When we adopted Gracie from Russia at 19 months old, we knew the potential existed for a variety of post-institutional issues. We plugged in with excellent therapists within a year of coming home and began working on her symptoms of attachment disorder, mild markers for fetal alcohol exposure, and general anxiety. We were relieved to discover she was overall very responsive to intervention, but finding a way to reduce her anxiety remained elusive. Over the years, we watched our little girl become more and more anxious until drug therapy was suggested as a last resort. Gracie's issues were so complex and severe that we were eventually referred to a developmental pediatrician who began digging more deeply into Gracie's issues.

A sleep study revealed four separate (but likely related) sleep disorders. The results were so severe we began working with a pediatric neurologist who specialized in sleep disorders in children. A variety of medications were tried over the next few months but nothing improved her sleep. And worse, the medications fueled a downward spiral that eventually landed us in a psychiatrist's office with a child in crisis.

Our developmental pediatrician was the first to suggest an emotional service dog might be a good strategy for helping Gracie deal with her anxiety and depression. At the time it seemed an unlikely solution, but when the psychiatrist told us that hospitalizing our 8 year old was all she could think to try next, I knew I needed to find another option. We took Gracie out of an institution at 19 months old. I could not bear the idea of placing her back in one. Suddenly, the doctor's unusual suggestion was more viable. While we investigated other alternative approaches, I also began researching how to find the right dog for my child.

Important Definitions

Much has been reported about the use of animals in service capacities. There are several important terms that need to be defined in order to fully understand this discussion. According to www.servicedogcentral.com, "Service dogs are individually trained to perform tasks that mitigate the disability of their owner. There are many types of service dogs and many different types of tasks that might be performed, based on the disability of the individual owner, their abilities and limitations, and their specific needs." Typically, we would not be talking about a service dog for a post-institutionalized child, unless the psychiatric needs were so severe a legal argument could be made that the presence of the dog is required for basic level functioning. Contrast that with "therapy animals," which have no legal definition. They are most often animals who are pets first, but also provide support services such as visiting hospitals or nursing homes or even in schools or libraries as "reading buddies" for children.

Recently, a third distinction has developed: Emotional Support Animal (ESA). An ESA is a therapeutic pet, usually prescribed by a therapist or psychiatrist or medical doctor that helps people with emotional difficulties or loneliness. An ESA cannot go everywhere a service animal goes, but usually does have privileges in rental housing and may travel in the cabin of aircraft.

Finding the Right Dog

Through personal contacts in the dog training community, we were able to match Gracie with Bandit, an 8 year old Australian Shepherd from Windypine Kennels in Florida. Although he was an older dog, Bandit was selected for his even temperament and history as a therapy dog. For Gracie, it was crucial her dog not match her anxious energy, but rather provide the balancing neutral energy she needed to facilitate the de-escalation of her emotional state. Bandit was trained by Aimee Kincaid of Boomerang Kennels in Florida. In addition to basic obedience training, he was evaluated in a variety of social situations with children. His temperament was tested to better predict his reaction in the presence of anxious, loud, and unbalanced behavior from children. But the connection Bandit and Gracie had from the beginning was not something the trainer could create.

Shawna Swanson is a trainer with the Soldier's Best Friend project, a non-profit which connects soldiers with Post Traumatic Stress Disorder (PTSD) and emotional support dogs. She makes this important point: "the bond between the dog and human is nothing that can be trained. It's a relationship that has to form. In the case of emotional support dogs, that bond, which is crucial to the success of the partnership, is not guaranteed to exist with every dog. It may take trying several different dogs before the magic happens."

We were prepared for the reality that Bandit may not have been the right dog. Aimee, Bandit's trainer, flew Bandit to us from Florida and stayed several days to work with Gracie and Bandit together. Amazingly, Bandit knew his job almost immediately. The very next afternoon Gracie suffered an anxiety attack. The trainer put Bandit on the sofa beside Gracie. Through her hysterical tears, she felt Bandit lovingly place a paw on her leg. That touch caused her to shift her focus and attention to the dog. As she met his gaze, we watched her anxiety begin to dissipate. Bandit's behavior was not trained-it was instinctive. The adults in the room looked at each other with teary wonderment and knew this relationship was going to be something special.

Clear Expectations

While Bandit's positive influence in Gracie's life is undeniable, it is important to understand an emotional support animal is not necessarily the best option for all families. The reality is every animal has the potential to behave in unexpected, unpredictable ways-especially around children. Adding an emotional support dog to the family is a huge commitment of time and resources. We have had to continue Bandit's training in order to refine his responses to Gracie and to make sure his behavior remains socially acceptable. For instance, we noticed he was too sensitive to unbalanced behavior around Gracie and would take a protective stance even when she was playing. We had to condition him that things like swinging or running and squealing with friends did not indicate Gracie was in distress. Bandit's breed and bloodline make him highly responsive to training and he learns quickly, but it is still an on-going process.

Moving Forward with Caution

If you are thinking an ESA might be a good option for your family, it is important to do your research and carefully weigh the pros and cons of this approach. Because there isn't one way to go about this, it will require you find a reputable local trainer, preferably with some history training ESAs and/or service animals. Be prepared to interview trainers and find one with whom you have good rapport and who understands and respects your needs. You will likely have an on-going relationship with this person so it needs to be the right fit from the outset. You will also want to consider if you are willing to try a rescue, an adult pure-bred, or a puppy. They each have benefits and draw-backs and every family will have to decide what works best for them. It is crucial you don't make an impulsive decision, running to the nearest shelter or litter of puppies and choosing an animal that seems like it may work. This decision must be carefully thought out and strategically implemented together with your trainer. And remember even then, you must be willing to accept the first choice may not be the best.

Exciting Results

Gracie and Bandit continue to enjoy an amazing bond. Gracie is no longer on any medication for anxiety or depression and is learning to apply the strategies she is learning in therapy to take more control over her emotional state. Her sleep issues have been resolved and it appears her healing is underway. Bandit is her emotional support, homework helper, reading buddy, confidant, and companion. Bandit is a dog who loves his job and loves his girl. While there is no guarantee the results we have experienced will be experienced by all, watching them together reminds us of the power that exists in an unconditional, judgment-free, loving relationship. Among many lessons, this experience has taught us medication is just one modality for dealing with our child's post-institutional issues. Using ESAs to support a child's mental and emotional health is still a relatively new concept and so far has not been widely studied. However, research in other settings reveals animals to have a positive influence on blood pressure, anxiety, and overall health. This, coupled with what we know from anecdotal evidence supports the idea that ESAs could be an effective tool for parents who are struggling to address their child's emotional difficulties.

For More Information

http://www.4pawsforability.org/ This organization specifically trains dogs for a variety of disabilities, including children with emotional disabilities. They are the national leaders in placing dogs for autism and other specialty training. Their site has a wealth of information that can be helpful, even if not going through their organization for your animal.

http://www.servicedogcentral.com This site is a clearinghouse for many topics related to this discussion. This is a good place to start to basic definitions, legal definitions and implications, as well as trainer recommendations.

http://www.iaadp.org/psd_tasks.html This article clearly defines the tasks a dog would be trained to do in the case of seeking a psychiatric service dog distinction. This thorough document helps to differentiate the tasks ESAs perform versus a true service dog.