Service Dog Pilot Study

Q1. What is a mental health service dog?

Mental Health Service Dogs (hereinafter referred to as service dogs) are extensively trained to respond precisely to specific disabilities of their owners, and are typically allowed entry into public facilities (including public transit). Service dogs attend to individuals with mental health diagnoses such as post-traumatic stress disorder (PTSD), panic and anxiety disorders, depression, etc. Service Dogs are trained to detect and intervene when their handler is anxious; contribute to a feeling of safety for their handler; and promote a sense of relaxation and socialization for their handler.

Q2. What is VAC doing about the interest in service dogs?

There is great interest in using service dogs to assist Veterans with mental health conditions. However, research is needed to evaluate the use of service dogs as a safe and effective support for Veterans with PTSD.

This pilot study will fulfill the requirement of the Veterans Affairs Canada Suicide Prevention Strategy Action Plan item 7.11, (part of the Canadian Armed Forces and VAC Joint Suicide Prevention Strategy) to increase knowledge of the role of service dogs in helping Veterans with a mental health condition through studying the impact of service dogs on Veterans with PTSD.

Q3. How can a Veteran obtain a service dog?

Service dogs are provided by service dog organizations. VAC does not currently pay for or provide service dogs to Veterans.

Q4. What is the status of the pilot study?

The research team, led by Dr. Claude Vincent of Laval University, has been working on the project since the summer of 2015. Due to the unforeseeable recruitment and retention issues, the Phase Two Final Results report is not anticipated to be complete until July 2018. To date, the research team has completed a Phase One Interim Findings report. As noted, in July 2018, a Phase Two Final Results report is expected to be completed, which will further examine findings from Phase One and assess other measures of effectiveness.

Q5. What are the key findings from the pilot study’s Phase One Interim Findings report?

Key findings from the Phase One Interim Findings report include:

  • Part of this pilot study includes monitoring 21 Veterans with PTSD before and after they are paired with a service dog. For this Phase One Interim Findings report, there are results available for 18 of the total 21 Veterans being monitored. For these 18 Veterans, service dogs have had a positive impact on the Veterans’ PTSD and depressive symptoms, quality of life domains, mobility in their neighborhood, and sleep - six months after receipt of their service dog. Longer term results for these 18 Veterans and results for the other three remaining Veterans who entered the study a later date will be included in the Phase Two Final Results report.
  • For a separate group of 10 Veterans who have been using a service dog for between two and four years, interviews with these Veterans identified: potential service dog roles and tasks, advantages and obstacles of having a service dog, and recommendations for potential service dog programs.
  • Effective communication between service dog training schools and Veterans is key for Veterans to obtain and maintain a service dog.
  • High standards should be used in the dogs’ behavioral tests. A calm and obedient dog is very important.
  • Interviews with 22 stakeholders identified four roles and tasks of service dogs (detection and intervention when the Veteran is anxious, contributing to a feeling of safety, a sense of relaxation and socialization), two major undesirable events that can occur with the service dog (public access and stigmatization), and nine potential positive impacts of service dogs.

Some important considerations for this pilot study (Phase One and Phase Two) are as follows:

  1. The pilot study does not address:
    • The effect of a service dog in comparison to a companion dog, emotional support dog, or even a simple pet;
    • Which dog breeds are more effective at performing the duties of a service dog; and
    • If and how service dogs impact and interact with existing evidence-based treatments (medical, psychotherapies, etc.).
  2. Not all dogs can be effective service dogs, especially if the history of the dog is unknown or problematic (e.g. the dog has experienced an abusive history, health issues).

For further details of these findings, please see below or contact the VAC Research Directorate at VAC.Research-Recherche.ACC@vac-acc.gc.ca

Q6. What is expected to be included in the pilot study’s Phase Two Final Results Report?

The pilot study’s Phase Two Final Results Report is expected to be completed in July 2018 and provide the following:

  • For the 21 Veterans being monitored, the impact service dogs have had on Veterans’ medication usage, psychosocial health, physical activity, and life space assessments. These impacts will be measured at various time intervals, before and after the Veterans’ receipt of their service dog.
  • As referenced above, the report will also provide findings on the impact service dogs have had on various Phase One report measurements over a longer term for the 21 Veterans. These measures include PTSD, depression, quality of life domains, mobility in their neighborhood, and sleep.
  • The report will also include findings on the impact service dogs have on caregivers, based on assessments completed at various time intervals before and after the Veterans’ receipt of a service dog.

Q7. How does the pilot study work?

The pilot study focuses on determining how service dogs may assist Veterans with PTSD. The study is following two groups of Veterans. The first group includes 21 Veterans paired with a service dog and monitored for approximately 18 months. The second group involves interviewing a group of ten Veterans who have had their service dog between two and four years.

Q8. Why are there two study groups?

The two groups allow the researchers to examine the impact receiving a service dog has on Veterans as well as any additional impacts based on having a service dog for a number of years.

Q9. Will Veterans who participate in the pilot study receive financial reimbursement?

Veterans paired with a service dog during the pilot will be reimbursed up to $1,500 a year to cover the cost of food, grooming and veterinary care for the dog for the duration of the pilot study. In addition, participants will be reimbursed for travel expenses related to obtaining the dog and becoming orientated to the use of the service dog.

The Veterans (who have had a service dog between two and four years) interviewed by the research team will be paid an honorarium for their interview.

Q10. Why does the pilot project only involve Veterans with PTSD?

To date, most of the interest expressed by Veterans, service dog organizations and the public has focused on using service dogs for assisting Veterans with PTSD. Additionally, PTSD is one of the more common mental health conditions of the Veteran population. To ensure that the findings are useful, it is best to focus on one mental health condition.

Q11. What happens to the dogs after the pilot project ends?

The dog will remain with the Veteran, if the dog is a suitable match with the Veteran.

Q12. I am a Veteran who has a service dog. Will I be reimbursed for my expenses?

At this time, only Veterans who are part of the pilot project will be reimbursed.

Q13. How can I get chosen to participate? Can I submit my name as a volunteer or a participant for the study?

The recruitment process is now complete.

Q14. If a Veteran is not chosen for the pilot study or is not interested in participating in the pilot, what are his or her options for getting a service dog?

The Veteran should contact their nearest service dog organization. If the service dog organization determines that the Veteran is a good candidate for a service dog, the organization may put them on a placement list. VAC does not pay for or provide service dogs to Veterans.

Q15. What is the end date for reimbursement of food, grooming and veterinary care for Veterans participating in the Service Dog Pilot?

December 31, 2018. Receipts dated after this date will not be reimbursed.

National Standards for Service Dogs

Q16. Will Veterans Affairs Canada continue to work on service dog standards?

We are committed to ensuring Veterans have access to the supports and resources they need for their mental health and overall well-being. While there was no consensus on a National Standard for all service dogs, we will be moving forward with a standard specifically for psychiatric service dogs.

Following the technical committee’s broad consultations and input, and a review of standards internationally, we’re working to put in place standards, rapidly, so that Veterans have access to properly trained psychiatric service dogs.

Q17. What will happen to the information that was collected through the CGSB technical committee?

The hard work of the Veterans and stakeholders advocating for the best standards for psychiatric service dogs on this technical committee has proven extremely valuable and we will continue to work alongside them as we move forward.

Q18. What does this mean for the pilot study?

This will have no impact on the current pilot study on the efficacy of psychiatric service dogs. The research team, led by Dr. Claude Vincent of Laval University, has been working on the project since the summer of 2015. The first phase of the study offered positive findings, which is why we moved forward in Budget 2018 with a tax credit for psychiatric service dogs. We remain on track for the findings from final phase to be completed this summer.

Q19. When will VAC have service dogs standards in place?

We are committed to ensuring Veterans have access to the supports and resources they need for their mental health and overall well-being. While there was no consensus on a National Standard for all service dogs; we are committed to moving forward with a standard specifically for psychiatric service dogs. Following the technical committee’s broad consultations and input, and a review of standards internationally, we’re working to put in place standards, rapidly, so that Veterans have access to properly trained psychiatric service dogs.

Q20. What are the next steps that VAC will be taking for service dogs?

Once the pilot study is complete, VAC will review the findings of the study to determine next steps.

Detailed Research Summary

What are some of the detailed findings of the Phase One Interim Findings report? 

A. Prior to this pilot study, the research team engaged in consultations to identify factors to consider when designing this pilot. The main objective of these consultations was to propose a logic model (for clinicians) that examines how service dogs assist veterans with post-traumatic stress disorder (PTSD) and concerns related to service dogs. The consultations consisted of phone interviews with 22 individuals consisting of dog trainers, Veteran advocates, Veterans, and three medical doctors. The logic model proposed some of the following variables:

Reported Efficacy

  • Detection, prevention, and control of crises and nightmares;

  • Improved sleep and moods;

  • Better concentration;

  • An offset in hyper-vigilance;

  • Increases in self-confidence, the number of visits to public places and social participation; and

  • Decreases in medication usage.

Undesirable Events

  • Difficulty access public places; and

  • Stigmatization associated with having a service dog for a mental health condition.

Details on the other variables identified in the logic model are included in a published scientific journal found HERE

B. For 18 Veterans with follow up assessments six months after receipt of service dog, Veterans generally experienced:

  • Decreases in several PTSD symptoms;

  • Increases in quality of life domains;

  • Increased mobility in their neighborhood;

  • Increases in sleep quality and efficiency; and

  • Decreases in depressive symptoms.

These measures will be assessed for another six months and are expected to be reported as part of the Phase Two Final Results report.

C. A case series study was completed with ten Veterans who had experience owning a service dog for at least two years. The following four main themes were noted in interviews with these Veterans:

  1. Service dog’s roles and tasks (8 subthemes, e.g. acting as a socializing agent, maintaining an appropriate free space around the veteran);
  2. Personal advantages and environmental impacts (8 subthemes, e.g. alleviating symptoms; increasing outings and physical activities, enabling social interactions and relationship building);

  3. Obstacles (4 subthemes, e.g. high costs of dog maintenance, dog’s presence attracted unwanted public attention, prompting intrusive questions); and

  4. Recommendations for psychiatric service dog’s programs (16 subthemes, e.g. creating a national registry for service dogs, encouraging mental health practitioners’ involvement).

Conclusions and Implications for Practice: The case series study offers insights into how service dogs assist their handlers and help address PTSD chronicity. It presents the roles health professionals may play when dealing with patients using service dogs for PTSD. The proposed conceptual framework can be useful to policy makers, dog trainers and caregivers. Detailed results from these interviews will be published in a scientific journal at a later date.

D. Other Findings

  • Effective communication between dog training schools and Veterans is critical for the Veteran to obtain and maintain a service dog;

  • Veterans were more likely to keep a service dog provided by training schools with effective communication and program management resources; and

  • Behavioral tests should be done with all dogs prior to the start of their service dog training;

The pilot study’s Phase Two Final Results Report is expected to be completed in July 2018 and provide the following:

  1. For 21 Veterans, the results of:
    • Usage of various medications measured three months before receipt of service dog, at receipt of service dog, three months after receipt of service dog, six months after receipt of service dog, nine months after receipt of service dog and 12 months after receipt of service dog.
    • Psychosocial impacts measured at six months after receipt of service dog and nine months after receipt of service dog;
    • Physical activity and quality of sleep measured three months before receipt of service dog and nine months after receipt of service dog;
    • Life space assessments (mobility areas : 1-inside home, 2-around home, 3-neighborhood, 4-in town, 5-outside town) measured at nine months after receipt of service dog and 12 months after receipt of service dog to determine the impact a service dog has had for Veterans’ social integration in the community and comfort in public and commercial places; and
    • Other measures previously noted (PTSD, depression, and quality of life) assessed at   nine months after receipt of service dog and 12 months after receipt of service dog.
  2. The impact service dogs have on caregivers, based on assessments completed at the following time intervals: three months before receipt of service dog, three months after receipt of service dog, and six months after receipt of service dog.
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