It was dinnertime in the Whittier, Calif., home of Air Force veteran Danielle Clark-Gutierrez, and Lisa, a 3-year-old yellow Labrador retriever, was looking forward to a bowl of kibble and canned dog food.

Her fingernails clicking on the kitchen floor as she danced, Lisa looked more like a rambunctious puppy than a highly trained service animal helping Clark-Gutierrez deal with PTSD symptoms.

“Having her now, it’s like I can go anywhere,” Clark-Gutierrez said. “And yes, if someone came at me, I would have had a warning – I could have run away.”

A growing body of research on PTSD and service animals paved the way for President Joe Biden to sign the Wounded Service Dogs into law (PAWS) for the Veterans Affairs Therapy Act. Legislation passed in August requires the Department of Veterans Affairs to open its service dog referral program to veterans with PTSD and launch a five-year pilot program in which veterans with PTSD train service dogs for other veterans.

Clark-Gutierrez, 33, is among the 25 percent of female veterans who report having survived military sexual trauma while serving in the US Armed Forces.

Military sexual trauma, combat violence and brain injuries are some of the experiences that increase the risk that service members will develop PTSD. Symptoms include flashbacks to the traumatic event, severe anxiety, nightmares and heightened vigilance — all normal reactions to experiencing or witnessing violence, according to psychologists. Someone is diagnosed with PTSD when symptoms worsen or persist for months or years.

That’s what Clark-Gutierrez said happened to her after ongoing sexual harassment by a fellow airman escalated to physical assault about a decade ago. A lawyer with three children, she said that in order to feel safe leaving home, she needs her husband by her side. After diagnosing Clark-Gutierrez with PTSD, doctors at Virginia hospitals prescribed a cascade of medications for her. At one point, Clark-Gutierrez said, her prescriptions resulted in more than a dozen pills a day.

“I had medications and then I had medications for the two or three side effects for each medication,” she said. “And every time they gave me a new drug, they had to give me three more. I just couldn’t take it anymore. I was just so tired. So we started looking at other therapies.

And so she got her service dog Lisa. Clark-Gutierrez’s husband, also an Air Force veteran, founded the nonprofit K9s for Warriors, which rescues dogs — many from kill shelters — and trains them to be service animals for veterans with PTSD. Lisa is one of about 700 dogs the group has matched with veterans dealing with symptoms caused by traumatic experiences.

“Now Lisa and I go on bike rides, we go to the park, we go to Home Depot,” Clark-Gutierrez said. “I’m going shopping – normal people things that I have to do that I didn’t do before Lisa.”

That’s no surprise to Maggie O’Hare, associate professor of human-animal interaction at Purdue University. Her research shows that while service dogs aren’t necessarily a cure for PTSD, they do alleviate its symptoms. Among her published studies is one display that veterans partnered with these dogs experience less anger and anxiety and sleep better than those without a service dog. Another study of hers assumes that service dogs lower cortisol levels in veterans who have been traumatized.

“We actually saw patterns of this stress hormone that were more similar to healthy adults who don’t have PTSD,” O’Hare said.

A congressionally mandated VA study that focused on the impact of service dogs on veterans with PTSD and was published this year suggests that those who partner with the animals experience fewer suicidal thoughts and more improvement in symptoms si than those without them.

Until now, the federal dog referral program — which relies on service dog nonprofits to pay for the dogs and provide them for free to veterans — required participating veterans to have a physical mobility problem, such as a lost limb, paralysis or blindness. Veterans like Clark-Gutierrez, who have PTSD but no physical disabilities, have been on their own to arrange for a service dog.

The pilot program created by the new federal law will allow veterans with PTSD to train mental health dogs for other veterans. It is modeled after a program at the VA Hospital in Palo Alto, Calif., and will be offered at five VA medical centers nationwide in partnership with accredited service dog training organizations.

“This bill is really about therapeutic training, on-the-job training or ‘train the trainer,'” said Adam Webb, a spokesman for Sen. Tom Tillis (RN.C.), who introduced the legislation in the Senate. “We don’t expect the VA to start prescribing service dogs for PTSD, but the data we generate from this pilot program will likely be useful in the future.”

The Congressional Budget Office estimates the pilot program will cost the VA about $19 million. The law does not require the VA to pay for the dogs. Instead, the agency will partner with accredited service dog organizations that use private money to cover the costs of adopting, training and pairing dogs with veterans.

Still, the law represents a welcome reversal in VA policy, said Rory Diamond, CEO of K9s for the Warriors.

“For the last 10 years, the VA has basically told us that they don’t recognize service dogs as helping a veteran with PTSD,” Diamond said.

PTSD service dogs are often confused with emotional support dogs, Diamond said. The latter provide companionship and are not trained to support someone with a disability. Service dogs with PTSD cost about $25,000 to adopt and train, he said.

Diamond explained that the “cover” command means “the dog will sit next to the warrior, look behind them and alert them if someone approaches from behind.” The “block” command means the dog will “stand perpendicular and give them some space from whatever is in front of them.”

Retired Army Master Sergeant David Crenshaw of Kearney, New Jersey, said his service dog, Doc, changed his life.

“We learn in the military to have a battle buddy,” Crenshaw said. “And these service animals act as battle buddies.”

A few months ago, Crenshaw experienced this firsthand. He generally avoided large gatherings because constant hypervigilance was one of the symptoms of his post-traumatic stress caused by combat. But this summer, Doc, a pointer-Labrador mix, helped Crenshaw navigate the crowds at Disney World — a significant first for Crenshaw and his family of five.

“I wasn’t excited. I wasn’t alarmed. I wasn’t upset,” said Crenshaw, 39. “It was really, really amazing and so much so that I didn’t even have to stop to think about it right now. It just happened naturally.

Thanks to Doc, Crenshaw said, he no longer takes PTSD medication or self-medicates with alcohol. Clark-Gutierrez said Lisa also helped her quit drinking and stop taking VA-prescribed medication for panic attacks, nightmares and periods of dissociation.

The dogs actually save the VA money over time, Diamond said. “Our warriors are far less likely to take expensive prescription drugs, far less likely to use other VA services and far more likely to go to school or work. So it’s a win-win.

KHN (Kaiser Health News) is a national newsroom that produces in-depth health journalism. Along with policy analysis and polling, KHN is one of three major operational programs in the KFF (Kaiser Family Foundation). KFF is a charitable, non-profit organization providing information on health issues to the nation.

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