What Every Psychologist Should Know About Writing Letters for Patients with Service Animals

Additional Note: A column in the January/February 2015 issue of Family Therapy (scroll to p. 64), a publication of the American Association for Marriage and Family Therapy, describes how the columnist, Alli Spotts-De-Lazzer, reacted upon first being asked to write a letter for a patient with an emotional support animal.  Ms. Spotts-De-Lazzer, a licensed marriage and family therapist in Los Angeles, began reading and spoke with many of those who had published on the legal, ethical, and psychological aspects of the issue. She discusses the importance of such letters to patients, but also goes into the risks to a therapist who does not consider that writing such a letter is a serious responsibility. Her summary should be read by any mental health professional faced with a letter request.  

Psychiatrists, psychologists, and other medical professionals are increasingly asked to provide letters for users of service and support animals that will help get the animals into apartment buildings, airplanes, and even restaurants, or sometimes to justify a tax deduction for the dog as a medical expense.  Far too many professionals, faced with such a request, ask the patient to provide the letter for them to sign.  The Department of Transportation has told airlines that they may require that such a letter be on the professional’s letterhead and provide contact information for the professional’s licensing authority. Presumably the airline will contact the licensing authority if it believes the professional has been party to transforming an uncontrollable pet into a service animal.  Apartment and condominium owners may also ask for detailed information from medical and mental health professionals when a prospective tenant or buyer claims that a dog should be excepted from a no-pets policy. 

Most of the literature on the subject either takes the perspective of the person with the disability or the business or entity faced with admission of the animal, so Dr. J. Lawrence Thomas and I decided to take the viewpoint of the psychologist or other medical professional who is asked to write such a letter.  An analysis of case law turned up a number of situations where letters from professionals actually harmed a patient’s ability to get an animal, usually a dog, into restaurant, fly with it in an airplane, or live with it in a no-pets building.  One of the problems is that many professionals do not bother to learn that there is no one-size-fits-all letter that will help a patient in every situation.  A dog that is appropriate for an apartment building may not be well enough trained to behave in an airplane even if it provides its owner with emotional support.  A dog that is calm and controlled enough to fly in the cabin may nevertheless not meet Department of Justice criteria for entering a place of public accommodation, such as a restaurant. 

Patients should understand that the professionals they ask to write such letters may find themselves accused of ethical lapses if the professional’s letter claims more about the benefits of an animal than is actually the case.  They should not expect that a psychologist’s letter will upgrade a dog from a pet to an emotional support or service animal.  The psychologist is not a dog trainer but can evaluate how the functions the dog performs affect to the patient’s mental condition.  Patients should also understand that evaluating the patient’s use of the animal will take time for which the professional is entitled to charge.  Psychologists and other professionals should understand that they have an obligation to society as well as to the patient, and Dr. Thomas and I list eight broad issues that should be considered by a professional before writing a support letter. 

Our article, Writing Letters to Help Patients with Service and Support Animals, appears in the Journal of Forensic Psychology Practice, 13(2), March 2013, and can be read or downloaded from the Journal’s website.