This is Part 8 of our Support Protocols for 14 Common Situations series. The cases described in this series are drawn from everyday scenarios found in general veterinary practice or emergency and specialty practices. Below you’ll find an example of a type of case you’re likely to encounter in practice. This blog’s subject is a case involving client guilt.
Situation: Client Guilt
Mark McEachern is sitting in an exam room waiting for news about his beagle, Snoopy, who was hit by a car. You knock gently, enter, and explain to him that Snoopy has died. He stares at the wall for a moment, processing the awful news, then looks at you and say, “I knew I should have fixed our gate. It didn’t latch right, and Snoopy got out, and now he’s dead…I killed him. I’m the one who caused his death….I will never, ever forgive myself.”
Assessment: What’s Going On Here?
Guilt is the critic, the inner voice that judges one’s thoughts, actions, behaviors, decisions, and feelings. Sometimes client guilt is justified and other times it is not. Some clients do create the circumstances that either directly or indirectly cause their pet’s death. For instance, some owners decide to euthanize their pet simply because the pet exhibits unwanted behavior, or because the clients are making a lifestyle change (for example, moving into an apartment). Others may be negligent in the way they care for their pet, or knowingly put their pet in potentially dangerous situations (for example, walking a pet off leash near a busy street). When death occurs in these cases, feelings of client guilt may be justified.
Other times, client guilt is not justified. For example, many clients feel guilty when their pet is diagnosed with a terminal illness. They feel they “should have known” or could have done something to prevent the disease. At the very least, many feel they should have noticed the symptoms sooner. In addition, many clients feel guilty after euthanizing their pet, even if the decision was clearly in the animal’s best interests.
In general, client guilt usually stems from a client’s belief that he or she has breached the contract they made with the pet to keep the pet alive, safe, and healthy. The support you offer a client who feels guilty may vary according to whether or not you believe the client’s guilt is justified.
Plan: Support Protocol for What to Say and Do
Lay the Foundation (Step 1)
- Structure the environment so you and your client can have a private emotional conversation. During the conversation, use attending behaviors, touch, and paraphrasing, making comments such as, “it sounds as though you had every intention of fixing your gate,” and “If I’m hearing you right, Snoopy had never gotten out of your yard before.” Listen in an active way to your client.
- Be certain the room is well stocked with tissues as well as client education materials and referral information.
- Support Tool Suggestions:
Implement Support Techniques (Step 2)
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Acknowledge Feelings of Client Guilt
Acknowledge the client’s feelings of guilt and create opportunities for them to talk about their feelings. You cannot change or fix another person’s guilty feelings; you can only listen without judgement. For example, in the scenario that opens this situation, instead of saying, “Don’t feel so bad,” or “It wasn’t really your fault,” you might say something like “I hear how guilty you feel about Snoopy’s death, Mark, and I know you would give anything to be able to go back in time and fix that gate.”
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Facilitate a Goodbye
Facilitate a way for the client to say goodbye or even apologize to the pet if the client feels that they indirectly caused an accident. You might suggest that the client view the pet’s body, go home and write a letter to the pet, or compensate for the negligence by donating to or volunteering for an animal-related organization.
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Minimize
Taking away the guilt that is commonly present when a client decides to euthanize a very sick or injured pet is not possible, but you can minimize it. You can gently tell the client that people often use guilt to distract themselves from the more painful feelings of sadness and loneliness. You can also give the client permission to experience the full range of grief manifestations that accompany loss. Finally, you can remind the client that you consider euthanasia to be a privilege and a gift. For example, “You did everything of a medical nature that you could possibly do for Snoopy and, in the end, you gave him a loving gift–a peaceful, painless death.”
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Hold Accountable
Occasionally, you will see clients who you believe deserve to feel the guilt they are experiencing. Perhaps they have been grossly negligent or even abusive to their pet. In these cases, your goal is not to alleviate the client’s guilt, but to act as an advocate for the animal. In most instances, these are not the kinds of clients you want to cultivate. Rather, they are the ones you want to report to the authorities in order to prevent them from owning other animals in the future.
Stay Connected through Follow-up Care (Step 3)
- Even when a client’s guilt is not justified, remember that it is not your job (nor is it often even possible) to make guilty feelings go away. No matter what you say, some clients will remain convinced that the little, insignificant things they did or didn’t do actually caused their companion animal’s death. Clients hang on to these beliefs and their guilt for a multitude of reasons, none of which are within the scope of your ability or responsibility to resolve. The best you can do to support clients who are dealing with unjustified guilt is to patiently and repeatedly review the medical facts pertaining to their pet’s death and acknowledge their feelings
- Most clients who feel guilty also feel embarrassed that they may have harmed their pet by making bad decisions or participating in dangerous activities. Along with their embarrassment, they are probably wondering how their pet’s accidental injury or death has affected your opinion of them. If you can separate the person from his or her questionable behavior, you can probably honestly say, for example, “Mr. McEachern, I can see that this mistake is making you feel terribly guilty. But I do believe you are a responsible and conscientious pet owner who never intended to bring any harm to Snoopy. I agree, though, that it’s important to keep a secure, safe space for your animal to be in.”
- This statement won’t do much to alleviate your client’s guilt, but it will reassure them that you still support him, won’t judge them, and don’t wish to see them punished themselves over the accident. They will return your kindness and understanding by remaining a loyal client.
Client Guilt: Role-Play Ideas
- For hospital managers and client care specialists: Using the opening case scenario, try talking to the fictional Mr. McEachern about his feelings of guilt over Snoopy’s death. Practice ways you can acknowledge his feelings without telling him outright not to feel guilty.
- For veterinary technicians: Practice talking with Mr. McEachern about his guilt and how he blames himself for Snoopy’s death. Then practice talking with a client who feels guilty about waiting too long before making the decision for euthanasia.
- For veterinarians: Practice talking with clients who feel guilty for a variety of reasons. For accidental deaths you can use the opening scenario to practice helping Mr. McEachern deal with his feelings about Snoopy’s death. Additionally, practice talking with a client who feels guilty about their pet’s death due to a sudden illness, such as cancer. You can also practice talking with a client who feels guilty about the euthanasia (such as waiting too long or euthanizing too early).
Keep up the good work,
Laurel Lagoni
Co-Founder
World by the Tail, Inc.