Abuse—handling and managing cases (Proceedings)

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Abuse—handling and managing cases (Proceedings)

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Nov 01, 2010

In this session, we will – based on a variety of cases – discuss situations commonly encountered in practice. We will include scenarios in which a veterinarian is faced with potential child abuse cases, cases of suspected animal abuse, and the emotional abuse of veterinarians and their staff.

Even the best veterinarian will eventually face a client who is disappointed, angry or frustrated. In this session we will discuss examples that you bring to the table, such as 'Rocky', a ten year old male Springer Spaniel had bitten the clients' two year old daughter. The girl sustained serious facial injuries. The family has two other children. Both parents worked full time. A nanny is at home during the day. The dog had bitten many times before. Bites occur with little predictability and their intensity is increasing. To make a long story short, the situation in which Rocky lived made him a high risk for future bites and made living with the dog dangerous for the little girl – and others. The situations didn't allow me to give the clients a good prognosis for case outcome. After a detailed explanation of my assessment, treatment options, the limitations, and the risk, I recommended that the clients considered euthanasia since placement was a risky alternative with a low likelihood to be successful for the dog or the adopting family.

The husband was – understandably – very emotional. He had acquired the dog in a rough period of his life, years before he met his wife and started a family. He was very close to Rocky and while he understood what I had said, he understandably wanted a different answer. He had made the appointment at the University's behavior service hoping that I had a solution. But I didn't have a magic wand. He invested another $500 and felt that I had cheated him. He loved his daughter and each time he looked into her face he was reminded of Rocky's action. Still, I told him it was best to kill his best friend.

The initial politeness and apparent respect for my professional credentials turned into reactions that were caused by grief that caused deep anger. The anger was directed at me, the messenger.

How should we respond to a client who is hurt so deeply and ventilating his or her anger and hostility openly?

First and foremost, it's not about me. The client's anger is directed at the system and not the clinician personally. Even if the things this client said feet very personal, responding to the client on this level is the worst possible reaction. Instead, keep a neutral facial expression and tone of voice. Hold eye contact and straight posture to communicate confidence in your decision and composure.

Listen and agree using empathetic responses. In the response you reflect his emotional nuances, using a voice and expression attuned to the client's underlying feelings. Empathy is often confused with compassion and "I'm sorry to give you the bad news" will likely worsen things. Instead show appreciation for his reaction and paraphrase what the client tells you to reflect understanding: "Being forced to lose your best friend and learning that I don't have the solution that you hoped for surely frustrates you very much. I see that you understand the risk for your daughter, and want only the best for her. But it seems that you feel incredibly sad and left alone in making the hardest decision that a dog owner can be asked to make".

When speaking to clients who are angry and upset, it is best to send 'I messages'. Diffuse anger by asking more information. "I understand that you ..." Find out if he had been giving this information before by others. Ask if he had to euthanize a pet before – maybe as a child. It might be appropriate to determine if he has a spiritual belief system and how it relates to this situation. Ask if his family or friends understand and share his bond with Rocky. Give him time to think and to answer. Be comfortable with periods of silence.

Try to get the client to agree (and state himself) the problem and the factors involved. Let him develop the idea that you previously outlined. This helps process and helps the client realize that it's not you. Discuss the alternatives and let the client determine their feasibility – he is discussing it, you facilitate with information.

Finally, it is fine to refer: " If you are interested, I would like to point you to additional resources that clients found very helpful, ...". Resources may include books, internet resources and other specialists in the area. Outline advantages and disadvantages and be open to offer resources of people who may approach issues differently. Clients will find them with or without your help – your openness will allow the client to see you as confident and dependable which will benefit you in the long term.