“Who’s a Good Boy?”
“A dog is the only thing on earth that loves you more than he loves himself.” Josh Billings
It will come as no surprise to anyone who has a pet, whether it’s a cat or a dog, that they can almost act as therapists.
Thus, animal-assisted interventions (AAIs) from therapy dogs in the therapy room to equine-assisted services are becoming a common complementary support for people recovering from personal or service-related trauma.
But what is the mechanism behind this? How does petting a dog during psychotherapy sessions for PTSD help someone more than not doing so?
What is PTSD and C-PTSD?
The most recognised trauma-based condition globally is post-traumatic stress disorder, or PTSD.
According to the Diagnostic Statistical Manual, or DSM-5, for a person to meet the criteria of PTSD, they must have behaviours that fit into the following four categories for over one month, and not have them related to any substances, medical conditions, or other mental health disorders.
Intrusion symptoms– Unwanted, distressing memories or flashbacks, nightmares and intense psychological or physiological distress at trauma reminders.
Avoidance – Avoiding thoughts, feelings, or conversations about the trauma and avoiding places, people, or activities that trigger reminders.
Negative alterations in cognitions and mood- Persistent negative beliefs about self, others, or the world, as well as distorted blame of self or others. There is usually persistent fear, horror, anger, guilt, or shame, accompanied by a diminished interest in activities. They may feel detached or estranged and may have an inability to experience positive emotions
Alterations in arousal and reactivity– A person with PTSD will likely have irritability or aggressive behaviour, hypervigilance, an exaggerated startle response, problems with concentration and sleep disturbance.
At the time of writing, the DSM-5 does not list complex post-traumatic stress disorder (C-PTSD) as a separate disorder from PTSD. It specifies that people who have C-PTSD have a diagnosis of PTSD, with associated symptoms, such as borderline personality disorder, persistent depressive disorder, or a dissociative disorder, such as dissociative identity disorder (DID).
PTSD, pets and Reduction in Symptoms
Looking at the research, there are some clear signs that AAIs can help to reduce symptoms, especially among veterans.
A 2024 nonrandomized controlled trial in JAMA Network Open (N=156) highlighted that adding a trained psychiatric service dog to usual therapy care led to greater reductions in PTSD severity, depression and anxiety after three months, versus the care on its own. (Leighton et al., 2024).
Equine-assisted services (EAS), or horse husbandry, has also shown interesting effects.
A 2024 BMC Psychiatry meta-analysis of 13 studies in veterans showed a reduction of 12 points on PTSD checklists, favouring EAS post-treatment. Complimenting this review, there was a 2024 randomised control pilot (N=9) of adaptive horsemanship, which showcased improvements in global psychiatric distress, compared with a waitlist control for this treatment, pointing towards a reduction in PTSD symptoms (Rankins et al., 2024)
Service Dogs and Sleep
A core feature of PTSD and C-PTSD is disturbed sleep, nightmares and night terrors. With AAIs, there is some interesting research into sleep, trauma and how having service dogs nearby can help improve sleep quality, reducing these symptoms. A 2024 study by Bristol (et al) found that veterans who had psychiatric service dogs self-reported better sleep quality and less fear of sleep over three months. Actigraphy (or reporting the cycles of sleep and their length or quality) was not recorded but this change in perception suggests that more research is needed in this area.
Children and Complex Trauma
An area that many people do not want to think about his how many children suffer from trauma. This can be due to bullying, abusive parents and/or siblings, as well as neglect. For young children and teens with complex trauma, a 2024 systematic review in Children concluded that dog-assisted therapy can enhance standard treatments and potentially reduce attrition, though only one included study directly measured dropout. So, overall, evidence remains preliminary but seems to point that this is beneficial for trauma recovery Chapman et al., 2024).
Action for Children, and foster agencies, like Foster Care Associates, have noted the difference that having a foster placement with pets (particularly dogs) has on children placed into them, noting that dogs are calming, comforting and often help children to settle in to the placement faster. Dogs also provide a routine for children in foster care, which can be helpful to manage trauma and difficult emotions.
How Does Pet Therapy Help?
There are a few reasons why pet therapy may be beneficial to both kids with trauma and those with trauma from conflict in adult life.
The pathways have been linked to the reduction in a perceived threat and arousal during therapy sessions, pointing to co-regulation. There is also an enhanced engagement for therapists who use pets in therapy, which can lead to better client retention. When it comes to horse-based pet therapy, there is an element of mastery and agency, such as learning how to calm and approach a horse, as well as ride one. Then, there is the social buffering that counters isolation and avoidance.
A study from Frontiers in Psychology (2020) found that service dogs who are trained for certain tasks, such as interrupting anxiety and performing safety checks, align with particular PTSD symptoms, which showed targeted, symptom-linked benefits. A study from Rankins et al (2024) released results from a pilot study which did not show consistent changes in cortisol or oxytocin over an eight-week horsemanship program. So, the biomarker mechanisms remain an open question about any potential clinical gains.
Over the last five years, the research has pointed to AAIs as a meaningful way to reduce PTSD symptoms for veterans and to improve their overall mental health. However, it should be seen as a complement to usual PTSD or C-PTSD treatments. Horse-based treatments also show moderate but promising effects; however higher quality trials are needed. It should also be noted that, at the time of writing, C-PTSD is not a separate condition from PTSD in the DSM-5, so, with the arrival of the DSM-6 and the potential change of this, more research into the effects of animal therapies and their impact on C-PTSD will likely follow.
I hope you found this blog article an interesting read. If you have enjoyed this article, feel free to drop a comment. We appreciate all feedback and want to hear how you find these blogs. If you are struggling with trauma or PTSD-like symptoms, please contact My Family Psychologist on 07801 079 555 or email luisa@myfamilypsychologist.com to see how I can help you.
FAQS
How can pet therapy help people with PTSD or C-PTSD?
Pet therapy can help to reduce perceived threat and arousal during therapy sessions, promote co-regulation and also increase client engagement. Research also highlights that trained service dogs and equine-assisted therapy may reduce PTSD symptoms, as well as depression and anxiety among veterans.
Do service dogs improve sleep for trauma survivors?
The early evidence suggests that yes, psychiatric service dogs can help to reduce nightmares, night terror and fear of sleep in those who have PTSD, although more research is needed to confirm objective improvements.
Can children with trauma benefit from pet therapy?
Absolutely. Children and young people with complex trauma have been found to be helped by dog-assisted therapy as an enhancement to standard treatments. Foster agencies have also noted that children who are placed in foster homes with dogs settle quicker and feel calmer than children who are placed in homes without dogs.
References
Action for Children. (n.d.). Fostering with pets. Retrieved August 16, 2025, from Action for Children website: https://www.actionforchildren.org.uk/fostering/who-can-foster/fostering-with-pets/
Bristol, S., Lowe, S. R., Benedict, M. L., Rodríguez, K. E., MacLean, E. L., Vonk, J., … O’Haire, M. E. (2024). The influence of service dog partnerships on perceived sleep quality in veterans with PTSD: A nonrandomized controlled study. Frontiers in Sleep, 3, 1432919. https://doi.org/10.3389/frsle.2024.1432919 Frontiers
Chapman, R. L., Baselmans, C., Howell, T. J., Ronken, C., & Butler, D. (2024). Exploring the benefits of dog-assisted therapy for the treatment of complex trauma in children: A systematic review. Children, 11(8), 1017. https://doi.org/10.3390/children11081017 MDPI
Foster Care Associates. (n.d.). Can I foster if I have a pet?. Retrieved August 16, 2025, from Foster Care Associates website: https://www.thefca.co.uk/about-fostering/who-can-foster/can-i-foster-if-i-have-a-pets/
Leighton, S. C., Kloep, M. L., Rodriguez, K. E., Rodriguez, S. M., Gherardini, A., … O’Haire, M. E. (2024). Service dogs for veterans and military members with posttraumatic stress disorder: A nonrandomized controlled trial. JAMA Network Open, 7(6), e2414686. https://doi.org/10.1001/jamanetworkopen.2024.14686 PMC
Optional physiological marker reference (if you plan to discuss cortisol awakening response in a longer version): Nieforth, L. O., et al. (2024). Cortisol awakening response in veterans with psychiatric service dogs: A replication. Scientific Reports, 14(1), 14868. https://doi.org/10.1038/s41598-024-65607-4
Provan, M., Ahmed, Z., Stevens, A. R., & Sardeli, A. V. (2024). Are equine-assisted services beneficial for military veterans with post-traumatic stress disorder? A systematic review and meta-analysis. BMC Psychiatry, 24, 544. https://doi.org/10.1186/s12888-024-05984-w PMC
Rankins, E. M., Quinn, A., McKeever, K. H., & Malinowski, K. (2024). Ground-based adaptive horsemanship lessons for veterans with post-traumatic stress disorder: A randomized controlled pilot study. Frontiers in Psychiatry, 15, 1390212. https://doi.org/10.3389/fpsyt.2024.1390212 PMC
Rodriguez, K. E., Bryce, C. I., Granger, D. A., O’Haire, M. E., & Kertes, D. A. (2020). Clinical features of PTSD and the perceived importance of psychiatric service dogs. Frontiers in Psychology, 11, 1631. https://doi.org/10.3389/fpsyg.2020.01631 DOI