The study has been withdrawn due to the pandemic and lack of funding.

Prior literature demonstrates that human stress can be reduced with exposure to animals. This study challenges current dogma by introducing a widely available, low cost method of dog therapy to reduce patient and provider stress. The objectives of this study are to determine if interaction with a certified therapy dog and handler can;

• decrease reported anxiety levels in emergency department (ED) patients,
• decrease salivary cortisol in ED patients,
• decrease total morphine equivalent dosing in the emergency department or at discharge and/or,
• decrease reported stress levels in emergency department providers caring for participating patients

when compared to usual care.

Inclusion Criteria:

Patients

• Age 18-89 years
• Chronic pain, defined as pain on most days for >6 weeks
• Triage pain score >6 out of 10

OR

• Age 18-89 years
• Currently experience crisis, including suicidality, or
• Meet the standard of a provider assessment of "severe stress" defined by their identification that the patient meets a score of greater than six on the FACES stress scale

Providers

• Faculty, residents, advanced practitioners, and nurses who work in the ED and identify themselves as being the nurse or physician of record for the enrolled patients.

Therapy Dog Handlers

• Handler of a certified therapy dog and volunteer of Eskenazi's Therapy Dog Program

Exclusion Criteria:

Patients

• Violent behavior
• Overt intoxication
• Non-English speaking
• Any reported prior fear or adverse reaction to dogs

Providers

• Any reported prior fear or adverse reaction to dogs

Therapy Dog Handlers

• None