Selected OHAIRE Publications - Service Dogs

Systematic Review

O'Haire, M. E., Guérin, N. A., & Kirkham, A. C. (2015). Animal-assisted intervention for trauma: A systematic literature review. Frontiers in Psychology, 6, 1121.

Summary: This paper presents a systematic review of the empirical literature on AAI for trauma, including posttraumatic stress disorder (PTSD). Participants were predominantly survivors of child abuse, in addition to military veterans. The presentation of AAI was highly variable across the studies. The most common animal species were dogs and horses. The most prevalent outcomes were reduced depression, PTSD symptoms, and anxiety. There was a low level of methodological rigor in most studies, indicating the preliminary nature of this area of investigation. We conclude that AAI may provide promise as a complementary treatment option for trauma, but that further research is essential to establish feasibility, efficacy, and manualizable protocols. It is open access and free to the public.

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Standardized Surveys

O'Haire, M. E., & Rodriguez, K. E. (2018). Preliminary efficacy of service dogs as a complementary treatment for posttraumatic stress disorder in military members and veterans. Journal of Consulting and Clinical Psychology, 1(6), e1-8.

Summary: Military veterans with PTSD are increasingly pursuing complementary treatments, one of which is the provision of a psychiatric service dog specifically trained to perform tasks that are thought to mitigate PTSD symptomology. This publication is a proof-of-concept study assessing the effects of this practice. Participants were post-9/11 military veterans with PTSD recruited from a national service dog provider, K9s for Warriors. The study compared usual care alone (66 veterans on the waitlist to receive a dog) versus usual care plus a trained service dog (75 veterans already placed with a dog). Results found that those with a service dog had clinically significant reductions in PTSD symptoms, but average reductions were not below the cutoff for a diagnosis of PTSD. Compared to the waitlist, those with a service dog also had lower depression, higher quality of life, and higher social functioning. We conclude that while the addition of trained service dogs to usual care may confer clinically meaningful improvements in PTSD symptomology and quality of life for military veterans with PTSD, this practice should remain a complementary, rather than standalone, treatment option in its current format.

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Stress Response (Cortisol)

Rodriguez, K. E., Bryce, C. I., Granger, D. A., & O'Haire, M. E. (2018). The effect of a service dog on salivary cortisol awakening response in a military population with posttraumatic stress disorder (PTSD). Psychoneuroendocrinology, 98, 202-210.

Summary: After controlling for other factors, military veterans with a PTSD service dog had higher cortisol awakening response than those on the waitlist. These veterans with a service dog also had significantly less PTSD severity, anger, anxiety, sleep disturbance, and alcohol abuse symptoms than those on the waitlist. These results that PTSD service dogs may be beneficial for military veterans both for their mental health and physiological health.

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Dog Training, Behavior, & the Bond

LaFollette, M. R., Rodriguez, K. E., Ogata, N. & O'Haire, M. E. (2019). Military veterans and their PTSD service dogs: Associations between training methods, PTSD severity, dog behavior, and the human-animal bond. Frontiers in Veterinary Science, 6, 23.

Summary: This publication focuses on training methods, PTSD severity, service dog behavior, and the veteran-service dog bond in a population of military veterans with PTSD. Results found that veterans use many different training types. In general, more frequent reported use of positive punishment (correction-based) training was associated with negative outcomes. Conversely, more frequent reported use of postive reinforcement (reward-based) or bond-based training was associated with reporting more positive outcomes.

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Defining the Intervention

Rodriguez, K. E., LaFollette, M. R., Hediger, K., Ogata, N., & O’Haire, M. E. (2020). Defining the PTSD service dog intervention: Perceived importance, usage, and symptom specificity of psychiatric service dogs for military veterans. Frontiers in Psychology, 11, 1638.

Summary: This publication aimed to define the PTSD service dog intervention by (1) quantifying the importance, usage, and PTSD symptom specificity of service dog trained and untrained behaviors, (2) exploring how PTSD severity, time since receiving the service dog, and the veteran-dog relationship relate to outcomes, and (3) comparing expectations of veterans on the waitlist to experiences of veterans with service dogs. Results from this study offer valuable knowledge toward understanding the specific components and therapeutic value of PTSD service dogs and the PTSD symptoms that are helped most by the service dog’s trained tasks among a large and representative sample of military veterans both with a service dog and on the waitlist to receive one.

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PTSD Symptoms

Jensen, C. L., Rodriguez, K. E., & O’Haire, M. E. (2020). Service dogs for veterans and military members with posttraumatic stress disorder (PTSD): Replication with the PTSD Checklist for DSM-5. Journal of Traumatic Stress, 00 , 1-8.

Summary: Recent cross-sectional studies using the PTSD Checklist (PCL) for the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) have found significantly lower PTSD symptom severity in military members and veterans with a specially trained PTSD service dog. This publication aimed to replicate previous findings using the most recent version of the PCL for the DSM fifth edition (PCL-5). Results found that, compared to veterans on the waitlist, symptom severity was significantly lower in veterans partnered with a PTSD service dog. The secondary aim was to investigate the relationship between symptom severity and amount of time since receiving the service dog. There was no effect of time since receiving the service dog and PTSD symptom severity.

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Spouses & Families

McCall, C. E., Rodriguez, K. E., Wadsworth, S. M. M., Meis, L. A., & O’Haire, M. E. (2020). “A part of our family”? Effects of psychiatric service dogs on quality of life and relationship functioning in military-connected couples. Military Behavioral Health.

Summary: PTSD service dogs can have significant, positive effects for Veterans’ well-being and quality of life; however, less is known about the impact on romantic partners. We sought to examine how Veterans’ use of PTSD service dogs impacted their partners’ well-being and quality of life, and couples’ relationship functioning. While some partners mentioned notable challenges or no significant changes associated with service dogs, there were also positive impacts on family systems. Results from this study highlight the complexities of PTSD service dogs in the context of families, and encourage researchers and practitioners to consider the interdependence between PTSD service dogs, Veterans, and partners.

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Experiences vs Expectations

Nieforth, L. O., Rodriguez, K. E., & O'Haire, M. E. (2021). Expectations versus experiences of veterans with posttraumatic stress disorder (PTSD) service dogs: An inductive conventional content analysis. Psychological Trauma: Theory, Research, Practice, and Policy.

Summary: This study describes the benefits and drawbacks of a posttraumatic stress disorder (PTSD) service dogs from the perspective of Veterans with service dogs and compares those reports to the expectations of Veterans who were on a waitlist for a PTSD service dog. Experiences and expectations centered on the effects the service dogs had on Veteran mental health, human–dog interaction, and the associated drawbacks. Although the majority of Veterans reported benefits from their service dogs, the findings revealed that Veterans on the waitlist more frequently mentioned benefits than those with a service dog. Study findings suggest that the drawbacks expected from service dogs differ from the drawbacks experienced. Understanding expectations versus experiences provides critical information for mental health professionals who are informing Veterans on individualized interventions for PTSD.


Resilience Among Veteran & Military Families

Nieforth, L.O., Craig, E.A., Behmer, V.A. et al. (2021). PTSD service dogs foster resilience among veterans and military families. Current Psychology.

Summary: Veterans, their spouses, and their families face many challenges following military deployment and when rejoining society. Of these challenges, 23% of Veterans deployed after 9/11 have been diagnosed with post-traumatic stress disorder, or PTSD. Although it has been found that service dogs can help reduce symptoms related to PTSD when used with other treatments, there is little research that explores the role of service dogs in improving resilience among veterans and their families. In this study, 101 individuals, including Veterans and their spouses, reported their experiences. Findings of this study suggest that the communication processes in military relationships and family adaptations are complex. Based on these results, researchers suggest that service dog trainers and mental health providers incorporate strategies for the maintenance of relationships and a family-based approach when integrating service dogs in military families.

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Caregiver/Family Focused Qualitative Data

Nieforth, L.O., Rodriguez, K. E. & O'Haire, M. E. (2021). Benefits and Challenges of Mobility and Medical Alert Service Dogs for Caregivers of Service Dog Recipients. Disability & Rehabilitation: Assistive Technology (online first publication), doi: 10.1080/17483107.2021.1916630

Summary:This publication analyzed caregiver responses to open-ended surveys in order to understand their perspective on benefits and challenges they face as caregivers of individuals with mobility and medical alert service dogs. They mentioned several benefits of the service dog to both themselves and their family, but also described numerous drawbacks. Benefits specifically related to caregivers included the formation of the human-animal bond and stress and worry reduction, while benefits to the entire family unit included emotional support and an overall positive impact of the service dog. The most commonly mentioned drawbacks of having a service dog in the home from the perspective of caregivers were general maintenance of the service dog, grooming of the service dog and issues with traveling with the service dog. Overall, findings suggest that benefits and challenges of mobility and medical service dogs extend beyond the service dog recipient, affecting the caregiver and other family members as well.

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How do service dogs impact families and caregivers? 117 caregivers were asked about the benefits and drawbacks of having a service dog in the home. Benefits to themselves and families: "The entire household has benefited from [the service dog] being here;" "Having [the service dog] keeps me calm." Benefits of the service dog's role: "[The service dog} has a sense when something is wrong, making it easier for us to address any issues before they become a problem." Caregiver drawbacks: "[The service dog] does require a significant amount of extra time and attention;" "Sometimes we find it causes more difficulty and stress to take [the service dog] places."

Standardized Surveys

Rodriguez, K. E., Bibbo, J. & O'Haire, M. E. (2020). The effects of service dogs on psychosocial health and wellbeing for individuals with physical disabilities or chronic conditions. Disability and rehabilitation, 42(10), 1350-1358.

Summary: This publication examined the effects of service dogs on psychosocial health and wellbeing indicators among individuals with physical or chronic conditions. Results found that participants with a service dog had better psychosocial health including higher social, emotional, and work/school functioning. Within this population, there were weak correlations on outcomes with emotional closeness, dog-owner interaction, and amount of time with the service dog. This publication shows that the benefits of service dogs can extend beyond their specific trained tasks.

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Qualitative Data

Rodriguez, K. E., Bibbo, J., Verdon, S. & O'Haire, M. E. (2020). Mobility and medical service dogs: a qualitative analysis of expectations and experiences. Disability & Rehabilitation: Assistive Technology, 15(5), 499-509.

Summary: This paper focused on open-ended survey responses about benefits and drawbacks of having a service dog. Both individuals with or on the waitlist to receive a service dog were included. Overall participants identified several physical and psychosocial benefits to service dogs including emotional, quality of life, and social. Participants identified dog car, public access/education, lifestyle changes, and dog behavior as drawbacks. There were some differences with the waitlist such as not anticipating public discrimination. Overall this publication shows that there about both positive and negative aspects to having a service dog.

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Family Member Effects

Bibbo, J., Rodriguez, K. E., & O'Haire, M. E. (2019). Impact of Service Dogs on Family Members’ Psychosocial Functioning. American Journal of Occupational Therapy, 73(3), 7303205120p1-7303205120p11.

Summary: Even though a growing body of evidence supports service dogs’ positive psychosocial impact on individuals with a disability, very little is known about the effect of service dogs on the family members with whom they live. This study aimed to measure the impact that a service dog may have on family member functioning. Results found that compared to those on the waitlist, family members who lived with an individual with a service dog had less health-related worry, better overall psychosocial health and better emotional functioning, and better emotional health-related quality of life. Their families also not only had less total family impact from the service dog recipient's disability, but had better family relationships. These findings provide preliminary evidence that service dogs can have family-wide effects on parents and spouses' psychosocial health as well as family functioning.

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Systematic Review

Rodriguez, K. E., Greer, J., Yatcilla, J. K., Beck, A. M., & O'Haire, M. E. (2020). The effects of assistance dogs on psychosocial health and wellbeing: A systematic literature review. PLOS ONE, 15(12), e0243302.

Summary: Beyond the functional tasks that assistance dogs are trained for, there is growing literature describing their benefits on the psychosocial health and wellbeing of their handlers. Our objective was to identify, summarize, and methodologically evaluate studies quantifying the psychosocial effects of assistance dogs for individuals with physical disabilities. Following PRISMA guidelines, a systematic review was conducted that identified 24 articles were (12 publications, 12 theses) containing 27 studies (15 cross-sectional, 12 longitudinal). Studies assessed the effects of mobility (18), hearing (7), guide (4), and medical (2) assistance dog partnerships with an average sample size of N = 83. An analysis of 147 statistical comparisons across the domains of psychological health, quality of life, social health, and vitality found that 68% of comparisons were null, 30% were positive in the hypothesized direction, and 2% were negative. Positive outcomes included significant effects of having an assistance dog on psychological wellbeing, emotional functioning, self-esteem, and vitality.

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