In 2017, when I was looking for someone to write a guest post for therapists highlighting the difference between service and emotional support animals, Licensed Professional Counselor and Certified Rehabilitation Counselor Kimberly R. Duff offered to step up and take on the task.
Kimberly is particularly well-suited to address this topic because she is a Licensed Professional Counselor who specializes in working with individuals who facing challenges impacted by their own chronic illnesses and/or disabilities.
Today she is joining us to talk about what every therapist needs to know before responding to a client’s request for a letter verifying a need for an emotional support animal.
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A Guest Post by Kimberly R. Duff, LPC, CRC
As therapists, we may be asked to write a letter for a client to obtain an emotional support animal.
This concept may be unfamiliar to the mental health counselor.
Sometimes it is difficult to determine when a client is attempting to take advantage of his or her psychological condition and when this is a legitimate request.
Individuals who are blind or visually impaired are clearly covered by the Americans with Disabilities Act (ADA) and are permitted to bring a guide dog into public places as an accommodation, but what about persons who use an animal for emotional support?
In this post, I examine these questions, explain the difference between emotional support and service animals and also explore the federal laws in the USA that pertain to these animals in the areas of housing, travel, and public accommodation.
I will also provide some guidelines for therapists who are asked to write a letter on behalf of a counseling client with an emotional or other psychiatric disability.
Service Animals
A service animal is an animal that has received special training to help a person with a physical, sensory, cognitive or psychiatric disability.
These animals are protected by Title II and Title III of the ADA.
The work of the service animal must be directly related to the person’s disability; note that a letter from a doctor or other professional does not make the animal a verified service animal.
Examples of service animals include guide dogs, animals that assist persons with a hearing impairment, and animals that provide a signal of an impending seizure to persons with epilepsy.
Service animals are specially trained to help a person with a disability and are protected by the ADA.
Emotional Support / Comfort Animals
An emotional support animal, sometimes known as a comfort animal, may help provide support to an individual by helping mitigate symptoms of depression, relieving loneliness, and / or providing companionship.
Because emotional support animals are not trained to provide a service to a person with a disability, these animals are not covered by Title II and Title III of the ADA.
As a mental health professional, you should consult laws in your specific jurisdiction regarding emotional support animals because they do vary from place to place.
Emotional support animals do not have specialized training and these animals are not protected by the ADA.
Housing Rules Pertaining to Service and Emotional Support Animals
Under the ADA, the owner of a housing facility is required to allow a service animal on the premises.
The owner is not allowed to charge a fee or deposit for the service animal.
Additionally, owners of the housing may be required to allow emotional support animals for persons with psychiatric or other disabilities.
Landlords may require proof of disability and verification that the animal is an emotional support animal.
Travel Laws Pertaining to Service and Emotional Support Animals
Under the ADA, service animals must be allowed to travel with the person with a disability.
The transportation provider may not charge a fee for the animal and the person with a disability is not required to provide prior notice.
Individuals wishing to travel with an emotional support animal on an airplane may be required to provide documentation from a licensed mental health professional stating the person’s mental health diagnosis.
The required statement should explain that the animal is necessary for the person’s mental health functioning or treatment.
The professional should also state that the individual is under his or her care, the professional’s title, state or jurisdiction, and the date of licensure.
Service Animals and Emotional Support Animals in Public Spaces
Verified service animals are covered by the ADA and must be permitted in public spaces such as restaurants and shopping centers.
Emotional support and therapy animals are not protected by the ADA and should not be allowed in public places unless the establishment permits pets or other animals.
The general public (and specifically pet owners) who want to take advantage of the widespread ignorance on this subject may attempt to falsify documents or signage in order to bring their pets into these same public spaces.
For a comical but disturbing account of this phenomenon, check out this article in The New Yorker titled Pets Allowed: Why are Animals Allowed in So Many Places They Shouldn’t Be?
A mental health professional is not qualified to provide documentation for a service animal.
Service animals such as guide dogs complete specialized training programs to be able to assist a person with a disability.
Licensed mental health professionals do possess the qualifications to verify dogs as emotional support animals by verifying that the individual has a psychiatric disability as described by the DSM 5.
The Letter of Verification for Emotional Support Animals
The letter of verification should include:
- The professional’s license, state or jurisdiction of the license
- The date(s) of the license,
- The individual’s clinical diagnosis,
- A statement that the individual is under the care of this professional, and
- That the animal is necessary for the individuals’ functioning/ treatment.
Regulations regarding emotional support animals are often set by individual states and municipalities and can vary greatly from state to state and city to city.
Persons with an emotional support animal are often legally covered by laws pertaining to housing and travel.
They are typically not legally able to take their emotional support animal into public places unless the establishment allows the general public to bring pets.
The individual with an emotional support animal may be required to show a letter of verification to:
- The owner of the apartment or other type of housing and / or
- An airline provider prior to a flight.
When faced with the request to write a letter for client related to emotional support and / or service animals, I would encourage you to check out some of the additional resources below:
- Fact Sheet on Service Animals (ADA Nation Network, 2017)
- Frequently Asked Questions about Service Animals and the ADA (US Department of Justice, July 20, 2015)
- Emotional Support Pet
- Psychiatric Service Dogs & Emotional Support Animals: Access to Public Places & Other Settings
- Service Animals and Emotional Support Animals (Southwest ADA Center, 2014)
And, of course, if I’ve left anything out or you’ve got questions related to emotional support or service animals, I’m happy to talk below!
What experiences have you had in working with service, emotional support, and therapy animals?
[This post was last updated on 07-20-19]
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Kimberly R. Duff, LPC, CRC practices as a Licensed Professional Counselor and a Certified Rehabilitation Counselor in Acworth, Cartersville, and Marietta, Georgia. Kimberly specializes in assisting clients with psychological issues related to disability and chronic illness.
Recently I had a conversation with an acquaintance. She has GAD and asked her counselor write a letter stating that the dog needed to accompany her on her trip, which he did. In actuality she didn’t want to leave her dog with a dog sitter and this was her way to avoid the cost.
Obviously I couldn’t stop her, but I did verbalize that I am highly allergic to dog dander and that others may be also and taking her dog along could cause problems for the other passengers on board. Does the ADA have anyway to demand more through rules regarding the increase of incidents similar to this? Would it help to have a therapist note in the initial paperwork that they are not qualified to support a person with a letter under certain situations?
Lois thank you so much for your comment. It is important to recognize that emotional support animals are not provided protection by the ADA. In problematic circumstances such as where someone has allergies or other concern, a housing or travel provider is not required to permit these animals. I think it would be most beneficial to provide education to the owner of the housing or transportation company about these limits. You also want to be mindful of confidentiality concerns since you don’t want to violate the individual’s trust. Do you think there would be a way to communicate with a housing or transportation provider without breaking confidentiality? Looking forward to your response!
Kimberly, thank you for staying engaged in this discussion! You make a really good point about the benefit of speaking directly with the housing or transportation company – and I hadn’t thought about this at all!
Kimberly, I continue to be grateful for your guest post on this topic.
Two years later this conversation continues as anxiety spreads during the COVID-19 pandemic and more therapists are faced with requests to assess in areas outside of their comfort levels and training, write letters in support of emotional support pets and travel / living needs.
I am also seeing an increase in what appears to me to be profiteering at the expense of naive or misinformed therapists to sign up for ESA-specific income sources or directories like this one – https://www.esaregistration.org/faq/#what-s-the-difference-between-an-emotional-support-animal-esa-and-a-service-dog.
( Most ironic of all is that the “services” are related to no governmental or professional entity related to mental health. I’m not even sure that there is a mental health professional involved in some of these businesses at all. However, the fine print in the one above does note that what the professional is actually signing up for is “updates” related to changes in rules and regulations related to emotional support animals.”)
I hate seeing therapists or the general public being scammed by businesses that simply want to make a buck on other people’s needs and concerns.
Your blog post empowers both mental health professionals and their clients to make more informed decisions.
Excellent article. People, especially counselors need to know the difference and how to reply with any client’s request for such a letter. I am all in favor of the use of animals for emotional support, but I see it being abused all over the place, and I wish there were tighter laws to protect the general health and safety of patrons in all areas. I myself, for example, have severe asthma. Most poeple who have service dogs, are already committed to doing appropriate groooming, especially when going into smaller, more restrictive areas. I am in the process of training my Golden Retriever to be a “Certified Therapy Dog”, so I can bring her into hospital settings, schools, etc. SHe is receiveing very intense training, and most places require that the dog be thoroughly shampooed and groomed before ever stepping foot into a public place. I am a cancer survivor, and Pet therapy was GREAT! But, there needs to be clearer delineations/and certifications that indicate they are ABLE to respond to voice commands, that they have shown that even in situations wher there are loud noises, distractions, that they are able to stay in control. Your article/blog was fantastic, and I will be using your references to help others, clients, and colleagues alike. Great job!
Thanks, Mary, for joining the conversation here! I hadn’t even thought about the need for grooming or the need for the animal to respond to voice commands.
Mary, good point about the importance of grooming and training. Service dogs are a big responsibility. They follow commands and work for their owners because of the bond with the owner. My husband had a new guide dog (he is blind) In 2012 that he received around the time of my daughter’s birth. He was unable to bond properly with the dog because of our new baby and the dog had to be returned to be retrained for another user. I had developed asthma, and this surprisingly disappeared after the dog was returned.
Check out Attorney Julie Jacobs’ article Can You Write Me a Letter for an Assistance Animal? – Why Therapists Should Proceed with Caution – http://julieajacobspc.com/resources
Hi, Kimberly! I was sharing your post here on Facebook when a therapist, Becky Stone, took issue with a couple of things you had written.
Would you care to comment, clarify or revise anything you’ve said?
Here is what she said:
“Thanks for sharing, Tamara Suttle! I’m glad to see that others are also educating providers about ESAs.
Overall, this is helpful information. There are a couple of inaccuracies in the article I wanted to share so they may be edited. I considered PMing them, but I wanted to post here so anyone that’s already read the article can get the info for clarification, too.
The article notes that Service Animals are required to have documentation per the ADA, which is not accurate in most circumstances. Documentation cannot be required except, however, under the ACAA, psychiatric service animals may be required to furnish documentation for flights.
Additionally, it states that prior notice of flying with an ESA is not required earlier in the article, and in the bullet points states that it is required (correct) down below. Airlines topically require the passenger to provide 48hr advance notice, including the submission of any required documentation, as well as in-person check-in with the animal at the gate amongst other expectations.
References:
https://www.ada.gov/regs2010/service_animal_qa.html#cert
https://www.transportation.gov/…/service-animals…)
Feel free to PM me if there are any questions.”
I was wondering if you know of any CEU training for therapist that address this topic?
Heather, I love that you asked this question! Dr. Cynthia Kay Chandler at the University of North Texas in Denton is one provider of such training – https://coe.unt.edu/consortium-animal-assisted-therapy. She was one of the first I ever heard speak to this need for training. She’s been doing this work for at least 20 years and is worth taking a look at.
Hello. I am a LCSW in in private practice in the LA area. I am in support of clients with mental health disorders. But I am wondering about the guidelines around writing a letter for a client who does yet have a dog and wants to go get a rescue. Would I be liable if the get a dog that ends up having behavioral issues or ends up biting someone, by writing a letter for them to have it ?
Oh, Valerie! Thank you for asking this question!
I am not an attorney and do not want to offer legal advice; however, my understanding is that “yes, you could be liable for making any recommendation concerning the needs of the client OR the appropriateness (or not) of a dog.
According to Attorney Julie Jacobs, “mental health professionals rarely have sufficient information to make a determination whether or a client has a disability or of the disability-related need for an assistance animal.”
Those types of assessments need to be made by a qualified evaluator instead.
And, since you are asking about making a recommendation about a particular do rather than a client’s actual need, you can assume that the same would be true i.e. only a qualified evaluator of dog behaviors would be able to make a recommendation of that nature.
Both of these would typically fall outside a mental health professional’s scope of practice.
Hey:
Thank you for the post. I have a client requesting ESA and I do not want to write it. She emailed me about it for an upcoming trip and has never mentioned it before to me. I’m also against my beliefs as a person that flies on airplanes. I think the ESA thing has gone too far and I do not want to contribute to it but I also do not want to ruin the great rapport I have with my client.
Thank you,
Kelly
🙂 You are so welcome!
“. . . beyond the scope of practice . . . .”
“. . . not trained to offer this type of evaluation . . . . ”
“. . . dual relationship . . . .”
” . . . need to protect our professional counseling relationship . . . .”
This is language that might be of use to you in this situation.
Thank you, Kelly, for taking the time to let me know your situation and that you find this helpful to you!
Hi, I still feel unclear. In working with a client experiencing PTSD, I have seen a clear reduction in symptoms when my dog is present for our sessions. I do feel qualified to make that assess because of my expertise in trauma. This client would like to get a dog and my assessment is that it would be quiet beneficial for treatment. In writing a letter (say if there is an issue with housing at some point), I take liability for the animal itself?
Selina, I’m not sure I am understanding what you are asking.
Can you ask it differently?
What I do understand is that because you feel competent to provide a trauma assessment, you also feel qualified to assess needs for service and emotional support animals.
I believe that the law might equate this to being the equivalent of being trained to fly and airplane and then believe you are trained to drive a bus.
If you would like to provide an assessment and subsequent documentation of this nature, I would urge you to first seek out the training required to do so – to protect both you and your client.