AVMA guidelines for pet loss support services

Research has shown that the human grieving process following a pet's death is similar to that experienced by people who have lost a family member or close friend. Telephone helplines and support groups have been used for some time to address grief associated with the end of human-human interrelationships, but have only recently emerged as a means of assisting pet owners in dealing with the death of their companion animals. The American Veterinary Medical Association (AVMA) recognizes the benefits of pet loss support helplines and groups for pet owners, veterinarians, veterinary technicians, students and faculty at colleges of veterinary medicine and veterinary technology, and lay employees of veterinary practices, and encourages their responsible establishment.

The Internet has also attracted considerable attention as a new medium for delivery of pet loss support. Although it may serve as a source of information for grieving pet owners, it has unique characteristics that make it a more limited and risky medium for delivery of counseling services.

Pet loss support helplines

Purpose

The primary purpose of pet loss support helplines is to provide emotional support, via telephone, for pet owners who have experienced, or are anticipating, the death of their companion animal. This service is usually provided by volunteers who have been trained by a licensed mental health professional. These volunteers are often veterinarians, veterinary technicians, students and faculty at colleges of veterinary medicine and veterinary technology, or lay employees of veterinary practices. Helpline volunteers actively listen to callers and attempt to answer their questions, concerns, and needs by providing information verbally, in print, or through referral to private counselors and crisis centers.

Pet loss support helplines also provide education for volunteers in the social service aspects of veterinary medical practice associated with companion animal loss, grief, and bereavement. Colleges of veterinary medicine and veterinary technology will find that helplines benefit students by providing them with real-life examples of the depth and implications of the human-animal bond. Veterinary organizations, practices, and hospitals hosting or contributing to pet loss support helplines benefit from skills learned by their members or employees and from positive public response engendered by these helplines.

Minimum requirements for establishing a responsible and successful pet loss support helpline

• A mission statement that encompasses the philosophy of the helpline
• Documented approval of the sponsoring agency and legal counsel
• A coordinator or coordinating committee—Their responsibility is to oversee the management of the helpline, including site acquisition, financial support, training, scheduling of staff, and documentation.
• A procedure and training manual—During its development, the expertise and experience of volunteers should be considered. The manual should contain a description of how calls are received and returned; notes from training sessions; referral information for private counselors, crisis intervention centers, parallel interest groups, and other helplines and support groups; copies of relevant reference materials; and information on pet cemeteries and cremation facilities.
• A formal training program that is attended by all volunteers prior to their answering phone calls on the helpline—Training must include a discussion of attachment theory pertaining to the human-animal bond (including information pertaining to special attachments, needs, and concerns, such as those experienced by owners of service animals, children, the immunocompromised, the elderly, and police officers) and the normal and pathological manifestations of loss, grief, and bereavement. Volunteers must be taught supportive listening skills, how to set appropriate boundaries (i.e., keeping callers focused on appropriate topics and recognizing when referrals are needed), crisis management and intervention skills (including lethality assessment and police intervention), how to deal with typical as well as angry and abusive callers, and how to resolve ethical dilemmas. Volunteers' personal stress generated by working the helpline must be carefully monitored and techniques for management discussed and implemented.
• A steady source of trainable volunteers—Deciding who will answer helpline calls is important. Veterinarians, veterinary technicians, students at colleges of veterinary medicine and veterinary technology, and lay employees of veterinary practices provide a logical pool of volunteers who are easily trained because they are familiar with companion animal loss and its consequences and usually have a realistic view of the situations helpline volunteers encounter.
• Professional supervision that includes direct involvement of a licensed, clinically trained mental health professional—Timely access to a clinically trained mental health professional for consultation regarding calls; maintenance of quality control via discussion rounds, follow-up letters, and questionnaires; and monitoring and management of stress in volunteers are essential.
• A site of operation in a quiet, undisturbed location, free from distractions that could interfere with delivery of comforting emotional support over a telephone line—Establishing an office location at which volunteers actually answer the phone is ideal, because resources such as computers, references, other volunteers, and crisis intervention personnel are often readily available. Voice mail systems can also be used, providing information is sent to a central location and collated to ensure quality control.
• Record compilation, including a log of all calls—Analysis of statistical information can assist helpline volunteers in identifying areas of greatest need, targeting information, and providing improved support. Information that might be gathered includes age and species of pet, whether the pet was dead at the time of the call or grief was anticipatory, how the pet died, how long ago the loss occurred, whether there are children or other individuals with special needs involved, and the length of the call. Care must be taken to ensure that attempts to gather information do not reduce the effectiveness of the support provided.
• Liability insurance that covers the activities of the helpline
• A marketing program—Helplines are not successful unless they are used. The public can be made aware of these programs through appropriate marketing by veterinarians, veterinary organizations, veterinary colleges, allied professionals, and community resource listings. Brochures, pamphlets, and bookmarks publicize the helpline and can provide basic information concerning companion animal loss, grief, and bereavement. Plans for responding to media contacts should also be developed.
• Financial support—Financial support must be sought to cover expenses associated with telephone use, production of training manuals and marketing materials, training sessions, and data collection.
• Assessment—A method of evaluation is needed to assess the effectiveness of training volunteers and the value of the helpline to callers and volunteers.

Pet loss support groups

People often attend support groups as they attempt to address grief associated with personal crises or the end of human-human relationships, but only recently have people sought out this resource as a way to cope with the death of their pet. The AVMA believes that support groups may be of substantial benefit to animal owners in addressing the emotional aspects of attachment and loss if these groups are conducted responsibly.

Purpose

As for helplines, the primary purpose of pet loss support groups is to provide emotional support for animal owners who have experienced, or are anticipating, the death of their companion animal. Support groups provide a structured environment in which members can release strong emotions, while being educated in psychological models that can help them understand the grieving process. Group members benefit from the realization that their painful experience is shared by others.

Establishing pet loss support groups also benefits the veterinary profession by communicating its concern for grieving clients and by increasing the effectiveness of veterinary hospitals and clinics in dealing with emotionally distraught clients.

Considerations in establishing a pet loss support group

• Select a facilitator. The skills and experience of the facilitator determine the effectiveness of the support group. Pet loss support groups are considerably different than pet loss support helplines because they include multiple individuals in varying stages of grief, have the potential to elicit intense interactions between these individuals, and incorporate instruction in psychological models of grieving. Although pet loss support helplines are often staffed by appropriately trained veterinarians, veterinary technicians, lay staff of veterinary clinics/hospitals, or students of veterinary medicine and veterinary technology, the AVMA believes the only qualified facilitator for a pet loss support group is a licensed, clinically trained, mental health professional with experience in group dynamics and counseling owners regarding grief and bereavement associated with the loss of companion animals. Addressing grief associated with the loss of a companion animal can be more difficult than addressing grief associated with the end of human-human relationships because there are presently no universally accepted social mechanisms or rituals to facilitate resolution of an owner's grief. In addition, an owner's expression of grief may be met with social disapproval. An effective facilitator must understand and be prepared to address these differences.
• A coordinator—A coordinator is needed to perform administrative duties such as site acquisition, soliciting financial support, and scheduling. The coordinator should obtain documented approval of the sponsoring agency and legal counsel.
• Location and time—The site of operation should be centrally located in the area that is expected to be served by the support group. A quiet location, which is free from distractions, is essential to ensure comfort and delivery of quality emotional support. A time should be selected that is convenient to all expected to participate in the group. Evenings, for example, may be best as they will facilitate participation by individuals who work during the day. Location, frequency of meetings, and starting time should be consistent.
• Protocol and ground rules—The facilitator should determine the best way to operate the group, after consideration of the participating individuals' needs. Ground rules that foster participation by all attending and respect for the feelings of others should be established as a group effort. Group members should be encouraged to share their experiences and feelings, but should not be coerced into participating. Universal acceptance of confidentiality is imperative.
• Financial support—Financial support must be sought to cover professional services and facility expenses. Funding should be obtained from a stable source, such as a private company, school, or association. Although private donations are helpful, they can be sporadic.
• Promotion and public education—The success of support groups can depend on the number of individuals participating. The public can be made aware of these programs through referrals by veterinarians, veterinary organizations, veterinary colleges, allied professionals, and community resource listings. Brochures, pamphlets, and bookmarks help publicize support groups and can provide basic information concerning companion animal loss, grief, and bereavement. Plans for responding to media inquiries should also be developed.
• Liability concerns—Liability insurance that covers the activities of the support group should be obtained. Appropriate licensure of the mental health professional must be verified.
• Assessment—A method of evaluation is needed to assess the value of the pet loss support group to its participants and the referring and sponsoring agency (ies). Number-coded (to protect confidentiality) survey forms are an inexpensive assessment tool.
• Learn from the experience of others—Because setting up a pet loss support group requires a great deal of effort and commitment, it is advisable to speak with those conducting existing groups to ensure the success of new ones.

Internet counseling

Skilled interpretation of nonverbal (e.g., gestures, facial expression, tone of voice, and inflection) and verbal cues is necessary for effective grief counseling, and face-to-face contact is the best medium for this service. This is particularly true when a specific diagnosis and ongoing treatment are required. Although standard telephone contact does not provide visual cues, it does permit transmission of auditory nonverbal cues, and can be used effectively for brief crisis contact, referral, and provision of educative information. Because standard Internet communication eliminates even auditory nonverbal cues, the AVMA recommends that Internet assistance be limited to provision of educative information, such as display of articles written by qualified veterinarians and counselors, or referral to appropriate books and articles. Internet sites can also provide lists of licensed counselors and veterinarians who are qualified to establish a relationship in person. Receiving counseling through the Internet, beyond provision of information, may place pet owners at risk of being harmed by inadequately trained individuals.

Related resources

Client education materials

English-language brochure: Pet loss and grief
Spanish-language brochure: Pérdida de mascotas y aflicción
Webpage: Coping with the loss of a pet