Emotional support animals: A framework for clinical decision-making.

Abstract

An emotional support animal (ESA) is a type of legally recognized assistance animal that purports to provide emotional support to individuals with mental and emotional disabilities. Due to their no-cost access to housing that is ordinarily not pet-friendly (and previously no-cost access to airline travel), ESAs have increased in popularity, reflected in media attention highlighting problems that occur when individuals obtain ESA verification fraudulently, or without critical thought and legal considerations. Given recent legal clarifications by the U.S. Department of Housing and Urban Development (HUD; 2020), ESAs should be considered an accommodation and adjunct to ongoing treatment for chronic mental health disorders. The present article approaches ESA decision issues from a human-animal bond research and positive ethics perspective and introduces an ESA Decision-Making Framework. The framework provides clinicianfriendly overview of welfare, clinical, and legal aspects of ESA decisions and potential ESA selection. The framework can structure beneficial conversations about ESAs between providers and clients in order to facilitate collaborative treatment planning and to strengthen therapeutic alliances regardless of the outcome of the ESA decision. Public Significance StatementEmotional Support Animals (ESAs) should be considered an accommodation and adjunct to ongoing treatment for chronic mental health disorders. The present article provides a clinician-friendly overview of welfare, clinical, and legal aspects of ESA decisions and potential ESA selection from a humananimal bond research perspective.

Objectivity or Advocacy? The Ethics of the Scout Mindset in Psychoeducational Assessment

“…A similarly detailed decision model, endorsed by relevant professional bodies, for recommending particular accommodations or services would take pressure off of individual clinicians to make inappropriate recommendations. (For an initial attempt at such a model for making recommendations about emotional support animals, see Ferrell & Crowley, 2021 .) Publicly funding, or even partially subsidizing psychological evaluations (for those individuals who first go through inexpensive screenings), would reduce financial incentives for problematic clinical practices and help to separate therapy work from neutral, dispassionate evaluation work.…”