AVMA News

Psychologists offer strategies for de-escalating violence in the veterinary clinic

Security measures and communication training are some solutions offered

Updated December 30, 2024

Workplace violence is a growing problem that affects around 2 million Americans every year, although the Occupational Safety and Health Administration (OSHA) believes such incidents occur far more frequently than reported.

Approximately 70% of workplace assaults occur in health-care settings, namely emergency rooms, but also veterinary clinics, according to clinical psychologist Jane Jenkins, PhD, who specializes in trauma-focused interventions.

“Veterinary professionals often have unique relationships with clients, caring for animals from their first checkups to the end of their lives. This creates deep emotional bonds and, at times, high-pressure dynamics,” Jenkins said.

A panel of three presenters sit at a table with a PowerPoint slide showing behind them
Veterinarians work in a field where emotions are raw and situations can quickly escalate. Psychologists (left to right) Dorsey Howard, PsyD; Dustin Kashnik, PsyD; and Jane Jenkins, PhD; spoke at an AVMA event about ways veterinarians can protect themselves and staff during potentially violent situations.

Jenkins led a workshop on de-escalating violence in the workplace along with colleagues Dustin Kashnik, PsyD, and Dorsey Howard, PsyD, during AVMA’s Diversity, Equity, Inclusion, and Wellness Summit, held November 7-9 in Atlanta.

Practical strategies for clinics

Veterinary professionals deal with stressful and emotionally charged situations regularly, including euthanasia, financial disputes, and breaking the news of a difficult diagnosis to a client, Jenkins said. These conflicts take a toll on a person’s mental health, laying the groundwork conflict.

“Workplace violence doesn’t occur in a vacuum. Each incident shapes future interactions, making prevention and de-escalation skills critical,” she said.

Jenkins is a counselor and well-being specialist at Washington State University’s Veterinary Teaching Hospital. She recounted a recent incident at her hospital where effective de-escalation by a skilled director prevented a potentially dangerous situation. It was a wake-up call to implement a formal workplace violence prevention program.

Veterinarian Conversing with Dog Owner in Animal Hospital
Psychological support for staff is must. Kashnik stressed the importance of ongoing mental health resources and supporting employees consistently, not just after critical incidents.

“We realized we had no clear protocols and that had to change,” she said.

OSHA defines workplace violence as “any act or threat of violence against workers. It can occur at or outside the workplace and can range from threats and verbal abuse to physical assaults and homicide.”

Workplace violence occurs on a spectrum, Jenkins added. On one end are verbal disputes, such as yelling or insults, which many professionals experience regularly. Moving along the spectrum, issues such as bullying, stalking, and threats escalate toward physical violence and, in extreme cases, serious or even deadly attacks.

“These events, though rare, have devastating and long-lasting impacts,” she stressed.

Jenkins outlined four key elements for preventing workplace violence:

  • Physical security measures, including controlled entry points, emergency protocols, and designated crisis response personnel
  • Communication training that cultivates empathic and trauma-informed responses to defuse tense situations
  • Escalation prevention to help identify potential triggers and address them before conflicts intensify
  • Ongoing psychological support, such as providing continuous mental health resources for employees

The importance of empathy

Kashnik, an assistant clinical professor of psychology at the University of California-San Francisco, emphasized the importance of creating safe environments. This requires controlled entry points, multiple barriers, and clear crisis-response protocols.

“Physical safety measures provide essential time to make decisions and call for support when needed,” he noted, encouraging collaboration with local law enforcement for tailored security advice.

That said, a culture of communication is foundational to a safe workplace. Kashnik introduced the concept of “empathic conjecture,” which involves recognizing and addressing others’ emotions proactively.

There’s a difference between prevention and de-escalation, he clarified. “Prevention is about keeping things calm; de-escalation is about cooling things down when the situation has already heated up,” he explained. Validating emotions and responding with empathy are key tools for defusing conflict.

Kashnik urged workshop attendees use “trauma glasses” to help de-escalate situations, that is, a lens through which to view others’ behavior with empathy. Behaviors often dismissed as manipulative or disrespectful might stem from feelings of fear, disconnection, or overwhelm. Recognizing this allows for more compassionate and effective responses.

For example, he described a scenario involving a veterinarian accused by a client of overcharging. While the client’s anger is visible, their underlying fear of being taken advantage of might be the true driver. Addressing this fear directly, by saying something like “I understand why this might feel upsetting,” can transform the interaction, Kashnik said.

Managing disputes

Howard, a clinical psychologist at the Lebanon VA Medical Center in Lebanon, Pennsylvania, encouraged a shift in perspective on how to manage workplace disputes.

He challenged the traditional me-versus-you mindset often associated with conflict.

“Too often, we see disputes as a battle to be won, relying on logic and experience to dominate the conversation. But what if we focused instead on creating a safer environment and preserving relationships?” Howard asked.

He advised adopting a growth mindset, which allows individuals to view conflict not as a zero-sum game, but as an opportunity to build understanding and trust. This approach shifts the focus from being “right” to achieving meaningful resolutions.

Timing and mental state are essential conditions for addressing conflicts.

“We’ve all been in situations where we’re too drained, distracted, or angry to have a productive conversation,” Howard said. He recommended recognizing when these conditions are present and postponing discussions until both parties can be fully present.

For conflicts that seem to reach an impasse, Howard advocated stepping back to find areas of agreement.

He provided an example from veterinary practice where disagreements with a client over a pet’s care can become heated. “By acknowledging shared goals, such as wanting the best outcome for the animal, you can reset the tone of the conversation,” he said.

And don’t underestimate the power of a genuine apology, Howard said.

“An apology isn’t just about saying ‘sorry.’ It’s about acknowledging the specific harm caused and committing to meaningful change,” Howard said, adding that an insincere apology can easily exacerbate tensions.

To further enhance workplace safety, he encouraged practices provide de-escalation training and using the Veterinary Mental Health Support program available from Not One More Vet, which provides facilitated support sessions for veterinarians.

“Having visible, trusted support personnel within an organization can make all the difference. When people feel supported, they’re more likely to engage constructively in resolving conflicts,” Howard said.

The AVMA offers a library of free resources available to members to help them manage their reputations, prevent conflict, and limit risk from cyberbullies.

And for companion animal practices specifically, the Positive Pet Care Guide can help foster healthy lines of communication and a positive partnership with pet owners.