Fear Free Veterinary Certification Program Intro

Veterinary Professional Certification Program

• The Fear Free Veterinary Certification Program has 8 modules that includes an introduction

Fear Free Philosophy

• Fear Free seeks to improve the emotional wellbeing of the vet team, patients, and owners
• It aims to improve health care by creating a Fear Free environment
• Fear Free protocols empower veterinary staff, hospitals, clients and patients
• The goal is to reduce a pet's negative experiences by using techniques that reduce fear, anxiety, and stress (FAS)
• Fear Free techniques help create manageable patients as they associate the hospital with positive experiences
• Fear Free protocols build client trust & commitment, with owners noticing positive changes in their pet's behavior during vet procedures
• Owners are more likely to bring fearful or aggressive pets in earlier for issues like ear infections or UTIs if they trust the Fear Free approach

Benefits of Fear Free Culture

• Using Fear Free methods opens a new way of interacting with patients and clients.
• It strengthens bonds between the veterinary team, clients, and patients; also ensuring safety, security, and emotional stability
• Pet owners often find veterinary visits stressful, causing delays or avoidance of care
• Creating a Fear Free space and handling diminishes FAS, encouraging owners to embrace veterinary care
• This creates a harmonious environment in the veterinary practice

Importance of Change

• Science proves that stress and ongoing stress hurts health and wellbeing
• Stress and distress cut lives short
• Stress and chronic stress show up as fear and anxiety, together creating FAS
• These are visible through body postures and facial expressions
• Stress and distress can hinder the right diagnosis of medical conditions, how well they heal and how long they live
• So, stopping and controlling FAS will make patients healthier and improve their care

Fear Free Implementation

• Veterinary medicine constantly changes to include the newest progress in pet healthcare
• Easy ways to use Fear Free in hospitals will enable you to reach your goal of creating a Fear Free hospital

Four Cornerstones of Fear Free

• Recognizing FAS as a serious problem needing treatment
• Good communication between owner, pet, and veterinary team
• Using a Considerate Approach (CA)
• Using Gentle Control (GC) techniques when handling patients

Stressors

• A stressor is anything that interrupts the body's normal state
• Stress isn't always bad if the body can return to normal, like being surprised at a birthday party
• Stressors fall into 3 kinds: environmental, physiologic, and psychosocial

Environmental Stressors

• Environmental stressors include humidity, noise, odors, bright lights, fast movements, and pheromones

Physiological Stressors

• Physiological stressors include pain, hunger, thirst, and illness.

Psychosocial Stressors

• Psychosocial stressors include unfamiliar people/pets and separation from the owner

Negative Impacts of FAS

• Ongoing FAS hurts the health and wellbeing of patients
• It must be spotted, fixed, and avoided

Understanding FAS Levels

• FAS most likely happens to some degree in every patient and falls on a scale of 1-5
• Think of a traffic light: green, yellow, and red when it comes to levels of FAS and when to step in

Green - Level 1

• Level 1 shows slight stress but they return to normal quickly with treats, CA, and GC.

Yellow - Level 2-3

• Level 2 and 3 patients take more time to return to baseline, where a risk that they may not return and remember their experience negatively
• Lowering FAS helps baseline return, spotting FAS early and using the right tools, communication, CA and GC
• They may need proper tools and recognition for improvement

Red - Level 4-5

• Level 4-5 patients face extreme FAS, sometimes from the start while unaddressed
• Extreme FAS hurts health, wellbeing, and safety and the aggression is a warding off attempts to handle them
• Quick escalation of FAS signs is distress, also emotional distress needs addressing
• Fear Free aims to stop exactly this, and helps at all levels

Communication is Key

• Understand how cats and dogs communicate FAS, adapt management accordingly
• Good communication between the team and client = a Fear Free visit

Client Communication

• Good communication with clients is key to Fear Free visits
• Owners need to help create a Fear Free visit up front using team compassion, confidence, and competence
• Create a nurturing setting and address how they can help to create a Fear Free visit for their pet

Program Goals

• The program aims to help recognize FAS in patients and avoid it
• You can apply learning theory to change emotions and reactions to stressful times

Achieving Fear Free

• Instruct owners on Fear Free practices for transport
• Creating Fear Free reception and waiting areas are critical
• Establishing Fear Free examination rooms and protocols is important as well
• Give FF treatment anywhere in the hospital needed
• Use medications and nutraceuticals to lower FAS levels when needed

Goal of Fear Free

• Fear Free focuses on the emotional wellbeing of the veterinary team, patients, and pet owners
• Feel confident that Fear Free makes better medicine and know that you have given the best treatment possible

Module 1 Overview

• Module 1 is about Fear Free Behavior Modification Basics

Communication

• Communication will impact the visit as well as client trust.
• Look for and share signs of FAS.
• You address things during the visit and how what is being done helps the pet.
• Ask about pet behavior
• You can improve the visit by describing owner contribution keeping FAS low, and the benefit of Fear Free

Effective Client Communication

• Asking open ended questions allows for a true response to potential issues
• Asking about any concerns helps in communication
• Reflective listening will improve the understanding of the client by explaining the owner's words back to them
• Empathic statements helps clients know you care and will make the visit better for them and their pet

Considerate approach

• Considerate Approach: interaction with environment including pet, and environment to help pet care
• Reduce FAS to help patient

Gentle Control

• Gentle Control is how to position the patient comfortably and safely for examination

Touch Gradient Components

• Touch gradient involves initiating physical contact and administering treatments that involve physical contact

Touch Gradient Technique

• Maintain constant physical touch during the procedure
• Slow and gentle movements over the body considers startle response and possible FAS
• Start with a non-sensitive area and gently move toward others
• Touch Gradient also includes acclimating a patient to an increasing level of touch intensity associated with procedures, while continuosly looking for signs of comfort

Lessons

• This module includes a stress response, body language, learning theory, behavior modification, and perception

Why this is important

• Team members help with health - patients feel worse
• Visits can cause behavior and impair healing or cause aggression
• Reduced FAS is better for all

Lesson breakdown

• Learn to describe what causes stress, and the effects

Stressor defintion

• It's any living or nonliving thing that disrupts a normal body function

Stressor Categories

• Environmental from noise of people
• Physiological- hunger
• Psychosocial - separation from owner

Stress Response Definition

• Stress response describes the bodies way to return to normal function and addresses the patients needs

Body Response to Stress

• All body systems are affected when responding to stress
• Heart and breathing increase, with blood diverted to muscles
• Animal blocks pain for escape but decreases rational thought
• Changes in memory and reaction happens in under a second

When does it become distress

• Is there longer insult such as continued visits
• It has long term immunosuppression effects and changes wound healing

How to help

• Make it easier to provide care and abbreviated exams may be needed
• Stress puts a higher risk on the patient
• Clients also get upset when animals are upset

The Fear Response

• Is automatic in bad situations and not patient thinking
• Patient may not respond to commands
• A patients behavior is not the owners fault and fight back or leave happens automatically

Stressors

• Patients can include anything from living or non living things
• Cognitive abilities are changed

Stress response

• Stress is the result of fear or anxiety. Watch body language

What you should know

• Being able to see relaxed behavior in cat or dog

Behavioral Responses

• The Four F's are fright ,flight, freeze, or fidget which are categories
• You can see these through gross signs of FAS like panting and pacing

Stress in Cats Manifests in

• Vocalization, body position, and physiologic aspects
• Listen for crying, panting and increased HR

Relaxed cat

• Includes normal pupils, ears forward, and mouth closed

FAS cat

• FAS in cats show round pupils, and tense legs

Visible signs for a relaxed dog

• Include a soft mouth, normal pupils and flexible neck

Stress signs in dogs

• Include tense body, pulled back lips and dilated pupils

Behavior

• Behavior may be punished or reinforced
• Consequences following those actions have to be addressed as adverse events lead to FAS

What you'll know

• Know why not to use punishment

What is reinforcement

• Positive reinforcement adds something as reward
• Can offer a toy

Video Example

• Demonstrates adding something positive to a behavior by training a technician to touch a hand to an animal's nose for a treat

What is punishment

• It can be a verbal such as NO
• Using punishment is not recommended

Negatives of punishment

• Adding an adverse option makes patient more dangerous
• Shock collars should never be used

Reinforcement vs Punishment

• Always reward the better choice through reinforcment of play or food
• Punishment can lead to adverse results

Basic principles of behavior

• Include modifying and conditioning

Learning Points

• Learn conditioning, terms, classical and opperant and how to use them
• Giving food does not reduce the the result of FAS

Learning

• Conditioning =learning which is changing a result of an experience
• You always learn even unintentionally

Operant Conditioning

• It's learning to associate a behavior to an outcome of a patient using cues
• An intended reinforcer or punishment

Classical Conditioning

• Is a stimulus associated with a conditioned emotional response or CER
• Responses lead to enviroments of people or items
• Stimuli is food related to change it

The Goal

• Classical conditioning should create a happy emotion
• Create good emotional responses

Classical Counterconditioning

• Changing from a bad to a good experience like pairing scale and happy behavior

Desensitization

• It's using gradual exposure
• Need to figure out at which level of stimulus causes highest tolerance without showing FAS.
• Combining with foods is better

Video Example

• Desensitizing dog using touch
• Always using positive with happy actions

Best approach

• Food will reduce if fearful
• Never more fearful, and owner being anxious increases the situation
• Team should model and show new clients this

The rest

• Show team that the food is the method of reward, gradient control

Learning

• Patients learn even when you do not intend for them to

Pair stimulus to pair emotions

• Counterconiditioning changes it from positive and negative
• Changing behavior helps

Perception Reality

• It affects the patients view and changes those responses to the environment to improve interactions

Lesson Topics

• Should know animal connections for social aspects
• The important aspect of taste, sound, and smell

Patient Senses

• As they use senses better make sure to remove scents so the patient is happy.
• Clean disinfectment and know scent. Cat with not want to smell a dog as it's too dangerous

Having tasty behavior

• When you are seeing a patient all will smell them and see you are seeing them
• Visual are motion of movement . Dogs have distance where they won't accept individual entry

Patient Handling

• Patient think threats are posture. People's movements can calm or aggravate

How to improve

• Do not lean or grab
• Move deliberate

Body Movement

• Motion can be a fast trigger
• It can be fleeing is dangerous
• The dog is showing signs of FAS

Considerate Approach

• Helps the team react by lowering the sensory input and approach animal side to side without eye contact

Good Steps

• Offer food or the patient walk away
• To show approach helps with lowering anxiety.

Being in the Room

• When they are cautious it is because the tech has been there longer
• The vet should slow the animal as the new presence lowers anxiety

Hearing

• Some animals can hear great or ultrasonic sounds.
• Dogs and cats help those in the room communicate using sounds
• Watch the noise use fan so others calling does not hurt animal

Taste

• Not all animals enjoy having hidden medication with taste
• Some will refuse food entirely future because of a bitter experience

Most area is sensitive

• The head.
• You need to always be gentle for their touch and use to get to treat

The touch

• Helps soothe or excite and make sure to know what touch and behavior helps with the animal

What can you do

• Know about animals sense of what they want to help make them comfortable

Basic behavior

• As you learn you provide the best environment to make it Fear Free
• It creates sentience and emotion to show reactions. Now it will benefit for the future
• This knowledge helps show what to do to make the experience positive