Mental Health Assistance Dogs:Opening New Doors For Some

 Gradually Lara Lee Rubino was running out of options to overcome agrophobia (fear of crowds). Her husband, Ryan, was scheduled to be deployed to the Middle East soon and most of her friends were unaware the 28-year-old Nebraskan was becoming highly reluctant to set foot in nearby stores.

She had been seeing a physician and was taking anti-anxiety medications for the disorder. Then, her physician suggested a “service dog” might help alleviate her fear to drive, go shopping or even go into a nearby fast-food outlet for a quick meal. 

“I tend to get obsessive when researching things,” she explains, “and that’s what happened when I began combing the internet for leads of organizations with expertise on dogs’ ability to help individuals with this problem. “

She discovered Heeling Allies in Seattle and Darcie Boltz, owner-training director who also owns a degree in health psychology. Rubino’s parents and her in-laws live in the Puget Sound area, so this seemed like a potential fit while her husband was about to leave for Kyrgyzstan.

Heeling Allies trains Mental Health Service Dogs to provide assistance to individuals with psychological impairments, just as Guide Dogs provide assistance to those with visual impairments. The psychological afflictions range from Post Traumatic Stress Disorder and major depression to Autism Spectrum Disorders.

Boltz offers a comprehensive Mental Health Service Dog board-and-train program, as well as private lessons.

“With three small children, I was painfully aware that I was creating a negative impact on my kids’ lives,” explains Rubino. “Being a military family, moving and family separation is always a factor.”

After a phone visit with Boltz, Rubino says “I felt hope for the first time in years, as she talked me through the process of choosing and training the perfect dog for me and my needs. Ryan and I talked it over before his deployment and felt the benefits of adding a Mental Health Service Dog to our family was a good move.”

Boltz encouraged Rubino to write a letter of support to send to friends and family, since money is a barrier in obtaining a medical-alert dog. The recipients of letter responded with overwhelming support, enabling her to move forward.

“None had been aware of my issues,” she explains. “I had worked so hard for so many years to hide my fears and anxiety by creating excuses to avoid social situations and many other activities.”

Training and room-and-board costs $3,000 monthly. None of Boltz’s clients has yet to find a medical-insurance company willing to pay some of the costs, despite the fact service dogs have proven to help reduce medical costs for their human partner.”

After Rubino obtained financial support, Boltz immediately began searching for the right dog to match her needs.  Enter Blue, a 1-year-old black standard poodle.

“At first, I was a bit nervous about a stranger choosing the right dog for me,” adds Rubino. “Ryan and I envisioned a small dog at the outset, but Darcie seems to have a sixth sense when it comes to dogs and pairing them with their owner.

“Blue has been a dream come to true. He wakes me up in the morning and when my youngest son cries, he reminds me to take my meds twice a day and provides a calming presence during the day.“ His wake-up call is a strong nudge from beside the bed, and the med reminder is triggered by an alarm setting attached to Blue’s collar. Immediately after it sounds, he is trained to come to Rubino and nose her hand steadily.

Blue remained with Boltz for 3½ months of room-and-board and training, then segued into Rubino’s home for additional training and bonding. For the past several weeks, Boltz, Rubino and Blue (equipped with a service-dog-in-training vest) have ventured into Costco, grocery stores, outlet malls, etc., for training and confidence building.

“I update Ryan regularly on our progress,” adds Rubino, “and he says he can tell the difference in my voice when we are talking on the phone.  He has become a big fan of Blue’s, even though they have never met first-hand. “

In stores, Blue serves as Rubino’s Velcro dog, being literally attached to her side and providing the needed room to maneuver through aisles. “People automatically give us a wider berth, and when it does get crowded, Blue presses up against me, which turns my attention to him rather than the crowds.  I had forgotten what this type of freedom felt like.”

Blue passed his American Kennel Club Canine Good Citizen test in March and his public-acccess test in early April.

“Blue and Lara Lee have progressed very nicely,” explains Boltz. “Often it takes six months or more of intensive training for a dog to become proficient in all areas of Mental Health Service Dog training.”

After her husband returns from the Middle East, the family will return to Nebraska, where he will be stationed at Offutt Air Force Base in Bellevue, Neb.

Whenever Rubino has a question relating to Blue, she knows that Boltz is just a phone call or e-mail away. “Her advice and support have been key to making this all work,” adds Rubino.

In 1989, 20-year-old Trina McDonald was assaulted and raped three times while serving with the U.S. Navy in Adak, Alaska. Since leaving the service later that year, she has suffered from Post Traumatic Stress Disease, which eventually triggered alcohol and drug abuse and an eventual “meltdown.”

“I was a mess,” admits McDonald, 40, of Puyallup, who has been “totally clean” since 1999. “I learned that to battle the anxiety and depression associated with PTSD I had to become my own best advocate.  And I have been doing that with the Veterans Administration since then.

Through years of therapy, she refused to be taken down by bureaucratic denials and delays in her case.  She received assistance from the Department of Veterans Affairs personnel in Seattle and Dr. Ellen Li, assistant residency training, Seattle VA Medical Center and a member of the University of Washington School of Medicine Department of Psychiatry and Behavioral Sciences staff.

While treating McDonald since 2003, Li has encouraged her to move forward and has been an advocate for her to obtain an assistance dog. “She has written people on my behalf, including Darcie, and been instrumental in the VA agreeing to help fund a service dog for me,” explains McDonald.

Exactly how much funding will be forthcoming remains uncertain, but Boltz and McDonald are targeting early May for beginning her service-dog training.  She prefers being paired with a middle- to large-size breed like a Labrador retriever or German shepherd.

“I’m like a little kid before Christmas who knows he’s getting a bike, but he’s uncertain what kind,” smiles McDonald. “I’ve been looking at one dog-rescue web site after another for my new partner, and I e-mail Darcie with my finds almost daily. I’m certain she’s getting sick of seeing e-mails from me.”

For the first time in 20 years, McDonald is on an emotional high with anticipation that a dog will soon be opening emotional pathways for her that she has feared to embark upon. 

Mental Health Service Dogs are also known as Psychiatric Service Dogs. They are not pets, rather working dogs trained to assist individuals with disabilities. As service animals, they must be granted access rights to anywhere the general public is allowed to occupy.                                                                  

“One problem my clients might potentially face,” explains Boltz, “are questions and maybe even occasional contempt from someone saying, ‘I don’t see anything wrong with you. You don’t have any physical problem that should require a service animal.’ When the dog owner informs that individual what his or her needs are for the dog that often resolves the matter.”

To qualify for Heeling Allies, a client must provide documentation that he/she has been formally diagnosed with a mental impairment or psychological disability by a qualified health-care professional and produce a letter from that professional stating how and why the client would benefit from owning a Mental Health Service Dog and that the potential client is capable of providing a dog with exceptional care. 

It hasn’t happened yet, but Boltz assures all clients that should months or years later a dog needs to be surrendered, she will willingly take it back.

While she has found dogs for the bulk of her clients, Boltz will accept a client’s pre-owned, untrained Mental Health Service Dog providing it passes an aptitude and behavior evaluation. “I ask a lot of these dogs in training, so I want to be certain that they can respond accordingly,” explains Boltz.

The bulk of the dogs – they cannot be older than 3 — come from area shelters.  And for some clients, small dogs can be just “as powerful and practical” as larger counterparts. A dog’s ability to handle a complexity of tasks and its aptitude are top priorities in her selection process.

“Each case is so different,” she adds. Anxiety, childhood, mood, personality and substance-abuse disorders are among the wide array of potential cases she might see.

“When I have finished working with them, these dogs want to please and know their job. It then becomes imperative that the client is totally focused on what he or she needs to do to maximize the dog’s skills,” Boltz says.

After the initial in-house, one-on-one training by Boltz and gradual introduction to the new owner, the trio (Boltz, client and dog) spend time interacting in public, testing the ability of client to cope with elevators, crowds, smells, loud noises, different floor surfaces, tight spaces, etc., for which the dog has already been proofed with in-house training.

Funding scares 50 percent of her potential clients off. The $3,000 monthly fee might eventually range from $9,000 to $20,000, with the median being $12,000, before the animal and owner are totally ready to enter society as a functioning team.

Some dogs are in training for much longer, depending upon the severity of their handler’s mental impairment and the complexity of the tasks the dog must learn. “Blue was an exception to the rule. His training took half the amount of time it would have normally taken us to train a dog to do what he does,” adds Boltz. “We always joke that Blue was a service dog in a past life.”

Boltz, who spent a year developing her creative training regimen, rates her No. 1 strength as matching dog and client. A certified American Kennel Club Canine Good Citizen evaluator and a graduate of Bastyr University with a degree in health psychology, she brings a strong  judgment mix to the table from the standpoint of client and canine.

She says on her website,”Animals, especially dogs, have an innate ability to reach to the depths of the human spirit in a way other humans simply cannot. I have seen a dog soothe and bring a smile to the face of a person who was in tremendous emotional pain. Assistance Dogs enable people to live fuller, happier and healthier lives. Training serves an important purpose, but a dog’s ability to heal has nothing at all to do with training, and everything to do with its purely magnificent spirit.”

Boltz is not a member of the regional nonprofit The Assistance Dog Club of Puget Sound or the International Association of Assistance Dog Partners. The two will conduct a major workshop, “Assistance Dogs at Work,” Sept. 25-26 in Seattle. 

(For more information on Heeling Allies, visit the web site,  Another superb resource on psychiatric service dogs is “Healing Companions: Ordinary Dogs and Their Extraordinary Power to Transform Lives,” by Jane Miller, New Page Books, $16.99. A review of this volume, by Ranny Green, can be found on the Picks of the Litter link on this web site.)