Download file includes - Atlantic Provinces Veterinary Conference

Atlantic Provinces Veterinary Conference
Halifax Marriott Harbourfront Hotel, Halifax, Nova Scotia
Saturday, April 22, 2017
Lynne Seibert DVM, MS, PhD, Dipl ACVB
Veterinary Behavior Consultants, LLC, Roswell, Georgia USA
Email: [email protected], Ph, 1-678-878-4410
Behaviour-Friendly Practice Strategies
Lynne Seibert DVM, DACVB
Replace non-scientific interpretations of animal behaviors with scientific knowledge
Make assessment of behavioral health as much of a priority as assessment of
physical health
Risk factors for relinquishment of cats to shelters (Patronek et al., 1996)
Unrealistic expectations
Allowing cat outdoors
Owning a sexually intact cat
Inappropriate elimination
Reducing Pet Relinquishment
Predominate age group being euthanized:
Adolescent and older animals that have been in homes but are no longer wanted
Addressing pet fertility alone will not solve the problem
Scarlett JM et al., JAVMA 220(3), 2002
Shelter Relinquishment
Behavior problems cited as reason for relinquishment
(Salman MD et al., J Appl Anim Welfare Sci 2000, 3:93-106)
40% of dogs
Veterinary intervention:
Most pets have been taken to the veterinarian at least once in the year preceding
relinquishment: 70% of dogs
Only 25% of dog owners report routine veterinary behavioral advice
Incidence of behavior problems
Feline house-soiling
In about 10% of households with cats there is a house-soiling problem
Aggression
New et al., J Appl Anim Welfare Sci, 2000, 3:179-201
National survey of >3000 pet-owning households
16% of households have aggressive dogs
13% of cat-owning households
Veterinary visits for cats
Almost twice as many cats than dogs never visit veterinarian
86 million cats; 78 million dogs
41% of cat owners visit vet only for vaccinations
39% of cat owners only take their cat to veterinarian if cat is sick
60% of cat owners report that their cat hates going to vet
2011 Bayer Healthcare, L.L.C., Brakke Consulting, Care Usage Study, American
Pet Products Association 2011-12 Pet Owners Survey
Cat friendly practice program
American Association of Feline Practitioners
www.catfriendlypractice.catvets.com
CATALYST Council www.catalystcouncil.org/about
Vision: raise level of care and welfare of cats by cat owners – one that any owner will
embrace through human-animal bond and can achieve – supported by highest quality
veterinary care, preventative medicine, and cat specific products
www.catalystcouncil.org
Partners for Healthy Pets www.partnersforhealthypets.org/practice_feline.aspx
Many of your “active” clients are, in fact, NOT active!
Data from practice management systems of over 5,000 companion animal practices
revealed that over 50% of pets considered “active” had not been in for visit of any kind
in over 18 months
Behavior Issues in General Practice
 Avoidance of cat carrier
 Stress during veterinary visits
 Difficulty handling
 Difficulty administering medication
 Reactivity in waiting area
 Anxiety during boarding
Clients will limit non-emergency veterinary visits
Provide Educational Resources
 Realistic expectations
 Pet selection counseling
 Behavioral needs of pets
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Prevention and socialization
Humane and effective solutions to common problems
Identification of problem behaviors
BEHAVIOR TEXTS
Puppy's First Steps: The Whole-Dog Approach to Raising a Happy, Healthy, WellBehaved Puppy by Faculty of the Cummings School of Veterinary Medicine at Tufts
University, Lawrence Lindner, and Nicholas Dodman 2007
Behavior Cost Center
 Preventive counseling
 Puppy classes
 Training sessions
 Behavior consultations
 Recheck appointments
 Behavioral medications
 Diagnostic testing
 Product sales
Total Team Approach
How will you involve the entire team?
Technicians, assistants, Receptionists, Kennel staff, Office managers, Veterinarians
How will you handle staff training?
Receptionists
Recognize owner comments and complaints
Schedule appointments with behavior needs in mind
Identify anxious pets as they enter hospital
Manage owner and pet traffic to minimize stress
Kennel staff
Interpret species-specific signals
Reduce stress and arousal
Use humane handling techniques
Note problem behaviors that occur within the hospital
Assistants
Obtain behavioral histories
Offer basic behavior advice
Answer general behavior questions
Model good handling and interactions
Technicians
Offer basic behavior counseling
Complete diagnostic tests requested by doctor
Communicate doctor’s discharge instructions to client
New pet checklists
Behavior history
Complete behavioral history essential for early recognition of medical problems
Often the first sign of medical condition will be change in pet’s behavior
Behavior checklist
Since your last appointment…
have your pet’s elimination habits changed?
has your pet had an increase in anxiety or fear?
has your pet’s personality changed?
has your pet destroyed anything?
has your pet begun to vocalize excessively?
are you concerned about any other behaviors?
Treatment considerations
 Medical interventions
 Pain management
 Environmental management
 Avoidance
 Behavior Modification
 Pharmacotherapy
How to refer
Provide timely referrals
Be clear to client that referral is necessary
Ensure that behavior consultant is qualified
Client’s experience with referral resource reflects on referring DVM
What about obedience classes?
Completion of an obedience class does not protect against behavior problems
Adverse effects of inappropriate training, especially if physical force is used, can
result in significant morbidity and mortality
Hospital Design
Separate entrances for dogs
Cubicle layout in reception area
Sound-absorbing materials
Towels draped over cages of frightened animals
Surfaces with traction
Reactive animals taken immediately to exam room
Species Segregation
120 shelter cats in 4 different shelters
Cat stress score
Urine cortisol-creatinine measurements
Extent of exposure to dogs biggest factor affecting cat stress level
Enclosures - Enriched
Soundproofing
Natural light
Elevated kennels
Perches
Hiding areas
Resources
Blackwell's Five Minute Veterinary Consult: Clinical Companion: Canine and Feline
Behavior with CD; Debra F. Horwitz and Jacqueline C. Neilson 2007
Handbook of Behavior Problems of the Dog and Cat
Gary Landsberg, Wayne Hunthausen, and Lowell Ackerman 2007
HUMANE HANDLING DURING VETERINARY VISITS
Lynne Seibert DVM, DACVB
GENERAL SAFETY PRINCIPLES
In the veterinary hospital, animal bites and injuries associated with animal handling are
the two leading sources of workers’ compensation losses. According to the AVMA
PLIT, in a recent analysis of 605 veterinary workers’ compensation losses, 50 percent
were due to animal bites. Cat bites are the most frequent and costly bite injuries. The
average cat bite cost $757, while the average dog bite cost $495. Educating staff about
animal behavior, and how to approach, handle, and safely restrain patients, will result in
less expense, fewer injuries, safer procedures, and happier clients.
It is critical that each hospital have an established training protocol for new employees
regarding animal handling protocols. Waiting areas should have signs posted requiring
owners to keep pets on leashes or in carriers. Separate waiting areas may be
designated for dogs and cats and smaller exotic species. Difficult patients should be
taken to an examination room as quickly as possible, since prolonged delays in the
waiting area can exacerbate the patient’s anxiety. Scheduling difficult patients for the
beginning or end of the day to reduce their waiting time may also be prudent. It is
strongly recommended that employees hold or restrain all animals during examination
or treatment procedures to prevent injury to owners.
Patients with a history of aggression during the veterinary visit should have notes in
their files detailing the specific concerns. Patient file notes are most helpful when they
detail specific interventions that were successful for that particular patient in the past.
For hospitalized patients, cage cards should be labeled with client-friendly stickers that
alert the staff to potential problem areas.
Most aggression in the veterinary hospital is due to fear or pain. Hospital staff may also
see territorial, possessive, irritable, or drug-induced types of aggression. It is important
to recognize when an animal is uncomfortable and likely to act defensively.
Understanding the animals’ postural signals will help to determine the type of restraint
that is indicated. Restraint must be safe for the humans as well as the patient. Avoid
excessive neck pressure and do not position the animal in such a way that it could fall
or be injured as a result of restraint.
APPROACHING ANIMALS
The way staff members approach the patients can set the tone for the subsequent
examination. Dogs are often highly sensitive to unfamiliar individuals reaching toward
or over their heads, particularly if they are cornered or restricted by a leash. Hospital
staff should avoid standing over, staring at, and reaching over canine patients. Any
canine patient that shows excessively submissive postures (ears pinned back, caudal
retraction of lip commissure, avoidance of eye contact, submissive urination) can
potentially become frightened enough to bite. Dogs that are trembling, hiding, urinating,
defecating, expressing anal sacs, yawning, or panting excessively, or any combination
of these behaviors are frightened and could become aggressive.
Patients that are hiding under chairs or tables can be removed with their leashes before
being restrained. It is never advisable to reach under a table or into a cage to remove a
fractious patient. Cat carriers can be disassembled to safely remove the cat with a
towel.
HANDLING CATS
Friendly cats greet with their tails straight up, ears forward, and back straight. Cats that
are exhibiting an arched back, curved or tucked tail, or pin their ears back are frightened
and may defensively bite or scratch.
No single approach will work for every patient, but most fractious cats can be wrapped
in thick towels for a cursory examination. Gloves, collars, cat bags, squeeze boxes,
muzzles, or chemical restraint are options if the cat is too fractious to examine
otherwise. All employees should be instructed on the proper handling of cats for
transport (with forelimbs held to prevent scratching), restraint for venipuncture, and
restraint for examinations.
HANDLING DOGS
For examination of difficult canine patients, towel holds, head collars, and/or muzzles
can be used. If the patient is extremely fractious, the best approach might be to send
the owner home with instructions for acclimating their dog to a basket style muzzle, and
attempt the examination at another time, when the dog can comfortably return wearing
the muzzle. Basket style muzzles do not restrict the dog’s ability to breathe, but will
prevent injury to handlers.
Larger examination rooms are preferred for difficult patients. Kennels and cages can
aggravate defensive or territorial/protective responses, so patients may need to be
removed from cages before handling is attempted.
Be cautious with chemical restraint. There is no perfect medication to address fearinduced aggression, unpredictable reactions can occur, and some medications can
disinhibit aggressive tendencies.
Good Restraint
Informed
Compassionate
Attentive
Technique, not strength
Techniques to Avoid
Scruffing
Verbal reprimands
Pinning, alpha rolls
Frontal approaches
Muzzle grips
High Stress Areas
Head and neck
Legs and extremities
Abdomen
Painful areas
What’s the harm in using force?
Forceful restraint breaks your promise to “do no harm”
Can lead to aggression
Can lead to poor veterinary care
Examine the pet where it is most comfortable
Use Rewards and Treats
Record Exam Details
Note in record what works best
With or without owner
More or less restraint
Problem areas
On or off table
Encourage Friendly Visits to Hospital
PREVENTING BEHAVIOUR PROBLEMS IN DOGS AND CATS
Lynne Seibert DVM, DACVB
Prevention of feline behavior problems
Behavior problems can result from environments that are not compatible with cats’
needs
Common problem behaviors
Destructive behaviors
Scratching
Urine marking
House soiling
Jumping on counters
Play, prey-related activities
Aggression
Nocturnal playfulness
Environmental enrichment
Environment must provide sufficient outlets for species-typical behaviors:
Play
Scratching
Marking
Climbing
Exploration
Scratching
Functions of Scratching
Nail grooming
Muscle stretching
Marking territory
Use of Scratching Post
Desirable surface
Place near sleeping areas
Confine kitten with scratching post initially and supervise when not confined
Food rewards for approaching and using post
Textures
Rope or woven sisal
Back of carpet
Cardboard scratchers
Nubby or pile carpet
Smooth wood
Mounted driftwood
Non-toxic branches
Orientation
 Stable, tall, vertical scratcher
30” or taller unobstructed post height
 Horizontal scratching area
Flat on the floor scratchers
Sisal-covered boards
Carpet remnant
Cardboard scratchers
Scratching Deterrents
Play Behavior
Cats are hunters” avoid using hands or other body parts as toys
Toy Time
Chase toys
Chew toys
Hide and stalk toys
Toys with treats inside
Avoid coverings or stuffing that are easily shredded
Fibers could prove fatal if swallowed
Long threads, large diameter fibers, synthetics fibers
Toys with string parts should be available only under supervision to avoid
tangling or swallowing
Rotate toys and games to maintain novelty!
Prevention of canine behavior problems
Housetraining
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Do not punish your dog, unless you catch her in the act
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If you catch her in the act, made a loud noise to interrupt the behavior, then take her
outside
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Walk your dog outside on leash and take food treats along so she can be
immediately rewarded for eliminating outside
o Go outside shortly after feeding
o Go outside every 3-4 hours for young and/or small dogs
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Increase supervision of your dog while inside
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Keep her confined to a smaller area of the house
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Crate her when you cannot watch her
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Use a long leash to keep her near you
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Teach an elimination command by saying the word, or short phrase, every time she
eliminates, and follow it with a reward
Treat affected areas with good odor eliminating product
Chewing
Puppies chew on whatever they can get their mouths on for any number of reasons:
they are bored, they have a lot of energy, they are teething, or they are just curious.
Dogs learn through their mouths. It is their tool; it is how they receive a great deal of
information. They are naturally inclined to use their mouths whenever they can.
Fortunately, most destructive chewing behavior can be prevented or controlled. To
prevent problem chewing and to direct your pup's natural inclination to chew toward
appropriate objects
CRATE TRAINING A PUPPY
Confining a puppy to a crate is a simple and humane way of preventing unwanted
elimination and destruction around the house when you are unable to supervise your
puppy. The key to crate training is making it a very pleasant and positive experience for
your puppy. The crate should not be used as punishment. The crate should be a
haven for the puppy.
Before getting the puppy accustomed to the crate, make sure you purchase an
adequately sized crate to house your growing puppy. The crate should be large enough
so that when your puppy reaches adult size, it can still stand up and turn around without
any difficulties. If the crate is too large, your puppy may eliminate at one end and stay
at the other end. Crate training is based on the principle that a dog will not eliminate
where he/she sleeps. For large breed dogs, plan to partition the crate or get a series of
different sized crates. A cardboard crate should not be used to house a puppy as
he/she may destroy it by chewing.
Once you have purchased the crate, you can begin with the training exercises. Place
the crate in an area of the house that you spend a lot of time, but not where there is a
lot of household traffic.
1. Place tasty food treats in the crate and allow the puppy to go in and eat the treats
and come back out. Keep the crate door open or off entirely. When the puppy
walks into the crate, say a command, such as “kennel up,” “crate,” or “house.” Over
time the puppy will learn to associate the command with going into the crate. Have
the crate available with the door open for several days.
2. Once your puppy is comfortable going into the crate, you can begin leaving him in
the crate for very short periods of time. The next time your puppy goes in the crate,
close the door. Let the puppy stay inside the crate for 15-30 seconds before
allowing him to come out. Be sure to let your puppy out when he/she is not crying,
whining or acting anxious.
3. Very gradually leave your puppy in the crate for longer periods of time. You can
provide your puppy with toys stuffed with food treats to keep her occupied. You can
also place a pad or cushion to make the crate more comfortable for the puppy.
4. If you are using the crate for housetraining, do not expect your puppy to control its
bladder or bowels for an eight-hour day. A reasonable time period is staying 2-4
hours in the crate before giving your puppy an opportunity to go outside to eliminate.
5. If your puppy is consistently eliminating in the crate, even if you are taking him
outside frequently, you should have your puppy examined by your local veterinarian.
RELAXATION EXERCISES
The relaxation exercises are the foundation for further behavior modification.
The purpose is to teach your dog to sit, stay, or lie down, while relaxed, in a variety of
situations. The obedience command is not the goal – it is simply a tool that allows your
dog to earn a reward for an appropriate behavior. It also teaches your dog to rely on
you for all cues as to the appropriateness of its behavior in a variety of situations.
Since the purpose is relaxation, and not strict adherence to obedience commands, it is
important to be able to recognize when your dog is relaxed. It is normal for your dog to
turn its ears to the side or back as you reach for it. It is not acceptable for your dog to
keep its ears pinned back or held to the side. You must get your dog to bring its ears
forward prior to giving the reward. If your dog is reluctant to do this, you will need to
become less “threatening.” You can accomplish this by avoiding direct eye contact with
your dog, crouching or swatting, dropping the reward rather than reaching directly
toward the dog, or speaking more softly. If your dog still seems anxious, contact the
behaviorist for further advise.
Your dog’s favorite food treat will be used in the exercises. This is a reward or salary –
not a bribe. Treats should never be used to bribe a problem dog. Food rewards should
be tiny, easily consumed, and highly palatable. They should be given only during
exercises so the dog’s motivation for them is maintained. Dog biscuits may not provide
sufficient motivation, but some foods are so desirable that the dog is too stimulated to
relax. Something between the two extremes is preferred.
Teaching “Sit”
Ask your dog to sit. If it will not sit immediately, raise a treat slightly and ask again.
Do not tug on the leash, raise your voice, or push it into the sitting position.
As soon as your dog sits, with its ears perked forward, say “good dog” and give the
food treat. If your dog jumps up prior to receiving the treat, then withhold the reward,
and ask it to sit again. Remember that you are rewarding the behavior or behaviors that
are occurring immediately prior to the reward.
IMPROVING COMPLIANCE WITH BEHAVIOR MODIFICATION PLANS
Lynne Seibert DVM, DACVB
Compliance can only be achieved when a specific and consistent recommendation is
made by the veterinary team, the client accepts that recommendation and the practice
follows up with that recommendation.
What?
Veterinarians report that client compliance with behavior modification is poor
So, What?
230,000 pets were euthanized in veterinary practices in 2006 for behavior problems.
By comparison, approximately 244,000 dogs were diagnosed with heartworm disease.
So, What?
The average veterinary practice loses up to 15% of the patient base each year to
euthanasia due to behavior problems
What Next?
Train your team
Keep it simple
Focus on the positive
Make behavior modification plans simple to follow
Focus on positive reinforcement
Use rewards and treats
Keep It Simple
Chunk and Check
Information should be provided to clients in short, digestible chunks. Give a portion of
the discharge information, then check in with the client to gauge their understanding.
Handouts
Less is more
Be tight and concise
Cut out all unnecessary items
Stick to key messages
Make every word, phrase, sentence count
Learning Concepts
CLASSICAL CONDITIONING
Classical conditioning is a form of learning that occurs when a neutral stimulus is paired
with an unconditioned stimulus over one or more trials. The neutral stimulus comes to
elicit a response that it would not naturally elicit. The UCS (Unconditioned Stimulus) is
any non-habituating stimulus that elicits a response without prior training. The CS
(Conditioned Stimulus) is the stimulus that does not initially elicit a particular response
(neutral), but will elicit the response as a result of pairing with the UCS. An UCR
(Unconditioned Response) is a reflex or autonomic response (physiological or
emotional) to a stimulus that occurs without the necessity of prior conditioning. The CR
(Conditioned Response): response is the response made to the conditioned stimulus
during classical conditioning. Classical conditioning is often involved in the
development of fear responses in pets, and can also be used in behavior modification
programs.
Extinction of Classical Conditioning
If the conditioned stimulus is repeatedly presented without being paired with the
unconditioned stimulus, we can break the association between the CS and UCS, and
the conditioned stimulus eventually reverts to being a neutral stimulus. This can be
applied to behavior modification plans.
Many dogs with separation anxiety will display anxiety during the caregivers’ predeparture routine (picking up keys, putting on shoes, setting the house alarm). Because
the pre-departure cues are temporally associated with prolonged owner absences,
these dogs develop classically-conditioned fears of the elements of the pre-departure
routine. Thus, anxiety begins before the caregiver ever gets out of the door. These
classically conditioned fears can be extinguished by disrupting the pairing of the
conditioned stimulus (keys, shoes, alarm) with the unconditioned stimulus (extended
absences). This process of extinction can be accomplished if the owners will repeat
elements of their pre-departure routine, and stay home instead of leaving (pick up keys
and put them down, put on shoes and stay home with the dog instead of leaving).
Another application of extinction applies to veterinary hospital visits. Painful or
uncomfortable veterinary procedures can result in conditioned fears of the examination
room, the doctor’s white coat, and the sights and smells of the hospital. By encouraging
caregivers to bring their pets to the veterinary hospital for atraumatic visits (visit
hospital, get a treat, and leave), the conditioned fear of the hospital may be lessened.
Inhibitory Classical Conditioning
Conditioned inhibition is a technique that can be used to teach dogs with separation
anxiety to relax during their owner’s absence. These exercises involve using a safety
signal (inhibitory conditioned stimulus) during ultra-short practice departures. The safety
signal should be a signal that has never previously been associated with an extended
owner absence, and will be presented during brief departures. Over time, as the dog
learns to associate this special signal with short, safe owner absences, the length of the
practice departure can be gradually extended. Conditioned inhibition does not involve
reward-based training. It simply relies on the dog’s ability to learn an association
between the safety signal and the absence of the UCS (extended owner absence).
OPERANT CONDITIONING
Operant conditioning, also called instrumental conditioning, is a form of learning in
which behaviors are affected by their consequences. An eliciting stimulus, or
antecedent, gives information that there will be a specific consequence to a specific
action at that time. Eliciting stimuli may be deliberately presented to a pet as part of a
training program (command, request), but are not always intentional. The eliciting
stimulus prompts a response or behavior, and the response results in a consequence,
or controlling stimulus.
There are four paradigms in operant conditioning: positive reinforcement, negative
reinforcement, positive punishment, and negative punishment. Reinforcement means
that the probability that the behavior will recur is increased. Punishment means that the
probability that the behavior will recur is decreased. The term ‘positive’ means that the
controlling stimulus, or consequence, is present or occurs as a consequence of the
response occurring. The term ‘negative’ means that the controlling stimulus is absent or
is removed as a consequence of the response occurring.
Positive Reinforcement
Positive reinforcement is very important when working with anxious dogs. The
caregiver must first be able to recognize activities and body language that are
consistent with a confident, non-anxious pet, and offer rewards specifically at those
times. Food rewards are highly motivating for most dogs. During times of anxiety,
attention-seeking, whining, pacing, pawing or jumping, owner attention (reinforcement)
should be minimized. It is natural for owners to inadvertently reinforce anxiety unless
they are instructed otherwise. Owner attention, reinforcement, and reassurance during
departures and arrivals should be minimized in cases of separation anxiety, as these
are times of heightened anxiety.
Shaping is a training exercise that can be used to teach anxious pets to be more
confident. Positive reinforcement is used to reward activities that are successive
approximations of the desired result, until more confident postures are elicited. Basic
obedience cues can be used for confidence-building exercises, but the focus should be
the overall attitude of the learner (ear and facial postures), and not simply the ability to
obey the commands.
Negative Reinforcement
In negative reinforcement, the probability that a behavior will recur increases as a
consequence of the controlling stimulus being absent or removed if the behavior occurs.
This becomes a problem when fearful pets are cornered or forced into uncomfortable
situations. If a dog is afraid of children, and a child is allowed to corner the dog causing
the dog to bark defensively, the barking is likely to cause the child to leave the dog’s
vicinity. The dog learns that the barking display will successfully get the child to leave. It
is always in the best interest of all involved to avoid eliciting fearful or defensive
behaviors in our pets.
Positive Punishment
Positive punishment, usually referred to as punishment, means that the probability that
a behavior will recur decreases as a consequence of a specific stimulus occurring
immediately subsequent to the behavior. For punishment to be effective, three
conditions must be met: the punishment must occur immediately, the punishment must
be consistent (occur every time), and the punishment must be an appropriate intensity
for the individual. If these three conditions are not met, use of “punishment” is unlikely to
be successful. For owner-absent misbehaviors, such as those that occur with
separation anxiety, it is never acceptable to attempt to punish the pet when the owner
returns home. This does not meet the requirement for immediacy. Also, the use of the
aversive stimuli typical of punishment introduces the risk of causing or worsening fearrelated problems.
DESENSITIZATION AND COUNTER-CONDITIONING
Desensitization is an exercise that results in a decrease in responding produced by
gradual exposure to the stimulus eliciting a given response. Stimulus exposure
proceeds at such a low level that the response is not elicited. The stimulus intensity is
gradually and steadily increased over time, and response does not occur. To use
effectively, you must be able to identify the stimulus that elicits the fear response, find a
level of the stimulus to which the pet does not respond, manipulate the intensity of the
stimulus, and then gradually increase the stimulus intensity (increase volume, proximity,
length of owner absence).
Counter-conditioning is often used in combination with desensitization. This is a
conditioning procedure that reverses a previous response to a stimulus by associating
that stimulus with a different UCS (one that promotes an opposite type of reaction). In
practical terms, we teach a behavior that is incompatible or interferes with the
undesirable behavior. Advantages of desensitization and counter-conditioning include a
minimal risk of adverse outcomes, excellent responses if done correctly, and positive
interactions between pet and owner.
Desensitization and counter-conditioning for separation anxiety will involve teaching the
dog to exhibit relaxed postures on a cue for rewards. Once the dog has learned to be
calm on cue, independence training can be practiced with the dog maintaining a stay
command while the owner moves gradually further away for increasingly longer periods
of time. Desensitization and counter-conditioning for noise phobia involves exposure to
a gradually increasing volume of audio-recorded noise. Desensitization and counterconditioning to fears of objects or people will involve gradual decrease in the distance
between the dog and object.