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Therapy, Service, and Emotional Support Dogs

Understanding their training, tasks, and roles.

Key points

  • Credentialed health care providers may include therapy dogs in their medical or psychological interventions.
  • Emotional support animals provide comfort to people with psychiatric disabilities.
  • Service dogs are professionally trained to perform specific tasks which mitigate sensory, developmental, or mobility disabilities.
Elizabeth Ruegg
Source: Elizabeth Ruegg

Working dogs in harnesses, vests, and bandanas are seemingly everywhere. They visit community organizations as therapy dogs; escort their handlers to restaurants, shops, and workplaces as service dogs; and offer comfort to their human companions at home and during travel as emotional support animals. Sometimes, their gear warns: “Don’t touch or distract me!” Sometimes, it invites: “Please pet me!” These conflicting messages can be confusing until you understand their unique roles and responsibilities.

Therapy Dogs in Community Settings

Accompanied by their guardian-handlers (in less enlightened times, we called them “owners”), these sociable, gentle, well-trained canines visit hospitals and nursing homes to bring cheer and enjoyment to patients and staff, drop in at schools and libraries to encourage young learners, and visit colleges to relieve stressed or homesick students. They stroll through busy airports to soothe anxious travelers. They’re deployed at disaster sites to console disaster survivors and in courtrooms to calm testifying witnesses. These friendly visits are facilitated by guardian-handlers who live with, train, and generously volunteer their time with their canine companions. Although they are described as “therapy dogs,” interaction with them is not intended to provide therapy but to offer enjoyment, stimulate social interaction, and reduce stress. These services are typically provided at no charge.

Therapy Dogs in Health Care Services

Sometimes, therapy dogs work in interdisciplinary health care settings. In this clinical specialty, credentialed providers operating within their professional scope of practice include dogs in the treatment process to help patients improve their physical, emotional, cognitive, or social skills. The change process consists of specific goals for change, measurable animal-assisted objectives, and the expectation of client progress toward achieving their treatment goals. This description can apply to any health care provider who includes dogs (or occasionally other animals) in their work. For example, physical therapists may help patients improve their standing balance by instructing them to kick a ball for the dog to retrieve and return. Speech therapists may encourage their patients to practice intelligibility by asking the dog to sit, stay, or come. Occupational therapists may help patients improve their fine motor control by teaching them to grasp a brush and groom the dog’s flank using repetitive, even strokes.

You may also work with a therapy dog at your counselor’s office, participating in animal-assisted activities to help you achieve your treatment goals. Your mental health provider will use the principles of the human-animal bond to facilitate your treatment. For example, the therapist may help you or your child improve sequential planning, concentration, and task persistence by collaborating with you to teach the therapy dog a new trick or skill.

Therapists specializing in animal-assisted psychotherapy typically train and volunteer with their therapy dogs in community settings for months or years before considering them for professional work. This exposure increases the dog’s confidence and range of experience. It also allows the therapist to evaluate the dog’s suitability for the longer days and higher demands of working as a helper in psychotherapy practice. This period of observational assessment is vitally important; not every dog who enjoys working in the community will thrive in the more intense and demanding environment of the professional counseling office.

Emotional Support Animals

Therapy dogs are often invited to visit organizations that are not pet-friendly, such as hospitals and schools, but they do not have any universal legal protections or rights of public access. Emotional support animals, by contrast, are permitted under the Fair Housing Act to reside in no-pet housing and may be allowed to fly in the main cabin of an aircraft with their guardian handlers at no charge, at the discretion of each airline. Beyond housing and transportation, however, emotional support animals do not have public access rights in stores, restaurants, and other places of public accommodation. They may be any species and are not required to have even basic obedience training; they are obliged only to provide comfort to their guardian-handler by virtue of their presence. To qualify for an emotional support animal, the guardian handler must have a psychiatric diagnosis that results in disability and must obtain documentation from a healthcare professional, such as a physician or social worker, attesting to the individual’s need for the animal’s companionship.

Service Dogs

Service dogs are trained to perform specific tasks which mitigate the disability of their guardian-handler. For example, the hearing dog working for a deaf handler alerts to audible signals such as alarms and sirens; the guide dog for the blind leads his handler safely from one place to another, and the mobility support service dog working for a physically challenged handler retrieves items, open or close doors, or push buttons. Service dogs work for people with various disabilities and medical needs, including those with sensory, developmental, mobility, and psychiatric impairments.

Service dogs have special legal protections under the Americans with Disabilities Act, along with nearly universal rights of public access not afforded to companion animals, therapy dogs, or emotional support animals. Service dogs work solely for their guardian-handlers and are expected to ignore environmental distractions while performing their tasks, which is why you may see a harness patch asking you not to distract the dog while it is working. Service dogs must be task-trained to perform at least one skill that meets the specific needs of their guardian handler. Also, like therapy dogs, they must demonstrate advanced obedience so that they do not become a nuisance (for instance, by barking or soiling) in areas of public accommodation.


Now that you know the different tasks and roles of therapy, emotional support, and service dogs, it’s easy to interact appropriately with them. By all means, follow the instructions on the animal’s harness or bandana. If you’re asked not to touch or distract, please don’t; the handler’s life might depend on it. Similarly, even if a therapy dog’s gear invites you to pet, please ask the guardian-handler’s permission first, so they can teach you the best way to approach their dog.

One final tip: All these canine overachievers put in many training hours before they appear at your grandmother’s assisted living home or in your therapist’s office. So, if you’re at your local garden center, lumberyard, playground, or another dog-friendly locale, you might see a young dog or two in a training vest working with an instructor. Feel free to watch, but please don’t interrupt their work unless the trainer specifically asks you to participate in a training exercise.

More from Elizabeth Ruegg DSW, LCSW
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