title: Military veterans and canine assistance for post-traumatic stress disorder: A narrative review of the literature.
abstract: BACKGROUND
  Veterans with post-traumatic stress disorder (PTSD) are a vulnerable population at high risk for depression, isolation, and suicide. A substantial body of anecdotal evidence exists supporting the use of canines as an effective adjunct treatment for this population. However, a comprehensive review of its use based on scientific literature has thus far not been conducted.
  
  
  METHODS
  A narrative literature review was conducted to examine the current state of the science on canine assistance for veterans diagnosed with PTSD in order to synthesize current empirical knowledge on the subject. Articles were retrieved among the small body of recent literature using computerized database searches. Inclusion criteria included peer-reviewed journal publications published through October 1st, 2015. Only originally published articles that examined the outcomes of canine assistance on veterans with PTSD were examined. Additionally, each included article was specific to veterans, dogs, and, PTSD in combination rather than article that discuss the concepts separately. Exclusion criteria included symposia and conference material, dissertations, media articles, and no mention of canines as a treatment modality. 563 articles were retrieved; 6 met the criteria. When evaluating data, information and themes were extracted into an Excel table; this table was employed in the synthesis of information into manuscript form.
  
  
  RESULTS
  The following themes were explored within the selected publications: What is Canine Assistance; Why Use Canine Assistance for PTSD in Veterans; Concerns; and Future Directions. The literature endorsed canine assistance for PTSD in veterans as a promising modality. Authors also raised concerns about lack of protocols, cost and availability barriers, and animal welfare calling for additional, rigorous research to advance its use as a treatment for veterans with PTSD.
  
  
  CONCLUSIONS
  PTSD continues to pose significant psychological, health, and welfare challenges to veterans and the multi-disciplinary providers who treat them. Analysis of this literature should expand knowledge and outline future directions for healthcare professions and improve health and wellness for veterans with PTSD through the use of canine assistance.
authors.affiliation: C-P.A.W.W. (Canines Providing Assistance to Wounded Warriors), Health Research Initiative for Veterans, University of Colorado, College of Nursing, Anschutz Medical Campus, 13120 E. 19th Avenue, Aurora, CO 80045, United States. Electronic address: Cheryl.Krause-Parello@ucdenver.edu.
authors.forename: Cheryl A
authors.initials: CA
authors.lastname: Krause-Parello
authors.affiliation: C-P.A.W.W. (Canines Providing Assistance to Wounded Warriors), Health Research Initiative for Veterans, University of Colorado, College of Nursing, Anschutz Medical Campus, 13120 E. 19th Avenue, Aurora, CO 80045, United States. Electronic address: Sarah.Sarni@ucdenver.edu.
authors.forename: Sarah
authors.initials: S
authors.lastname: Sarni
authors.affiliation: C-P.A.W.W. (Canines Providing Assistance to Wounded Warriors), Health Research Initiative for Veterans, University of Colorado, College of Nursing, Anschutz Medical Campus, 13120 E. 19th Avenue, Aurora, CO 80045, United States. Electronic address: Eleni.Padden@ucdenver.edu.
authors.forename: Eleni
authors.initials: E
authors.lastname: Padden
mesh_terms: D056447:Animal Assisted Therapy / Q000379:methods*; D000818:Animals; D015928:Cognitive Behavioral Therapy / Q000379:methods; D006233:Persons with Disabilities / Q000534:rehabilitation*; D004285:Dogs; D005260:Female; D006801:Humans; D008297:Male; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology* / Q000534:rehabilitation*; D014728:Veterans / Q000523:psychology*
keywords: Canine assistance; Literature review; Military; PTSD; Post-traumatic stress disorder; Service dogs; Therapy dogs; Veterans