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Emotional Support Dog, Therapy Dog, Facility Dog, or Psychiatric Service Dog. What’s the difference?

Updated: Feb 15

It’s almost impossible to find any other creature as loving and comforting as a dog. Their ability to empathize and their natural desire to be close to us make them remarkably predisposed to helping get through emotional distress. But knowing what type of dog we need can be confusing. From the calls we get daily at our office at Medical Mutts, it’s clear that there is a lack of understanding of the services rendered by therapy dogs, facility dogs, emotional support dogs, and service dogs, including among healthcare professionals.

What kind of help do you need from a dog? Are you looking to assist others who might be going through a tough time or do you need help yourself? Do you need the help of a dog when you go out, or do you need the comfort of a dog only when you’re at home?

Let’s define each one of those terms. Each one represents a very specific category of dogs, with some major differences in their purpose and in their legal rights.

Therapy Dogs

You do not have a disability, but you have a dog who loves people and doesn’t consider anyone a stranger. Why not put his social qualities towards helping those going through hardship? Therapy dogs do not assist their handler but instead, provide comfort to others. Have you seen dogs go through hospitals, nursing homes, schools, or funeral homes? Such dogs can make a big difference in places where people need a break from their daily challenges. They will snuggle up with a child on a hospital bed or place their head on the lap of a son who just lost his father. Therapy dogs will put a smile on the face of an elderly person or sit next to a scared little girl on her first day in school. The presence of a dog will help patients recover faster from surgery or an emotional event. Studies confirm that dogs can reduce stress levels and improve physical, emotional, and cognitive functions (Wisdom & al., 2009), including reducing mortality rates in patients with heart failure (Friedman & al., 1980).

Therapy dogs are pet dogs. They are NOT covered under ADA laws because they don’t provide a service to a person with a disability. They have the right to go to hospitals or other institutions, but only when they have received the authorization to do so. Most therapy dogs are enrolled in therapy dog programs such as Therapy Dogs International or Pet Partners. But before they can start offering their support, they must first follow a specific training program. This prepares the teams (handler and dog) to interact appropriately with the people they meet. The dogs must be confident and well-behaved but they also must truly enjoy interacting with all sorts of strangers.

Facility Dogs

If you work in a school, a courtroom, a dental clinic, or a rehabilitation center and want a dog to assist people coming to your facility, the type of dog you need is a Facility Dog. A Facility Dog is a dog trained for general obedience, but also for behaviors specific to the needs of the organization. A Facility Service Dog might for instance:

  1. Lay down next to a child going through a dental procedure, providing comfort and security and helping to keep the child still and calm.

  2. Get on a person’s lap to help the person calm down through deep pressure therapy. This could be very useful in a rehabilitation center or a firehouse where first responders sometimes need a way to recover when coming back from a traumatic situation.

  3. Retrieve objects in a senior care facility.

  4. Encourage certain movements in patients recovering from an accident. By caring for the dog, the person is stimulated to accomplish certain fine or large motor tasks. A person might, for instance, feed the dog one kibble at a time, throw a ball, put the collar on and off, walk the dog, give the dog hand signals or verbal cues, point or touch certain parts of the dog, read to the dog, walk towards the dog, etc.

A Facility Dog will typically be under the care of one of the facility staff, like a teacher, a doctor, a therapist, an activity director, a social worker, a mental health practitioner, etc. They play an important role in increasing patient motivation, encouraging patients to participate in certain activities, promoting the use of language, encouraging trust in the therapist or the teacher, increasing social interaction with the staff and other residents, etc.

Facility Dogs are similar to Therapy Dogs. But unlike Therapy Dogs, who only work occasionally as they are taken a few hours at a time to a hospital or other institution, Facility Dogs generally “work” full-time at the facility. They also require special training to fit the needs of that institution. Like Therapy Dogs, Facility Dogs must be highly social and enjoy working with a variety of people.

Facility Dogs do not have public access rights as outlined by the ADA but can work inside a particular facility when the administration of the facility has approved of the presence of the dog.

Emotional Support Animals (ESA)

Having a dog in your home helps you calm down from an emotional situation. Your dog might also help you fight depression and encourage you to be more active. An ESA can be used as part of a medical treatment plan as their presence provides companionship, relieves loneliness, and can help with anxiety and even some types of phobias. Emotional Support Animals are NOT considered service animals under the ADA. They are pets with the only mission of being present for their human. They do not require any training whatsoever.

To be considered an ESA, the dog’s owner must have been diagnosed with an emotional or mental disorder such as anxiety, depression, or panic attacks.

Up until recently, ESAs were covered under the Air Carrier Access Act (ACAA) which allowed them to travel in the cabin of an airplane with their owners. Unfortunately, in the past few years, ESAs have drawn much attention. Many pet owners claimed their animals as an ESA for the sole purpose of getting them on airplanes for free. Airlines used to allow all sorts of animals on board, including pigs, hamsters, kangaroos, and even a peacock. This problem was compounded by websites offering fake IDs and certificates to anyone sending a check and a picture. The ongoing abuse of the system has recently led to stricter guidelines that no longer allow for ESAs onboard.

ESAs are protected under the Fair Housing Act (FHA). The person must be diagnosed with a disability and have a healthcare provider who can attest that the animal helps alleviate some symptoms. This law allows for EASs to live in a house or apartment even when a “no pet” policy is in place, without paying additional fees to the landlord.

Even though ESAs have certain legal protections, unlike service animals, ESAs DO NOT have public access rights. The only animals allowed to go everywhere with their person are service animals.

Psychiatric Service Dogs

If you have been diagnosed with a disability and could use a dog to help you by performing specific trained tasks, you need a Service Dog. If you suffer from an anxiety or depression disorder, PTSD, or other mental disability, the type of service dog that you will need is referred to as a Psychiatric Service Dog. Unlike Therapy Dogs or ESAs, Service dogs are specifically trained to perform certain behaviors that will help alleviate some of your symptoms. The dog might be trained to remind you to take your medication, to interrupt repetitive or self-harming behaviors, to get your attention and calm you down before or during an anxiety attack, to get help, etc.

Here are a few examples of how a Psychiatric Service Dog might help:

  1. Engage in attention-seeking behaviors, such as nudging, pawing, licking, or tugging on the person’s clothes any time the person unconsciously starts self-harming behaviors (scratching, pulling skin, hair, etc..) or zones out into a flashback.

  2. Anticipate an anxiety attack and redirect the person’s attention to them. They can help their person come back to a normal state by staying close, getting on their lap to provide pressure and comfort, getting help from a relative, fetch a drink or medication.

  3. Help the person stay calm while going to the store. With the dog, a normally social-phobic person may remain calm as they keep focused on their dog. The presence of the dog and the need to manage them helps reduce the potential impact of certain triggers when out in public. The dog can also be trained to place their body in front or behind the person anytime they stop, keeping strangers at a safer distance.

Title II and III of the ADA, limit service animals to dogs but may in certain instances also allow for trained miniature horses. In any case, such animals must not only be trained to perform specific tasks to alleviate a disability but must also receive extensive obedience training to be well-behaved and easy to manage out in public.

Unlike any other dog, Service Dogs have the right to go everywhere the public is allowed to go. They are selected for their ability to handle many different situations and be comfortable around all sorts of people, sounds, activities, etc. Their role is to help their person gain independence and a sense of security. Mostly, they help with tasks that are necessary for the person’s well-being and ability to live a normal life. These are tasks that the person would not be able to do on their own, thus making the Service Dog a necessity.

In summary, if you do not have a disability and want to work with your pet dog in helping others, you’ll need to work with an organization and train your dog to be a Therapy Dog. If you work for an organization that might benefit from having a trained dog assist in therapy sessions, you need a Facility Dog. If you have a diagnosed disability, you might consider an Emotional Support Animal whose company will help you in your home, or, you might need a Service Dog if you need the dog to perform specific tasks and/or go everywhere with you.

For more information on service dogs and emotional support animals, visit the ADA page

For information about the service dogs that Medical Mutts provides, visit


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