Study plagued with problems
FAYETTEVILLE, N.C. — Army veteran Joe Aguirre opens a restaurant door, then steps aside to let his golden retriever take point. “Clear,” Aguirre commands, and 3-year-old Munger pivots right, left, then right again, sweeping the room for potential threats.
“He's basically looking for ... anything that would be out of the ordinary. A bag. A particular weapon. People acting erratic,” says Aguirre, who suffers from post-traumatic stress disorder after three tours of duty in Iraq and one in Afghanistan. At the cash register, Aguirre says “Block,” and the dog places himself perpendicular to his master, creating a buffer to anyone who might approach.
Before Munger, a simple outing like this would have been terrifying, if not impossible. “He's put faith back into my way of looking at society,” Aguirre says.
But do the comfort and security this lovable dog provides come at the expense of true healing from PTSD? Is Munger merely preventing Aguirre from confronting his demons?
Since 2002, the U.S. Department of Veterans Affairs has paid veterinary bills to veterans with guide or service dogs for physical disabilities. Now, the agency is in the midst of a $12 million study to gauge the efficacy and costs of using dogs to help those who suffer from post-traumatic stress.
Four years in, that research has been plagued by problems. Only about 50 dogs have been placed with veterans, and critics question whether the protocol itself is flawed — with the dogs being trained to do things that could reinforce fears. Others worry the animals could become a substitute for the hard work that comes with therapy.
“You will have the veterans go to more places with the dogs and do more things than they would otherwise do. But they are reliant on the dog, not on their knowledge of ... whether really they are afraid of a ghost,” said Dr. Edna Foa, director of the Center for Treatment and Study of Anxiety at the University of Pennsylvania Perelman School of Medicine.
More than 350,000 veterans of the Iraq and Afghanistan wars have sought help from the VA for PTSD. Yet the agency is authorized to pay only for “evidence-based” therapies such as cognitive processing and prolonged exposure, which involve having veterans confront and analyze traumatic events.
In 2010, Congress permitted the VA to study alternative treatments for PTSD, including the therapeutic use of animals. The study began in late 2011 in Tampa, Fla., with three nonprofits contracted to provide up to 200 service dogs for veterans, who would be compared against a control group that did not receive dogs.
The effort soon ran into trouble. The VA cut off two of the three dog vendors following biting incidents involving participants' children. The final contract was terminated in August 2012 amid allegations of lax veterinary care and placement of dogs “with known aggressive behavior,” according to VA records. By then, only 17 dogs had been placed.
During the next year and a half, the study protocol was revamped to exclude veterans with children under age 10. It also dropped the no-dog control in favor of a group that would receive less-specialized “emotional support dogs” whose “sole function is to provide comfort.”
Critics of the study object most strongly to the tasks the VA is requiring of the dogs — sweeping the perimeter of a room before a veteran enters, for example, or protecting the veteran by “blocking.”
“Isn't that saying that al-Qaida could be behind the shower curtain? That's supporting paranoid, pathological thinking,” said Meg Daley Olmert, author of a book on how contact with a dog can create a sense of well-being.
Olmert is chief research adviser for Warrior Canine Connection.
The group's leaders say dogs should be trained to pick up on cues from PTSD sufferers and then provide the appropriate support, such as learning to wake someone up during a nightmare or detecting when a veteran is anxious, and interacting in a way that helps calm him.
