Journal of Human Behavior in the Social Environment

ISSN: 1091-1359 (Print) 1540-3556 (Online) Journal homepage: http://www.tandfonline.com/loi/whum20

Veterinary social work: Practice within veterinary

settings
T. Melissa Holcombe, Elizabeth B. Strand, William R. Nugent & Zenithson Y.
Ng
To cite this article: T. Melissa Holcombe, Elizabeth B. Strand, William R. Nugent & Zenithson
Y. Ng (2016) Veterinary social work: Practice within veterinary settings, Journal of Human
Behavior in the Social Environment, 26:1, 69-80, DOI: 10.1080/10911359.2015.1059170
To link to this article: http://dx.doi.org/10.1080/10911359.2015.1059170

Published online: 29 Jul 2015.

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Date: 14 December 2016, At: 11:28

JOURNAL OF HUMAN BEHAVIOR IN THE SOCIAL ENVIRONMENT

2016, VOL. 26, NO. 1, 6980
http://dx.doi.org/10.1080/10911359.2015.1059170

Veterinary social work: Practice within veterinary settings

T. Melissa Holcombea, Elizabeth B. Stranda, William R. Nugenta, and Zenithson Y. Ngb
a

College of Social Work, University of Tennessee, Knoxville, Tennessee, USA; bCollege of Veterinary Medicine,
University of Tennessee, Knoxville, Tennessee, USA
ABSTRACT

KEYWORDS

Veterinary social work (VSW) is the provision of services at the intersection

of veterinary medicine and social work practice. Based on scholarly literature and practice experience, four competency areas are identified for social
workers attending to the human side of the human-animal bond: grief at
the loss of an animal companion, compassion fatigue in the animal services
fields, the connection between animal and human violence, and animalassisted interventions. This review explores how the four competency areas
of VSW have evolved, to what extent these services are being provided, and
in what realms these services exist.

Animal-assisted
interventions; compassion
fatigue; human-animal
bond; human and animal
violence; pet loss; social
work; veterinary

As a champion of the human-animal bond, Leo K. Bustad was an accomplished veterinarian,

academician, and cofounder of the Delta Society, who committed his career to attracting recognition
and acceptance of the positive benefits that human-animal interaction can produce for both human
and animal. Bustads immense personal and professional contributions, including the coined term
human-animal bond (HAB), continue to spread receptiveness and integration across veterinary
medicine and into many mental and physical health disciplines (Hines, 2003). Over time, this
term has evolved to be defined by the American Veterinary Medical Association (AVMA, 2013) as:
The mutually beneficial and dynamic relationship between people and animals that is influenced by behaviors
that are essential to the health and well-being of both. This includes, but is not limited to, emotional,
psychological, and physical interactions of people, animals, and the environment.

Historically, veterinarians have long understood the bond between animal and person (Hines, 2003),
but only recently has the impact of this attachment been formally acknowledged as playing a role in
businesses and livelihoods. Martin and Taunton (2006) explored veterinarians views on the influence that the HAB has on their private clinical practices. They found that the majority of respondents recognize the importance of actively evaluating the bond between people and pets as well as
the impact the HAB has on the success of their veterinary practices.
Social works recognition of the shared social and mental health benefits between people and
animals began with a publication entitled The Dog as Significant Other, which documented the
attachment between an elderly woman and her canine companion (Bikales, 1975). Bikales outlined
the hardships of maintaining the HAB during times of human health crisis (1975). Since then, social
workers have continued to play a critical role in the field of the HAB through their contributions
toward the understanding of how animal companions intertwine with the lives of humans (Strand &
Risley-Curtiss, 2013). For example, Cohen (2002) established that pets and their owners provide care
and comfort to one another and that owners often view their pets as family members. Based on this
knowledge, social workers are now beginning to gather information about animal companions for
the psychosocial assessments they conduct (Risley-Curtiss, 2010). As part of the psychosocial

CONTACT T. Melissa Holcombe

melissaholcombelcsw@gmail.com
Cumberland Avenue, 109 Henson Hall, Knoxville, TN 37996-3333, USA.
2015 Taylor & Francis

College of Social Work, University of Tennessee, 1618

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T. M. HOLCOMBE ET AL.

assessment, a social worker can assess the quality of care a pet owner provides to help determine if
the owner has any problems with daily living skills and/or emotional issues. Social workers can also
assess concerns of potential child abuse or domestic violence by observing an alleged perpetrators
interactions with the family pet or by eliciting information about any fears regarding safety of their
pet from family members. Additionally social workers have begun to integrate animals within their
practice through animal-assisted interventions (Risley-Curtiss, 2010).
With a mutual understanding and acceptance of the HAB between veterinary and social work
practices, a natural integration of the two fields emerged into what is now known as veterinary social
work (VSW), a term developed and defined by Dr. Elizabeth Strand from the University of
Tennessee (Jackson, 2013). VSW is the provision of services that occurs at the intersection of
veterinary medicine and social work practice. The primary focus of this discipline is on the
human side of the human-animal bond in four competency areas: grief from the loss of an animal,
compassion fatigue in the animal services fields, the connection between animal and human
violence, and animal-assisted interventions (Cohen, 1985; Ryder & Romasco, 1980). VSW can be
implemented in any setting where social workers and veterinarians work together to promote public
health. The purpose of this literature review is to report the past and current status of VSW services
within the schools of veterinary medicine and private veterinary practices.

Search methodology
Only scholarly literature written and published in English from 1985 to 2014 met the inclusion
criteria for this literature review. Sources that were reviewed included professional journals, academic presentations at conferences, and professionally related books or chapters. Material from these
resources had to contain content on human-animal relationships to be included. Relationships with
all non-human animal species were included.
Databases used for searching relevant material included Google Scholar, PsycINFO, ProQuest,
Social Service Abstracts, PubMed and EBSCOHost. Cochrane Library, Campbell Collaboration, Sage
Journals Online, Wiley Online Library, Social Work journals, reference lists of published papers, and
professional web sites were also explored for potential resources. Key terms included companion
animal, pet, loss, bereavement, animal assisted, domestic violence, veterinarian, compassion fatigue,
burnout, shelter, animal shelter worker, animal control, pet guardian, pet death, veterinary social
work, animal abuse, human-animal bond, work stress, and counseling. Combinations of these terms
were created to reduce material to content related to both humans and animals.

Grief and loss of an animal companion

For myriad of reasons, animal companions are playing more significant roles in peoples lives. One
reason may be the decline in family size and the disappearance of extended families. Animal
companions provide support, unconditional love, and loyalty (Clements, Benasutti, & Carmone,
2003; Levinson, 1984). Wrobel and Dye (2003) studied 174 individuals who lost a pet to death and
found that 85% of them experienced at least one symptom of grief. Loss of a pet or animal
companion can also be traumatic and lead to a time of mourning and bereavement
(Quackenbush, 1984; Wrobel & Dye, 2003). Evidence supports that the grief response to the death
of a pet is very similar to the death of a closely related human being, and pet owners can manifest
feelings of guilt, anger, anxiety, and depression that require intervention (Chur-Hansen, 2010;
Clements et al., 2003; Planchon, Templer, Stokes, & Keller, 2002; Quackenbush, 1984).
Pet loss, not only by death, but also by dissolution of the relationship as a result of financial
hardships or residency restrictions, or animals that are lost or stolen or have run away, can also
facilitate grief responses (Chur-Hansen, 2010; Morley & Fook, 2005). Providing therapeutic services
to individuals and families experiencing the loss of a pet can be an important part of veterinary
practice (Dando, 2012) and may be invaluable to the bereaved owner.

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Socially acceptable forms for grieving the loss of animal companions are lacking in Western
culture (Toray, 2004; Turner, 2003). For example, having a funeral for a pet, missing work due to a
pets death, or discussing the feelings of intense loss with others is typically frowned upon (Toray,
2004). This dismissal of a pet owners pain can lead to isolation, shame, or suppression of feelings,
which makes recovery from grief more complicated (Chur-Hansen, 2010; Dunn, Mehler, &
Greenberg, 2005; Toray, 2004). Unacknowledged grief from the loss of a pet or companion animal
can be described as disenfranchised grief (Doka, 1989).
Loss of a pet can impact a client in many other ways as well. Often pets provide owners an
impetus to interact socially with other human beings (Morley & Fook, 2005). When a pet is an
important part of the individuals environment, separation can cause disturbing disruptions in daily
routines (Quackenbush & Glickman, 1983; Turner, 2003), shift family roles, and change interaction
patterns within a family (Levinson, 1984). Additional changes may include changes in sleeping and
eating patterns, withdrawal from social activities, job-related difficulties, and suicidal ideation (Poe,
Strand, Nimer, & Lyall, 2011).
The choice to euthanize a beloved animal involves complicated dynamics and results in feelings of
guilt and anger when there are internal conflicting thoughts and feelings regarding the choice (ChurHansen, 2010). Euthanasia is utilized to protect a dying patient from needless pain and suffering.
Social workers and veterinarians can assess both the quality of the pets life as well as the quality of
its death. Presenting all options to clients allows them to make informed decisions and gives them a
sense of control (Shanan, 2011). If veterinarians and their staff are uninformed of the benefits of the
HAB and the consequences of pet loss, social workers can provide training about the significant
influence pets have on clients mental health, the importance of grieving, the difference between
typical grief and complicated grief, and methods of referral (Stallones, 1994; Toray, 2004).
Owners of pets and companion animals are not the only individuals who experience loss. ChurHansen (2010) brought attention to the grief that farmers and their families experience when they
lose livestock animals (e.g., cows, sheep, goats, lambs, alpaca, chickens). The guilt that stems from
the act of culling, or destroying, livestock due to disease, drought, or an inability to properly care for
and feed them often compounds the grief these farmers endure. In serious cases, culling can lead to
suicidal thoughts and symptoms of posttraumatic stress disorder (PTSD) (Peck, 2005). Other
responses may manifest as guilt, regret, shame, helplessness, anger and a sense of failure (Hood &
Seedsman, 2004). Chur-Hansen (2010) emphasized that it is not simply the loss of life that causes the
grief, but is rather what the animals life meant to the person that determines the level of grief.
Animal shelter workers are particularly susceptible to deep feelings of grief when they lose their
own pets (Chur-Hansen, 2010). Their feelings may be exacerbated by the work that they perform.
Shelter workers observe numerous animal deaths, see animals that have been abused, and are often
required to end the lives of young, healthy animals simply because there are not enough homes for
them. Consequently, the loss of a shelter workers pet may seem unfair considering all of the needless
destruction of healthy animals they frequently witness (Chur-Hansen, 2010).
Although some research endorses the importance of recognizing pet loss, legitimizing symptoms,
and being aware of potential implications, research is lacking on treating pet loss bereavement
effectively (Chur-Hansen, 2010; Clements et al., 2003; Wrobel & Dye, 2003). Even fewer studies
examine collaborative programs between mental health disciplines, colleges of veterinary medicine,
and private clinics (Quackenbush, 1984; Turner, 1997).
Veterinary social work services for grief and loss
The earliest reported formal collaboration between social work and a school of veterinary medicine
was at the University of Pennsylvania (Quackenbush, 1984; Ryder, 1984). A part-time program was
initially implemented at the University of Pennsylvania School of Veterinary Medicine in 1978 and
was expanded to a full-time program in 1980. Staffed by social service students and a postgraduate
veterinary fellow under faculty supervision (Quackenbush, 1984; Ryder, 1984), the program had two

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goals: (1) to better understand pet and owner relationships and (2) to provide support to owners
distressed by their pets medical conditions (Quackenbush, 1984).
Veterinary teaching hospitals in the 1980s were considered secondary care institutions because
veterinarians in private practice only referred clients that were willing to spend the time and money
to care for their seriously ill pets. Understandably, the emotional responses of owners of hospitalized
pets could be extreme. At the programs inception, social work students began participating in
hospital rounds with the veterinarians, primarily within the oncology service. Quickly, social work
students became responsible for intervening with extremely distressed pet owners utilizing a crisis
intervention framework. The two themes that emerged were (1) the indecisiveness of pet owners
about euthanasia and (2) the anticipated grief and subsequent grief following the death of a pet
(Ryder, 1984).
The social work program at the University of Pennsylvania School of Veterinary Medicine also
provided opportunities for veterinarians and veterinary students to discuss their own thoughts and
feelings about emotionally reactive clients. Ryder (1984) found that veterinary professionals often
experience their own emotional reactions when assisting pet owners with painful challenges and
decisions. While veterinary professionals tended to recognize the need to emotionally protect
themselves when working with distressed clients, results indicated that they struggled with responding to tearful clients and they were particularly challenged if the client was male. Social work
students were able to assist their colleagues by offering suggestions including listening, providing
comforting physical contact (i.e., placing a hand on their arm), and offering the opportunity to speak
with a social worker or someone with the professional skills to help them deal with their feelings of
grief.
Quackenbushs (1984) study on the University of Pennsylvanias veterinary-social work program
examined 132 referrals to social work services. Ninety-nine of the referrals were requests for direct
social work intervention. Thirty-six percent of the 99 referrals were a result of troubling owner
responses to their pets death, and 35% of the referrals were requests to assist owners in making a
decision about euthanasia. The studys sample size was small, so findings may not be able to be
generalized to populations in private veterinary practice. However, the need for social service
intervention for pet owners was highlighted.
The University of Pennsylvania School of Veterinary Medicine developed a bereavement support
group for pet owners as a collaborative effort between the School of Social Work, the Matthew J.
Ryan Veterinary Hospital, and the School of Nursing. The support group applied a short-term, timelimited, functional open-ended model that served an estimated 2,000 people over 15 years. The goals
of the group were to educate, provide support, and alleviate grief for pet owners (Dunn et al., 2005).
Dunn et al. (2005) studied the program and found that the average number of participants per group
ranged from eight to 12 individuals. A demographic breakdown of age, race, and gender was not
reported. The average total attendance per person ranged between two and 10 group sessions.
Frequent topics that emerged during sessions involved anger about their pets death, feelings of
stigmatization for the sadness they were experiencing as a result of their loss, guilt for choosing
euthanasia either too soon or too late, anger at the veterinarian, and the resurfacing of pain
associated with previous losses.
Turner (1997) conducted a qualitative study on a pet loss support hotline at the Ohio State
University College of Veterinary Medicine that was established in 1996. The study utilized
participant observation and content analysis of existing records. Unlike the program at the
University of Pennsylvania, students of veterinary medicine who received 6 hours of pet-loss
training from mental health professionals staffed the Ohio State Universitys program. Turner
(1997) found that 90% of calls to the hotline were related to dogs and cats and 87% of the callers
were female. Themes that emerged from the study involved guilt associated with euthanasia and
identification of their animals as surrogate children. Callers also frequently reported the desire to
find in-person support groups because they felt a lack of understanding and social support in
dealing with their grief.

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Compassion fatigue
As a result of the growing body of knowledge providing evidence about the complexities associated
with the HAB, veterinary services are shifting from providing care solely to animals (patients) to
tending to both patients and their pet owners. Despite this positive change in direction, this shift is
not without risk of increasing the psychological stress that can lead to veterinarians and their staff
developing compassion fatigue (CF) (Cohen, 2007; Mitchener & Ogilvie, 2002). Compassion fatigue
is characterized by the depletion of internal emotional resources that occurs from listening, relating,
and emotionally engaging empathetically with others who are experiencing emotional turmoil and/
or pain (Figley & Roop, 2006; Mitchener & Ogilvie, 2002). One contributing factor for this increased
risk of CF is the rising number of pet owners requesting advanced treatments (Cohen, 2007;
Mitchener & Ogilvie, 2002) due to the phenomenal progress researchers have made toward preventing, identifying, and treating ailments that were once fatal (Rollin, 2011).
Juxtaposed to this expectation of prolonging life is the expectation that veterinarians have the
responsibility to euthanize healthy pets at the owners insistence, regardless of the veterinarians
thoughts and feelings about their choices (Fogle & Abrahamson, 1990). Since pets are considered
property, an owner has the right to make the final decision on his or her pets care and life. Such
powerlessness can create ethical quandaries and moral distress when veterinarians are faced with the
extremes of prolonging pets lives beyond what is in their best interest and killing healthy vibrant
animals because they no longer fit into their owners lives (Black, Winefield, & Chur-Hansen, 2011;
Chur-Hansen, 2010; Fogle & Abrahamson, 1990; Rollin, 2011).
Compassion fatigue is often insidious and difficult to identify during its manifestation (Cohen,
2007). Over time, symptomatology can mirror some of the same symptoms of PTSD (Figley & Roop,
2006; Mitchener & Ogilvie, 2002) including intrusive thoughts or images, dissociation, numbness,
decrease in interests, social isolation, hyper-vigilance, difficulty sleeping and concentrating, and
obsessive or avoidant behavior (Cohen, 2007; Figley & Roop, 2006). Individuals experiencing CF
may not acknowledge, realize, or recognize the signs until their health and personal relationships are
compromised (Cohen, 2007).
Often those who are responsible for life and death wear exhaustion like a badge of honor and fail
to take measures to restore their own mental health (Cohen, 2007). The consequences of not
practicing self-care can be dire. A study by Platt, Hawton, Simkin, and Mellanby (2012) found
that the suicide considerations were directly associated to CF. Gardner and Hini (2006) conducted a
study of 927 New Zealand veterinary professionals regarding CF. One hundred thirty-six participants reported having serious thoughts about suicide, and 20 participants acknowledged that they
had attempted suicide. Skipper and Williams (2012) conducted a similar study in Alabama. Of 701
respondents, 24% reported that they had considered suicide since starting veterinarian training.

Sources of compassion fatigue

Multiple researchers have identified the sources of stress for veterinarians, students, and staff. Figley
and Roop (2006) found that dealing with difficult and noncompliant clients topped the list for
eliciting negative emotions for veterinarians, technicians, and administrative staff. Time demands
were second on the list for veterinarians and administrative staff, while problems with coworkers
were listed as second for technicians. Other identified stressors were client disputes with fees and
billing, disputes with supervision, concern with sufficient training and skills, discussion of euthanasia
with clients, and performing euthanasia on an animal. Similarly, Cohen (2007) found that office staff
and technicians feel less control over their environment and have more emotionally charged
interactions with clients than veterinarians do. Considering that veterinarians experience death
five times more often than human general practitioners (Mitchener & Ogilvie, 2002) and endure
animal deaths at high numbers, both short- and long-term emotional impacts are possible (Fogle &
Abrahamson, 1990). Veterinarians tend to be deeply affected by euthanasia, as evidenced by Fogle

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and Abrahamsons study (1990), where 44% of the respondents admit they have regretted euthanizing a pet.
In contrast to the United States, Bartram, Yadegarfar, and Baldwin (2009) found the top stressors
for veterinarian staff in the United Kingdom were the number of hours worked, mistakes, and
professional liability. Results from Black et al.s (2011) study revealed that Australias veterinary
nurses perceive their jobs as highly demanding and felt confined by a lack of social support and
control within their work environment. Consequently, their working conditions led to low job
satisfaction and high psychological distress. In New Zealand, Gardner and Hinis (2006) survey
results from 927 veterinarians identified client expectations, long work hours, and the need to keep
up with new skills and technology as their primary work-related stressors. Overall, work stressors in
both the United States and abroad were very similar. Difficult clients, the time demands of practice,
and negative interactions with coworkers lead to a stressful environment, all of which have the
potential to increase the risk of CF in veterinary professionals.
Prevention and intervention efforts
As compassionate providers who endure high levels of stress, practicing self-care is especially
important for preventing and treating CF in veterinarians and veterinary staff. Incorporating
personal and social protective factors into an individual self-care plan can be especially useful for
preventing emotional depletion and treating CF (Mitchener & Ogilvie, 2002). Creating a safe place or
a sanctuary within the workplace setting can help staff reduce stress and tension, particularly after
interacting with clients that stimulate highly emotional reactions (Cohen, 2007; Gardner & Hini,
2006; Mitchener & Ogilvie, 2002). Social workers can play vital roles in achieving and maintaining
these goals of self-care.
In addition to the veterinary staff, the psychological needs of veterinary students are also being
recognized and addressed by colleges of veterinary medicine throughout the United States. Kogan,
Schoenfeld-Tacher, and Hathcock (2012) examined the services available to veterinary students and
staff for psychological problems that arise in relation to education and clinical training. They found
that 65% of veterinary staff and students within colleges of veterinary medicine felt a need for an
increase in the available counseling services. Of the 26 veterinary schools surveyed in the United
States for this research, 22 utilize the student-counseling center on campus. Nine of the 22 schools
have a designated counselor within the universitys counseling center and 13 schools reported having
a staff or faculty member within the program dedicated to providing veterinary student counseling,
though the majority of these positions were part-time. Intervention services offered to students and
veterinary staff in the study above included individual (88.5%), group (50%), and couples (65.4%)
counseling. Seventy-seven percent of U.S. veterinary schools in the study allowed students to attend
an unlimited number of sessions.
Veterinary students and staff identified time constraints and perceived stigma as barriers to
accessing services (Kogan et al., 2012). School administrators should be aware of these barriers to
develop creative ways to mitigate them, thus facilitating the treatment of CF, prevention of emotional depletion, prevention of suicide, and promotion of self-care.

Human and animal violence

Frank Ascione (1993) defined animal abuse as the socially unacceptable behavior that intentionally
causes unnecessary pain, suffering, or distress to, and/or the death of, an animal. This definition is
widely accepted by a large number of disciplines (Becker & French, 2004). In the context of domestic
violence, control, coercion, intimidation, and retaliation are some forms of the tactics perpetrators
use to torment victims and maintain control (Ascione, Weber, & Wood, 1997; Gallagher, Allen, &
Jones, 2008). Abusing animals is another effective tactic used by perpetrators to instill fear, prevent
victims from leaving, manipulate children within the home, and provide a preliminary precursor to

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75

suggest the violence the perpetrator intends to inflict on the victim(s) (Gallagher et al., 2008). An
association between animal abuse with domestic violence as well as child abuse is supported by
literature; its presence could be an indication of the escalation of violence toward others within the
home (Ascione et al., 1997; Becker & French, 2004).
Arkow (1992) reported that cruelty to animals is symptomatic of disturbed individuals and dysfunctional families, and a predictor of human violence (p. 521). As previously mentioned, research provides
evidence of support of a link between human and animal violence. Ascione et al.s (1997) study of 48
domestic violence shelters in the United States found that 85.4% of women and 63% of children who
come to the shelter discussed incidents of pet abuse. When shelter workers were asked if they had
perceived a coexistence of domestic violence and pet abuse, 83.3% answered yes. A limit to this study is its
generalizability to larger populations due to the small sample size.
Faver and Strand (2003) conducted a study consisting of 41 women who were receiving services
in two rural and four urban shelters to explore the differences between the pet abuse experiences of
battered women within these two settings. Twenty women (58.8% rural, 41.7% urban) reported that
their partners had threatened the well-being of their pets. Nineteen women (58.8% rural, 37.5%
urban) reported that their partners had actually harmed their pets. Concern for their pets well-being
affected the decision to leave or stay in the shelter for 11 (41.2% rural, 16.7%, urban) of the 41
women surveyed. Although the researchers found no statistically significant difference between
clients residing in rural and urban shelters, higher proportions of rural women reported the threat
of harm and concern for their pets compared to urban women. Some specific concerns regarding
rural domestic violence victims include increased geographic isolation, less access to resources, and
owning less conventional pets like horses or goats, which would be more challenging for finding a
shelter. Since this study had a small sample size, a larger study sample size may help to reveal a
statistically significant difference between the two demographics.
Volant, Johnson, Gullone, and Colemans (2008) results from a study conducted in Australia also
supported the previous research, indicating a link between domestic violence and animal abuse. Two
groups of participants were recruited: a domestic violence group receiving support services (102
participants) and a nondomestic violence control group (102 participants). Almost 53% of the
participants receiving services for domestic violence reported partner pet abuse. None of the
participants in the control group reported partner pet abuse. Of women residing in a shelter in
both groups (34 of 204), 33% shared that they delayed their departure anywhere from one to more
than eight weeks out of concern for their animals. Twenty-nine percent (27 of 93) of women with
children in the domestic violence group reported that their children observed their pets being
abused; 19% (18 of 93) reported that their children had also committed acts of violence toward
their pets. This latter result provides evidence to support a potential link between witnessing and
committing acts of violence.
Beirne (2004) intended to reveal that the act of animal abuse precedes child and/or adult abuse,
based on a literature review using multiple data sources. His findings validated that family violence
and animal abuse often co-occur, but the lack of empirical data, absence of longitudinal studies, and
inconsistent definitions of animal abuse and animal cruelty prevented any suggestion that animal
abuse can be a precursor to family violence.
The veterinarians role of reporting animal abuse remains unclear. Mandates to report abuse are
inconsistent and definitions of animal abuse vary significantly (Arkow, 1998; Beirne, 2004;
Lockwood, 2000; Sharpe & Wittum, 1999). Mandated reporters who report in good faith are legally
protected from litigation, but if veterinarians are not considered mandated reporters, they may fail to
report out of fear of reprisal. Very few states legally protect veterinarians even when reporting
suspected animal abuse (Lockwood, 2000).
In addition to a lack of consistent definitions and state laws, Sharpe and Wittum (1999) further
characterized the terminology in that veterinarians do not feel competent when faced with suspected
animal abuse or neglect. Although over 50% of veterinarians agreed they have a responsibility to
intervene in suspected family violence, only 8% felt they had the necessary skills to do so. Even in

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instances of suspected animal abuse, only 55% of participants thought they were prepared intervene
or educate clients regarding animal abuse. The high number of veterinarians who report not feeling
competent or prepared to address concerns of abuse highlights an important need for education to
empower and strengthen their skills in this area.

Animal-assisted intervention
Boris Levinson introduced the concept of using companion animals as therapeutic tools in the 1960s,
and the Delta Society (now known as Pet Partners) further characterized the terminology of the use
of these therapeutic companion animals. Yet, terminology regarding animal-assisted intervention,
animal-assisted therapy, and animal-assisted activity are inconsistent throughout the literature. To
clarify, animal-assisted intervention (AAI) is an umbrella term used to describe therapeutic
interventions that include animals as part of a treatment or ameliorative process. AAI draws from
a variety of disciplines and perspectives including genetics, biology, developmental psychology,
psychoanalytic theory, and behaviorism (Kruger & Serpell, 2006). Incorporating animals into traditional psychotherapeutic models is used to support the therapeutic process. The animal serves as a
nonthreatening partner and can assist in developing the initial trust connection that may then be
transferred to the clinician (Tedeschi, Fitchett, & Molidor, 2005).
Although AAI can be used as a more generalized and umbrella term, animal-assisted therapy and
animal-assisted activity are more specific types of interventions. Truncated definitions of animalassisted therapy (AAT) and animal-assisted activities (AAA) are as follows: AAT is a goal-directed
intervention that is part of a treatment process delivered by health/human service professionals with
specified goals, objectives, and outcome measurements, whereas AAA can be delivered by trained
professionals or volunteers and does not have specified treatment goals, but rather provides
opportunities for motivational, educational, and recreational benefits to enhance quality of life
(Frederickson-Macnamara & Butler, 2010; Kruger & Serpell, 2006).
Kruger and Serpell (2006) and Palley, ORourke, and Niemi (2010) reported that humans
benefited from AAI in both health and well-being. From their reviews, they found animal interactions reduced anxiety, improved depression and feelings of loneliness, decreased agitation, and
increased number and content of social interactions. According to Tedeschi et al. (2005), these
benefits are derived in part from the perceived social support that an animal companion provides.
Odendaal (2000) conducted a study that involved completing a blood analysis on participants
both before and after a positive interaction with dogs. Two different interactions were measured: one
with the participants own dog and the other with an unfamiliar dog. The results showed that people
interacting with their own dog had a statistically significant increase in levels of oxytocin, the feel
good hormone, and a decrease in levels of cortisol, the stress hormone. Thus Odendaal concluded
that there was a positive physiological basis for animal-assisted interaction.
Although most frequently reported with canines, AAI benefits are not limited to interactions with
this species. One study found that elderly men in an adult day health care program experienced
reduced depressive symptoms when exposed to a bird aviary (Holcomb, Jendro, Weber, & Nahan,
1997). Hart (2010) suggested that although dogs are noticeably more prevalent in AAI research, they
could be more problematic companions for individuals with health or personal burdens due to the
care a typical dog requires. Hart advised that it is important to tailor animal characteristics to the
psychosocial needs and physical limitations of the client.
AAI is quite varied depending on the nature of the program and the participants involved. In
hospitals, AAI can be incorporated into physical therapy simply by having the patients brush a dog
(which utilizes repetitive motion) or by having them walk a dog up and down a hall (Jalongo,
Astorino, & Bomboy, 2004). Games involving animals can be used in schools, hospitals, or outpatient therapy programs to address speech and literacy needs (Jalongo, 2005; Jalongo et al., 2004).
Dogs are also currently being utilized to provide tactile comfort, affection, and companionship to
returning military personnel with PTSD (Beck et al., 2012). Moreover, they are being used at

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77

counseling centers for group and individual work (Parish-Plass, 2008). When used in any capacity,
AAI is only one aspect of a comprehensive treatment plan (Hart, 2010).
To date, research studies that have examined the applications of AAI have produced mixed results
and have lacked evidence of validity and efficacy. Some problems identified with the studies that
support the beneficial effects of AAI include small sample sizes, lack of control groups, randomization, inconsistent definitions of terms, and lack of well-defined interventions (Kruger & Serpell,
2006; Palley et al., 2010).
Although AAI is the umbrella under which AAA and AAT fall, Palley et al. (2010) suggested steps
to developing the kind of research base that would specifically support the use of AAT in mainstream medicine. Agreement of a standardized definition of AAI, utilization of guidelines to select
the appropriate animal, frequency and duration limits for therapeutic intervention, defined role of
the handler, and the nature of interactions are the first steps. These parameters are needed because
interventions utilizing animals encompass a wide range of fields, organizations, facilities, species, and
requirements. Replicable and generalizable studies are the only way to demonstrate efficacy and
validity. Studies will need to be controlled, systematic, and randomized. Standardized medical and
psychological outcomes and measures are a necessity to ensure generalizability of studies. Finally,
Palley et al. (2010) recommend a national database for all research in this field. The Human-Animal
Bond Research Initiative is an example of a resource that has provided just that.

Conclusion
The research conducted during this review highlights a need for services to humans at the intersection of pets and people and explores some of the VSW services already being offered. As pets become
more important to people and medical advances prolong pet life, the potential for an overlap of
medical and psychological interactions expands. The majority of the material reviewed involved
veterinary practices servicing dogs and cats. However, it is also important to consider the bond and
potential interaction between humans and animals that would be considered part of the large animal
veterinary practice. Humans have formed strong bonds to livestock, such as goats, cows, and horses.
The HAB is not dependent on the perceived pet status of the animal. Emotional bonds to these
nontraditional animal companions can result in the same interactions between client and veterinarian as with a dog or cat.
This review of the literature found evidence that VSW services are being provided in a variety of
ways by a variety of people. A barrier to further mapping of the provision of the services that make
up VSW is that many of the programs do not refer to themselves as veterinary social work. Also,
each program may provide only one or two of the four aspects of VSW. Further research is needed
to identify existing social work practice within veterinarian clinics and colleges of veterinary
medicine. The range of services needs to be identified and examined for effectiveness and efficacy.

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