How Emotional Support Animals Promote Mental Health

Many of us will have experienced a soothing sense of calm when hugging a much-loved pet.

Petting your cat or dog stimulates the release of oxytocin — a neurotransmitter and hormone that promotes social and emotional bonding and trust, and reduces stress (Beetz et al., 2012).

In my work supporting neurodivergent clients, I often hear how their emotional support animals provide unconditional affection and comfort and also aid emotional regulation.

Emotional support animals (ESAs) are valued for their ability to promote mental health by both clients and professionals alike (Chandler, 2015, 2024; Ferrell & Crowley, 2021). This article will explore how emotional support animals improve wellbeing and can enhance the quality of life of those facing mental health challenges.

Before you continue, we thought you might like to download our five positive psychology tools for free. These detailed, science-based exercises will help you or your clients build healthy, life-enriching relationships.

What Is an Emotional Support Animal?

An emotional support animal (ESA) is more of a companion than a pet, because their explicit function is to promote emotional regulation, boost mood, and help to ground a person dealing with diagnosed mental health challenges (Hassing, 2020; Severin, 2020; Tomson, 2020).

Emotional support animals reduce feelings of loneliness and isolation, and provide structure, as most animals require a routine. ESAs can also help soothe frayed nerves and reduce stress through their acceptance and unconditional love (Severin, 2020; Tomson, 2020).

ESA vs. Service Animal vs. Therapy Animal

The key difference between an ESA and a service animal (like a guide dog or hearing dog) is that ESAs aren’t trained to perform specific tasks that their owner needs support with to live independently.

Rather, an ESA’s presence promotes a sense of psychological safety, comfort, and ease (Severin, 2020; Tomson, 2020).

ESAs don’t need specialized training, unlike service dogs. Their natural companionship and affection is what helps. ESAs are most commonly dogs and cats, but any animal could be an ESA if its presence supports emotional regulation and wellbeing (Severin, 2020; Tomson, 2020).

In contrast, a service animal is almost always a dog and has been trained to perform highly specialized tasks to empower their human partner to live as independently as possible (Sutton, 2015). The United States also recognizes miniature horses as service animals for those that need a sturdier guide or mobility assistance (Howell & Salmon, 2024).

Service animals include dogs for the visually impaired and hearing impaired, as well as medical assistance dogs like diabetic alert dogs that detect abnormal blood sugar levels, seizure alert dogs, and cardiac alert dogs (Howell & Salmon, 2024).

There are also mobility assistance dogs that can fetch and carry things, open and close doors, and help with balance and walking, among other tasks. Finally there are psychiatric service dogs that are trained to interrupt panic attacks, remind someone to take medication, wake somebody from a nightmare (relevant for post-traumatic stress disorder), and ground somebody when they become dissociated (Howell & Salmon, 2024).

Finally, a therapy animal is different from both an ESA and a service animal. Therapy animals are trained to work with specific client groups in structured settings like schools, care homes, or disaster zones. They provide comfort, emotional support, and stress relief to groups rather than individuals (Taylor, 2018). The following table summarizes the differences.

Differences between ESAs, service animals, and therapy animals

6 Psychological Benefits Emotional Support Animals Can Provide

Emotional support animals provide many psychological benefits. Different people will experience a different combination of benefits depending on their relationship to their ESA.

Here are some of the most common ones according to research and animal support therapy practitioners (Hassing, 2020; Severin, 2020; Taylor, 2018; Tomson, 2020):

1. Structure and routine
   Animals need routines, rather like children do. Taking care of an animal — including feeding, walking, and grooming — adds healthy structure and purpose to a person’s day, which can be especially helpful for people struggling with mental health conditions.
2. Social interaction
   Taking care of an animal often provides opportunities for socializing; for example, talking to other pet owners and taking a dog for walks can reduce feelings of isolation.
3. Reduced stress
   ESAs can lower stress hormone levels and increase feelings of calm. Petting an ESA releases oxytocin that generates positive emotions toward others, increasing feelings of safety and protection.
4. Improved mood
   Emotional support animals offer unconditional love and companionship, which can lift a low mood and diminish anxiety.
5. Emotional regulation
   Animals are nonjudgmental, and their calm, accepting presence can help people manage overwhelming emotions like anger, sadness, or panic attacks more effectively.
6. Support in a crisis
   ESAs provide immediate emotional grounding during moments of intense distress due to all of the above.

You can watch this informative video, What Does an Emotional Support Animal Really Do? by psychiatrist Tracey Marks to find out more.

Given all the benefits ESAs provide, some professionals include emotional support animals in their coaching practice or therapy sessions. I’ve coached many neurodivergent adults with their ESAs present. Let’s explore how to include animals in a professional practice.

Using Animals in Practice: What Professionals Should Know

Mental health professionals can involve animals in their practice in a range of different ways, depending on the needs of their clients. However, animals brought into the therapeutic or care spaces must be properly trained, certified, and licensed (Sutton, 2015).

Meanwhile, practitioners can permit clients to bring their own emotional support animal into sessions. Let’s explore more formal ways to include animals in practice.

• Animal-assisted therapy is a formal, goal-directed treatment where a trained dog, horse, or even rabbit is part of the therapeutic process. The animal helps the client meet specific psychological goals, like building trust, improving emotional regulation, or practicing communication skills like empathy (Howell & Salmon, 2024; Trevathan-Minnis & Platz, 2023).
• Certified therapy animals can also be included in sessions to create a calming environment, help clients open up emotionally, and provide support. Just the presence of an animal can lower defenses and ease tension (Howell & Salmon, 2024; Trevathan-Minnis & Platz, 2023).
• Equine-assisted therapy is a specialized form of therapy involving horses. Clients often work with horses to overcome trauma, most especially by building emotional regulation skills (Prieto et al., 2022).
• Group therapy with animals can encourage interaction by creating a nonthreatening focal point for conversation that helps open people up and build trust (Chandler, 2024).
• Mindfulness and grounding exercises can be modeled and supported by animals because they are naturally present in the moment. Therapists can use activities like mindful petting or observing the animal’s behavior to help clients practice mindfulness and stay grounded (Schramm et al., 2022).

Therapists and counselors can also decide to include animals in their sessions. The following section explains which modalities are most suited.

5 Therapy Modalities That Work With Animals

Therapeutic modalities that are body-focused, emotion-focused, mindfulness-focused, and relationship-focused work best with animals because animals are nonverbal, sensory, emotional beings that live in the present moment (Hoy-Gerlach et al., 2022). Here are some examples.

1. Trauma-focused therapy

Animals can be especially supportive of somatic approaches to working with trauma. Trauma survivors often struggle with body awareness and emotional regulation.

Animals offer a safe, regulating presence to help clients reconnect to their bodies without overwhelm.

For example, using a therapy dog’s breathing to guide slow, deep breathing exercises with a client recovering from post-traumatic stress disorder (PTSD; Richerson et al., 2023).

2. Mindfulness-based therapies

Animals naturally live in the moment, making them excellent “teachers” of mindfulness practices.

For example, petting a cat mindfully by focusing on texture, warmth, and rhythm can help anchor the client in the present moment (Schramm et al., 2022).

3. Attachment-based therapies

Animals model secure attachment by offering unconditional affection, consistency, and nonjudgment, which can help clients work through issues of trust, abandonment, or relational trauma.

For example, using a therapy dog to build trust with the client can be a useful model or metaphor for safe relationship building (Richerson et al., 2023; Taylor, 2018).

4. Play therapy

Kids naturally connect through play, and animals add a living element to therapeutic storytelling, role-play, and emotional exploration.

For example, a child might be more likely to express feelings in a role-play involving a therapy dog as a living model than they would with dolls or other toys (Chandler, 2024).

5. Equine-assisted psychotherapy (EAP)

EAP is a specialized therapeutic modality all of its own. Horses are especially powerful mirrors for nonverbal communication, emotional states, and leadership dynamics. EAP works well for trauma, grief, depression, anxiety, and interpersonal difficulties (Prieto et al., 2022).

Again, in all the interventions mentioned above, only certified and trained animals should be used. If clients request the presence of an emotional support animal in sessions, the animal should also be certified. Sometimes, professionals are asked to provide assistance with the certification process by providing a testimonial about how a client’s animal benefits their mental health. Let’s explore how that works.

How to Register an ESA: What You Need to Know

Registering an ESA differs depending on citizenship or country of residence.

However, wherever you are, a licensed mental health professional (LMHP) will usually need to write a letter confirming that an ESA would be beneficial for the client’s mental health (Ensminger & Thomas, 2013).

ESAs are not legally recognized in every country the way service or assistance animals are recognized, although they can still be vital for a person’s wellbeing.

In some countries, ESAs are protected under certain laws, for example, under the Fair Housing Act in the United States. However, the general rule is that ESA registration does not confer any legal entitlements but may help when requesting accommodations from service providers and landlords. The provision of accommodations is discretionary. It helps if the ESA is registered and an emotional support animal letter is provided (Ensminger & Thomas, 2013).

Many websites promise to certify pets as ESAs to access housing, for example. It’s important to be aware that these can be scams and to register ESAs correctly. Here’s a short, three-step method for registering an ESA that applies in most countries that recognize service animals.

1. Obtain an emotional support animal letter

First, a licensed mental health professional will need to provide an emotional support animal letter. Professionals must know their client’s situation well. There are trusted online platforms that can direct clients to an LMHP, such as US Service Animals.

For more guidance, these websites offer free emotional support animal letter templates:

• ESA Doctors
• THERA Platform
• Lawrina Templates

2. Understand the legal rights

Legal rights vary across countries and states (such as under the Fair Housing Act in the United States). It’s important to be aware of limitations. Most ESAs are not entitled to special accommodations by service providers, airlines, or landlords. However, there are some ESA voluntary registration websites that can offer advice on requesting accommodations. They can never assure access rights, however (Howell & Salmon, 2024).

3. Avoid dubious online certification options

Given the above, be sure your clients avoid unofficial online registries that require payment and make false promises to secure access rights that have no legal standing.

In sum, registering the ESA using a letter from an LMHP plus a legitimate website that can offer advice on requesting accommodations might help facilitate access to services or housing, but these decisions are always discretionary.

Challenges and Considerations With ESAs

Getting a pet is a big decision for anyone, let alone a person with mental health challenges. ESAs are deeply helpful for many people, but their lack of legal recognition, poor access to most places, and the responsibility involved in caring for an ESA mean there are challenges to be faced and many things to consider before taking the plunge (Hassing, 2020; Severin, 2020; Taylor, 2018; Tomson, 2020).

Here’s a simple table to summarize the pros and cons clients can consider before deciding to get an ESA. These are not exhaustive but cover most issues. Remember, having an ESA is not a one-way relationship, but rather a mutually beneficial partnership.

One of the most important challenges with an ESA is the restriction on traveling.

Today, ESAs are treated like regular pets by most airlines, unlike service or assistance animals. Therefore, clients will need to be sure that they can travel by other means or afford the extra costs of air travel, pet passports, and animal care for the ESA (Hassing, 2020; Severin, 2020; Taylor, 2018; Tomson, 2020).

More Resources From PositivePsychology.com

If you’re interested in finding out more about how you can include animals in your practice, you can read this article here:

• Animal Therapy Explained: 4 Best Courses & Certifications

If you’re exploring the benefits of having an emotional support animal, you may also find it useful to understand how your beliefs about health shape whether you seek out — and stick with — supportive wellbeing practices like ESAs in our dedicated article.

Meanwhile, if you’re looking for tips on self-soothing or emotional regulation with or without a pet, take a look at these:

• 4 Best Self-Soothing Techniques & Strategies for Adults
• Emotional Regulation: 5 Evidence-Based Regulation Techniques

We also have a range of free worksheets you can use while including pets, such as the following:

The Rate Worksheet is an exercise to support emotional regulation that can include talking to a much-loved pet. As the author says, cats are excellent listeners.

Our Nature Play worksheet guides you through a mindful walk in nature. Also a great practice with a dog, as they are naturally mindful and present.

This Loving Kindness Meditation worksheet includes focusing on a loved person to generate loving kindness and compassion, but focusing on a much-loved pet and animals in general rather than people is also a great meditation practice. I’ve done this practice with stressed or overexcited dogs in my care, and they respond very quickly to the soothing, positive vibes.

If you’re looking for more science-based ways to help others build healthy relationships, this collection contains 17 validated positive relationships tools for practitioners. Use them to help others form healthier, more nurturing, and life-enriching relationships.

A Take-Home Message

The most important thing to remember when deciding on whether to include an emotional support animal in your life or practice is recognizing that the relationship between a human being and an ESA is a collaboration. ESAs require a lot of care themselves and are a big responsibility.

I’d suggest a trial period for anyone considering getting an emotional support animal. Clients can borrow a friend’s or relative’s pet for a day or a week, perhaps while they’re away on vacation. They could also try voluntary pet sitting through one of the many services available online.

I do both because I love animals, but due to frequent travels for work and pleasure, owning my own pet might not be fair on me or the animal. Regardless, I benefit greatly from animal companions when they’re around. I also enjoy bird watching to relieve stress and reconnect to the present moment.

Please share your stories in the comments about how animals have helped you. As an avid animal lover, I’m really interested to know. Animals remind us of our innocence and can be a wonderful consolation in tough times.

We hope you enjoyed reading this article. Don’t forget to download our five positive psychology tools for free.

ED: Updated Aug 2025