Monday, July 2, 2012

Army Medical Journal Describes Service and Therapy Dog Programs For Wounded Warriors

Sixteen articles on various canine-related activities that involve wounded soldiers and veterans appear in The United States Army Medical Department Journal for the second quarter of 2012. At least one article might satisfy the rigorous requirements of a refereed journal, but most are interesting and there is a wealth of data to prove that there are people in the military who see the benefits of service and therapy dogs for those wounded in foreign wars. 

No Opinion Expressed on Army Medical Command Policy

Given the policies adopted by Forts Bliss and Campbell following a January 30 memorandum issued by the Army Medical Command at Fort Sam Houston, Texas, it must be asked whether the authors of the papers in the Army’s medical journal are in agreement with Herbert A. Coley, Chief of the Clinical Services Division, and his decision to apply a very restrictive definition to the term “service dog” in Army contexts.  I could find only two references to Coley’s memorandum throughout the entire issue of the Journal, both of which acknowledged its existence but neither of which elaborated on it.  One paper refers to “proponents of much less training,” which may be a reference to soldiers and veterans who have trained or are trying to train their own service dogs in contravention of Coley’s memorandum, but even if that is the intent, it is not clear that any of the authors in the medical journal are happy with Coley’s policy. 

Need for Additional Service Dogs

One of the papers, citing earlier research (American Journal of Public Health, 99(9), 1651-1658) says that “approximately 40% of Iraq and Afghanistan Veterans treated at American health centers during the previous 6 years [2002-2008] were diagnosed with PTSD, depression, or other mental health issues…. In 2007, Brashear and Rintala [SCI Psychosocial Process, 20(1)] reported that 30% of Veterans with spinal cord injuries indicated at least some interest in obtaining a service dog, and 42% desired information concerning service dogs.” 

If 40% of returning soldiers seeking any kind of medical help suffer from psychological or neurological traumas, many of whom are interested in getting service dogs, the need for dogs runs to the thousands, probably tens of thousands.  If there is an overall weakness to this dedicated issue of the Army’s medical journal, it is that it makes no further effort to quantify the number of dogs required to satisfy this need.  While the programs described are all excellent, the excellence often concerns relatively small numbers of dogs for relatively small populations of soldiers and veterans. 

Programs Described in Army Medical Command Journal

Still, credit must be given where credit is due, and many of the articles in the Army Medical Department Journal are worth a close read by all segments of the medical community as well as by service and therapy dog trainers.   The major findings of the dedicated issue of the Journal are the following:

  1. Learning to give commands to therapy dogs was determined to be beneficial to wounded soldiers under self-assessment measures of psychological function, work performance, and quality of interaction.  However, no difference was detected in a comparison with wounded soldiers who did not work with dogs as to mood state, stress level, resilience, and fatigue. "Several Soldiers informed the Warrior Family Support Center Director that they enjoyed the dog sessions, looked forward to seeing the dogs again and regretted the conclusion of the study." Despite the generally nonsignificant results of the study, the researchers felt that the anecdotal evidence supporting the program argued for continued development. 
  2. Eight combat and operational stress control dogs (“COSC dogs”) have been deployed in Iraq and Afghanistan after training to be therapy dogs, with specific modifications for the war theater environment, such as learning to tolerate extreme noise and get on and off of helicopters.  The dogs were found to help communications between occupational therapists, who became handlers of the dogs, and a wide range of personnel in war zones.
  3. Occupational therapists who became handlers of COSC dogs have to live with the dogs virtually all the time, unlike military working dogs in theater (e.g. dogs to detect IEDs), which presents problems because of the extreme heat and sand storms in the Middle East, and because some dining facilities will not admit dogs, but the therapists all felt the experience was extremely rewarding.
  4. NEADS, a service dog training program in Princeton, Massachusetts, has been training dogs for wounded warriors at the Walter Reed National Military Medical Center.  Some wounded soldiers are learning to train service dogs for other soldiers.  NEADS has developed a special fitted harness that can be used by veterans with prosthetics.  Dogs are trained to pick up dropped items, even credit cards and coins.  NEADS has undertaken a pilot study on use of service dogs by veterans with PTSD.
  5. The Washington Humane Society’s Dog Tags Behavior and Grooming Training Program allows participants to learn skills in working with dogs, skills that may lead to post-discharge employment. Certain staff at the Walter Reed Warrior Transition Brigade can bring pets to work if the dogs are certified by Therapy Dogs International.
Although the scientific results are minor, the anecdotal information on the value of service and therapy dogs is considerable.  The most important result of the material is that it provides strong evidence that the rank and file Army and medical staff working with wounded soldiers and veterans is extremely positive to continued use and expansion of service and therapy dog programs. 

Conclusion

Critics of the January 30 Army Medical Command policy, including me, are concerned that it is designed to guarantee that numbers of soldiers and veterans receiving service and support dogs will remain low and that the need will continue to far outstrip the number of dogs and programs available.  Implementation of the restrictive service dog policy at Forts Bliss and Campbell has had disastrous results in morale, and the successes of those programs that have been implemented at other locations cannot pave over the failure to provide dogs to a large segment of wounded soldiers and veterans. 

Nevertheless, it is not surprising that medical personnel in the Army would not take on the establishment above them, and the research and descriptive articles included in this issue of The United States Army Medical Department Journal are a welcome addition to the professional literature on service and therapy dogs.

2 comments:

  1. Thank you, John, for this wise post regarding our service men/women, service dogs and the stunningly suspect definition to the term “service dog” in Army contexts.

    I applaud your professionalism and focus on this issue. It is extremely difficult to read, reflect upon or discuss the Fort Bliss and Campbell situations without becoming enraged.

    What can we do to help our soldiers/veterans and facilitate meaningful change for these programs?

    Keep up the great work!

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  2. I, too, appreciate the information and wisdom in your post. Could it be that Mr. Coley is using a the very narrow specific definition in this case because he is ignorant on the subject? Or could it be that the few organizations who benefit from providing these dogs to the military 'helped' with the definition? By benefit, I mean payment of $10,000 (or possibly $20,000, I can't recall), per dog, to accredited SD organizations recently for the placements they've made with Veterans - RETROACTIVELY and currently.

    I know of one Guide Dog school's program formed specifically for Veterans and injured active duty of the Gulf War and current wars in Iraq and Afghanistan, with less than a dozen placements made in the first several years. As of last year, the number jumped to over 100 placements of dogs with Veterans & service members, as they retroactively included ALL service members, no matter whether in conflict/war or not.

    It seems odd that the payments were made without any fanfare or media report, as far as I can tell. And, now the Chief of the Clinical Services Division has issued a directive which further insures no money will be paid, other than to these accredited institutions, for SD/PTSDs. Perhaps therein lies the rub?

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