THERAPIST, PC Licensed Independent Social Worker

Licensed Independent Social Worker
Therapist Office
Street address
City, State, Zip
To Whom It May Concern:
As CLIENT’s psychotherapist, I am writing to make the case for CLIENT to live in a single room in a
substance-free dorm, and to bring her __________(pet specie and name) as an Emotional Support
Animal to Grinnell College. I am a Licensed Independent Social Worker in the state of Iowa who is
qualified to make mental health diagnosis and treat mental health conditions. I have over 16 years of
experience as a mental health professional. CLENT is currently under my professional care.
CLIENT has been struggling with depressive and anxiety symptoms since high school. My diagnoses
for CLIENT are: Major Depressive Disorder, Recurrent, severe without psychotic features, Panic
Disorder without Agoraphobia, and Social Anxiety Disorder. CLIENT has been actively and
consistently engaging in both medication and psychotherapy treatment for the past two and a half
years. I have been meeting with her on a weekly basis since she came to Grinnell College. I have
observed the following symptoms in my work CLIENT: depressed and anxious moods, low energy,
difficulty with motivation, panic attacks, fearful and negative ruminative thoughts, feelings of
overwhelm, clinically significant distress and inhibition in social situations, and social isolation and
withdraw. In addition, CLIENT has a history of migraine headaches, which have occurred
intermittently over the fall semester. Noise and bright light can cause exacerbation of the pain and
prolong the migraine headaches.
CLIENT would benefit from access to a predictable and quite space to self regulate when she
experiences emotional distress. In addition, CLIENT will benefit from access to a quite and dark room
to recuperate from migraine headache. Finally, living a substance free life style is very important for
CLIENT, both by choice and for medial reasons. Living on a floor where people use substances is
very anxiety provoking. I believe being in a single room in a substance-free dorm is crucial for
CLIENT’s mental health, and her not having access to such accommodation exacerbates her mental
health symptoms.
CLIENT has found the presence of her pets very helpful in alleviating her mental health symptoms
back home. It is apparent to me that CLIENT is already strongly attached to her emotional support
animal. I see her animal as an important element of CLIENT’s on-going treatment plan. I believe it is
crucial that her animal can accompany CLIENT as an Emotional Support Animal to college. Since
CLIENT is emotionally attached to her animal, having the animal with her can provide the much
needed secure attachment and emotional support. Having a positive and safe connection with her
animal can help increase CLIENT’s feelings of social engagement, which can activate the brain’s
relaxation response, essential in decreasing panic and anxiety symptoms and increasing positive
emotions. In addition, the structure and activity involved in caring for her animal can help CLIENT
stay more present and actively engaged in her own life and activities. Being able to access care taking
capacity for her animal can help CLIENT take better care of her self. Finally, placing her attention on
Address, City, State Zip
Licensed Independent Social Worker
her animals calming presence can help alleviate the impact of negative distressing ruminations
associated with depression and anxiety.
CLIENT will additionally benefit from academic accommodations which may include advance notice
of assignments to adequately prepare and work ahead to mitigate the impacts of her migraines and
anxiety. Additionally, CLIENT will benefit from short extensions in the event that a migraine requires
her to receive emergency medical treatment. In these instances, CLIENT will be able to provide you
documentation of the treatment that occurred.
Please don’t hesitate to call me if you have any questions regarding my letter.
Best wishes,
Address, City, State Zip