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Effects of Psychiatric Service Dogs on Quality of Life and Relationship Functioning in Military-Connected Couples

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Effects of Psychiatric Service Dogs on Quality of Life and Relationship Functioning in Military-Connected Couples Military Behavioral Health ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/umbh20 “A Part of Our Family”? Effects of Psychiatric Service Dogs on Quality of Life and Relationship Functioning in Military-Connected Couples Christine E. McCall , Kerri E. Rodriguez , Shelley M. MacDermid Wadsworth , Laura A. Meis & Marguerite E. O’Haire To cite this article: Christine E. McCall , Kerri E. Rodriguez , Shelley M. MacDermid Wadsworth , Laura A. Meis & Marguerite E. O’Haire (2020): “A Part of Our Family”? Effects of Psychiatric Service Dogs on Quality of Life and Relationship Functioning in Military-Connected Couples, Military Behavioral Health, DOI: 10.1080/21635781.2020.1825243 To link to this article: https://doi.org/10.1080/21635781.2020.1825243 Published online: 14 Oct 2020. Submit your article to this journal Article views: 39 View related articles View Crossmark data Full Terms & Conditions of access and use can be found at https://www.tandfonline.com/action/journalInformation?journalCode=umbh20 MILITARY BEHAVIORAL HEALTH https://doi.org/10.1080/21635781.2020.1825243 “ ” A Part of Our Family ? Effects of Psychiatric Service Dogs on Quality of Life and Relationship Functioning in Military-Connected Couples a b à a c Christine E. McCall , Kerri E. Rodriguez , Shelley M. MacDermid Wadsworth , Laura A. Meis , and b Marguerite E. O’Haire a Military Family Research Institute, Department of Human Development and Family Studies, College of Health and Human Sciences, b Purdue University, West Lafayette, Indiana; Center for the Human-Animal Bond, Department of Comparative Pathobiology, College c of Veterinary Medicine, Purdue University, West Lafayette, Indiana; Center for Care Delivery & Outcomes Research, Minneapolis VA Health Care System, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota ABSTRACT KEYWORDS Posttraumatic stress disorder (PTSD) can have corrosive impacts on family relationships and Posttraumatic stress individual functioning. Emerging evidence has shown that psychiatric service dogs may be disorder; families and an effective complementary treatment for military veterans with PTSD, benefiting veterans’ children; military couples; mental and social health. However, few studies have examined the effects of psychiatric ser- psychiatric service dogs; family systems; vice dogs on the family members of veterans, specifically their partners. Mixed-methods human-animal interaction; data from 60 veteran-partner dyads examined individual and relationship functioning animal-assisted among partners of veterans paired with a service dog (service dog group; n ¼ 37) and those intervention; veterans awaiting placement (waitlist group; n ¼ 23). While there were no statistically significant dif- ferences across groups, the effect sizes for group differences suggested that partners in the service dog group (relative to those on the waitlist) may experience higher levels of resili- ence and companionship, and lower levels of anger, social isolation, and work impairment. A topical survey of partner qualitative data within the service dog group indicated that ser- vice dogs provided more benefits than challenges. Partners reported improvements in vet- eran functioning, family relationships, and partners’ quality of life. Results, although preliminary, suggest that psychiatric service dogs may provide modest positive experiences for some veteran family systems. Beyond impairing individual functioning, veterans’ relationship functioning, as well as partners’ quality of posttraumatic stress disorder (PTSD) can corrode life, mental well-being, work functioning, and social family relationships and disrupt the functioning of functioning. Guided by family systems theory, we family systems (e.g., Dekel & Monson, 2010). expected that the positive effects of psychiatric service Emerging evidence has shown that the use of psychi- dogs experienced by veterans (e.g., Kloep et al., 2017; atric service dogs, as an adjunct to PTSD standard O’Haire & Rodriguez, 2018; Yarborough et al., 2018) treatment, is associated with improvements in veter- would extend to veterans’ families (in this case, their ans’ mental well-being and quality of life (e.g., romantic partners). Yarborough et al., 2018). Still to be examined, how- According to family systems theory (Cox & Paley, ever, is the broader impact of psychiatric service dogs 1997), family dynamics are defined by both the actions on veterans’ family systems. Given that caregivers of and responses of each individual member. This inter- veterans of the post-9/11 conflicts are most commonly dependence within family systems has been used to their romantic partners (Ramchand et al., 2014), it is describe how veteran’s PTSD can impact other family important to understand the impact of complemen- members (Lester et al., 2017). Existing research indi- tary treatments on family relationships. The present cates that companion animals (i.e., pets) make positive study examined associations between veterans’ use of social, emotional, and instrumental contributions to psychiatric service dogs and veteran-partner family environments (Mueller et al., 2015;Walsh, CONTACT Marguerite E. O’Haire [email protected] Center for the Human-Animal Bond, Department of Comparative Pathobiology, College of Veterinary Medicine, 625 Harrison Street, West Lafayette, IN 47907. à Current affiliation: Human-Animal Bond in Colorado, School of Social Work, Colorado State University, Fort Collins, Colorado. 2020 Taylor & Francis Group, LLC 2 C. E. MCCALL ET AL. 2009). The bond between humans and animals has Morales, 2018; Kruger & Serpell, 2010;O’Haire, 2010). also been hypothesized to promote family resilience PTSD service dogs are a type of psychiatric service (Walsh, 2009), though this has received little empirical dog that are trained to perform tasks directly related attention. Human-animal interaction scholars have to PTSD symptomatology, such as waking veterans repeatedly called for a better understanding of the roles from nightmares, positioning themselves behind veter- that animals—both companion animals and service ani- ans in public to “watch their back” or responding to mals—play in family systems (Mueller et al., 2015; veterans’ distress during reexperiencing episodes. Triebenbacher, 2006). Responding to this need, we However, it is important to acknowledge that no evi- examined individual and relationship functioning dence has yet met the VA’s threshold for considering across couples with and without psychiatric service PTSD service dogs an evidence-based treatment for dogs in the household. veterans’ PTSD (Department of Veterans Affairs/ Department of Defense, 2017). Some clinicians have argued that PTSD service dogs can undermine veter- Veteran mental health ans’ PTSD primary standard treatment by reducing Military service members can experience traumatic opportunities to confront negative experiences in daily events, such as combat exposure, military sexual life (Finley, 2013). trauma, or training accidents, that can lead to elevated While controversy exists, early research is promis- rates of PTSD, depression, anxiety, substance use, and ing. For example, in multi-group intervention studies, comorbid mental health problems among veterans veterans with PTSD service dogs reported less PTSD (Tanielian & Jaycox, 2008; Trivedi et al., 2015). PTSD symptoms, less anxiety, less depression, and better is an enduring psychiatric disorder characterized by psychological well-being than veterans on waitlists high levels of reactivity and arousal, the reexperienc- (O’Haire & Rodriguez, 2018; Whitworth et al., 2019). ing of traumatic events (e.g., flashbacks), intrusive and Qualitative studies of veterans with PTSD service dogs negative thought patterns (e.g., anger, sadness), and have found increased feelings of safety and commu- avoiding triggering situations (American Psychiatric nity connectedness; improved sleep, quality of life, Association, 2013). PTSD is a “signature wound” of and social relationships; and reduced need for medica- the post-9/11 conflicts (Tanielian & Jaycox, 2008) and tion (Crowe et al., 2018; Yarborough et al., 2018). has an estimated prevalence rate of 23% (Fulton et al., Recent research found that PTSD service dogs are 2015), although estimates have ranged from 1 to 30% associated with changes in the body’s stress response (Institute of Medicine, 2013). Consequences of PTSD system, suggesting that the benefits of PTSD service for veteran functioning include elevated risky behavior dogs’ assistance and companionship may extend to such as suicide ideation and substance use, poor biological and physiological processes (Rodriguez et physical functioning, financial and employment chal- al., 2018). Despite these benefits, studies have reported lenges, and decreased social engagement (Tanielian & notable drawbacks to PTSD service dog therapy, Jaycox, 2008). including concerns about animal welfare, financial costs, difficulty maintaining service dog training, and challenges arising from the public’s lack of knowledge Veterans and psychiatric service dogs regarding service dogs (Krause-Parello et al., 2016; The reach and effectiveness of evidence-based treat- Yarborough et al., 2018). While the number of studies ments for PTSD (e.g., cognitive behavioral therapy, examining associations between PTSD service dogs pharmacotherapy, prolonged exposure) can be limited and veterans’ functioning has increased in recent due to institutional barriers to accessing care,
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