“Many times, the veteran with severe PTSD is housebound,” said Sandra Sindeldecker, director of the Dogs 4 Valor program. “They are isolated. They are very nervous. They will not make eye contact. Some don’t leave the house at all.”

The program includes both group and individual training. The goal is for the veteran and the dog to feel comfortable and understand each other. The group conducts excursions to help veterans regain their balance in public places such as airports. Program leaders also provide mental health therapy at no cost.

Veterans and dogs graduate in six to nine months, but group meetings continue.

There is growing evidence of the value of service dogs for veterans with post-traumatic stress disorder. A small study published in JAMA Network Open in June looked at a program operated by K9s For Warriors. The program’s service dogs are taught to detect a veteran’s physical signs of distress and can interrupt panic attacks and nightmares with a loving nudge.

The researchers compared 81 veterans who received service dogs with 75 veterans on a waiting list for a trained dog. After three months, PTSD symptoms improved in both groups, but veterans with dogs saw greater improvement on average.

O’Brien, 40, recalled that the camp where he worked in Iraq sometimes held more than 20,000 detainees. Violence and riots were common and left her with severe anxiety.

“When I got out of the military, I assumed that as a veteran, you’re supposed to be nervous all the time,” O’Brien said.

O’Brien’s mother saw the playful Labrador poodle mix on Facebook and convinced her daughter to adopt the dog she named Albus. Months later, O’Brien learned about Dogs 4 Valor and the pair joined the show in October 2023.

O’Brien says he can now go out in public again; he even went on vacation to Branson, Missouri, “things I never would have thought I would actually do, probably ever again.”

Mark Atkinson, 38, served in Afghanistan as a Marine Corps corporal. He returned home with post-traumatic stress disorder and major depressive disorder, which caused insomnia and anxiety. He adopted Lexi, now 5 years old, in 2020.

Lexi, a muscular breed of Cane Corso, needed Atkinson as much as he needed her. Her previous owner had kept Lexi chained before handing her over. Since joining Dogs 4 Valor, the two are able to go out together and enjoy life.

“I don’t really like leaving the house because I’m safe there, you know?” Atkinson said. “And having Lexi has made me more social.”

Having a group of fellow veterans facing the same challenges has also helped, Atkinson said.

“We come from the same backgrounds, from different branches,” Atkinson said. “The same problems. You know, PTSD or traumatic brain injuries. And everyone is very welcoming too. There is no trial.”

O’Brien compared life with Albus to a relationship with a sometimes aggressive best friend who often wants out.

“Best friend constantly wants to make you do things that make you nervous,” O’Brien laughed, acknowledging that it’s ultimately up to her.

“I have to decide to walk away and just deal with life,” O’Brien said. ”And that has been difficult. And it’s still tough from time to time, but it’s getting manageable.”

Some veterans said their family relationships have improved since starting the program.

“I can talk, not lose control and just get along with people and not be as stressed, not have as much anxiety,” Atkinson said. “Or even if I do, she (Lexi) is there with me.”

Timothy Siebenmorgen, 61, said his relationships also improve with the help of his 1-year-old American bulldog, Rosie, and Dogs 4 Valor, which he joined in July. He served in both the Marine Corps and the Army, deploying 18 times.

“You’re in the military and they teach you not to show weakness,” Siebenmorgen said. ”So you think you can tackle everything yourself and you honestly believe it. And then you realize you can’t do it alone.”

Veterans said the dogs and the program have given them new hope and a renewed ability to move forward.

“I got my life back,” O’Brien said.