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Dr. Aaron Norton, executive director of NBFE, and Dr. Tony Tan, an educational psychologist at Xi’an Jiaotong University and the University of South Florida, conducted a study on how clinical mental health counselors (CMHCs) in the U.S. handled emotional support animals (ESA) letter requests and whether the assessments used by CMHCs for clinical decision making were related to whether they would decline or agree to write the ESA letter.  Overall, they found that (1) whether CMHCs assessed for disability, inquired as to how ESAs alleviated symptoms, and discussed alternatives to ESAs predicted the likelihood that a CMHC would approve or deny a client request for an ESA letter; and (2) most CMHCs lacked formal training in ESA assessment, and many relied on personal discretion rather than established guidelines in making clinical decisions.  This study draws attention to the importance of training clinicians on appropriate methods for assessing ESA letter requests.  The study was published in the American Journal of Orthopsychiatry.