What do we do if the client says no?
If a client refuses to comply with advice or treatment plans, it can be frustrating and lead to reduced self esteem.
In behavioural medicine, owner compliance is essential. Without it, nothing will change for the animal, animal behaviourist Karen Wild said during a lecture at BVNA Congress today (6 October). So what if they don't want to comply?
For practitioners, if a client refuses to comply with advice or treatment plans, it can be frustrating and lead to reduced self esteem. Here, support from colleagues and organisations such as the Association of Pet Behaviour Counsellors, can be invaluable.
Reaching clients 'in crisis' is difficult as they may be in a state of confusion or distress over their animal's behaviour. Such circumstances make learning more challenging and also create a sense of urgency in the client. Owners in crisis are more likely to follow advice, but unfortunately this is not always expert advice. They may seek help from an internet forum or television show and are prone to taking more extreme or inadvisable actions, such as using shock collars, rehoming or even euthanasia.
Stereotypes are another barrier to effective treatment; statements such as "All Labradors are greedy", "collies train themselves", or "a typical Chihuahua" create the impression that it is impossible to change their behaviour. It is important that as a profession we are not seen to 'agree' with such statements, Karen said.
There may be other barriers to providing the ideal treatment; for example, the client may not be able to afford it, they may not have much time due to family commitments, or they may live near a busy main road, preventing their cat from getting outdoors. It may be necessary to settle on a realistic plan they can actually achieve, and go from there. If we don't assess their preparedness, or set unrealistic goals, they are not going to comply.
Instead, encourage the client to describe exactly what they saw, and to provide a video if possible (without putting themselves at risk or 'setting up' the situation on purpose).
In order to improve compliance, Karen discussed use of the Health Action Process Approach, which is a sequence of two self-regulatory processes - goal setting (motivation), and goal pursuit (volition).
In the motivation stage, ask yourself: does the client feel able to do what is being asked of them? Do they feel the outcome will be worth the effort?
In the second stage, practitioners should ensure the client has a plan of action with specific instructions, including what to do if things go wrong. They should ask, can the client keep this action plan going? It is also important to consider other factors, for example if the client is suffering from a condition such as dementia or Parkinson's.
Clients will inevitably debate and question instructions, Karen added, but these objections - while frustrating - are part of the negotiation process, and if the client is negotiating, they are considering the treatment methods you have advised. Try to handle these objections using positive language; for example "I'm really glad you brought that up", "Well at this stage…" and so on. This shows you are listening, softens their objections and helps to avoid arguments.
It is also worth noting that clients often struggle to recall instructions properly. Providing them with, for example, a link to a video showing how to do something correctly, can be very useful. Likewise, have some practice handouts available for common procedures.
Finally, it is important to measure the impact of any modifications. Checklists and progress charts are helpful, such as puppy socialisation charts given out to clients after registering, which they can bring back to show you on their second visit.
The RCVS has announced a new version of its 1CPD mobile app, with enhanced features for veterinary surgeons and veterinary nurses to record their continuing professional development.
