Abstract

The purpose of this literature review is to present the benefits of using service dogs to treat military veterans who suffer from PTSD or PTSD-related symptoms. Due to the limited forms of treatment for PTSD and the introduction of service dogs, medical professions are beginning to use service dogs more frequently. The effectiveness of using service dogs is tested by assessing its effects on quality of life, involvement in daily activities, stress levels, panic attacks, depression levels, sleep patterns, and overall happiness of military veterans who suffer from PTSD. This is tested through the usage of self-reporting questionnaires and in-depth interviews between participants and researchers. The specific types of tasks that dogs are trained to perform are described in order to analyze how their interactions with the veterans cause an improvement in the mental health of military veterans.

Notes

Introduction

Some military veterans return from war with injuries. However, not all of these injuries are physical because some are psychological and the most common is PTSD, post-traumatic stress disorder. Post-traumatic stress disorder is a psychological disorder that is triggered by stressors and trauma (Ohaire et al. 2018). It affects around 6.8% of the general population and affects the quality of life and everyday activities (Kessler et al. 2005 as cited in Kloep et al. 2017). PTSD affects sleep, relationships, and mental health. (American Psychiatric Association 2013 as cited in Kloep et al. 2017). PTSD affects around 10.1% to 30% of military veterans (Gradus 2014 as cited in Kloep et al. 2017). Post-traumatic stress disorder is a large issue because it can lead to other psychological or behavioral problems, such as depression, alcohol and substance abuse, and suicidal behavior (Grieger et al. 2006; Jacobson et al. 2008; Kemp & Bossarte 2013, as cited in Ohaire et al. 2018). There is a lack of successful treatment options for military veterans who are suffering from PTSD. Military veterans do not seek treatment themselves because of the amount of stigma surrounding mental health issues in military veterans (Greene-Shortridge 2007 as cited in Yarborough et al. 2017). There have been multiple forms of treatment found, whether drugs or therapy, but researchers are still unsure of their effectiveness. The lack of data is due to dropouts from the programs or poor treatment response (Foa et al. 2009 as cited in Kloep et al. 2017). A new treatment that addresses these problems and encourages the patient to remain involved is needed and this treatment is the use of trained service dogs (Ouimette 2001; Pietrzack et al. 2009; Hoge et al. 2014, as cited in Ohaire et al. 2018).

Despite these improvements, there is still a lack of research on whether or not service dogs are an effective form of treatment and should be used for PTSD and PTSD-related treatments. This literature review focuses on the benefits of using service dogs, type of services they offer, and overall effectiveness of service dogs in PTSD and PTSD-related symptoms. Service dogs are a sufficient form of treatment for military veterans suffering from PTSD and PTSD-related symptoms because of the various tasks they perform to improve their health.

Health benefits of Using Service Dogs

Researchers tested for the types of benefits that service dogs provide by either having military veterans self-report their improvements or conducting interviews. Participants were given questionnaires or were interviewed about their symptoms, quality of life, involvement in daily activities, stress levels, panic attacks, depression levels, sleep patterns, and overall happiness (Kloep et al. 2017; Yarborough et al. 2017; Ohaire et al. 2018). The questionnaires provided by Yarborough (2017) were distributed among 78 military veterans; 54 of these were veterans who were on a waitlist to receive a service dog and 24 were veterans who had already received a service dog. The military veterans self-reported their experiences in the various categories and the data from both groups was compared. The purpose of having two different groups was to compare the overall health of the veterans in both groups in order to assess if those with service dogs experienced fewer issues. According to Kloep (2017), the participants were given questionnaires at three points surrounding the completion of a three-week training program. Military veterans completed the questionnaires one month before the training program, the first day of the program, and six months after the completion of the program. The questions were based on specific scale systems that tested for PTSD symptoms, depression, anger issues, social life, and overall quality of life. There was a significant improvement in the overall quality of life after the use of service dogs (Kloep et al. 2017; Yarborough et al. 2017). Participants reported high levels of stress and anger prior to partaking in the training programs; They also experienced panic attacks during the day and at night, affecting their sleep patterns (Kloep et al. 2017; Yarborough et al. 2017). After a 6 month following, 91.7% had reduced PTSD symptoms. Researchers who interviewed their participants reported an 11.54 to 22.36 point reduction, which accounts for a significant decrease in PTSD symptoms (Ohaire et al. 2018). Participants also had a significant improvement in their social life by engaging in more activities and reduced feelings of social isolation (Ohaire et al. 2018). There was a 91% decrease in depressive symptoms in military veterans with service dogs (Kloep et al. 2017). The dog reduces feelings of anxiety, anger, isolation, and helplessness (Kloep et al. 2017; Ohaire et al. 2018). Military veterans report having increased feelings of positivity, as well as an improvement in overall wellbeing (Winkle et al. 2012 as cited in Yarborough et al. 2017). Overall, the data proved that service dogs provided health benefits and improved the overall quality of life. (Kloep et al. 2017; Yarborough et al. 2017; Ohaire et al. 2018).

Service Dogs Trained Responses

Service dogs were trained to perform certain tasks that would assist the veteran in preventing a panic attack, reducing negative feelings, or engaging them to interact in social activities (Kloep et al. 2017; Yarborough et al. 2017; Ohaire et al. 2018; Yarborough et al. 2018). The service dogs would alert the veteran by nudging or licking them if they sensed any sign of increasing anger or stress that may lead to a panic attack or trauma-related thoughts (Yarborough et al. 2017; Yarborough et al. 2018). They ensured that the military veterans remained “in the moment” and did not experience any visual reminders that have caused their PTSD (Yarborough et al. 2017). There were improvements in sleep patterns because the service dog would wake up the veteran once they sensed that the veteran was about to have a nightmare (Kloep et al. 2017; Yarborough et al. 2018). Service dogs are also helpful in encouraging the military veterans to engage in day to day activities, as they are required to not only care for themselves, but for the dog as well; This requires the veteran to interact with others and improve their social health (Yarborough et al. 2017). Some service dogs were also trained to retrieve medication as a way to remind the veteran to take them (Ohaire et al. 2018). A sense of personal space and comfort was created when the service dogs accompanied the veterans in a social place (Yarborough et al. 2017; Ohaire et al. 2018) Service dogs were taught various tasks that assisted in improving the health of military veterans, specifically with PTSD and PTSD related symptoms (Kloep et al. 2017; Yarborough et al. 2017; Ohaire et al. 2018; Yarborough et al. 2018).

Conclusion

Despite the various research projects done on service dogs, there is still a lack of data. More research needs to be done to show the long-term benefits of using service dogs, as most of the studies were short-term. Data is needed to compare the usage of service dogs to other forms of treatment for PTSD or PTSD-related symptoms. Research studies should also focus on whether or not service dogs need to be used in addition to other forms of treatment or if it is sufficient enough on its own. Overall, service dogs improve the quality of life of military veterans by reducing their depression and anxiety and instilling a sense of comfort. Veterans are encouraged to engage in daily activities, which improves their social life and overall quality of life. Service dogs serve as a beneficial way to treat military veterans who are suffering from PTSD or PTSD-related symptoms.

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