VNJ Articlesclinicaldesensitisationpractice
23 August 2022
Understanding desensitisation – making it work in practice by Francesca Riccomini
ABSTRACT: Systematic desensitisation is a psychotherapeutic technique whereby an individual's response to a stimulus decreases as a result of controlled exposure in circumstances where the animal remains calm. It is commonly used in companion animal behaviour counselling during programmes aimed at addressing a range of conditions associated with arousal.
Its principal value, however, is in the treatment of problem behaviours involving fear and anxiety – for example, fear of fireworks and storms, negative reactions to places such as the veterinary surgery or grooming parlour, and fear of specific activities, including car, bus or train travel, wearing head collars and muzzles (Figure 1).
Figure 1: Desensitisation and counter-conditioning can be used for a variety of aspects of pet care, such as getting dogs accustomed to wearing head collars, muzzles and harnesses, and cats used to their carriers and grooming
Whilst the underlying theory is straightforward, execution of the technique is quite complicated and results can be disappointing. It is thus essential that all involved have a clear understanding of systematic desensitisation and its practical application as well as:
• the nature of the pet’s problem
• all the factors involved in its development
• those currently influencing and maintaining the behavioural difficulties.
Failure to correctly implement a planned protocol addressing all contributory aspects of any given case often results in a worsening of the problem. Timing is especially important.
During the behaviour programme the animal must not encounter the stimulus in its natural form and, as the aim is to modify his or her emotional response, any attempt to accelerate the pace is likely to be counterproductive. Therefore, expectations must be realistic and with complicated situations establishing priorities, tackling problems from several different aspects and gradually working through them in a controlled manner is essential.
Attempts to do too much too soon usually place an intolerable strain on both pets and clients, who must be advised not to inadvertently reinforce the problem reaction by trying to comfort and reassure their pets. Rather they should ensure that difficulties are avoided and appropriate, relaxed behaviour in potentially problematic circumstances is always rewarded.
Practical application
Once the motivation(s) underlying an individual’s problem behaviour has been identified, the aim is to control circumstances sufficiently well that the threshold at which an animal reacts to a repeatedly presented problem stimulus is gradually raised. Evidently he or she must be aware of it, but the intensity must be muted enough to avoid arousal and/or distress. This can be done using a facsimile, a good quality sound recording or modified replica, for instance, or the real thing presented in a low-key fashion.
For example, many dogs that have not been carefully introduced and habituated to heavy traffic find living in towns difficult (Figures 2a and 2b). Every time the animal encounters the feared scenario the problem is likely to intensify with the increasingly anxious and fearful response often resulting in refusal to move, safety risks caused by bolting across roads and pulling people over, and, occasionally, aggression or agoraphobia.
Figures 2a and 2b: Some dogs can cope with major roads at quiet times of day but become fearful when traffic is heavy. Owners often fail to handle such situations sensitively and desensitisation and counter-conditioning programmes can be helpful
Initially owners must completely avoid exposure to the volume of traffic that is problematic – and which inadvertently reinforces the fear – by using routes with minimal traffic or making other arrangements for pets to exercise and to ‘relieve’ themselves. For instance, by playing games and practising obedience training in the garden or transporting dogs by car to quiet parks.
Concurrently, desensitisation training sessions are systematically undertaken. These can employ a recording of traffic noise played at low volume when the pet is relaxed at home, the sound being gradually increased at a rate indicated by the dog’s awareness but lack of reaction. Such recordings must include all the sounds associated with motor vehicles, different engines running at varying speeds, squealing brakes, emergency vehicle sirens, lorry air brakes being applied and bus doors opening for instance.
Traffic, however, is a complex stimulus with visual aspects and an associated variety of vibrations and odours difficult to replicate artificially. Therefore, using the real thing with care and sensitivity – instead of, or in addition to, a recording – is generally the best option.
Careful planning required
A haphazard approach risks inadvertent reinforcement of the fear, as does failure to carefully observe and correctly interpret the dog’s reactions. In particular, good recognition of low grade signs of arousal and stress, lip smacking, nose licking, out of context yawning and blinking, is essential, because the aim is to avoid reaching this stage while giving the dog frequent opportunities to learn to live comfortably with the feared experience.
The nature of the individual situation determines the starting point. The more intense and well established the fearful behaviour, the lower the volume of traffic with which it is realistic to begin. Once aware of the relevant behavioural indicators and the nature of the desensitisation process, however, most owners can identify where they should start. The first session involves choosing a time when traffic volume is low and stopping in a quiet side road, on the way home from an enjoyable outing, when a dog is relaxed.
Having selected a location that experience indicates is appropriate, the dog is walked from the quietest end of the road towards the busiest, with the session kept deliberately short and positive. The next day/session begins a little further back than the previous finishing point before moving forward so that progress is carefully consolidated (Figure 3).
Figure 3: During a behaviour modification programme, challenging conditions should be avoided until early phases have been fully consolidated (Image courtesy of Samantha Lindley.)
Provided indicators are positive, the programme gradually proceeds at a prearranged pace. For example, after five or six relaxed encounters in a specific location, the dog and owner walk nearer to the busier traffic, repeating the now established process of several enjoyable sessions before moving forward to the next stage. Later more hectic times of day can be systematically included in a similar fashion, and, only when the dog has a consistently calm and positive reaction to all areas o
f the quiet road, is the adjoining busier one tackled in the same controlled manner.
Evidently the rate of progress depends upon the individual, the nature and intensity of his or her problem, the time the owner has available to dedicate to the programme and the number and type of complications encountered. If problems arise and the dog becomes aroused during a session, he or she should be quickly and calmly removed from the situation. Then after a break – the length of which depends upon the seriousness of the setback – the next session starts a step or two further back before the programme moves forward, possibly at a slower pace if over-enthusiasm caused the slip-up.
Counter-conditioning
Desensitisation is context specific. Therefore, the process must be repeated in a range of different circumstances to generalise the pet’s changed reaction. It can also be slow to achieve, not particularly robust and quite easily undermined. Thus it is generally combined with counter-conditioning, a process where a behaviour that is incompatible with the previous undesirable response is conditioned to the problematic stimulus.
Two forms are used. With classical (Pavlovian) conditioning, pets are taught to associate an enjoyable activity, such as eating or playing, with the problem scenario. Evidently the positive state the activity induces must be stronger than the negative emotions engendered by the problem-inducing stimulus; a good example being timid dogs that are offered food by unfamiliar people.
When contact is close, these are invariably rejected. However, by adopting non-confrontational body language to ensure that the dog is not inadvertently pressurised and keeping the person at a distance while they gently toss treats towards him or her, is generally successful. Sensitively conducting such a programme over a series of sessions can make a significant difference to the dog’s general response, especially when individuals of different sexes, ages and varying appearances are recruited.
A second approach involves response substitution or operant/instrumental conditioning. Here a pet is first reliably taught to perform a behaviour or command (conditioned response), such as a ‘sit, attention focused on the owner’, in a variety of non-arousing circumstances to consolidate it before it is used in a structured programme employing a modified form of the problematic stimulus. This technique can often be helpful in dealing with dogs that self-defensively lunge at other canines as a result, for instance, of having been attacked.
Again care must be taken to construct and implement a behaviour programme based upon individual circumstances and to avoid any potentially problematic, uncontrolled contact with other dogs until the affected pet’s emotional response has been successfully modified.
Author
Francesca Riccomini
BSc(Hons) BVetMed CCAB MRCVS DAS(CABC)
An experienced small animal clinician and author of two cat books, Francesca gained a post graduate Diploma in Behaviour Counselling from Southampton University in 2001. A member of the FAB's Behaviour Expert Panel and of the Association of Pet Behaviour Counsellors, she now specialises in the subject and runs a behavioural referral service based in south-west London.
Veterinary Nursing Journal • VOL 25 • No3 • March 2010 •