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No Differences in Overall Functioning and Quality of Life among Veterans with PTSD Receiving a Service vs. Emotional Support Dog, with both Providing Benefit

PTSD is highly prevalent among Veterans and has increased dramatically. Current treatments are not effective in all individuals, creating a need for new treatments that work with existing therapies. Because the human-dog bond has been shown to benefit people physiologically as well as psychologically, service dogs trained to assist Veterans with PTSD appear to be a promising augmentation strategy. While service dogs are trained to perform tasks directly related to a person’s disability, pet or emotional support dogs have no special training. This study assessed the therapeutic and economic benefits of service dogs versus emotional support dogs for Veterans with PTSD. A multicenter trial randomly paired 181 Veterans with a service dog or emotional support dog from December 2014 to June 2017. Participants were then followed for 18 months. Primary outcomes included overall functioning and quality of life. Secondary outcomes included PTSD symptoms, suicidal ideation, depression, sleep, healthcare costs and use, medication adherence, employment, and productivity.


  • There was no significant difference between Veterans paired with a service dog and those paired with an emotional support dog in overall functioning and quality of life (primary trial outcomes).
  • Veterans with a service dog showed a greater reduction in PTSD symptoms and a trend toward potential improvement in suicidal behavior and ideation compared to those paired with an emotional support dog (secondary outcomes).
  • There were no significant differences between service dogs and emotional support dogs in terms of costs, use of healthcare services, employment, or productivity outcomes, but Veterans with service dogs experienced improved antidepressant medication adherence.


  • Pairing service dogs with Veterans who have PTSD can complement existing evidence-based treatments and may result in high levels of engagement and reductions in PTSD symptoms.


  • Limitations included the inability to blind participants to dog type and the lack of a no-dog control group.

This study was funded by the Office of Research and Development (ORD). Dr. Wagner and Ms. Illarmo are with HSR&D’s Health Economics Resource Center (HERC); Dr. Abrams is with HSR&D’s Center for Access & Delivery Research and Evaluation; Dr. Skelton is with the Atlanta VA Medical Center; Drs. Biswas and Stock, and Ms. McSherry are with the CSP Coordinating Center in Perry Point, MD; Drs. Frakt and Pizer are with QUERI’s PEPReC; Dr. Magruder is with the Medical University of South Carolina; Drs. Groer, Dorn, and Huang are with ORD.

Richerson J, Wagner T, Abrams T, Skelton K, Biswas K, Illarmo S, McSherry F, Fallon M, Frakt A, Pizer S, Magruder K, Groer S, Dorn P, Huang G, Stock E. Therapeutic and Economic Benefits of Service Dogs versus Emotional Support Dogs for Veterans with PTSD. Psychiatric Services. January 31, 2023; online ahead of print.

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What are HSR Publication Briefs?

HSR requires notification by HSR-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR published articles. Visit the HSR citations database for a complete listing of HSR articles and presentations.

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