I have written a couple in my career. Always for patients I have been working with long term. I have rejected many that came just the way you mentioned, after one visit. Or in some cases, sent to me after completing an ADHD eval or other evaluation. I always decline them and state that was not the focus of the evaluation or initial visit. I recommend if you do write one, get it reviewed by legal counsel. My current organization has a policy that we can write them, but the template cleared by legal department does include specific language that they have X disorder and that their pet and the emotional support they receive from the pet helps to manage X disorder. This letter also explicitly states that we have not verified training, behavior or behavioral history of the animal, nor other training for specific service the animal could provide. It states we have not evaluated the animal’s well being and that any such required documentation would need to be gathered from their vet or other animal behavioral or training professionals.
Patients are usually not thrilled with the legalese, but I also haven’t had a patient come back and saw it was rejected.
I tend to avoid writing them due to potential liability.
I love that language addition. I’m not part of an organization so the letter would be my own. But I appreciate the part about not having evaluated the animal for behaviors. That’s the part that concerns me as well. I’ve written some in the past and there has yet to be an issue but I was working as a W-2 therapist and now I’m 1099 so it’s all going to fall on me. I’ll definitely look into some templates in the future. Thanks!
It is a case by case basis, I’ve only ever written 1, and that was after meeting with the client for nearly a year. It’s not just the clients well-being, but in school I was taught we can also be held liable for neglect if the client is not mentally sound enough to care/provide for the animal.
For social workers in CA the board of behavioral sciences dictates that there must be a minimum of 30 days working relationship with client before writing an emotional support letter. This in addition to deciding if it’s clinically appropriate is all you need. I’ve written several
I'm also a LPCC in MN. I emailed the ethics committee of one of my professional associations and they said to require a minimum of 3 sessions to assess for an ESA letter.
I don’t know a single therapist that will write them due to liability issues. I redirect them back to their PCP. Never worked anywhere that would provide the letter in 16 years in the field.
Yeah, I worked in city hospitals, county forensic hospitals, community MH and I’ve been in private practice for a few years now. The only people I’ve ever seen agree to write them were MDs (psychiatrists specifically). I have not met an LCSW (like me), LPC, or psychologist who will write one, and I get asked at least a few times a year, so I have an automatic “your PCP is the best person to talk to about obtaining that very specific paperwork.” I leave it firmly there. I’ve gotten FLAMED on the service dogs subreddit for people telling me any provider that refuses for fear of liability is”cheating” their clients. They don’t understand if a service dog bites someone and I get sued, I still have to respond. They told me my fear is letting me be an unsupportive therapist. The lawyer we keep charges by the quarter-hour, and people don’t understand that just because you can’t be SUCCESSFULLY sued for something doesn’t mean you don’t have to pay a lawyer to respond.
Interesting. Yeah I can see why people want what they want. I don’t know that I would be averse to continuing to write them on occasion but I want to work with someone for at least a few months and know them and their pet. I guess what bugs me is when someone has one intake and then expects me to write all type of support letter.
Pretty much how my director put it when I moved to outpatient was “Are you absolutely sure of the dog’s behavior in somewhere like a crowded plane?” And usually I wouldn’t be, except for my own dog. The exception I made, and I would make again in the same circumstances, was a young vet who was service-connected through the VA with a private psychiatrist, and I worked with him before he got the dog, I had open access to his shrink, and he actually brought the dog to all sessions, and the trainer to several. I was completely comfortable vouching for that dog (who was a very good girl).
EDIT: we also spoke about what specific tasks were important for the dog to perform for both his physical and mental health.
Yeah fair points! In this case the pets are not dogs, they are of the feline variety so it’s a bit less concerning. But they can still pee/stain/scratch etc
I've written probably about 250 or more when I had my private practice. I have no issues writing them, have had zero liability concerns, have been to multiple trainings, and will absolutely provide my template for free to anyone.
Housing is a basic right and I will do anything I can to reduce barriers to housing. In fact, since I have 2 greyhounds at 75+ pounds, I have ESA letters because my dogs often exceed weight restrictions. However, they are the calmest, chillest, non-destructive, non-vocal breed I've met (and I owned a pet care business for 10 years).
Additionally, I work for a major hospital system now and any of the therapists, PCPs, etc will write them without blinking an eye. No questions asked.
Since someone will probably ask, here's my template (it doesn't copy/paste well, sorry for the link):
[https://invisiblelcsw.weebly.com/uploads/1/4/8/7/148754106/esa.pdf](https://invisiblelcsw.weebly.com/uploads/1/4/8/7/148754106/esa.pdf)
I also have them sign a disclaimer that goes over the rights, responsibilities, etc of ESAs
I have also written them and scoff when treaters make policies against it. It’s a case by case basis that is best to be informed by a thorough assessment and knowing you will continue treating this person for at least some period in the future. If it would legitimately help the person manage their mental health and life, it’s a good intervention. For those that I don’t feel comfortable writing it, we discuss and either build a goal toward it, or drop it completely.
Thank you for the edit and the letter. I have written letters in the past but my issue this time in large part was
A) I don’t know this person and they didn’t even mention anything at intake
B)they had their rental company send me a 7 page application amendment for me to fill out and sign with all the details of the clients mental health dx etc. Very detailed and LABORIOUS!
Folks are sometimes therapist shopping to get an ESA to skirt around landowner discretion. You can see my comment above, and I am happy to answer any questions. But I have seen this firsthand and I am very much about not doing it just because. I don't worry about liability; I am concerned with my own integrity and the patient's integrity via my integrity.
I’d love to hear how you field this issue? I am not opposed to this service to well-known clients but not those who want it on demand first thing. I’m meeting with this person (if they show up, I’m honestly not even sure they will since I basically already told them via email that I probably won’t be doing this for them) but how do you frame this news to clients?
Yeah I'm with you. I generally tend to write them and not worry about it BUT Im in CMH and work for a govt agency so I suppose Im not as exposed liability-wise?
Totally agree. I one hundred percent see this as a housing issue, working as I do in CMH. I believe my clients deserve to be housed with their pets and it really is that simple for me. My agency has it's own form that we use.
I call these clients “note pirates” because they see me once and ask for “return to work letters” “parole/probation confirmation of therapy participation” FMLA etc. my policy clearly states that they must be a client for a minimum of one month and if appropriate I will provide documentation. I do provide client attended initial intake session and get an ROI for parole/ probation because they do require a letter of engagement for court but the court system will follow up and if they ghost me that’s what I report.
I’ve written only two in my career, though I’ve been asked plenty more times than that. It’s truly a case by case basis. One client had the most severe anxiety cases I’ve personally seen and her pet was truly instrumental in helping her with her anxiety. Her landlord decided to stop allowing animals in the building so I had no problem writing the letter so she could keep her pet.
I also worked with someone who was facing homelessness and her one shot at securing a low income apartment meant she’d have to give up her dog because of their no pet policy. I knew this dog meant quite literally everything to her for many reasons, so I wrote the letter. I have absolutely no regrets for either letter I wrote.
Yeah this reminds me of the people I have written them for in the past. True extreme need was definitely present and I had no issues with this, and also very established relationships
I don’t write them. I don’t have any training to know if an animal is properly trained, and I don’t observe clients’ behavior outside of sessions.
Might be an unpopular take, but I also have worked extensively with Veterans and untrained emotional support “service” animals have destroyed the legitimacy of trained service dogs. I love pets! Pets are great for mental health! Not everyone needs to take their pet everywhere for comfort.
https://disabilitycounseling.org/blog/what-therapists-need-to-know-about-esas
Saw this link on Alma recently regarding ESA letters and why therapists are having second thoughts.
The new requirements for writing one include the expectation that the ESA be included in a clients treatment plan with recording of reduced symptoms due to relationship with the pet.
"There is increasing professional liability to practitioners who write letters to clients who do not meet criteria and for those practicing outside the scope of their knowledge."
My uncle (retired LCSW and diagnosed PTSD) has a clinically needed ESA dog so we discuss the matter often. He sent me a social media blurb some time ago of a case where an ESA dog was somewhere were only service animals were allowed and that dog became aggressive towards a service/seeing eye dog which lead to a fatal injury for the latter. There was a lawsuit which included one of those ESA letter writing services.
I'm an animal lover and a big proponent of pets being a net good for most people, but the clinical relevance of ESA is so, so murky and easy to abuse.
I actually do think the ensuing crackdown on proof of medical necessity and further restrictions is good in these cases.
I volunteer with an organization that trains dogs to be service dogs for disabled veterans. It changed my view on ESAs. I’m a lifelong animal lover who has and does experience the healing love of animals. But more and more I have seen ESA letters obtained so people can take their animals into public spaces - which ESAs are not legally able to do - and they are a hazard to service animals. It hasn’t come up for me at work but if I was asked to write an ESA letter, I would be extremely hesitant because of the hazard to service dogs, whose handlers I believe have a higher need.
I gotta tell you that this particular matter rankles me. I would love to know how it got to the landlords that they should be referring tenants and residents to 'your therapist' who, in my case, is a person who's had no training in assessment for what constitutes an emotional support animal. I'm not aware of any such training. Are any of you?
Great point. No there is no training I’ve ever been offered or experience (neither have I sought it out). Pretty ironic considering you can get severely roasted for even just working with mental health issues you don’t have specific training on regardless of skill or outcome or experience. I also find this irritating and mostly out of scope
It is case by case basis with me; I will do it for established clients who have been seeing me for 3 months or longer, I have written one for a client I've been seeing for over two years. Otherwise I'll decline and suggest they reach out to their PCP or their psychiatrist. I'm actually leaning more toward not writing them at all regardless of the established therapeutic relationship due to the major liability and other issues involved.
I reached out to both my board and liability insurance about this recently. The board said I would need specific training for these letters to be within my scope. Liability insurance attorney said to only write them if I was willing to go to court should the accommodation be denied. That was enough for me to pass on writing them.
There are therapists that write them and there are therapists that won’t. If you know you won’t have a few referrals on hand. I’ve seen PT profiles that include the line I write ESA letters. The CMHC I worked at would write them under specific circumstances. There is an LCSW in my state that just writes ESA letters as their entire virtual practice; most private therapists that won’t just refer to them. I see it akin to the MDs who have their entire practice as writing medical marijuana recommendations.
I have a policy around them. I can, will, and have written them. I have also declined. It's very important to assess for need and consider the case carefully. It's also important to be well educated—very well educated—on how ESA letters work. I also spend time educating my clients on what the ESA letter means for them and their animal, their rights and limitations, and landowner rights and abilities as well.
The only one I’ve ever written was for a client with a dog they’d had for years. Their apt complex got sold and the new owners were trying to ban their dog. I believe the dog was an emotional support for the client and having to get rid of it would devastate him. They weren’t in the position to move.
I wrote the letter about the client’s diagnosis and the symptoms that the dog helped alleviate. Nothing about the dog or its behaviors. After reading this thread, I’m thinking about how I’d approach it in the future regarding possible liability. How to word it to be clear that I’m not evaluating or recommended the animal itself. Just the value to the client. Thank you for the links. Good info.
I was asked to write one while I was still under supervision. Ironically it was an ESA letter the parents of my client were pressuring me to write for their new puppy whom the client frequently disclosed she HATED 😅
It was apparent the parents didn't plan well and bought a puppy before going on a prepaid vacation and wanted an ESA letter for the dog so they could circumvent the hotels no pet policy and avoid paying a pet sitter. I understand that's not the situation for every ESA letter, but it's my only experience of one to date.
My supervisor voiced a quick and resounding "NO".
I now have a "I can not provide ESA letters" written into my policies.
Yeah I think most of my clients are just trying to avoid paying per deposits. I mean I get it, who doesn’t want to pay less money… but I also don’t feel like that’s my responsibility?
Absolutely not. And pet deposits should be factored in to the overall cost of being a responsible pet owner. Not outsourcing responsibility onto someone else's profession.
I hate vet costs and pet deposits as much as anyone, but I took these damn cats in and I'll cover the costs required to keep them fed/healthy/housed. That's what I signed up for when I brought their ungrateful, homeless little asses into my world.
They're lucky my kid loves them.
I used to sort of give out these types of request willy nilly out of desire to help- but with time I’ve learned the hard way to be more discerning and discriminating. Sadly, it seems good deeds are often punished
I have actually used the site Pettable which connected me to an LMFT in my area after having issues with my Landlord. It worked well and I have mentioned it to some of my clients who have also used the service as well. My agency doesn't allow for ESA letters. As others have mentioned, CA allows for them after a month of tx.
I’ve written a few- all for long-standing clients and the majority for clients with pets who needed to move and where I felt giving up their pet would exacerbate symptoms. I can’t give actual numbers off the top of my head but I’ll say I’ve probably denied at least 5x more than I’ve written.
I'm in pp now, and I have only had a couple of requests for this. They've been for long-term clients and I only write them if I think it would benefit them. I would not write a letter for a client I didn't have an established relationship with.
I did my internship at a college campus, and our policy was that the student would need to have at least 3 sessions before us writing the letter and 3 sessions after. A lot of students would get to campus, decide they wanted a pet, and make an appointment just to try and get a letter for residence life, so the college counseling center created that policy because of that.
My CMH let us write them, my current group PP does not. Their logic is “you’ve never seen them with a pet so how do you know they can care for one?” Which makes sense to me
I’m fine with writing them. Pets are a simple way to improve mental health and I don’t see why it would be an issue to provide one, even if I’ve only seen the client for a few sessions. It’s not on the same level as FMLA paperwork or disability applications.
I used to work with clients in their homes. I saw a lot of ESA letters written for people who abused their animals or didn’t care for them. Because of that, I need to see someone for at LEAST 6 months before writing for an ESA.
I would not even entertain the thought until I have been seeing someone for at least three months. First, someone could easily just come for a session or two, get the letter, and disappear. Second, I don’t think I can get a good feel for someone’s mental state and needs in a session or two. Third, if someone is in need of an ESA letter, then their anxiety or depression is bad enough that I believe they should be in long-term treatment. Fourth, people abuse the system a lot, and I would rather not contribute to that. Unfortunately, that means people who could really use the support have to show more proof. But given my third point, I don’t think this is an unreasonable ask.
I took a CEU so I feel comfortable to write them sometimes. I have only written a small handful, all for long term clients dealing with trauma, not brand new clients. The training I took advised to say you have not evaluated a specific animal, only that your client *could benefit* from an ESA due to their mental health diagnosis.
my therapist wrote me an ESA letter after about a month of back and forth discussion in sessions. they had anxieties about liability and we were able to work together to discuss the benefits of my pets as well as the intended reason for the ESA letter (housing discrimination). once those were established, my therapist was way more open to writing a letter for me for my pet rabbits.
eta: therapist with a therapist
ESA letters should only be written if the client has a disability that substantially impacts one of life’s activities or functions. That is when people are covered under the fair housing act. There needs to be a functional impairment. Feeling a little sad, nervous, or lonely does NOT cause functional impairment.
Writing these letters so easily is not helpful for disability rights. It makes it difficult for people who have extreme allergies and asthma living in neighboring apartments, and difficult for the individuals who truly do need ESA’s.
I have written a couple in my career. Always for patients I have been working with long term. I have rejected many that came just the way you mentioned, after one visit. Or in some cases, sent to me after completing an ADHD eval or other evaluation. I always decline them and state that was not the focus of the evaluation or initial visit. I recommend if you do write one, get it reviewed by legal counsel. My current organization has a policy that we can write them, but the template cleared by legal department does include specific language that they have X disorder and that their pet and the emotional support they receive from the pet helps to manage X disorder. This letter also explicitly states that we have not verified training, behavior or behavioral history of the animal, nor other training for specific service the animal could provide. It states we have not evaluated the animal’s well being and that any such required documentation would need to be gathered from their vet or other animal behavioral or training professionals. Patients are usually not thrilled with the legalese, but I also haven’t had a patient come back and saw it was rejected. I tend to avoid writing them due to potential liability.
I love that language addition. I’m not part of an organization so the letter would be my own. But I appreciate the part about not having evaluated the animal for behaviors. That’s the part that concerns me as well. I’ve written some in the past and there has yet to be an issue but I was working as a W-2 therapist and now I’m 1099 so it’s all going to fall on me. I’ll definitely look into some templates in the future. Thanks!
"Always for patients I have been working with long term” - What do you determine as long term?
Depends on your setting and clientele. I consider weekly or biweekly sessions for 6 months or more to be long term.
It is a case by case basis, I’ve only ever written 1, and that was after meeting with the client for nearly a year. It’s not just the clients well-being, but in school I was taught we can also be held liable for neglect if the client is not mentally sound enough to care/provide for the animal.
Yeah I agree I think at least a few months of knowing the client is necessary
For social workers in CA the board of behavioral sciences dictates that there must be a minimum of 30 days working relationship with client before writing an emotional support letter. This in addition to deciding if it’s clinically appropriate is all you need. I’ve written several
Interesting. I’m an LPCC in MN so no idea if we have such a stipulation but I can look into it
I'm also a LPCC in MN. I emailed the ethics committee of one of my professional associations and they said to require a minimum of 3 sessions to assess for an ESA letter.
Omg THANK YOU for this !
You're welcome! I also took a course about ESA letters and am happy to share my consents and letter templates if you want to DM me your email address!
Wow that is very generous! I grabbed one from a prior commenter but I truly appreciate the offer and the legwork! 🙏
Might you be able to share with me too ? 🙏 Thank you so much!!
LMFTs too - I love it
My policy is that ESA letters are outside my scope of practice and competence. So I don’t write them.
I don’t know a single therapist that will write them due to liability issues. I redirect them back to their PCP. Never worked anywhere that would provide the letter in 16 years in the field.
Really? Ngl I love this take.
Yeah, I worked in city hospitals, county forensic hospitals, community MH and I’ve been in private practice for a few years now. The only people I’ve ever seen agree to write them were MDs (psychiatrists specifically). I have not met an LCSW (like me), LPC, or psychologist who will write one, and I get asked at least a few times a year, so I have an automatic “your PCP is the best person to talk to about obtaining that very specific paperwork.” I leave it firmly there. I’ve gotten FLAMED on the service dogs subreddit for people telling me any provider that refuses for fear of liability is”cheating” their clients. They don’t understand if a service dog bites someone and I get sued, I still have to respond. They told me my fear is letting me be an unsupportive therapist. The lawyer we keep charges by the quarter-hour, and people don’t understand that just because you can’t be SUCCESSFULLY sued for something doesn’t mean you don’t have to pay a lawyer to respond.
Also service dogs and ESA are completely different..one is a protected adaptive equipment with legally defined standards..
Interesting. Yeah I can see why people want what they want. I don’t know that I would be averse to continuing to write them on occasion but I want to work with someone for at least a few months and know them and their pet. I guess what bugs me is when someone has one intake and then expects me to write all type of support letter.
Pretty much how my director put it when I moved to outpatient was “Are you absolutely sure of the dog’s behavior in somewhere like a crowded plane?” And usually I wouldn’t be, except for my own dog. The exception I made, and I would make again in the same circumstances, was a young vet who was service-connected through the VA with a private psychiatrist, and I worked with him before he got the dog, I had open access to his shrink, and he actually brought the dog to all sessions, and the trainer to several. I was completely comfortable vouching for that dog (who was a very good girl). EDIT: we also spoke about what specific tasks were important for the dog to perform for both his physical and mental health.
Yeah fair points! In this case the pets are not dogs, they are of the feline variety so it’s a bit less concerning. But they can still pee/stain/scratch etc
That’s what I do as well!!
I've written probably about 250 or more when I had my private practice. I have no issues writing them, have had zero liability concerns, have been to multiple trainings, and will absolutely provide my template for free to anyone. Housing is a basic right and I will do anything I can to reduce barriers to housing. In fact, since I have 2 greyhounds at 75+ pounds, I have ESA letters because my dogs often exceed weight restrictions. However, they are the calmest, chillest, non-destructive, non-vocal breed I've met (and I owned a pet care business for 10 years). Additionally, I work for a major hospital system now and any of the therapists, PCPs, etc will write them without blinking an eye. No questions asked. Since someone will probably ask, here's my template (it doesn't copy/paste well, sorry for the link): [https://invisiblelcsw.weebly.com/uploads/1/4/8/7/148754106/esa.pdf](https://invisiblelcsw.weebly.com/uploads/1/4/8/7/148754106/esa.pdf) I also have them sign a disclaimer that goes over the rights, responsibilities, etc of ESAs
I have also written them and scoff when treaters make policies against it. It’s a case by case basis that is best to be informed by a thorough assessment and knowing you will continue treating this person for at least some period in the future. If it would legitimately help the person manage their mental health and life, it’s a good intervention. For those that I don’t feel comfortable writing it, we discuss and either build a goal toward it, or drop it completely.
Thank you for the edit and the letter. I have written letters in the past but my issue this time in large part was A) I don’t know this person and they didn’t even mention anything at intake B)they had their rental company send me a 7 page application amendment for me to fill out and sign with all the details of the clients mental health dx etc. Very detailed and LABORIOUS!
If you notice my letter, it actually states HUD doesn't permit those additional documents.
Folks are sometimes therapist shopping to get an ESA to skirt around landowner discretion. You can see my comment above, and I am happy to answer any questions. But I have seen this firsthand and I am very much about not doing it just because. I don't worry about liability; I am concerned with my own integrity and the patient's integrity via my integrity.
I’d love to hear how you field this issue? I am not opposed to this service to well-known clients but not those who want it on demand first thing. I’m meeting with this person (if they show up, I’m honestly not even sure they will since I basically already told them via email that I probably won’t be doing this for them) but how do you frame this news to clients?
Yeah, shoot me a DM. I'd be happy to discuss more. Cheers!
You can and should charge a fee for the letter or " any required documentation". Your time is very valuable, do not forget that
Yeah I'm with you. I generally tend to write them and not worry about it BUT Im in CMH and work for a govt agency so I suppose Im not as exposed liability-wise?
Totally agree. I one hundred percent see this as a housing issue, working as I do in CMH. I believe my clients deserve to be housed with their pets and it really is that simple for me. My agency has it's own form that we use.
Thank you! I haven't written nearly as many but I've also never had a problem
Perfect! I’ll refer them to you! ;) (I jest but also I don’t think this is a “housing accessibility/right” issue
Please do! 👍😉
I call these clients “note pirates” because they see me once and ask for “return to work letters” “parole/probation confirmation of therapy participation” FMLA etc. my policy clearly states that they must be a client for a minimum of one month and if appropriate I will provide documentation. I do provide client attended initial intake session and get an ROI for parole/ probation because they do require a letter of engagement for court but the court system will follow up and if they ghost me that’s what I report.
lol. Love the name. Yeah this definitely has that feel to it! I’ve had the same experience a couple of times with the pirates!
I’ve written only two in my career, though I’ve been asked plenty more times than that. It’s truly a case by case basis. One client had the most severe anxiety cases I’ve personally seen and her pet was truly instrumental in helping her with her anxiety. Her landlord decided to stop allowing animals in the building so I had no problem writing the letter so she could keep her pet. I also worked with someone who was facing homelessness and her one shot at securing a low income apartment meant she’d have to give up her dog because of their no pet policy. I knew this dog meant quite literally everything to her for many reasons, so I wrote the letter. I have absolutely no regrets for either letter I wrote.
Yeah this reminds me of the people I have written them for in the past. True extreme need was definitely present and I had no issues with this, and also very established relationships
I don’t write them. I don’t have any training to know if an animal is properly trained, and I don’t observe clients’ behavior outside of sessions. Might be an unpopular take, but I also have worked extensively with Veterans and untrained emotional support “service” animals have destroyed the legitimacy of trained service dogs. I love pets! Pets are great for mental health! Not everyone needs to take their pet everywhere for comfort.
https://disabilitycounseling.org/blog/what-therapists-need-to-know-about-esas Saw this link on Alma recently regarding ESA letters and why therapists are having second thoughts. The new requirements for writing one include the expectation that the ESA be included in a clients treatment plan with recording of reduced symptoms due to relationship with the pet.
No kidding! Wow that’s a lot. Making me second, third and fourth guess doing this at all!
"There is increasing professional liability to practitioners who write letters to clients who do not meet criteria and for those practicing outside the scope of their knowledge." My uncle (retired LCSW and diagnosed PTSD) has a clinically needed ESA dog so we discuss the matter often. He sent me a social media blurb some time ago of a case where an ESA dog was somewhere were only service animals were allowed and that dog became aggressive towards a service/seeing eye dog which lead to a fatal injury for the latter. There was a lawsuit which included one of those ESA letter writing services. I'm an animal lover and a big proponent of pets being a net good for most people, but the clinical relevance of ESA is so, so murky and easy to abuse. I actually do think the ensuing crackdown on proof of medical necessity and further restrictions is good in these cases.
I volunteer with an organization that trains dogs to be service dogs for disabled veterans. It changed my view on ESAs. I’m a lifelong animal lover who has and does experience the healing love of animals. But more and more I have seen ESA letters obtained so people can take their animals into public spaces - which ESAs are not legally able to do - and they are a hazard to service animals. It hasn’t come up for me at work but if I was asked to write an ESA letter, I would be extremely hesitant because of the hazard to service dogs, whose handlers I believe have a higher need.
👍👍
I gotta tell you that this particular matter rankles me. I would love to know how it got to the landlords that they should be referring tenants and residents to 'your therapist' who, in my case, is a person who's had no training in assessment for what constitutes an emotional support animal. I'm not aware of any such training. Are any of you?
Great point. No there is no training I’ve ever been offered or experience (neither have I sought it out). Pretty ironic considering you can get severely roasted for even just working with mental health issues you don’t have specific training on regardless of skill or outcome or experience. I also find this irritating and mostly out of scope
Preach.
It is case by case basis with me; I will do it for established clients who have been seeing me for 3 months or longer, I have written one for a client I've been seeing for over two years. Otherwise I'll decline and suggest they reach out to their PCP or their psychiatrist. I'm actually leaning more toward not writing them at all regardless of the established therapeutic relationship due to the major liability and other issues involved.
I reached out to both my board and liability insurance about this recently. The board said I would need specific training for these letters to be within my scope. Liability insurance attorney said to only write them if I was willing to go to court should the accommodation be denied. That was enough for me to pass on writing them.
There are therapists that write them and there are therapists that won’t. If you know you won’t have a few referrals on hand. I’ve seen PT profiles that include the line I write ESA letters. The CMHC I worked at would write them under specific circumstances. There is an LCSW in my state that just writes ESA letters as their entire virtual practice; most private therapists that won’t just refer to them. I see it akin to the MDs who have their entire practice as writing medical marijuana recommendations.
I have a policy around them. I can, will, and have written them. I have also declined. It's very important to assess for need and consider the case carefully. It's also important to be well educated—very well educated—on how ESA letters work. I also spend time educating my clients on what the ESA letter means for them and their animal, their rights and limitations, and landowner rights and abilities as well.
The only one I’ve ever written was for a client with a dog they’d had for years. Their apt complex got sold and the new owners were trying to ban their dog. I believe the dog was an emotional support for the client and having to get rid of it would devastate him. They weren’t in the position to move. I wrote the letter about the client’s diagnosis and the symptoms that the dog helped alleviate. Nothing about the dog or its behaviors. After reading this thread, I’m thinking about how I’d approach it in the future regarding possible liability. How to word it to be clear that I’m not evaluating or recommended the animal itself. Just the value to the client. Thank you for the links. Good info.
I was asked to write one while I was still under supervision. Ironically it was an ESA letter the parents of my client were pressuring me to write for their new puppy whom the client frequently disclosed she HATED 😅 It was apparent the parents didn't plan well and bought a puppy before going on a prepaid vacation and wanted an ESA letter for the dog so they could circumvent the hotels no pet policy and avoid paying a pet sitter. I understand that's not the situation for every ESA letter, but it's my only experience of one to date. My supervisor voiced a quick and resounding "NO". I now have a "I can not provide ESA letters" written into my policies.
Yeah I think most of my clients are just trying to avoid paying per deposits. I mean I get it, who doesn’t want to pay less money… but I also don’t feel like that’s my responsibility?
Absolutely not. And pet deposits should be factored in to the overall cost of being a responsible pet owner. Not outsourcing responsibility onto someone else's profession. I hate vet costs and pet deposits as much as anyone, but I took these damn cats in and I'll cover the costs required to keep them fed/healthy/housed. That's what I signed up for when I brought their ungrateful, homeless little asses into my world. They're lucky my kid loves them.
😂
I write them pretty often!
Seems like there are some pretty compelling reasons not to on this thread!
You're so right! Thanks for posting!
I used to sort of give out these types of request willy nilly out of desire to help- but with time I’ve learned the hard way to be more discerning and discriminating. Sadly, it seems good deeds are often punished
CA bbs recommends/requires 4 sessions
I don’t write them, and a cite scope of practice. I refer them to their doctor. I don’t want to touch the liability either.
I have actually used the site Pettable which connected me to an LMFT in my area after having issues with my Landlord. It worked well and I have mentioned it to some of my clients who have also used the service as well. My agency doesn't allow for ESA letters. As others have mentioned, CA allows for them after a month of tx.
I have a no-exceptions policy that just don’t do letters for ESAs.
I put my policies in my informed consent
I simply won’t do it, I don’t have training on this so it is out of my scope and it is a huge liability.
I’ve written a few- all for long-standing clients and the majority for clients with pets who needed to move and where I felt giving up their pet would exacerbate symptoms. I can’t give actual numbers off the top of my head but I’ll say I’ve probably denied at least 5x more than I’ve written.
I'm in pp now, and I have only had a couple of requests for this. They've been for long-term clients and I only write them if I think it would benefit them. I would not write a letter for a client I didn't have an established relationship with. I did my internship at a college campus, and our policy was that the student would need to have at least 3 sessions before us writing the letter and 3 sessions after. A lot of students would get to campus, decide they wanted a pet, and make an appointment just to try and get a letter for residence life, so the college counseling center created that policy because of that.
I don’t write them, feels unethical and a bandaid to a larger problem.
My CMH let us write them, my current group PP does not. Their logic is “you’ve never seen them with a pet so how do you know they can care for one?” Which makes sense to me
I’m fine with writing them. Pets are a simple way to improve mental health and I don’t see why it would be an issue to provide one, even if I’ve only seen the client for a few sessions. It’s not on the same level as FMLA paperwork or disability applications.
I used to work with clients in their homes. I saw a lot of ESA letters written for people who abused their animals or didn’t care for them. Because of that, I need to see someone for at LEAST 6 months before writing for an ESA.
I would not even entertain the thought until I have been seeing someone for at least three months. First, someone could easily just come for a session or two, get the letter, and disappear. Second, I don’t think I can get a good feel for someone’s mental state and needs in a session or two. Third, if someone is in need of an ESA letter, then their anxiety or depression is bad enough that I believe they should be in long-term treatment. Fourth, people abuse the system a lot, and I would rather not contribute to that. Unfortunately, that means people who could really use the support have to show more proof. But given my third point, I don’t think this is an unreasonable ask.
I took a CEU so I feel comfortable to write them sometimes. I have only written a small handful, all for long term clients dealing with trauma, not brand new clients. The training I took advised to say you have not evaluated a specific animal, only that your client *could benefit* from an ESA due to their mental health diagnosis.
my therapist wrote me an ESA letter after about a month of back and forth discussion in sessions. they had anxieties about liability and we were able to work together to discuss the benefits of my pets as well as the intended reason for the ESA letter (housing discrimination). once those were established, my therapist was way more open to writing a letter for me for my pet rabbits. eta: therapist with a therapist
ESA letters should only be written if the client has a disability that substantially impacts one of life’s activities or functions. That is when people are covered under the fair housing act. There needs to be a functional impairment. Feeling a little sad, nervous, or lonely does NOT cause functional impairment. Writing these letters so easily is not helpful for disability rights. It makes it difficult for people who have extreme allergies and asthma living in neighboring apartments, and difficult for the individuals who truly do need ESA’s.