Perspective

Service dog training helpful in treating combat-related PTSD

Soldiers with posttraumatic stress disorder or traumatic brain injury are experiencing positive treatment results from animal-assisted therapy, according to experts who have published a new feature article in Psychiatric Annals. The article is next in a series on the use of complementary and alternative medicine in the treatment of PTSD.

“A theme running through this series on the use of complementary and alternative medicine (CAM), or integrative medicine, is how much more the service members like CAM compared with conventional treatments,” retired Army Col. Elspeth Cameron Ritchie, MD, MPH, one of the authors of the article, said in an interview. “Nowhere is this truer than when working with dogs.”

Warrior Canine Connection

Ritchie, the chief medical officer for the District of Columbia Department of Mental Health, said animal-assisted therapy has been used in the theater of war for the past 5 years. In the article, the authors focus on the successes of a nonprofit organization named Warrior Canine Connection (WCC), based in Brookeville, Md. The program enrolls service members with PTSD or traumatic brain injury (TBI) to train service dogs for other fellow war veterans.

“This benefits the soldier or Marine training the dog, as well as the future recipient of the service dog,” Ritchie said.

WCC offers animal-assisted therapy at several locations, including Walter Reed National Military Medical Center, Fort Belvoir, National Intrepid Center of Excellence, and through the VA Palo Alto Health Care System.

Elspeth Cameron Ritchie, MD, MPH 

Elspeth Cameron Ritchie

“WCC’s training philosophy is based on positive methods of shaping behaviors and the premise that mastering the skills and patience required to train a service dog helps the WCC trainers regain control of their own emotions, focus their attention, and improve their social competence and overall sense of well-being,” the authors wrote.

Anecdotal reports by WCC participants include better emotional regulation, improved sleep, decreased depression and stress reduction, among numerous other benefits.

WCC was developed Rick Yount, MS, LSW, a social worker and service dog trainer, to treat the three symptom clusters of PTSD: re-experiencing, avoidance/numbing and increased arousal.

Possible mechanisms of action

Ritchie and colleagues said the release of the oxytocin, a neuropeptide that has been shown to modulate PTSD symptoms such as anxiety, interpersonal difficulties/social isolation, physical pain and sleeping problems, is one possible reason for the clinical success associated with animal-assisted therapy.

“Oxytocin in humans has been shown to enhance the processing of positive social information compared to negative information, increase a sense of trust in others, reverse the effect of aversive conditioning of social stimuli, enhance the buffering effect of social support on stress responsiveness, and reduce the stress response in people with a history of early trauma,” the authors wrote.

Similar effects have been observed in those who have participated in service dog training, which encourages the pro-social interaction that has been shown to increase oxytocin levels in humans. To provide examples, the authors detailed two cases in which Marines with PTSD and TBI had benefited from the intervention.

“As with other CAM treatments, more research is needed to understand why animal-assisted therapy works to relieve PTSD symptoms,” Ritchie said. “An increase in oxytocin levels may be part of the answer.”

Soldiers with posttraumatic stress disorder or traumatic brain injury are experiencing positive treatment results from animal-assisted therapy, according to experts who have published a new feature article in Psychiatric Annals. The article is next in a series on the use of complementary and alternative medicine in the treatment of PTSD.

“A theme running through this series on the use of complementary and alternative medicine (CAM), or integrative medicine, is how much more the service members like CAM compared with conventional treatments,” retired Army Col. Elspeth Cameron Ritchie, MD, MPH, one of the authors of the article, said in an interview. “Nowhere is this truer than when working with dogs.”

Warrior Canine Connection

Ritchie, the chief medical officer for the District of Columbia Department of Mental Health, said animal-assisted therapy has been used in the theater of war for the past 5 years. In the article, the authors focus on the successes of a nonprofit organization named Warrior Canine Connection (WCC), based in Brookeville, Md. The program enrolls service members with PTSD or traumatic brain injury (TBI) to train service dogs for other fellow war veterans.

“This benefits the soldier or Marine training the dog, as well as the future recipient of the service dog,” Ritchie said.

WCC offers animal-assisted therapy at several locations, including Walter Reed National Military Medical Center, Fort Belvoir, National Intrepid Center of Excellence, and through the VA Palo Alto Health Care System.

Elspeth Cameron Ritchie, MD, MPH 

Elspeth Cameron Ritchie

“WCC’s training philosophy is based on positive methods of shaping behaviors and the premise that mastering the skills and patience required to train a service dog helps the WCC trainers regain control of their own emotions, focus their attention, and improve their social competence and overall sense of well-being,” the authors wrote.

Anecdotal reports by WCC participants include better emotional regulation, improved sleep, decreased depression and stress reduction, among numerous other benefits.

WCC was developed Rick Yount, MS, LSW, a social worker and service dog trainer, to treat the three symptom clusters of PTSD: re-experiencing, avoidance/numbing and increased arousal.

Possible mechanisms of action

Ritchie and colleagues said the release of the oxytocin, a neuropeptide that has been shown to modulate PTSD symptoms such as anxiety, interpersonal difficulties/social isolation, physical pain and sleeping problems, is one possible reason for the clinical success associated with animal-assisted therapy.

“Oxytocin in humans has been shown to enhance the processing of positive social information compared to negative information, increase a sense of trust in others, reverse the effect of aversive conditioning of social stimuli, enhance the buffering effect of social support on stress responsiveness, and reduce the stress response in people with a history of early trauma,” the authors wrote.

Similar effects have been observed in those who have participated in service dog training, which encourages the pro-social interaction that has been shown to increase oxytocin levels in humans. To provide examples, the authors detailed two cases in which Marines with PTSD and TBI had benefited from the intervention.

“As with other CAM treatments, more research is needed to understand why animal-assisted therapy works to relieve PTSD symptoms,” Ritchie said. “An increase in oxytocin levels may be part of the answer.”

    Perspective
    Jan Fawcett

    Jan Fawcett

    In this article, Yount, Ritchie and colleagues illustrate not only the effectiveness of service dogs in addressing symptoms of war-induced PTSD, but how training these animals to provide service to other veterans results in therapeutic gains for soldiers with severe PTSD. They go beyond the explanation of the unconditional love these animals express for humans to suggest the possibility that their capacity to elicit increased oxytocin release, with a range of beneficial effects on human brain function, may be a mechanism involved.

    • Jan Fawcett, MD
    • Editor, Psychiatric Annals

    Disclosures: Fawcett reports no relevant financial disclosures.