Reducing client anxiety in veterinary medicine

There are many ways to incorporate anxiety reducing techniques into veterinary practice to promote mental well-being

Pets often come into a clinic stressed and scared. Well-meaning owners may not realize their own behavior can increase their pets’ fear. Photo courtesy Rosshelen / Istock / Getty Images Plus
Pets often come into a clinic stressed and scared. Well-meaning owners may not realize their own behavior can increase their pets’ fear.

As veterinary professionals, we know the signs of fear and anxiety in our patients because we see them every day. We see the crouched body language, tucked tails, dilated pupils, excessive panting, and darting/avoiding behavior. We see cats curled in the back of their carriers, or on the highest shelf of the exam room, we hear the hisses and growls, and witness many other variations of flight or fight responses.

Behind each of these anxious and fearful pets is almost certainly an anxious pet owner. With our complex cognitive awareness and unique human experience, anxiety is not uncommon even for pet owners of the most relaxed and stress-free pets. Concerns related to how a pet will act during an appointment, managing difficult behaviors like aggression, worrying over what an outcome or diagnostic may be, pet transportation struggles, and financial concerns can all quickly take over a client’s mind. They can overshadow thoughts and questions related to the actual goal or reason for an appointment. When an experience causes anxiety, it is natural to avoid the situation. We see pet care avoidance every day, and especially amidst COVID’s current curbside approach for veterinary medicine.

If clients arrive at appointment anxious, they are less likely to stay present and focused on their pets’ care. Companion animals are acutely aware of the subtle changes in their owners’ emotional state. So, the more anxious and agitated their owner gets, the more likely they will be to mirror this behavior.

This creates an environment where actual veterinary exams and procedures can be perceived as threatening and become more difficult for staff to manage. Each negative association with veterinary care leaves an imprint in the animal’s mind, potentially altering how future visits will be received and perpetuating this bleak cycle.

The good news is the veterinary industry is actively working on protocols and implementations for reducing fear and anxiety in pets. Fear Free programs in veterinary medicine are a great example, providing practice and individual certifications focused on empowering veterinary professionals with tools on how to better handle and reduce fear, anxiety, and stress in the veterinary environment.

Fear Free techniques increase patient compliance and client communication, as well as promote safer and more efficient work environments.1 When clients witness a more comfortable and compassionate environment for their pets, their own feelings of anxiety diminish, too.

With much-needed focus on reducing anxiety and fear in veterinary patients, the question still remains: What can we do better to reduce client fear, anxiety, and stress? There are several additional practices that can be implemented to create a safer and more stress-free environment for the pet parents themselves.

House call program/house call referrals

Having a trusted house call veterinarian to refer to, or implementing this service into a veterinary practice’s list of services, can be a huge resource to clients or patients with significant anxiety around travel, veterinary clinics, other people, or for pets who experience aggression toward other dogs or cats. This is particularly beneficial for feline patients, which, as a whole, tend to receive far less veterinary care than canines.

In a 2013 study by Bayer and the American Association of Feline Practitioners (AAFP), 52 percent of cat owners admitted avoiding regular veterinary visits and care for their cats. Reasons included the clients own fear of veterinary care, and the belief their cats shared this same anxiety. Providing in-home veterinary care can meet these clients in the comfort of their own home, providing valuable insight of a patient’s environment, and is one way to ensure more cats receive needed veterinary care, while potentially dispelling some of the negative connotation surrounding veterinarians and this industry.2

Train staff on active listening

Active listening is defined as uninterrupted and engaged listening that includes pausing, paraphrasing, and reflecting back when appropriate. It supports asking for clarification without judgement, undivided attention, and listening to what is being said as opposed to simply hearing someone speak. An active listener’s role is being a sounding board of what is truly being said as opposed to interjecting or interpreting with varying opinions, beliefs, or judgements.3

Not only will training staff to become active listeners promote healthier communication with clients, allowing them to feel more heard and more comfortable (subsequently reducing anxiety), but it will also allow support staff to transfer clearer, more well-rounded, and constructive information to the veterinarian.

In an industry such as veterinary medicine, where days are very busy, slowing down enough to truly tune in to what a client is saying allows for everyone’s job to function easier and in a less stressful manner, including the clients themselves.

Implement a species-appropriate emotional support protocol

Canine and feline enrichment techniques provide a healthy opportunity for pets to engage in species-appropriate behavior in a constructive and nondestructive manner. Regular enrichment activities and enriching environments naturally decrease stress in companion animals.4

Recommending clients provide these enrichment activities to their pets before each veterinary visit is an easy way to promote and encourage deepening the human-animal bond while offering easy mental and physical stimulation techniques for pets, setting them up to be in a less anxious state before arriving for veterinary care.

Providing these activities after veterinary care can also help reduce lingering anxiety from a stressful visit. Enrichment activities can include food puzzles (frozen to increase difficulty), scent work, access to appropriate chewing or scratching, and physical stimulation, such as walks or hikes. Many of these enrichment activities can and should also be provided for in-clinic use during a pet’s appointment.

Encourage consensual touch

Train staff to openly communicate with each pet. As nonconventional as it may sound, training and behavior specialists are now beginning to recommend “consensual touch” with animals. Of course, this is not always possible when veterinary care and procedures are immediately needed.

However, practicing consensual petting within a standard dog or cat wellness visit is a great way to fully assess a patient’s behavior, potentially gaining more trust from an animal by allowing it to be a part of the decision as to whether or not they would like to be touched. Openly walking through this process also provides education to clients who would benefit from desensitizing pets to certain touch aversions at home (like touching a dog’s nails or looking in their ears).

An example of consensual petting is having a staff member sit on the other side of the exam room, quietly talking to a pet until the animal comes over to seek more attention. Once the pet approaches the staff member, petting would start with a simple chin scratch, including multiple pauses to ask the pet whether the would like petting to continue and waiting for a behavioral cue from the animal.5

Consider the parallel concept: it would not be appropriate to walk up to a toddler or person and begin hugging them; instead, a better approach would be to get to know the individual and use their cues to guide your next steps in physical or verbal communication.

There are many ways to incorporate anxiety reducing techniques into veterinary practice that promote mental well-being for not only the client, but also the pet and staff. As our society becomes more emotionally intelligent, pet owners will ultimately become more conscious of the way we engage and interact with their pets. Implementing these strategies now can deepen the connection we make with both veterinary patients and their owners, and can provide a positive and more enriching experience for everyone.

Claire Primo, CVT, CCMT, is a veterinary nurse and certified animal massage therapist residing in Lyons, Colo. She offers animal massage therapy, laser therapy, hospice and palliative care, and veterinary nurse needs through her practice, Peak Animal Wellness & Massage, while also managing a holistic veterinary house-call practice, Boulder Holistic Vet. Primo specializes in senior pet care, holistic veterinary nurse care, and empowering guardians with all the appropriate tools and guidance needed for a healthy and nurturing relationship with their pets.

References

1 “Bayer-AAFP study breaks down why 52 percent of cat owners avoid regular vet visits” (n.d.). Retrieved May 13, 2021, from https://www.aaha.org/publications/newstat/articles/2013-07/bayer-aafp-study-explains-why-52-percent-of-cat-owners-avoid-vet-visits/

2 “What is Fear Free” Retrieved May 13, 2021, from https://fearfreepets.com/about/what-is-fear-free/

3 Cuncic, A. (n.d.). “How to practice active listening”. Retrieved May 13, 2021, from https://www.verywellmind.com/what-is-active-listening-3024343

4 Florsheim, B., & Member Carrollton, T. “Environmental enrichment for dogs: Canine behavioral health.” Retrieved May 13, 2021, from https://www.texvetpets.org/article/environmental-enrichment-dogs/

5 Zazie Todd, P. “How to pet cats and dogs.” 2021; April 15. Retrieved May 13, 2021, from https://www.companionanimalpsychology.com/
2018/05/how-to-pet-cats-and-dogs.html

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