Veterinary Social Workers: Supporting Teams and Clients Through Trauma and Grief

Stressed veterinary teams and clients can make for a volatile mix. Veterinary social workers provide the coping strategies and healthy communication needed. This professional attends to human needs at the four main intersections of veterinary and social work practice—the link between human and animal violence, grief and loss, animal-assisted interactions, and compassion fatigue and conflict management.

by Maureen Blaney Flietner

PRACTICING VETERINARY MEDICINE requires delicate navigation.

The changing winds of critical and emergency care whip up the rising tide of owner expectations and sweep over the already choppy waters of veterinary stress. Add to the mix the rising pressure of the global pandemic and it could be called a perfect storm.

Enter the veterinary social worker.

This professional attends to human needs at the four main intersections of veterinary and social work practice—the link between human and animal violence, grief and loss, animal-assisted interactions, and compassion fatigue and conflict management—according to Elizabeth Strand, PhD, LCSW, who came up with the term in 2002.

Rising Stresses Prompt Action

By now, Washington State University’s College of Veterinary Medicine in Pullman should have in place its first veterinary social worker. Earlier this year, the hospital advertised for that position, but it had no specific role as the concept is too new, said Charlie Powell, the college’s senior public information officer. The role was to be “developed on a case-by-case basis, giving the person a lot of leeway to possibly help in cases where Venn diagrams of clinical care and human emotions overlap.”

Why add the position?

“Pets, very broadly speaking, have been said to be the children of the 21st century,” explained Powell. “That’s why we have a $38 million state-of-the-art school in the middle of wheat fields. It was placed here because people demand advanced care for their animals and they come from a very wide geographic area to get it. Nationally and locally, it is very common for people to pay in the high five digits for care for their animals, and they leverage all manner of funding to get it.

“Here you see all the dimensions of the human and animal bond. It is not uncommon after euthanasia for pet owners to lock themselves in an exam room for two, four, up to eight hours. This is the level of emotion we are talking about. A social worker would be the hospital’s eyes and ears for these clients rather than a group of overworked house officers not trained to deal with this level of distress.

“We had to discontinue our pet-loss hotline in June 2019 because the level of mental health challenges had increased far beyond what our students were equipped to handle. Increasing levels of pathology were creeping into the calls and the students who answered the phones were not prepared for this and we did not want to attempt to bring them up to speed.”

And then there are the abuse cases, which are traumatic for the staff.

A dog presented to the hospital last fall by law enforcement had on a puppy-size choke chain that created an abscess, triggering septicemia. The dog died before it was able to get out of the intensive care unit. That death would have been a case ideal for a social worker to dive in to help the staff, said Powell, noting that abuse cases happen on a regular basis.

The hospital’s director, Debra Sellon, PhD, DVM, associate dean for clinical programs, had increasing concerns about the mental and emotional health of the veterinarians because of the number and types of cases, he said. Her sense of an undercurrent of stress was supported by counselors working with house officers. Suicide ideations had been heard, and that was a red flag.

Veterinary professionals, said Powell, are “stressed by the quality and depth of issues from all owners, good and bad. It’s like trying to drink out of a firehose.”

“As clients grow more attached to their pets, and the numbers of veterinarians and nurses
continue to decline, the need for this support
will only increase.”
—JAYDE QUIGLEY, MBA, CVT, CVPM, SPHR

Support for Team and Clients

AAHA-accredited Animal Emergency and Referral Center of Minnesota, a 24/7 emergency and specialty hospital in Oakdale, wanted to offer support to both its team members and its clients, according to Jayde Quigley, MBA, CVT, CVPM, SPHR, chief operations officer.

“Veterinary medicine is an exceptionally difficult field to work in, no matter the position in the hospital. Finding a way to foster mental health, coping strategies, and healthy communication among the team is vital to keep them engaged in their careers and to ensure they are as supported as they can be,” said Quigley.

“People enter into veterinary medicine because they have a passion for the field, and it’s important the employer recognizes the stress involved and provides the tools to allow them to keep doing what they love. Our clients are often dealing with difficult diagnoses for their pets and often need help not only making difficult decisions but in processing those events later.”

The center hired Colleen Crockford, MSW, LICSW, as its part-time veterinary social worker more than a year ago. But it became apparent within a few months that she would need to be full time, said Quigley.

“She supports our team members and clients, mentors our leadership members, cofacilitates our pet-loss support group, and provides training as needed on burnout, secondary trauma, and healthy communications. She participates in our biannual continuing education offerings to the local referring community. We accept social work interns into our program and she mentors them.

“We often don’t know what owners are experiencing in their lives and how those events may be factoring into their decisions. Colleen is able to help the client through this process, offer additional external resources if needed, mentor the veterinary team on how to proceed, and then debrief with the team when the case is resolved. If needed, she also can follow up with that client and those team members at a later time.”

The process allows the team to focus on its responsibilities and prepare to handle similar situations in the future, she explained.

“As clients grow more attached to their pets, and the numbers of veterinarians and nurses continue to decline, the need for this support will only increase.”

For practices considering adding a veterinary social worker, Quigley advised that “adding this service is new and scary but absolutely worth it. Even adding in a day or event at a time by contracting a local social worker will not only benefit your team and clients but go a long way in demonstrating your dedication to their wellbeing. We consider the investment as a necessary operating cost. The benefit is found in decreased turnover rates, client retention rates, and client referrals.”

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A Profession Coming into Its Own

Pioneers in the fields of pet loss and human-animal interaction have been working with veterinarians as far back as the late 1970s, said Elizabeth Strand, PhD.

One of those is Sandra Brackenridge, LCSW, who developed and supervises a veterinary social work internship program at the Center for Veterinary Specialty and Emergency Care in Lewisville, Texas. Decades ago, she said, veterinary specialists used to graduate and then teach at veterinary schools. Then private specialty practices began opening. Around that time, society was recognizing the human-animal bond and research was reporting that pets could lower blood pressure and reduce depression.

“With life-and-death decisions now being made in these practices, the public felt it had a right to demand veterinary care for their pets and now bring all of their emotions to the veterinary office. Enter the need for veterinary social workers,” said Brackenridge.

Those working in the field feel it is important to legitimize the profession, said Pamela Linden, PhD, clinical associate professor at Stony Brook University School of Health Technology and Management in Stony Brook, New York.

A group meeting weekly since last summer has determined a governance and structure, standards of practice, and vision and mission statements; is in the process of incorporating the International Association of Veterinary Social Work; and has set up a website: veterinarysocialwork.org.

“The credential would show that the person has the extra level of specialized training that provides a wide breadth of knowledge, allowing them to work in many different areas. The organization would offer guidance and resources and help universities and other animal-related settings like veterinary hospitals in creating opportunities for those interested,” said Linden.

The International Association of Veterinary Social Work will have a presence at the Sixth International Veterinary Social Work Summit, October 8–10, 2020, at the University of Tennessee, Knoxville, providing information and welcoming membership applications.

Crisis Intervention

Sarah Bernardi, RSW, MSW, has been a veterinary social worker for almost three years at the Veterinary Emergency Clinic and Referral Centre, a 24/7 provider in Toronto. She is the center’s first social worker and one of only two in Canada.

“[Veterinary professionals are] stressed by the quality and depth of issues from all owners, good and bad. It’s like trying to drink out of a firehose.” —CHARLIE POWELL, SENIOR PUBLIC INFORMATION OFFICER, WASHINGTON STATE UNIVERSITY COLLEGE OF VETERINARY MEDICINE

“At times with pet loss, it takes a while for people to call me. They are still struggling because pet loss is such disenfranchised grief in society. Knowing they can come to a professional’s office and not be judged really helps.”

Her work includes crisis intervention for codependency and domestic or animal abuse.

“One owner came through the emergency room with an older dog presenting with diarrhea and other issues. The attending veterinarian recommended humane euthanasia because there was nothing left that could be done. The case came to my doorstep when the veterinarian reported that the owner was going to harm herself if her dog died.”

When Bernardi talked with the woman, she learned that she had bonded with her dog during her difficult marriage and divorce and if her dog died, she would die too. Bernardi performed a risk assessment, and together they created a safety plan. The necessary supports were put in place to keep her safe, and the owner was then able to spend time alone with her dog. Afterward, the woman decided to humanely euthanize the dog. Bernardi said the woman contacted her not long ago and was doing well.

Finances, too, can spark a crisis.

“When an owner pays for care and the animal does not get better, the resulting anger mixes with the owner’s anticipatory grief and guilt. I try to validate their situation—‘It is expensive. It must be hard for you’—and be collaborative to bring the communication further.”

For staff, she provides counseling for work and personal issues, noting that “it’s a stressful environment. We try to be mental-health forward.”

While gerontology was her degree focus, Bernardi said the transferable knowledge and her experience with animals help guide her work. In some way, it may have been a personal experience that led her into this arena.

“When I was 17 and lost my dog, the veterinarian handed my family the debit machine over my dog’s dead body,” she recalled. While her family didn’t look kindly on the gesture at the time, Bernardi said she doesn’t think the veterinarian was a bad person.

“It could have been compassion fatigue,” she said, “but that was not the way to handle people.”

Social Work in the
Time of the Pandemic

The world has changed since this article was written, but the role of the veterinary social worker is all the more relevant in the face of the coronavirus emergency. The stress, fatigue, and uncertainty that go along with the global pandemic are taking their toll on everyone, including veterinary staff.

Elizabeth Strand, PhD, LCSW, clinical associate professor and director of veterinary social work at the University of Tennessee, noted that during this time “more clients might be facing having to make euthanasia decisions as opposed to treatment decisions because of the economy. This is very hard on the hearts of the veterinary staff.

“Veterinary social workers are being helpful in developing policies around euthanasia that both support the human-animal bond and protect the physical and emotional health of staff. The moral stress of not being able to provide the same comfort care that is typical—the hugging and supporting of people—that veterinarians and veterinary nurses often do in times of euthanasia is hard on the staff as well.”

Strand noted that the role of the veterinary social worker is to “provide a safe place for veterinary staff to grapple with and deal with that moral distress as well as provide end-of-life counseling and pet-loss counseling for clients who have had to say goodbye to their pets during this very unusual time.”

Validation and Support

Alyssa Pepe, LMSW, is a full-time veterinary social worker at AAHA-accredited Orchard Park Veterinary Medical Center, a 24/7 full-service and emergency hospital in Orchard Park, New York.

Alyssa Pepe, LMSW

With her focus on clients and staff, her services differ depending on the day’s needs. For example, one day a man who came in to euthanize his geriatric dog did not have support with him.

“I was able to be present with him and his dog throughout the process. Presence can have a strong impact. It is not necessarily the words a person shares but rather the compassion demonstrated through eye contact and sitting with them through a very difficult decision and process. Being present for euthanasia can assist the veterinarians as well. Once the procedure is over, the doctor can speak to the client and then leave to continue their workday as I continue to provide support and remain a presence for the grieving individual,” said Pepe.

Each family, couple, and individual is different in beliefs and understanding about their pet’s care and decisions about euthanasia. It’s best, she said, to meet the client where they are by taking the time to understand the client’s thoughts and perspectives.

“I try to provide a setting in which they do not feel judged or fearful of speaking. Most importantly, once a client comes to a decision, whether it is one I agree with or not, it is important to provide validation and ongoing support.”

The concerns she hears are not just about euthanasia, she explained.

“I have listened to parents share their fears and concerns about telling their children who are at different ages and developmental stages about their pet’s declining health. People worry about being able to properly care for their pet, particularly the elderly who do not have assistance at home. For the elderly, memory and medication can be difficulties. If a person has difficulty remembering when to take their own medication, it becomes an added responsibility to remember to give their geriatric cat [her] medication. Fortunately, when I brainstorm with the clients or family members, solutions are often found.”

Pepe said her work with staff helps them combat compassion fatigue and burnout.

“In such a stressful environment, moral distress can affect other aspects of an employee’s life and negatively impact the quality of both their work and home lives. One way that I assist is with debriefing. This is not therapy but a way of checking in with staff and seeing what is going well for them and what may be overwhelming.”

Pepe said she provides information about mental health and may refer someone to an employee-assistance program counselor or a private counselor; talks with staff about suicide and its prevention; and trains management in mental health awareness.

Business Aspects to Consider

“Goodness of Fit”

Strand, associate clinical professor and founder of the Veterinary Social Work Program and subsequent certification program at the University of Tennessee, recommends that when adding a veterinary social worker, practices look for someone who has “goodness of fit” with their philosophy.

Practices should ask applicants about their thoughts on euthanasia as well as other ethical quagmires in their business to be sure that their values and moral compasses match.

Specific Competencies

“Some competencies are tied to the term veterinary social worker,” said Strand. “The person should know how to handle conflict resolution; to mediate between parties that see things very differently; to cope with animal death, which includes witnessing a euthanasia, understanding their feelings about euthanasia, and managing those feelings so they can be present with clients experiencing that with their animals; to recognize and know how to intervene in issues of animal abuse; to understand the human-animal relationship in its broadest perspective so that while the relationship between, for example, a farmer and his cow is what it is—for finances or for food—it is still a relationship.

“Sometimes mental health professionals are drawn to animals because they see them as healing factors in peoples’ lives . . . and they are. But these professionals can’t just focus on the fun, sweet stuff but have to be competent regarding, exposed to, and knowledgeable about the darker, more painful sides of the human-animal relationship, and those are often the sides that contribute to veterinary compassion fatigue.”

Rachel Wright, MSW, LSWAIC

Finances and Resources

“Hiring a veterinary social worker is a major investment in time, finances, and resources, but the return on investment can be enormous,” according to Rachel Wright, MSW, LSWAIC.

Wright provides full-time contractual services for Summit Veterinary Referral Center in Tacoma, Washington, and manages Summit’s social work program, supervising MSW degree students in their practicum placement. She and her students provide support to the emergency/critical care and specialty practice and their clients on three levels: one-to-one, group and community, and macro.

Wright advised that practices need to consider costs, determining how many social work services will be fee based versus offered at no cost; space, providing a quiet, uninterrupted, confidential space to follow strict confidentiality laws; and contracted or salaried services, with each having its pros and cons. 

Maureen Blaney Flietner is an award-winning freelance writer living in Wisconsin.

 

Photo credits: ©iStock.com/Lisa-Blue; ©iStock.com/SDI Productions; ©iStock.com/monkeybusinessimages; ©iStock.com/DenGuy; ©iStock.com/aksim Tkachenko; photo by Christina Mae Johnson, used with permission; photo courtesy of Rachel Wright

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