The 15-year-old boy sat slumped in the waiting room before his first psychotherapy session. He hung his head and folded his arms.

When Lois Abrams, Ph.D., stepped out of her office with her co-therapist, a Cavalier King Charles Spaniel named Duke, the boy's eyes moved to the dog. Abrams surveyed the teenager. "Would you like to give Duke a treat?" she asked.

He nodded, and the spaniel trotted over, wagging his tail. Duke offered a paw to shake, then jumped in the boy's lap. He raised his head, looked up at his mother, and grinned.

"He's really nice," he said. "I'd like a dog like this."

His mother burst into tears. "I haven't seen him smile like this in months," she told Abrams. "I can't believe it."

Abrams believes it. She sees this kind of reaction all the time when she works with Duke and Romeo, her psychotherapy assistance dogs.

"Cavaliers are comfort dogs, and unlike some breeds, they aren't threatened by direct eye contact," Abrams says. She first heard about the empathic little spaniels from a student in a course she was teaching at Pepperdine University's Orange County, Calif., campus.

A few years later, she found Duke, and began socializing the puppy by letting him greet clients. Abrams took Duke to obedience classes, then began training him for therapy with an animal behaviorist, desensitizing him to people experiencing intense emotions.

Duke and Abrams are a certified pet therapy team with the Delta Society, a leading pet therapy organization. Trained in crisis-response work, Duke also helped Abrams counsel victims of the 2003, 2007, and 2008 California wildfires and worked at the Ground Zero memorial in New York in 2002.

But Duke and Romeo impact the most lives at their daily work- place in Los Alamitos, Calif. Romeo, Duke's nephew, joined the family a few years ago to help Duke with his sizable caseload. The affectionate younger Cavalier specializes in adolescents and young children. "Romeo loves toddlers," Abrams says. "In child abuse cases, sometimes a child that won't talk to us will talk to Romeo."

Duke has a way of telling Abrams just how a patient is feeling. "Duke sits at the feet of people with anxiety," she says. "But with people who are depressed, he jumps up on the couch and sits next to them.

"When I realized what he was doing, I thought, 'Hey, this little dog knows things I don't know, with all my years of training. I'd better start paying closer attention to what he's telling me.'"

Therapists aren't supposed to touch their clients, but Abrams believes that because the clients can pet the dogs, they feel more nurtured and safe in the office. "When Romeo rolls over and offers his belly, that's a sign of trust," Abrams says. "That really means a lot to some of our clients."