Assistance Dogs: Emotional Support


Emotional support dogs are recognized by the ADA and defined by the Fair Housing Act as dogs providing therapeutic support to disabled individuals by providing companionship, relieving loneliness, and “sometimes help with depression, anxiety and certain phobias” but are not specially trained to perform specific tasks.17,22 More specifically, an emotional support dog may help its owner to cope with conditions such as worry, mood swings, obsessive compulsive disorder, panic attacks, and irritability. An emotional support dog must be housebroken and obedient but requires no specialized training. Dogs used strictly for emotional support are not recognized as service animals, which are required to be trained.


Emotional support dogs have no restrictions on breed, size, or weight and can be any dog that alleviates symptoms of emotional or mental stress.

Relevant Information for Practitioners

Emotional support dogs should not exhibit disturbing behavior such as aggression or excessive barking. Generally, ESAs have the same public access restrictions as pets.4,15,17,23 According to a recent Department of Transportation ruling,24 ESAs are not considered service animals and airlines are not required to permit them to travel in the cabin. Although ESAs are recognized by the ADA, considerable controversy, confusion, and misinformation exist regarding these dogs because of the lack of a validated, universally recognized certification process. Additionally, an ESA requires a human health provider’s prescription and there is currently substantial confusion within the human health community on indications for and the process of evaluating appropriate dogs. Finally, “counterfeit” certifications are easy to obtain by pet owners who want to bring their pet with theminto situations typically reserved for service or assistance dogs, thereby “cheapening” the designation.25

Despite these ambiguities, the goal for the medical management of an emotional support dog is to focus on the canine standard of care, with an emphasis on preventive healthcare, prevention of infectious disease including zoonotic diseases, and ensuring the dog’s general welfare.26 Behavioral recommendations should focus on training consistent with the emotional support dog’s role and ensuring that the dog has a stable temperament.

These guidelines are supported by generous educational grants from the AAHA Foundation,
Boehringer Ingelheim Animal Health USA Inc., CareCredit, Merck Animal Health, and Zoetis.