Man's Best Friend Is Healing Veterans : Short Wave Service dogs have long helped veterans with physical disabilities. While there have been stories about veterans with post-traumatic stress disorder being transformed by service animals, the peer-reviewed science wasn't there to back up the claims. Health reporter Stephanie O'Neill reports that's changed in recent years. Studies suggest service dogs can be effective at easing PTSD symptoms and used alongside other treatments. Now, the PAWS for Veterans Therapy Act will help connect specially trained dogs to some veterans with symptoms of traumatic stress.

Read more of Stephanie's reporting: https://n.pr/32bXn8E

This reporting was done in partnership with Kaiser Health News.

Man's Best Friend Is Healing Veterans

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EMILY KWONG, HOST:

Hey, everyone. We want to let you know that today's episode talks about sexual harassment, assault and substance use. So it might not be suitable for all SHORT WAVErs. If you've experienced sexual violence or know someone who has and are searching for help, call the 24-hour national sexual assault hotline. That number is 1-800-656-4673. And if you're struggling with substance use, that 24-hour hotline is 1-800-662-4357. All right. Here's the show.

You're listening to SHORT WAVE from NPR.

STEPHANIE O'NEILL, BYLINE: Air Force veteran Danyelle Clark-Gutierrez is 33 years old. She lives in the Southern California city of Whittier with her husband and three kids, and with a yellow Labrador named Lisa

DANYELLE CLARK-GUTIERREZ: Right there, Lisa. Come on.

With Lisa, we take bike rides. And we go down to the park or go to Home Depot or just normal - like, go grocery shopping, normal people things that I get to do that I didn't get to do before Lisa.

O'NEILL: Danyelle has PTSD. She went through some pretty traumatic experiences while in the service.

KWONG: Yeah. The stats are pretty eye-opening. The VA, the Department of Veterans Affairs, says that up to 20% of veterans who fought in Afghanistan and Iraq have PTSD in a given year.

O'NEILL: And, I think, often, when we hear about trauma in the military, we mostly think about veterans coming home with battle-caused PTSD, especially since until recently, we were involved in war for two decades. But Danyelle was never a combat vet. She's among the 1-in-3 female vets who report experiencing what's known as military sexual trauma. It's also called MST for short. And it stems from ongoing sexual harassment or sexual assault or both that happens while the person is enlisted in the service.

KWONG: And it affects service people of all genders and from all backgrounds, not just women. So, Stephanie, when did MST start for Danyelle?

O'NEILL: Well, so in 2009, Danyelle was recovering from an abusive relationship. And she decided to join the Air Force.

CLARK-GUTIERREZ: I was trying to take my life back and really just, you know, get away and start over. So I joined the Air Force and, you know, went to basic training. I was the dorm chief. I was - you know, I felt confident again. I wasn't scared anymore. I just - you know, I felt whole again.

O'NEILL: Then the Air Force sends her to foreign language school in Monterey, Calif. And at first, she says, everything was great, except there was this guy in her class who started paying her unwanted attention.

CLARK-GUTIERREZ: At first it was just flirting. And then he would hit on me. And then it was, like, stalking. And then it just kind of escalated over the next two years.

O'NEILL: He begins breaking into her room, taking her things. Danyelle reports him to her superior officers.

KWONG: That's super scary. How did her superior officers respond?

O'NEILL: Well, they asked her how she might have provoked him.

CLARK-GUTIERREZ: To them, that was like, oh, he's just being silly. He just likes you. He'll get over it, whatever.

O'NEILL: And so about a year later, after a party, she's heading home. And the guy grabs her in the parking lot and pushes her up against a vehicle. And thankfully, you know, some of her friends see this happen. And they stop him.

KWONG: Did they report him?

O'NEILL: They did. And so the Air Force investigates him. And Danyelle says they reprimand him by restricting him to base and knocking him down in rank. She thought they'd kick him out of the service entirely, but they didn't. And so after that, Danyelle says she gives up hope on everything. And she leaves the service. Then, a couple of years later, she's at an Air Force promotion ceremony. And she's shocked to see the Air Force promoting her assailant.

CLARK-GUTIERREZ: I always thought that the Air Force was going to be everything that they said it was going to be, and it was a family and they were there to protect you. And then when I really needed them, nobody cared, you know?

O'NEILL: She sinks into this deep depression. She begins self-medicating with alcohol. Fast forward to 2015, she's finally diagnosed with PTSD, which likely was made worse by that prior abuse. The VA prescribes her a cascade of meds for her symptoms that include anxiety, night terrors, flashbacks, disassociation. At one point, Danyelle is taking 14 pills a day.

CLARK-GUTIERREZ: I had medication. And then I had medication for the two or three side effects for each medication. And every time they gave me a new med, they had to give me three more. I just - I couldn't do it anymore. I was just getting so tired. So we started looking at other therapies.

O'NEILL: And that's what leads to her partnership with that yellow lab, her service dog, Lisa.

KWONG: Today on the show, veterans' best friend helping veterans who really need it.

O'NEILL: Under a newly signed law, the VA launches a five-year long pilot program that offers dog training therapy to traumatized veterans.

KWONG: I'm Emily Kwong.

O'NEILL: And I'm Stephanie O'Neill, health policy reporter and regular NPR contributor.

KWONG: And you're listening to SHORT WAVE, the daily science podcast from NPR.

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KWONG: All right. Stephanie O'Neill, you were telling us about Danyelle and how her life changed for the better because, in huge part, of a dog?

O'NEILL: Yes. That is right.

KWONG: How did Danyelle find Lisa, her pup?

O'NEILL: Well, with that medication regimen overwhelming Danyelle, her husband starts searching around for something else to help her. And he finds a nonprofit group, K9s For Warriors. This group is one of a number of accredited nonprofits nationwide that adopt rescue dogs, many of them from kill shelters, and turns them into service dogs for veterans, like Danyelle, who are dealing with ongoing symptoms caused by traumatic experiences from combat, from military sexual trauma and from traumatic brain injuries.

KWONG: Got it. And what is the science behind these service dogs?

O'NEILL: Well, this is where Maggie O'Hare comes in.

KWONG: OK.

MAGGIE O'HARE: My name is Maggie O'Hare. And my title is associate professor of human-animal interaction at Purdue University.

O'NEILL: So Maggie has been studying veterans with PTSD and service dogs for about six years.

O'HARE: I initially began this area because everyone knew about veterans who had service dogs or who had magical transformations from interacting with them. And yet, when we went to look for science to back that up, there was no peer reviewed scientific evidence behind this at all. And that was something that really motivated and triggered us to start to collect that evidence base to build a scientific portfolio of the effects of service dogs for veterans.

KWONG: Basically, gathering data to back up the stories.

O'NEILL: Exactly. And in the first Purdue University study, Maggie and her team looked at 141 veterans with post-traumatic stress. About half the group had a service dog. And the other half was on a waitlist for a service dog. The guiding question for Maggie and her team being, did the service dogs make a difference?

O'HARE: For those veterans who had a service dog, we saw clinically significantly lower levels of PTSD, so their post-traumatic stress disorder symptoms. We also saw significantly lower anxiety, depression, higher quality of life. For example, we saw higher overall psychological well-being. So these are things like feeling happier and more elated and less sad and depressed, isolated and lonely.

O'NEILL: Maggie says they also saw the veterans getting out of the house more and engaging more in society...

KWONG: Wow.

O'NEILL: ...Through social activities and through work.

O'HARE: So in this study, we were able to quantify a number of ways that the service dog was measurably impacting the psychological, physiological and well-being of the individual.

O'NEILL: And so her ongoing studies in this area suggest that while service dogs aren't necessarily a cure for PTSD, they do ease its symptoms for many vets and can be used alongside other treatments.

KWONG: All right. Let's talk a little more about how you quantify canine love. How are they measuring that in these studies, like, with surveys?

O'NEILL: Yeah. Like most studies that look at any sort of psychological outcome, the researcher relies on self-reporting from those they're studying.

KWONG: OK.

O'NEILL: Maggie and her team then followed the studies of self-reported outcomes with one that offers the first objective measure of the effect these dogs have on traumatized vets.

KWONG: Oh, what was their objective measure?

O'NEILL: Well, they were measuring cortisol levels in veterans with service dogs and those without.

KWONG: Oh, that's really smart because cortisol, that's the stress hormone.

O'NEILL: That's right. And it affects nearly every organ in the body, helping you respond to stress, to fight infection, to regulate blood sugar - important stuff like that. And when it's working normally, you see the highest level of it in the early morning. And then it tapers off with each hour of the day. But often, it fails to work correctly for those with PTSD.

O'HARE: There's what we call dysregulation of that stress hormone. It's not functioning in the way that it does for healthy adults due to the fact that they're always experiencing stress and hyperarousal to such a strong degree.

KWONG: So how do you measure your cortisol?

O'NEILL: Well, they looked at spit.

KWONG: Spit?

O'NEILL: Or as it's technically known, saliva, which veterans spit into a cup.

O'HARE: What we found is that for those who had a service dog, their cortisol profile in the morning was significantly different than those who did not have a service dog. We actually saw patterns of that stress hormone that were more typical and healthy and similar to healthy adults who don't have post-traumatic stress disorder.

KWONG: We spit for science.

O'NEILL: (Laughter).

KWONG: That's pretty awesome. It's a big deal, too. I mean, this is the first study that appears to use a biomarker to study service dogs for veterans with PTSD.

O'NEILL: But wait, there's more.

KWONG: OK.

O'NEILL: There's this other, congressionally mandated study published in 2021. And its findings suggest traumatized veterans who partner with these service animals have less suicidal ideation and more symptom improvement than those without. And this research, along with Maggie's Purdue University studies, helped garner bipartisan support for the PAWS Act. And that stands for the Puppies Assisting Wounded Servicemembers for Veterans Therapy Act. And it just took effect.

KWONG: Of all the policy acronyms, PAWS is very cute. What does it do?

O'NEILL: So it requires the VA to launch a five-year long pilot program at an estimated cost of $30 million on dog training therapy for traumatized veterans. And although it does not provide money to pay for the dogs, people like Rory Diamond are excited about the move. He's the CEO of K9s for Warriors, the group that partnered Danyelle with Lisa.

RORY DIAMOND: This is step one of what we think is a critical mission for the VA, which is to recognize that service dogs are helping veterans with post-traumatic stress.

O'NEILL: And under the pilot program, the VA will work with K9s for Warriors and other accredited service dog training organizations to provide therapeutic on-the-job training to teach the vets with PTSD how to train and handle service dogs, and they can keep the dog at the end of the program. And as Rory tells me, to find these dogs, to adopt them, train them in the dozens of commands to assist veterans with PTSD is this really complex, time-intensive process because they're customizing this training for PTSD and for the particular needs of each veteran.

KWONG: Wow.

O'NEILL: So beyond sit, lie down, stay, these dogs learn other keywords.

DIAMOND: So cover, for example - dog will sit next to the warrior and look behind them and alert them if someone comes up behind, or block, so they'll stand perpendicular to the warrior in front of them and give them some space from whatever's in front of them. Those are the key commands for tailoring the dog to the warrior.

O'NEILL: And you know, Emily, these commands are helpful because when you're experiencing PTSD, the anxiety, the hypervigilance and other common symptoms often make it so you're not comfortable when strangers are really close by.

KWONG: That makes sense because in combat, that's when things can get really dangerous. And these dogs sound very specialized. They also sound expensive.

O'NEILL: Absolutely. All of this costs about $25,000 per dog, and Rory's organization has partnered about 700 dogs with traumatized veterans. It's the biggest one in the nation.

KWONG: OK. And will the PAWS pilot program help offset any of that cost?

O'NEILL: Nope. But still, the law is an important first step toward that, and you can see the payoff in the vets who've already gotten service dogs. I talked to another veteran, Army Master Sergeant David Crenshaw of New Jersey. He's got a service dog named Doc, a beautiful German shorthaired pointer lab mix.

DAVID CRENSHAW: He goes everywhere with me, and, you know, we teach in the military to have a battle buddy, right? Your battle buddy is that person you can call on any time of the day or night to get you out of every sticky situation. You know you can count on them. And these service animals act as a battle buddy. And so you know you're always going to have them, and they're always going to have you.

O'NEILL: For years, David's dealt with persistent hypervigilance as part of his combat-caused PTSD. It left him constantly on high alert, which is super stressful, causing him anxiety, and it was just plain exhausting, so he always avoided large gatherings. But this summer with Doc, he spent a few days at Disney World in Florida, which marked a huge breakthrough.

CRENSHAW: I left with a smile. I was not agitated. I was not anxious. I was not upset. It was truly, truly amazing, and so much so that I didn't even have to stop to think about it in the moment. It just happened naturally.

O'NEILL: David says because of Doc, he no longer takes any of his PTSD medications and no longer uses alcohol to self-medicate.

KWONG: That's wonderful. And what about Danyelle and her pup, Lisa?

O'NEILL: Well, Danyelle told me that Lisa's helped her to quit alcohol and to stop taking three of her meds for panic attacks, nightmares and periods of disassociation.

CLARK-GUTIERREZ: She checks on me all the time, and if she sees that I'm just kind of, like, out of it, she'll just, you know, whatever she has to do to bring me back. And I can't even put words to how helpful that is.

KWONG: Wow.

CLARK-GUTIERREZ: Come on. Come on. Come eat.

(SOUNDBITE OF DOG NAILS CLACKING)

CLARK-GUTIERREZ: You want some? Do you want some?

(SOUNDBITE OF DOG FOOD BEING POURED)

O'NEILL: So she and Danyelle have this really cute ritual where, as Danyelle mixes her food, Lisa dances and plays. Her nails are all clacking on the floor. And it looks just like a normal household. And Danyelle says this is what she wants for other vets struggling with trauma. And she hopes this new federal pilot program will help other vets like her by making the case for PAWS Act two, the sequel, which would contain actual funding for providing these dogs to veterans with PTSD.

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KWONG: Today's episode was produced by Rebecca Ramirez, edited by Rebecca Ramirez and Gisele Grayson, and fact-checked by Rasha Aridi. Josh Newell was the awesome audio engineer. Stephanie O'Neill joins us as part of NPR's partnership with Kaiser Health News. I'm Emily Kwong. And thank you for listening to SHORT WAVE, the daily science podcast from NPR.

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