What Therapists Need to Know About ESAs
Emotional Support Animals (ESA) have become quite controversial recently and there is a lot of confusion around this topic and the regulations. Therapists and other mental health professionals often get requests from clients for letters verifying that they need an ESA, but therapists often don’t receive training on how to handle these requests.
Let’s start by defining what an emotional Support Animal is/does according to regulations.
The term emotional support animal often gets conflated with therapy animals or service animals, but these are very different things. A service animal is a trained animal, most often a dog, which has specific training to perform tasks which mitigate the impact of a person’s disability. A guide dog for a visually impaired person is the most common example of a service animal. A therapy dog or therapy animal is a trained animal which participates in therapeutic treatments. They are still considered a pet, and do not have any of the rights of a service animal or ESA.
The Americans with Disabilities Act (ADA), which provides protections and requirements for service animals does not regulate emotional support animals. The Fair Housing Act (FHA) and Air Carrier Access Act (ACAA), determined regulations for people who need an ESA. According to the federal legislation, an emotional support animal is an accommodation for people with disabling mental health conditions, in which the animal is part of the treatment and mitigates one or more symptoms of the condition. The person’s ability to function must increase in order for the criteria to be met. The accommodation for ESA’s is exclusively for housing and air travel. ESA’s are not permitted in businesses or public places in which pets are prohibited.
To reiterate, this means that a person with a legitimate emotional support animal must meet all of the below criteria:
Have a diagnosis of a disabling mental health condition
Have a provider determine that an animal could reduce or eliminate one or more symptoms
Have the animal identified as part of the treatment plan
Document increased functioning directly related to the animal
As you can see, this criteria does not fit most people. It’s also important to note that the regulations are not about a specific animal, they are about the person’s need for an animal to mitigate symptoms.
An ESA is not required to have training of any kind, and the requirements for qualifying for an ESA have been exploited in recent years, which have led to the recent changes in enforcing policies. There are numerous people with disabling mental health conditions who benefit from their pet, and they are utilizing the animal in their treatment effectively. However, there are also people who want to be able to travel with their pets, and want to be able to live in pet-free housing without having to pay a fee or give up their animals. An ESA designation has allowed them to do this in the past. There are even online companies who will provide a letter recommending an ESA for a fee without the client participating in treatment. Due to this exploitation of the regulations, airlines are increasing their standards for documentation. These fee-for-letter companies are being identified and people’s documentation is being scrutinized. This increase in enforcement is necessary, but places a burden on those who genuinely have a need for an ESA.
The providers who are writing ESA letters are also receiving more attention, which is why it is so important for therapists and other providers to know the laws, the criteria for qualification, and the scope of their practice. Many of the professional associations are providing guidance on this topic and the ethics involved. There is increasing professional liability to practitioners who write letters to clients who do not meet criteria and for those practicing outside the scope of their knowledge. For this reason many providers are shying away from writing the letters all together. However, that doesn’t have to be the case. You just need to know who it’s okay to write the letter for and what is involved. Hopefully you have a better understanding of what an ESA is and does, and how this applies to you as a provider. To learn more about this topic, consider receiving training to increase awareness and confidence in your professional determinations.
