After six weeks of training, Goldendoodle Huck earns a therapy dog certificate with his handler, Madeline.

It’s an evening in early October, and Charli King, co-founder of Pawsitive Teams, is opening a new class for dog owners, canines in tow, who aspire to help people in need. That need is great — society is rife with both anxiety and trauma, and people need comfort: people in hospitals, assisted-living homes, airports, rehab centers, even college campuses during finals week. “Comfort” here means reduced blood pressure, reduced heart rate, reduced stress. That’s comfort that dogs can provide, but in order to fill that basic therapeutic role, those dogs must be trained by volunteers to the point where they can demonstrate fundamental skills with strangers and always, always display a calm demeanor.

Photos by Thomas Larson

Assembled before King, who’s been with Pawsitive for 26 years, are ten eager women (plus a husband or two) and their nervously yawning and attention-begging pooches. She tells her (human) students that before a handler’s dog can be a caregiver for others, the handler must be a caregiver for the dog. The Pawsitive team calls this first six-week class an introduction to “the maze of therapy dog programs.” If all goes well, if the right lessons can be instilled and the rug accidents and barking fits can be avoided, these retrievers and shepherds will produce in their charges a surfeit of oxytocin, the recently recognized “bonding” hormone that canine and companion share.

Attending therapy dog training is a bit like attending kindergarten and adult night school at the same time. The welcoming pronouncements from the staff members are delivered in fun/serious mode: lower your expectations for your poodles and Labs. Relax. Let them be their playful selves outside of class. But during the course, King says, “Your dogs will work with people, not each other. No contact between them, please.” That seems like a high bar, but it’s necessary, because, well, there’s a lot to make habitworthy — for dogs and for humans as well. The dogs, who already know how to heel, begin heeding their call to heal with this basic six-week prep-school class, offered four times a year in a spacious building set amid a host of similar structures in Miramar. If the dogs pass, they may undergo one-on-one training for a year or more to become a service or facility dog, the sort that performs tasks at specialized sites — think rehab clinics or mental health settings. Such a course facility dog program manager Mary Skrabucha calls “prep school on steroids.”

The first lesson, as in most sessions, is describe-and-do. When you visit a hospital, a rehab facility, or a retirement home, says one of the six green-shirted instructors, your dog cannot go directly at a person, say, who’s in a wheelchair. Rather, approach from the side, or at an angle. Ask if the person wants a visit. Ask which side is preferable. If it’s the other side, ask if you can go around behind the person. As you go, shift the leash from one hand to the other.

The handlers try the maneuver. A couple of them transmit clear commands, and the dogs get it. But most of the dogs are a bit jumpy, especially after the handler fails to get the snout near the sitter’s hand for a “Hello there” pet.

Prior to tonight, each animal has earned a Canine Good Citizen certificate through obedience training in ten key skills — all but one, supervised separation, tested. When trying to clarify a new “ask,” most dogs swivel their heads, look askance. Their tongues flap, their eyebrows meander. They sit, stand, sit, tail-wag, huff, whine, and gaze tenderly, treat-expectant. Hounds of good intention all.

Deb and Gracie

All this means the handlers must be taught what not to do. Like. Don’t let Saide get any closer two feet in your approach. Don’t let Fido urinate or defecate in “inappropriate locations.” Don’t let Pluto vocalize during therapy work — no barking, growling, or whining. Don’t let Max solicit or steal food from strangers. Don’t let Daisy annoy or disrupt the “normal course of daily business.” Don’t let Oscar block aisles or doorways. Do encourage Bella and Coco and Bruno to obey commands (orders are for the military), perform tasks calmly and quietly, resist pointing out another canine’s commotion with either sniff or snarl, and idle beside the boss, anticipating the next treat-enhanced behavior — also known as pleasing the master.

Painted in large green letters on the wall behind the team of volunteers presenting tonight’s lesson: “Be the person your dog thinks you are.” As staffer Barbara McKown tells the group, “We’re here because dogs can reach people emotionally in ways people sometimes can’t.”

* * *

Each week, the interactive exercises pile up. Everyone better be doing their doggie homework, notes an instructor. Handler Deb tells me she and her dog, a lean-legged, Black American Lab, have been “having a conversation. Just what kind of work would you like to do, Gracie, and with whom?” Deb notes Gracie’s answers can be found in her behavior: first week, she watches the door; second week, she gets flustered with too many instructions — the “leave it” / “take it” task is especially trying.

So, Gracie: imagine you’re ambling along, ready to meet and bring Big Joy to the elderly residents of the Vi (vee) in La Jolla, when into a private room you trot and there on the floor are a half-dozen pills (dementia meds, perhaps), which you better not gobble up as if they’re treats. Staffer Carol Davis puts it bluntly: “If you don’t have a solid ‘leave it,’ your dog will die.”

Pawsitive Teams’ executive director, Eileen Heveron, with her diabetic alert dog, Dex.

Gracie, dear, you must learn how to “leave it.” The lesson: Deb — holding a Pup-Peroni treat in one hand for Gracie to sniff — sees a rainbowy pill on the floor, stops moving, and tells Gracie to “leave it,” or the just-as-succinct, “look at me.” If Grace obeys, the peril is avoided and Gracie gets to “take it,” “it” being her reward. This is the good part of the exercise, the treat, which Gracie also receives at other times for being a “good girl.” But Gracie already knows she’s a good girl. What she needs to hear is the efficacious positive yes, “take it,” and the negative yes, “leave it,” both leveled with handler enthusiasm. To learn that is a rather process frustrating for Gracie. But after many repetitions, in class and at home, she’s eventually on board.

So too is Deb, via her own thousand-and-one repetitions of what is becoming their common language. These rhetorical assignments the dogs must learn in their prep program require training the human as well. At first, a few in the class use the unwanted directive, “No.” Corrections from staff were quick and numerous. You must retrain your phrases, not necessarily their tone or volume, McKown tells the group. She says that behaviors can’t be taught without reinforcement by treat. Dogs rely on food and praise for the things they do right. But after a time, the efficacious behavior can be expected to hold with the dog without an automatic treat —because, McKown says, the “positivity of me saying ‘Good, leave it’ is a reward in itself.” If Gracie, or any other of her classmates — the hypoallergenic Goldendoodles and the quick-study Yellow Labs — forget that association between the positive voice and the good response, then they will need a refresher course. A bit like law review for attorneys.

That’s because there’s a lot that has to be left. Consider the medical equipment and other sundry hazards that populate hospital floors and rehab units: I/V sacks hanging from poles on caster-wheels; closed-up wheelchairs; a blood-soaked bandage fallen on the floor; rough textures like grids and grates, sump dips and wobbly boards, extra-nubby concrete or scorching hot pavements that dogs hate; walkers with tempting tennis balls on the front legs, pushed by patients hell-bent on getting to the dining room; and the worst encounter (one practiced, of course, in class): Scary Mary. An instructor talks nicely to two dogs, steps behind a door, dons a sombrero and blankets her shoulders, then opens the door calmly — only to start quivering like Carmen Miranda. The poor doggies are tricked and go berserk. Were I in there place, I too might have barked myself silly then rushed at a woman with a hat made of fruit!

The solution to dealing with such a fright? The dog must feel the handler’s calming demeanor “rush down the leash.” In other words: handlers, don’t pull on the leash and yell, “No, no, no,” which is a universal tendency and also the most confusing. Teach Gracie (and Ivy Rose and Joe Bruin) to “look at me.” This attentional cue should work to retard the unwanted wild start, a lot or just enough, and so forestall any lawsuit resulting from your Rottweiler mauling the Dressup Lady.

* * *

Each time I see them, the dogs seem to be steadily easing into their new roles. Just as important, so do their handlers. The dogs face a bevy of commands, which, taken together, amount to asking them to display the manners of a Jane Austen heroine. Consider: “Dogs get twitchy in narrow lanes,” says trainer Denelle Curry. Finding himself in a tight space — say, between a set of chairs and a wall (no way out) or down a skinny corridor — Goldendoodle Huck, with mother/daughter Terri and Madeline, must not try and wiggle loose, but rather, back up. A tough move. Consider: approaching a bedridden patient, the eager-to-please Ivy Rose — with Mary Ann and Jim’s prodding — must mount the mattress’s surface with paws up. Consider: coming toward a seated person, Gracie, with a despite a surfeit of puppyish spunk, must target and touch Deb’s palm, thereby arriving at just the right position. Exercise: touch, treat, “Good girl,” come forward, touch, treat, a smidgen closer, “Very good girl.”

Linda and Brinkley

One night, the Pawsitive volunteers set up stations for role-playing as likely matchups: an amputee, an obnoxious child, a stroke victim. Handler: Let’s do a visit! Dog: Pant, pant. Volunteer: Don’t forget to move the food tray aside. Handler to Patient: Do you like dogs? Dog to Patient: How about me? Volunteer: Focus on the patient and don’t pull on the leash so much! When you calm down, the dog calms down. Patient: Hi, pup. Dog to Patient: I’m excited. My body’s shaking. My maw’s salivating. My tail’s wagging me, the dog. Volunteer: Remember the three things you shouldn’t say to a patient who’s medically fragile: How are you doing? I’ll be back next week. Have a nice day. Why? First, if you ask about their condition, you’ll get an earful of how dreadful they’re feeling; second, you can’t guarantee you’ll be back; and third, it’s doubtful a person, her memory failing, is having a nice day. Focus on the dog. Handler: Will do. Dog to Handler: So far, you’re still the person I think you are. Am I the good boy you think I am?

I wonder about the dogs’ reception of many sound-alike commands: Sit, stay, stand. Likewise, with back up and paws up, although the touch for each is distinct. Tough going, but not optional: vocal commands and body cues, such as “look at me” or “leave it,” are requirements, tools of the trade. Without demonstrated mastery of those, there’s no certification. Because these dogs must do more than comfort their charges; they must protect the institutions in which those charges reside. Certification is insurance. Against what? Against a bite, a tipped-over I/V, an upended meal tray that sends scalding hot coffee all over a candy striper. If someone — or rather, some dog — makes a mistake like that, someone’s got to pay.

I call it the ORG effect. For the last thirty years, the number of therapy and service dogs and the organizations that train them has grown like crazy. We’re talking dogs working at multiple sites, each with their own financial liability, background checks, in-house regulations—Love on a Leash, Alliance of Therapy Dogs, Kaiser and Scripps hospitals, as well as local hospices and the Pawsitive Teams’ own eleven different programs. Dog-work is a selective service, indeed. Most importantly, a therapy dog “is not legally recognized by law,” which means Buddy can’t be on an airplane, in a courtroom, or on military assignment unless he’s been stringently prepared and officially certified. Pawsitive Teams notes that this requires training “for 18-24 months in obedience, specialized tasks, and public access skills.”

* * *

Eventually, it’s time for a therapy outing. One evening, Pawsitive Teams and three leash holders and their canines — Duke, the whip-smart Australian Shepherd; Ivy Rose, the sugary Golden Retriever; and Joe Bruin (UCLA pedigree), the 18-month-old Goldendoodle who’s a bit touch-averse — gather at the San Diego Center for Children in Kearny Mesa, adjacent to Mesa College. The facility is “a residential site for kids with behavioral concerns,” Miss Katie, the skills coordinator, tells us. She estimates the staff, on-site and administrative, at four people for every adolescent. The center serves 80 teens on three-to-six-month stays; they’re mostly “on the spectrum,” that is, autistic, usually mildly so. Five arrive in a well-lit parking lot for a meet-and-pet. (I can’t name the kids. But I can say we know them: those who don’t fit in to high-school social hierarchies, their radical dress and creative caste outsidery. Thanks to private insurance and city/county funders, these boys and girls and nonbinaries have a safe place to be, for a while.)

Elizabeth and Joe Bruin

Right off, each teen, dressed in green or brown hoodies (hoods down), sweatpants, and sneakers, one with two silver lip rings, another with a stringy flop of hair covering half his face, is placed with a dog. It’s an uneven encounter: The dogs, whose socialization in a strange nighttime encounter is being tested, are wary — in part because the five kids approach eagerly, their manner noisy and over-chummy. Each handler suggests first an open palm for a lick, a finger-rub on the noodle, then maybe a tummy rub or petting the furry coat. It’s also good to just visit and have neither kid nor dog paw the other until the excitement tones down.

Soon, the kids are sharing canine tales. Each has a dog at home. Each speaks proudly of Ajax or Zeno as friends, confidantes, snugglers. One has two pit bulls, one of whom she says she’s trained to be a service dog, visiting a homeless shelter in El Cajon. Talking with each dog and handler, the teens describe their pooches’ personalities, tricks, and senses of humor. They miss caring for them. They yearn for their pets, if not the situations they’ve left behind; no doubt they feel lousy having to have left them there. “Therapy” suddenly feels applicable. I sense a collective anguish, strained separation from best friends who do not judge them, who love them for who they are.

Growing attachments suffuse the next hour. High-strung Duke will do anything for a treat; he jumps three feet in the air like he’s in a carnival act. Lovey-dovey Ivy Rose marshals a medley: she sits, offers a paw to shake, holds up the other paw for a high-five, then raises herself up on her hind legs to double the number for a high-ten. High-strung Joe Bruin keeps head-turning to see who’s behind him, keeping on eye on his vulnerable end. But each kid advises the miniature horse, “It’s OK, boy. I know you’re nervous. I get nervous too in new situations. Let’s just calm down.” Lots of pats on the head and rubs behind the ears. Who’s counseling whom?

Duke’s handler Kylie wants her Shepherd in her second-grade classroom (part of the day), Joe Bruin’s “Mom,” Elizabeth, an elementary school principal, wants the same for her Goldendoodle — a place in her office and with the resource teacher. Both dogs, their play instincts stratospheric, have a post-puppy climb toward managed tranquility because, as Barbara McKown says, “How you or anyone relates to your dog is how he’s going to relate back. If he’s treated like he’s treated all the time — that is, well — he’ll respond in kind.” That desired response means the dog has to know not to take things personally. It’s not easy. Kids show kindness, yes; they’re also rabbity with stress and predictably unpredictable. In any given encounter, they may bottom-out with sadness or go giddy silly.

Kylie and Duke

Handlers shoulder stress, too. At least for the first year of on-site duty, handlers must repeat to everyone, one-on-one and in crowds, what to do and what not to do during an encounter.

After exercises to “oxytocin” dog and student, each teen stands 30 feet away and, with treat in hand, calls each dog to come. This is a trusting maneuver. Duke and Ivy Rose hustle to the target, are fed, and rush back to a happy parent. And Joe Bruin? Tired from an hour of socializing, he first vogues his brow-furrowing look of canine incredulousness, sees the target everyone’s pointing at, and then gets it right. Good boy. No faux paw.

In the end, there’s a debriefing. The kids are upbeat: one dog “did a good walk and was speedy,” another “was a good sport” who “actually motivated me to want to take care of dogs.” Another states that a recalcitrant pooch should be more “flexible and needs to work on not getting so excited.” Still another says the dog’s “listening [capacity] is just amazing—and she’s good with treats.” Meaning further trainable.

I watch Duke, who watches the kids — they’re here voluntarily; a press on the buzzer at the gate and they can leave — walk back to their soft lockdown. I realize I’m projecting onto Duke, who’s avidly staring: Where are my buddies going? In the Pawsitive debrief, instructors and handlers agree: the dogs were splendid—patient, curious, “a super-motivated class of dog whisperers,” says Denelle. I note that the more the dogs nuzzle with strangers, the more solid their learning seems — as if they realize that “adaptability” tops their annual review. Carol Davis says, “Our more experienced dogs—you can hand them to someone who’s a little wild and, in two seconds, they’re like, ‘Oh, I get this person.’” That’s the goal.

* * *

In the post-prep-school realm — that is, when the dogs go visiting for therapeutic support — there are stories from the trenches about how a dog’s everyday role can change lives for the better. I hear a few of these feel-goods from Pawsitive Teams’ executive director, Eileen Heveron.

Years ago, a teenage boy got crazy drunk, crashed his car, and was paralyzed, sentenced to a wheelchair for life. Because, as Heveron notes, “the windshield went through him” and a brain injury ruined his speech, he needed to learn to speak. Depression set in and wouldn’t leave until a volunteer with a German Shephard began working with him. The dog had been trained to recognize 80 commands. These were coupled with the owner’s hand signals. The handler stood behind the boy and asked him to say, “Sit.” He stammered the word and, if the dog didn’t get it, the handler made the sign. The dog sat. The three persevered, very slowly, returning him to limited but functional speech.

In another case, a fetch-mad Labrador Retriever met a stroke victim in rehab. The woman’s right hand had been frozen, rendered unusable. A dog lover herself, she tossed the ball, but only with her good hand. Heveron asked to try the right, but the woman said, “No. It won’t work.”

“Just try it once. Just let the ball drop and dribble.”

She did: That “once” turned into ten tosses/retrievals, then a hundred, then a thousand, and a month later, following daily PT with this and other therapies, her right hand thawed out and came back to life.

Heveron, who is known in her circles as a person “who can work a room,” describes the ever-expanding realm of service dogs, those who require months of training for specific, certified jobs. Increasingly, we as a society are becoming are familiar with these dogs, they help the blind, retrieve medicine or a cellphone, sniff out drugs, find buried bodies, assist people with seizures, comfort children during courtroom trials, and oh yes, one specific task Heveron knows personally.

At age six and a half, Heveron was stricken with type 1 diabetes; she had the disease but, tragically, lacked the telltale symptoms that would signal when she was low on blood sugar (hypoglycemic), meaning she “needs sugar fast.” For years, she has monitored her condition with a blood-stick test and, if necessary, a drunk a glass of juice to elevate her sugar level. Having worked with therapy and service dogs most of her life, she decided several years ago to be matched with a diabetic alert dog. “Matched” here meant ordering the dog from a training program in Minneapolis called Scent Angels.

Every person, Heveron tells me, has a scent ID, a marker. Before her match, Heveron wiped her sweat and saliva with cotton balls, collected and froze them in an airtight plastic bag, and overnighted the package to the group. The Scent Angels, in turn, taught the dog to put his paws on the person in his care and lock eyes, telescoping concern.

Soon, she had her dog, Dex, a standard Poodle. When she first got him, Dex was “very pushy about alerting me. One night, I’d just had dinner . . . and he jumped up on me and stared me down. I thought it was silly, he was so insistent.” She complied, checked her blood sugar, and it was low. “He was right,” she says, “and I apologized.”

When Dex is by her side, people see him in his yellow vest and badge (Service Dog, Access Requested) and expect to seee in Heveron a visible infirmity. They ask why she has a service dog. She explains she has an “invisible disability.” She describes Dex as “just stunning. He’s quiet. He’s not in your face. He doesn’t like a lot of attention. He just trundles along beside me because I’m his person and he’s in charge of me.”

For several years now, she’s worn a CGM, or Continuous Glucose Monitor device, to measure her levels. The technology “has gotten much better over time,” and the system is very reliable. Heveron insists, however, that her dog has not been “replaced.” Dex and device complement one another. “He still alerts me, checks me several times a day,” she notes. “After six years together, he and I have a routine, and he’s spot on.”

* * *

In this century, our anxiety-ridden populace has decided that buddying-up with animals — known everywhere for their “emotional support”—should comfort our insecurities not just at home, but in public as well — seemingly, the more public the better. Hewing to the belief that others are always on board with “what’s right for me,” Americans have sentenced their pets to all sorts of compromising roles for which our public gatekeepers have laid down the law. An emotional-support kangaroo with its handler was told to leave McDonald’s, and the pair hopped out. An 80-pound nerve-soothing pig, so designated by its owner, was told to hoof off an airline before takeoff. Its smell was sickening passengers and crew. And a therapy-companion duck named Daniel Stinkerbutt who’d been paired up with a PTSD-pal waddled to his seat on a short intra-state flight and, apparently, loved the ride. Alas, despite the adoring quacks, a Captain America diaper, and tiny red shoes, Daniel was not allowed to fly again.

But here, in Miramar, we are worlds away from such nonsense. It’s Pawsitive grad night, and in a proud-panting row, six responsible canines are ready to begin work as companions. Their goodwill, already known to their handlers, will now provide for the health of others. In a final ceremony, they will trade their “Therapy Dog in Training” green bandanas for robes and mortar boards. Prior to receiving a certificate, each dog does a trick. Samples: Janey sits up, Joe Bruin crawls on the floor, Duke waits ten feet from a doggie bone and then gets it when given the okay, and Brinkley leaps and catches a ball, then returns it to a basket.

The Pawsitivity is contagious. Claps and happy yawns abound. Whatever the state of the world they are setting out to engage, I’m sure these tricks and the love they make will make it just a little bit better.