Behavior Treatment Plan
The treatment of any behavioral problem includes a multifaceted approach consisting of a 5-step process. You might choose to implement some, or all of the 5 steps involved depending on the case, the circumstances, and your level of skills; however, any veterinarian should be able to recommend steps 1 and 2. An example of a generic discharge template for 5-step treatment plan that works for any behavior diagnosis looks as follows:
Step 1. Management: Safety and Avoidance
In order to set up the patient for success, strict management is needed at the beginning of every plan. Initially, the owner will have to set the stage and manage the pet’s environment so as to avoid any situations in which the pet has displayed the unwanted behavior in the past. Initially, the treatment process can be slow; hence, in the meantime, the owner must prevent those events from reoccurring. Every time a pet displays this behavior, the behavior is further rehearsed and this might be inadvertently reinforcing the behavior problem you try to treat. Therefore, as you are in the process of treating, the patient should not be exposed to the trigger(s) which cause the unwanted or unacceptable behavior(s). The owner should begin by mentally taking note of all situations where the pet displays the(se) behavior(s). In addition to supporting the overall success of the behavior modification, avoidance may also be a safety recommendation in some cases.
Step 2. (Re-)Structuring the Relationship with the Pet and Strengthening the Human-Animal-Bond
Aware – Affirm – Award Approach
There are many advantages to using such a program as part of a training program for a pet. First, it is a program that fits all pets and all people, regardless of breed, age, size, gender or personality type. It is a non-confrontational technique which is designed to never put the people or pets involved at risk. It will help improve behavior and teach the pet to trust people based on predictable interactions with positive outcomes. The pet will learn to consistently follow commands at home or other low stress situations, which makes it easier for him/her to follow commands in potentially challenging situations such as when distracted, anxious or perhaps even while aggressive. Finally, it will help build confidence by providing clear communication and enjoyable outcomes for desired behaviors. This approach uses only positive, reward-based training methods to teach these valuable lessons. The program consists of predictable interactions with the pet based on Command – Response – Reward (C-R-R)
The 3 principles are:
- Awareness of the good/desired behaviors
- Affirm: Feedback is needed: communicate to the animal at the time of the behavior
- Reward any positive behaviors, especially when they are incompatible with the unwanted behavior
Step 3. Tools
This is any equipment that will help with the implementation of the management plan and the reward-based training program. Specific recommendations should be provided to the client. The list is endless, but could include items such as baby gates, kennels, crates, screen doors, window covers, leashes, tethers, head halters, front buckle harness, basket muzzle, clicker, target stick, MannersMinder, treat pouch, treats, relaxation mat, feed dispensing toys and puzzles, interactive toys, Relaxation music (Thru the dogs ear), visual entertainment (DOGTV), litterboxes and litter type, nail caps for cats, scratching posts and many more.
Note: My list does not include anti-bark devices, shock collars, prong collars, shaker cans, throw chains and other pain and fear eliciting items—these are punishment-based tools that help suppress behaviors rather than help teaching new positive behaviors and negative emotions can lead to increased fear, anxiety and aggression.
Step 4. Reintroduction: Positive Emotional Response and Incompatible Behaviors
First, the animal has to be prepared for the reintroduction to the triggers or situations that have to be avoided initially (see Steps 1, 2 and 3). The positive emotional response and behaviors that will be practiced and rewarded should be simple and incompatible with the unwanted behavior. (Example: sitting quietly is a positive behavior that is incompatible with lunging). The pet will gradually learn to associate good things happening and have a positive response. The Command – Response – Reward (C-R-R) approach helps the dog to perform trained commands reliably in various types of situations and therefore the pet can then be reintroduced to previously challenging situations in a step-by-step process (DS) while the emotional response will be changed (CC). It is a technique that all people, regardless of age, size, or personality type can do. It is a non-confrontational technique which is designed to never put the people or dogs involved at risk. The goal is that the unwanted behavior is never displayed—this process is called desensitizing and counter-conditioning (DS/CC). The client needs to receive specific homework. It is critical that the client understands the exercises; this will enhance owner’s compliance and overall success of the treatment plan. With the client define success and how to measure milestones or key performance indicators (KPIs).
The stimulus or stimuli that were identified during an appointment as causing the pet’s unwanted emotional reaction and subsequent problem behaviors need then be reintroduced in a series of gradual steps and intensities. The common gradients that are used for DS/CC are altering the intensity and changing the distance to the stimulus. The intensity can be changed by altering the location, loudness, speed of movement, duration, types of stimuli, or components and response of the stimulus. DS/CC needs to start at the lowest intensity that results in no signs of anxiety or concern. The stimulus (at the lowest intensity and/or at the furthest distance) is presented and the pet is rewarded for the new, relaxed attitude and behaviors. The stimulus is repeated over multiple sessions, while the pet is rewarded for the positive behavior. Every session should be brief and always end by rewarding the display of positive behavior(s). It is important to keep a log book or video tape session to track success.
Step 5. Medications
Medications can be part of any behavioral treatment. Medications should be used with a concomitant diagnosis and full laboratory testing (CBC, Chem and T4, UA, urine culture). Medications can help lower the anxiety levels and be an adjunct to a behavior modification plan. Most medications are “off label” use and the client needs to be informed about the potential side effects and adverse effects with any other medication(s).
Behavior treatment takes time and the process may be gradual. Since progress is often slow, maintaining a journal of the behavior to track the progress is helpful. Problems usually arise from progressing too quickly and not taking small, incremental steps. In most cases the problem behavior took time to develop and hence the goal is small, incremental improvements rather than instant results.
www.cliniciansbrief.com/sites/.../Addressing%20 Any%20Behavior%20Problem.pdf (VIN editor: link could not be accessed on 4/6/20).