefit society as a whole from a safety perspective.

Moving Forward

The researchers are hopeful their work will spur more research on the impact of emotional support animals on patients in order to build a larger body of scientific evidence.

The important takeaway here is that no one is arguing that pets provide both physical and mental health benefits to humans — those facts are well-estab­lished and backed up with an ever-growing library of scientific studies.

The human-animal bond is real and describes the powerful, positive interaction that exists between people and animals. It’s not just about companionship — it’s about a deep connection that enhances the quality of life of both humans and animals.

The issue is that in a civilized society, it’s necessary to develop and enforce guidelines and standards that benefit the many rather than the few. It’s also important to evaluate current trends, in this case the growing use of ESAs, for potential short and long-term consequences to the animals and humans involved in these pairings, as well as society as a whole.

Service dogs provide invaluable support to their owners, alerting them to potentially life-threatening medical problems or offering psychiatric or visual support. While most people will never experience the close bond that exists between service dogs and their owners, most everyone will cross paths with a service dog at some point in their lives.

Despite their prevalence — you’re likely to spot one sooner or later, since service dogs are allowed to accompany their owners virtually everywhere — many misconceptions persist about these generous animals. This is partly because service dogs look like any other dog, which leads some to believe they should be treated like any other dog — which isn’t the case if the dog is “working.”

Also problematic, the U.S. has no centralized process that allows people with disabilities to register service dogs,¹ which means, even though service dogs are afforded special rights, there’s a lot of grey area when it comes to how those rights are protected, for both the dogs and their owners.

Clearing up common misconceptions is an important part of ensuring that service dogs and their owners get the respect and protections they deserve.

Service Dogs Are Not the Same as Emotional Support Animals

The Americans with Disabilities Act 1990 (ADA) defines a service animal as, “Any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual or other mental disability. Other species of animals, whether wild or domestic, trained or untrained, are not service animals for the purposes of this definition.”²

Miniature horses have been added as an exception, however, provided they are housebroken, under the handler’s control, can be accommodated by the facility and will not compromise safety regulations.

On the other hand, emotional support animals (ESAs), according to the Fair Housing Act and Air Carrier Access Act (ACAA), can be any species of animal, who must fulfill a disability-related need and whose use is supported by a physician, psychiatrist or mental health professional. ESAs do not have to be trained to perform a particular task and do not qualify as service animals under the ADA.

Service Dogs Are Not Only for the Visually Impaired

Guide dogs for the visually impaired are just one type of service dog. Service dogs can be trained to help people with physical or mental difficulties, including post-traumatic stress disorder (PTSD). If a veteran is experiencing anxiety or stress due to PTSD, for instance, a service dog can be trained to notice the signs and step in to provide calm and comfort.

They may wake a veteran up from nightmares and are also taught specific commands, including “block,” in which the dog stands in front of the veteran to provide for more personal space, and “cover,” in which the dog goes behind the veteran to “watch their back.”³ Other examples of tasks that service animals may perform include:⁴

Not All Service Dogs Are Professionally Trained

Service dogs do not require professional training and there are no required ADA certifications for service animals. While most service dogs come from reputable trainers or organizations that specialize in training service dogs, according to the ADA, “People with disabilities have the right to train the dog themselves and are not required to use a professional service dog training program.”⁵

That being said, many service dogs undergo about two years of training before they’re ready and will continue to learn and adapt to their owner’s changing needs over time.⁶ There are also misconceptions about what type of dog can be a service dog; according to the ADA, any dog breed can be a service animal.

In choosing a service dog, personality is often more important than breed; dogs who are fearful or aggressive are not well suited to be service dogs.

Can Service Dogs Ever Be Denied Access?

People with disabilities are allowed to bring their service animals to all public facilities and private businesses. The owners of a business may ask two questions to determine if the animal is a service animal — and only if the need for the service animal isn’t obvious (such as a dog guiding someone who is blind. Those questions are:⁷

• Is this animal required because of a disability?
• What work or task has this animal been trained to perform?

Beyond this, no further questioning or “proof” is needed. As noted by the ADA, “A public entity or private business may not ask about the nature or extent of an individual’s disability or require documentation, such as proof that the animal has been certified, trained or licensed as a service animal, or require the animal to wear an identifying vest.”⁸

Generally, service animals are allowed to go where their owners go, but there are a few exceptions in which a business can ask for a service animal to be removed, including if the animal is out of control or not housebroken. A service animal may also be denied access if its presence interferes with “legitimate safety requirements,” such as a hospital unit that must maintain a sterile environment.⁹

Should You Pet a Service Dog?

One important point to remember is that certain rules of etiquette apply when it comes to interacting with service dogs and their handlers. Generally speaking, don’t interact with them at all; let the dog and the owner go about their business uninterrupted.

Service dogs should not be approached, talked to or touched unless permission is asked for and granted by the dog’s handler, but take no offense if the handler asks you not to interact with the dog — doing so could distract him from his important role, which is to look out for the health and safety of his owner.

Service dogs or animals who provide mental, emotional or physical support have transformed the lives of scores of people, as they make it possible for people with disabilities to live independently. Since new laws have sanctioned the public appearance of service animals, the lives of their humans are far easier and less stressful, as Katherine Moore, who is legally blind, can attest.

“When you have a service animal it’s like you are one. When I put my hand on his harness it’s like an extension of my arm … That’s like putting a value on your freedom. How do you do that? How do you say what your freedom is worth? It’s worth everything.”¹

Training for service animals is wide-ranging and extensive, which is why Moore says she’s able to live a full life, including working and commuting, just as she did before she lost her ability to see. One of the few organizations in Tennessee that specializes in service dog training, Smoky Mountain Service Dogs (SMSD),² focuses on training dogs that will be used by wounded veterans. Mike Kitchens, chairman of SMSD, explains:

“Every dog that we have we will take to Harley Davidson and have them start up the motorcycles. We will take them to the baggage area at the airport. Revolving doors. They have to be so environmentally stable because the intent is for that dog to be able to accompany that veteran wherever he goes.”³

Other animals may provide emotional comfort, but they don’t necessarily fall under the same federal protections as service animals. In fact, Dr. Zenithson Ng from the University of Tennessee Knoxville’s College of Veterinary Medicine contends that emotional support animals are pets. They may alleviate symptoms of conditions their humans have, and even be designated by mental health professionals, but still, they’re not considered service animals. According to the Americans with Disabilities Act (ADA):

“While Emotional Support Animals or Comfort Animals are often used as part of a medical treatment plan as therapy animals, they are not considered service animals under the ADA. These support animals provide companionship, relieve loneliness, and sometimes help with depression, anxiety, and certain phobias, but do not have special training to perform tasks that assist people with disabilities.”⁴

Bogus Service Dog Certifications: ‘There’s No Such Thing’

Where there’s a service, privilege or right, especially when it comes to animals, it seems there’s always people willing to bend the rules. It usually involves money, and selling so-called “service dog certification” to designate animals with qualifications they don’t actually have are no exception. Needless to say, the types of service and support animals are vast and can be confusing. Here’s a chart that summarizes all of the categories.

“It’s major issue for us because we see it all. We really do,” Kitchens says. “You can Google ‘service dog access’ and you will come up with multiple organizations that for $69.95 we will send you a service dog certification. Well, there is no such thing.”⁵ There’s also no national registry for animals who are designated helpers for humans, Ng says.

For a fee, there are dozens of websites that offer vests for dogs to wear that “certify” them as certified service, emotional support or therapy animals. There’s another reason why some people are willing to purchase vests without their animal having actual qualifications behind their label. WATE.com notes that for some, it’s also a way to bring their favorite animal with them into public places.

Ng, who’s a member of the steering committee on human-animal interaction with the American Veterinary Medical Association (AVMA), says the problem is a hot topic among personnel responsible for governing the situation due to what he terms as an “onslaught” of problems the AVMA has run into recently. He also notes:

“We are so lucky in this society to have this term of emotional support animal and … we really should designate that for the people who need them and the animals that are well behaved in public settings. So when people are taking advantage of the system that’s really hard, it’s disappointing.”⁶

Service Animals: Training to Perform Their True Function

The ADA acknowledges that it’s often fairly obvious when an animal is merely accompanying someone in a public place as a pet, or if it’s a bona fide service animal; you’ll know the latter is the case if a dog is guiding someone who is either blind or unable to see clearly, or helping someone who has trouble with stability or balance or is in a wheelchair. However, sometimes disabilities are not always visible to bystanders. The ADA, a division of the U.S. Department of Justice, states:

“When it is not obvious what service an animal provides, only limited inquiries are allowed. Staff may ask two questions: (1) is the dog a service animal required because of a disability, and (2) what work or task has the dog been trained to perform. Staff cannot ask about the person’s disability, require medical documentation, require a special identification card or training documentation for the dog, or ask that the dog demonstrate its ability to perform the work or task.”⁷

Further, service animals are limited to dogs under Title II and III of the ADA, as of March 15, 2011.⁸ Local laws prohibiting specific breeds of dogs do not apply to service animals.

The ADA states that a “service animal” refers to any dog individually trained to do what is necessary to help someone with a disability, whether it’s physical, sensory, psychiatric, intellectual or mental. It makes clear, however, that emotional support animals, comfort animals and therapy dogs are not in the same category: They’re not service animals. Similarly, the work service animals perform must be related directly to their human’s disability. In addition:

“It does not matter if a person has a note from a doctor that states that the person has a disability and needs to have the animal for emotional support. A doctor’s letter does not turn an animal into a service animal.”⁹

ADA Facts Regarding Service Animals

An animal may or may not be wearing a special collar or harness. Some, but not all, are certified, licensed and/or have identification papers stating as such; however, they may not be carrying those papers with them. Most service dogs perform jobs most are familiar with, such as Seeing Eye dogs, seizure response dogs and those who alert people with hearing impairments.¹⁰

It’s important to note, though, that some local and state governments have special rules for people entering businesses or public places with support animals aside from service dogs, such as emotional support animals, so it’s best to check with these agencies to find out if such ordinances exist. From a page on the ADA’s website, facts regarding service dogs in businesses include:¹¹

Service Animals: Sometimes Other Rules Apply

There are dozens of situations regarding service animals in public places, and probably just as many exceptions. For instance, the care and conduct of service animals is the responsibility of the disabled person they’re with — the animal’s owner. Business owners aren’t required to provide food, care or a special location for the animal.

Arguably one of the greatest concerns people have about service animals relates to fear of the animal becoming a threat to themselves or their customers. But fear of animals, dogs included, or allergies to animals are not good enough reasons to refuse service. The business or government entity is expected to find solutions if employees, other customers or travelers are afraid of or allergic to dogs, such as allowing more or even a separated space.¹²

As for air travel, the rules are different. The Air Carrier Access Act (ACAA) says airlines must allow both service and emotional support animals to travel in the cabin with the people they’re helping. True, the rules for the latter are getting more strict in light of a number of unfortunate animal incidents on flights.

For that reason, WATE News notes, people who want to travel with emotional support animals or psychiatric service animals may be required to supply specific documentation, including proof of their disability and why their animal is necessary, well before their trip.

People with disabilities who want more information regarding special circumstances, including air travel, may also want to check the provisions made under the Fair Housing Act, which can be found on the U.S. Department of Housing and Urban Development site,¹³ as it includes specifications for service and emotional support animals.

By Dr. Karen Shaw Becker

Service dogs or animals who provide mental, emotional or physical support have transformed the lives of scores of people, as they make it possible for people with disabilities to live independently. Since new laws have sanctioned the public appearance of service animals, the lives of their humans are far easier and less stressful, as Katherine Moore, who is legally blind, can attest.

“When you have a service animal it’s like you are one. When I put my hand on his harness it’s like an extension of my arm … That’s like putting a value on your freedom. How do you do that? How do you say what your freedom is worth? It’s worth everything.”¹

Training for service animals is wide-ranging and extensive, which is why Moore says she’s able to live a full life, including working and commuting, just as she did before she lost her ability to see. One of the few organizations in Tennessee that specializes in service dog training, Smoky Mountain Service Dogs (SMSD),² focuses on training dogs that will be used by wounded veterans. Mike Kitchens, chairman of SMSD, explains:

“Every dog that we have we will take to Harley Davidson and have them start up the motorcycles. We will take them to the baggage area at the airport. Revolving doors. They have to be so environmentally stable because the intent is for that dog to be able to accompany that veteran wherever he goes.”³

Other animals may provide emotional comfort, but they don’t necessarily fall under the same federal protections as service animals. In fact, Dr. Zenithson Ng from the University of Tennessee Knoxville’s College of Veterinary Medicine contends that emotional support animals are pets. They may alleviate symptoms of conditions their humans have, and even be designated by mental health professionals, but still, they’re not considered service animals. According to the Americans with Disabilities Act (ADA):

“While Emotional Support Animals or Comfort Animals are often used as part of a medical treatment plan as therapy animals, they are not considered service animals under the ADA. These support animals provide companionship, relieve loneliness, and sometimes help with depression, anxiety, and certain phobias, but do not have special training to perform tasks that assist people with disabilities.”⁴

Bogus Service Dog Certifications: ‘There’s No Such Thing’

Where there’s a service, privilege or right, especially when it comes to animals, it seems there’s always people willing to bend the rules. It usually involves money, and selling so-called “service dog certification” to designate animals with qualifications they don’t actually have are no exception. Needless to say, the types of service and support animals are vast and can be confusing. Here’s a chart that summarizes all of the categories.

“It’s major issue for us because we see it all. We really do,” Kitchens says. “You can Google ‘service dog access’ and you will come up with multiple organizations that for $69.95 we will send you a service dog certification. Well, there is no such thing.”⁵ There’s also no national registry for animals who are designated helpers for humans, Ng says.

For a fee, there are dozens of websites that offer vests for dogs to wear that “certify” them as certified service, emotional support or therapy animals. There’s another reason why some people are willing to purchase vests without their animal having actual qualifications behind their label. WATE.com notes that for some, it’s also a way to bring their favorite animal with them into public places.

Ng, who’s a member of the steering committee on human-animal interaction with the American Veterinary Medical Association (AVMA), says the problem is a hot topic among personnel responsible for governing the situation due to what he terms as an “onslaught” of problems the AVMA has run into recently. He also notes:

“We are so lucky in this society to have this term of emotional support animal and … we really should designate that for the people who need them and the animals that are well behaved in public settings. So when people are taking advantage of the system that’s really hard, it’s disappointing.”⁶

Service Animals: Training to Perform Their True Function

The ADA acknowledges that it’s often fairly obvious when an animal is merely accompanying someone in a public place as a pet, or if it’s a bona fide service animal; you’ll know the latter is the case if a dog is guiding someone who is either blind or unable to see clearly, or helping someone who has trouble with stability or balance or is in a wheelchair. However, sometimes disabilities are not always visible to bystanders. The ADA, a division of the U.S. Department of Justice, states:

“When it is not obvious what service an animal provides, only limited inquiries are allowed. Staff may ask two questions: (1) is the dog a service animal required because of a disability, and (2) what work or task has the dog been trained to perform. Staff cannot ask about the person’s disability, require medical documentation, require a special identification card or training documentation for the dog, or ask that the dog demonstrate its ability to perform the work or task.”⁷

Further, service animals are limited to dogs under Title II and III of the ADA, as of March 15, 2011.⁸ Local laws prohibiting specific breeds of dogs do not apply to service animals.

The ADA states that a “service animal” refers to any dog individually trained to do what is necessary to help someone with a disability, whether it’s physical, sensory, psychiatric, intellectual or mental. It makes clear, however, that emotional support animals, comfort animals and therapy dogs are not in the same category: They’re not service animals. Similarly, the work service animals perform must be related directly to their human’s disability. In addition:

“It does not matter if a person has a note from a doctor that states that the person has a disability and needs to have the animal for emotional support. A doctor’s letter does not turn an animal into a service animal.”⁹

ADA Facts Regarding Service Animals

An animal may or may not be wearing a special collar or harness. Some, but not all, are certified, licensed and/or have identification papers stating as such; however, they may not be carrying those papers with them. Most service dogs perform jobs most are familiar with, such as Seeing Eye dogs, seizure response dogs and those who alert people with hearing impairments.¹⁰

It’s important to note, though, that some local and state governments have special rules for people entering businesses or public places with support animals aside from service dogs, such as emotional support animals, so it’s best to check with these agencies to find out if such ordinances exist. From a page on the ADA’s website, facts regarding service dogs in businesses include:¹¹

Service Animals: Sometimes Other Rules Apply

There are dozens of situations regarding service animals in public places, and probably just as many exceptions. For instance, the care and conduct of service animals is the responsibility of the disabled person they’re with — the animal’s owner. Business owners aren’t required to provide food, care or a special location for the animal.

Arguably one of the greatest concerns people have about service animals relates to fear of the animal becoming a threat to themselves or their customers. But fear of animals, dogs included, or allergies to animals are not good enough reasons to refuse service. The business or government entity is expected to find solutions if employees, other customers or travelers are afraid of or allergic to dogs, such as allowing more or even a separated space.¹²

As for air travel, the rules are different. The Air Carrier Access Act (ACAA) says airlines must allow both service and emotional support animals to travel in the cabin with the people they’re helping. True, the rules for the latter are getting more strict in light of a number of unfortunate animal incidents on flights.

For that reason, WATE News notes, people who want to travel with emotional support animals or psychiatric service animals may be required to supply specific documentation, including proof of their disability and why their animal is necessary, well before their trip.

People with disabilities who want more information regarding special circumstances, including air travel, may also want to check the provisions made under the Fair Housing Act, which can be found on the U.S. Department of Housing and Urban Development site,¹³ as it includes specifications for service and emotional support animals.