Can a psychiatrist prescribe an emotional support animal

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Why therapists should not be involved
Who can write an ESA letter in Oklahoma?
Who can write an ESA letter in Ohio?
Who can write an ESA letter in Texas?

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Note: The following opinion is a lightly-edited excerpt from the fourth edition of Basics of California Law for LMFTs, LPCCs, and LCSWs. Emotional Support Animal (ESA) letters are discussed in one of the book’s “Room for Debate” segments, alongside Emma Jaegle’s counterargument supporting therapists writing ESA letters. Note the update at the bottom of this post.

An Emotional Support Animal (ESA) is different from the trained and certified service animals used by individuals with disabilities. Unlike service animals, ESAs do not need any kind of training or certification, and they aren’t allowed everywhere. They are primarily legally recognized in two contexts. Under federal law, ESAs can fly for free, with their owner, on commercial flights. And under both California and federal law, ESAs also can accompany their owners in housing situations, even ones that do not normally allow pets or that would charge pet rent.

Individuals can have ESAs if they have obtained a letter of support from a therapist. There are very few rules or restrictions on how a therapist can determine whether to issue such a letter, or what the appropriate justification for allowing an ESA should be. This is a surprisingly loose system, and in the past 10 years, the use of ESAs has grown much faster than the use of other types of service animals.

Some therapists will issue ESA letters to any client who asks. Others refuse to write such letters at all. Between those extremes, others have developed their own criteria for when to issue ESA letters, though there is no standard set of criteria for decision-making in this area that therapists are required to follow.

In the absence of clear legal or ethical guidelines, is it appropriate for therapists to issue ESA letters at all?

Why therapists should not be involved

I’m a pet owner and an animal lover. But for a therapist considering whether to issue ESA letters, questions come up about our scope of practice, our scope of competence, our ethics, and ultimately, what the purpose is for our work.

Determining whether to write an ESA letter is not simply a matter of issuing a mental health diagnosis. It also involves assessing whether an ESA would meaningfully help. And therapists are typically not trained to make this determination. We are not trained to assess disability, and we cannot certify a client’s claim for disability benefits. Given this lack of training, writing ESA letters is arguably outside of our scope of practice.

Ethical questions arise as well. Our ethics demand that we intervene with our clients only in ways that we expect will benefit them. Studies on the benefits of ESAs are inconclusive at best.

Ultimately, these letters call forward a bigger question about our work: Who do we serve? If our purpose is simply to please our clients, then it makes sense to write ESA letters for anyone who asks. However, if our purpose is to help clients better integrate into the community around them, then it makes little sense to place a client’s convenience over the comfort and safety of others who may have allergies, phobias, or other concerns.

The current process for clients to obtain ESA letters from therapists is, unfortunately, ripe for abuse. There’s little to stop a client wanting their pet to be an ESA from getting together with a therapist who wants a quick buck. But we shouldn’t make decisions we aren’t trained for. ESA rules need to be strengthened. When that happens, we should be taken out of the process.

Update: As of January 1, 2022, California has established new rules for therapists who wish to write ESA letters for their clients. See this post for more details: California sets new rules for therapists writing ESA letters

Who can write an ESA letter in Oklahoma?

How do you get an Emotional Support Animal in Oklahoma? You can assign your pet as an emotional support animal with an ESA Letter signed and issued by a licensed mental healthcare professional (LMHP). If you do not have any pet, you can get one from one of the following pet shelters: SPCA Animal Shelter, Oklahoma.

Who can write an ESA letter in Ohio?

ESA letters must be written by an Ohio licensed healthcare professional. Healthcare professionals that write ESA letters include: licensed clinical social workers (LCSW) psychologists.

Who can write an ESA letter in Texas?

Qualifying for an ESA Letter in Texas You can request one from your current healthcare professional responsible for your mental health. You can also use online healthcare professionals who specialize in emotional support animals and offer their services remotely, so you don't have to leave your home.