Emotional Support Animal (ESA) vs. Service Dog: What is the Difference?

Many people love to have a furry companion, humankind’s best friend.  Scientific research validates emotional support dogs are healers and discovered pets have reduced stress and depression, and other mental health conditions.  But if you’re not a dog lover, any animal, species, or breed that meets the qualifications can be an emotional support animal.  Some known emotional support animals (ESA) are dogs, cats, ferrets, snakes, rabbits, horses, pigs, etc.  However, dogs are the most common choice.   The animal can qualify if it helps support the individual’s emotional condition through the legal guidelines.  A licensed mental health clinican must agree that the animal helps the individual cope with their mental health condition.  

Often there is confusion on an ESA and a service animal.  Their purposes are quite different.  

Service animals are more in need of physical help.  Services animals are classified by the Americans with Disability Act (ADA).  Service animals are generally dogs.  Their training is specific to help with specific physical tasks to help people with disabilities.  Disabilities include physical, sensory, intellectual, psychiatric, and other mental health disabilities.  The work they do is specific to the disability.  Some examples of the work performed by a service animal are guide dogs for the blind or hearing “signal” dogs alert a deaf person of sounds, such as a doorbell or a person entering the room.  Psychiatric dogs are trained to help lessen the effects of a psychiatric occurrence.  They also can assist those in a wheelchair by opening doors, fetching things for the individual, and carrying items.  Autism assistance dogs help those on the spectrum with sensory signals like a smoke alarm or car alarm.  They can also alert their handler of overstimulation or recurring behaviors.  Service dogs are trained to recognize seizures and stand by their handler’s side during an episode.  

Now, emotional support animals are behaviorally trained geared for the specific owner and not to perform tasks or duties.  The training is the main difference.  Through positive interaction, they are considered companion animals to support those with mental health conditions, like anxiety, bipolar disorder, depression, loneliness, and phobias.  To have a licensed ESA, a licensed mental health clinician must prescribe an ESA and consider it a valuable therapeutic strategy for healing.  More so, dogs undertake a behavioral examination that includes role-playing animal-assisted therapy sessions introducing various mental health disorders.  Every dog’s assessment is based on their reliability, predictability, controllability of their social behavior, and no evidence of unjustifiable stimuli that can harm a patient’s welfare.  The clinician is highly perceptive to the patient’s safety and the dog themselves.  Dogs with the ability to cope with stressful situations, nurturing, awareness, and intuition are excellent candidates and meet the behavioral prerequisites.

Emotional support animals (ESA) offer many psychological benefits.  They can help minimize various mental health disorders; social, emotional, behavioral, psychiatric disorders, and physical illnesses with direct interaction.  For example, by simply stroking an ESA, the brain releases serotonin, prolactin, and oxytocin.  These are all hormones that elevate moods.  An ESA provides soothing support and is recognized as sixth sense when needed.  They are unique therapeutic animals who respond intuitively in crisis or during active mental health disorder symptoms.  Physical contact elevates the feeling of loneliness and isolation.  Cuddling, stroking, talking to an ESAs produces physical warmth companionship and opens the door to better communication.

Social relationships are essential to child and adolescent development throughout their life.  Evidence prevails ESA’s therapeutic benefit for children/adolescents emotional, behavioral, cognitive, educational, and social developmental.  The connection is evident in increased social competence, social networks, social interaction, and social play behavior.

The benefits don’t stop here.  ESAs are a favorable intervention to improve an individual’s physical health.  The positive impact on physical health derives from epidemiological studies.  The exchange between a person and an ESA lowers blood pressure, lowers breathing rate, lessens physical pain, and in some cases reduces the amount of medication needed.  They provide a catalyst for physical fitness through exercise.  Through animal-assisted therapy with dogs can motivate enhanced biological activity.  At Gateway to Solutions, we offer animal-assisted therapy for many clients.  Meet our CUTE emotional support dog Jaxxi.  Jaxxi is a hypoallergenic cockapoo.  She brings so much love and peace to our clients.  

Those interested in having an ESA or a service animal should be aware of the laws.  ESAs are protected by Fair Housing Act (FHA) which stipulates landlords cannot refuse to accept you for your rental accommodations.  Establishments like businesses, public buildings, libraries, restaurants, courthouses are not required to allow the ESAs to enter the location.  However, if it is wearing an emotional support vest, ID badges, collars, or the approved paperwork is readily available, the establishment may allow the animal to accompany you.  But again, they are not required.

Service animals have full public access rights to enter many establishments like businesses, public buildings, libraries, restaurants, courthouses, and other public places even when their general policy does not permit animals.  They are also allowed on airplanes and other transportation.  However, each airline has its own rules.  A service animal has a legal right to be always with you.

If you are interested in getting an ESA, here are some steps to take: 

  1. A mental health clinician must determine that an ESA will benefit those who suffer from anxiety and panic attacks, major depression, bipolar disorder, PTSD, phobias, and loneliness. 
  1. A licensed mental health clinician must prescribe and agree an ESA is essential to help aid their patients’ mental health condition.  There are many third-party sites you can register your ESA.  You will need an official diagnosis from the provider, although this does not need to be specified in the letter.  A letter from your licensed mental health provider stating the patient is under the clinician’s care with ongoing treatment for a condition that limits and or prevents the patient from daily life functioning.  Also included is the recommendation an ESA is necessary to alleviate the individual’s mental health disorder symptoms and the clinician’s professional license information and signature.  The licensed mental health provider must treat the patient in the state in which the patient lives.  You must renew your certification annually.  Pricing varies; I have seen it range from $69 to over $150, depending on the packages offered.  Pricing for a service dog is quite similar.  
  1. The following questions are most common when completing the application process or the evaluation from the therapist:
  • Have you experienced any significant changes in your mood in the past six months?
  • What mental health concerns would the ESA assist you with? 
  • Indicate if you have experienced any following symptoms in the past six months.  EX: difficulty focusing, irritability, fatigue, restlessness, depressed mood, elated mood, lack of motivation, weight changes, feelings of worthlessness, isolation, difficulties in activities, missing work, or school, etc.  
  • Frequency of those symptoms in the last 90 days.
  • Do you have feelings of sadness or depression?  For how long during the day?
  • Feelings of Anxiety?  For how long during the day? 
  • Do these symptoms impair your ability to function daily?

The proof required would be the letter from the licensed healthcare provider.

An ESA does not require “specific” training.  You can train your ESA on your own or hire a professional behavioral dog trainer.  The ESA’s behavior must help benefit the individual and alleviate the mental health symptoms.  The ESA must be calm, affectionate, obedient, house-broken, and non-aggressive.   Also, the ESA’s energy must be positive and calming, not overly stimulated.

It all sounds easy peezy, but beware, there has been questioning the validity of an ESA for some time.  Much controversy is on the animal owners getting online certifications with minimal to no psychiatric treatment for housing and airline travel.  If there is a fraudulent ESA, it can pose a risk to passengers, neighbors, roommates, etc.  Such as allergic reactions, public health, workplace safety, aggressive behavior, sanitary concerns, property damage, and even emotional distress for phobic aversions to animals.  The Guardian shares its story on the number of fake emotional support dogs exploding and how people are taking advantage of this privilege for their convenience.  

The requirements for an ESA are not as formal as a service dog.  The importance of professional and ethical ESA certifications and legitimacy of the mental health field is sustained when the evaluation for an ESA applies to the same professional standards used in healthcare.  If these standards and proper assessments are not upheld, the clinician increases the risk to others in the home, workplace, or public spaces.  

Gateway to Solutions’ Jaxxi is an excellent asset to our clients.  To learn more about the benefits of an ESA, check out my blog on “The Benefits of a Therapy Dog.”  

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