Veterinary Social Workers
There’s help for veterinary teams and their clients dealing with affordability issues, including economic euthanasia.
What can be said to the client who can’t afford recommended treatment for their pet?
“Making the decision to euthanize a beloved pet is never easy, and when that decision is in the context of financial limitations, there can be profound feelings of guilt, anger and shame in addition to the presence of grief,” said Debrah Lee, LCSW, director of veterinary well-being at DoveLewis, an emergency animal hospital in Portland, Oregon. “The reality of financial limitations in the ability to pursue treatment also has a profound impact on the well-being of veterinary team members.”
In fact, burnout in veterinary practices can be linked to the percentage of euthanasias performed due to economic reasons, according to the 2023 report “Veterinary Burnout Study: The Emotional Toll of Financial Stress, Work Environment, and Euthanasia” by Galaxy Vets, a veterinary healthcare system with burnout prevention as a strategic priority. “Specifically, staff who regularly performed euthanasia for patients who could not afford to continue taking care of their pets reported higher burnout than staff who performed fewer cases of economic euthanasia.”
As difficult as discussions about euthanizing a beloved pet may be, some practices are finding that a veterinary social worker – either on staff or on retainer – can help.
“In those moments of intense emotions and heartbreak, social workers can provide a grounded, non-judgmental, and empathetic presence during a very difficult time,” said Lee. “Social workers are adept at finding and supporting clients in utilizing community resources, and in situations where there is a financial limitation present in a non-emergent circumstance, a social worker may be able to refer a client to resources for lower-cost options for care.”
Help people who help animals
Veterinary writer and consultant Emily Singler, VMD, described the veterinary social worker’s role in an AAHA publication in October 2022: “With our myriad responsibilities, we veterinary professionals can easily become overwhelmed as we work to support our patients, clients, team members, and ourselves. The never-ending expectation to nurture and care for others, both animal and human, without always being nurtured and cared for in return, is one reason we experience burnout. Enter the veterinary social worker – a licensed social worker with specialty training on the unique needs and challenges of veterinary professionals and all those who interact with animals.”
“To be clear, mental health professionals have been in veterinary settings since the late 1970s, primarily doing pet loss support work,” said Bethanie Poe, PhD, LMSW, chair of veterinary social work educational programming at the University of Tennessee’s Center for Veterinary Social Work. Veterinary social work was developed in 2002 by Dr. Elizabeth Strand as a collaboration between the University of Tennessee Colleges of Social Work and Veterinary Medicine, she says.
“Veterinary social workers help people who help animals,” said Pamela Linden, LMSW, PhD, research associate professor at the UT College of Social Work and associate director of operations at UT’s Center for Veterinary Social Work.
Individuals holding a veterinary social work (LVSW) certificate are professionally licensed human services professionals who have extensive training in the four core focus areas of veterinary social work – animal-related grief and bereavement, animal assisted interventions, the link between violence toward people and animals, and intentional well-being, said Dr. Linden. (The term “intentional well-being” refers to the notion that animal-health professionals can engage in specific behaviors and activities to promote personal and workplace satisfaction, she said.)
Veterinary social workers are well-positioned to work with veterinary professionals and families to avoid, whenever possible, euthanasia of pets due to financial constraints despite treatable illness, she said. “As veterinary medicine explores concepts of incremental veterinary care, or spectrum of care, veterinary social workers can facilitate discussion of the unavoidable ethical dilemmas that research has shown are associated with moral distress among veterinary professionals.”
Ranks are growing
The ranks of veterinary social workers are growing. More than 460 people are either currently enrolled or have completed the University of Tennessee’s Veterinary Social Work Certificate Program or the Veterinary Human Support Certificate Program, said Dr. Poe.
“When the program first started, besides ‘What is that?’, one of the most common questions we would get was, ‘So… you do therapy on pets?’” she said. “As more attention has been brought to mental health and suicide prevention in veterinary medicine, the desire to have mental health professionals who understand the challenges of veterinary medicine has grown, resulting in more veterinary hospitals creating veterinary social work positions.”
Dr. Linden advises that any practice considering veterinary social work should first contact an LVSW to conduct a needs assessment. “Every veterinary and animal-health-related setting is unique and has diverse strengths and challenges that affect workplace satisfaction, client satisfaction and patient care. This process will result in a clear understanding of the needs and expectations of owners/managers, veterinarians, veterinary nurses, and veterinary support staff.”
Some practices employ one or more full time, embedded veterinary social workers who provide crisis support after critical incidents, provide emotional support, and make referrals for ongoing mental health treatment when needed. They can also provide individual and group pet-loss support and teach workshops on topics such as conflict management, achieving work/life balance and intentional well-being.
Other practices may decide to employ a part-time veterinary social worker or a per-diem VSW who can be called on to provide support for difficult cases, said Dr. Linden. “They can assist clients in making end-of-life decisions, support pet owners who are providing a high level of caregiving to ill, elderly or disabled pets, and provide support to the veterinary team encountering cases where they suspect domestic violence, animal abuse or neglect, or concerns about the ability of pet owners to provide appropriate home care to their pets. The VSW is a part of the interprofessional team dedicated to improving the lives of people and animals.”
Veterinary social work can be applied on a corporate scale as well. BluePearl, which is part of Mars Veterinary Health, has social workers in several regions across the country to connect with associates and pet owners at the company’s specialty and emergency hospitals, said Lori Harbert, MSW, LCSW, CAGCS, director of health and well-being. Select social workers are also located in hospitals, where they provide direct support to pet owners and associates when needed.
Reducing economic euthanasia
While it’s true that veterinary social workers can help the veterinary team and clients deal with economic euthanasia, practice owners can share options to address affordability-of-care dilemmas, according to experts.
“Consider providing training on ethical theories and mechanisms of coping with moral dilemmas, as well as coaching that covers emotional and psychological wellness topics,” write the authors of the Galaxy Vets report. Expanding payment options – e.g., third-party payment plans, pet insurance and collaborating with charitable organizations – can help address economic euthanasia from a different angle. “By educating clients about the alternatives and the importance of preventive care, you can help relieve the financial burden that can be caused by emergencies or chronic conditions, improve trust and compliance, and ultimately, reduce the number of economic euthanasias.”
Debrah Lee said, “Veterinary professionals are compassionate people, and they enter the profession with a genuine desire and dedication to providing care for pets and assisting and supporting their families. This is why fostering an open dialogue about financial limitations from the start is crucial. This transparency lays the foundation for veterinarians as they work with clients in navigating treatment discussions.
“By engaging in candid conversations early on, veterinarians can address treatment options, associated costs and alternative care approaches. This proactive approach empowers clients to make informed decisions aligned with their financial capacities, ultimately enhancing the overall quality of care provided to their beloved pets.”
The Veterinary Social Work Oath
“Specializing in veterinary social work, I pledge my service to society by tending to the human needs that arise in the relationship between humans and animals. From a strengths perspective and using evidence-based practice, I will uphold the ethical code of my profession, respect and promote the dignity and worth of all species, and diligently strive to maintain mindful balance in all of my professional endeavors.”
— From the University of Tennessee Colleges of Social Work and Veterinary Medicine
Understanding the Burnout Rate
“Veterinary Burnout Study: The Emotional Toll of Financial Stress, Work Environment, and Euthanasia” by Galaxy Vets explored the relationship between burnout and euthanasia. Only those respondents who confirmed that their hospital performed euthanasias were included in the following analysis.
On average, respondents reported euthanizing 17 pets per month. 20% of those cases were due to clients not being able to afford treatment, Galaxy Vets reported. “While the burnout rate and the number of pets that were euthanized were unrelated, burnout was significantly linked to the percentage of economic euthanasias. Specifically, staff who regularly performed euthanasia for patients who could not afford to continue taking care of their pets reported higher burnout than staff who performed fewer cases of economic euthanasia.”
Galaxy Vets concluded this particular finding enhances existing research on drivers of burnout among veterinary staff and the potential mental toll that euthanasia can have on the staff in cases when there is a viable medical alternative.
Photo credits:
istockphoto.com/AlexRaths
