I.

Title of Group

Animal Supporters

II. Type of Group

An open-ended, voluntary support group for active members of the veterinary profession.

III. Rationale

Veterinarians face many unique stressors in their profession that contribute to

psychological distress. This leads to male veterinarians being 2.1 times more likely and female

veterinarians being 3.5 times more likely to die by suicide than the general population in the

United States (Simon, S., Balaban, S., & Doubek, J. 2019). In the U.S. 11% of female

veterinarians and 7% of male veterinarians experience serious psychological distress. One survey

found that one third of veterinary students at a veterinarian medicine school had symptoms of

depression (Bartram & Baldwin, 2008) and 24.5% of male and 36.7% of female veterinarians

experience episodes of depression after graduation from vet school (Best, C. 2016).

There is a wide range of stressors that contribute to the experience of psychological

affliction in veterinarians. While individual stressors such as family obligations, relationship

difficulties, personality factors (Best, C. 2016) and psychiatric conditions (Stoewen, D. 2015) are

not to be ignored our focus will be on the multitudinous field-related contributions. Typically,

veterinarians deal with financial stress: recent graduates are often in over $140,000 of debt and

on average earn less than half of what physicians and surgeons make in a year (Simon et al.

2019). Veterinarians also deal with many interpersonal difficulties: these include conflicts with

peers as well as working with clients who have high expectations, are grieving (Stoewen, D.

2015), or are angry (Simon et al. 2019). Other work-related stressors include: compassion
fatigue, lack of resources, long hours that include after hours and on-call duties, possibilities of

litigation, (Stoewen, D. 2015) online harassment (Simon et al. 2019) poor work-life balance, and

performing euthanasia (Platt, B., Hawton, K., Simkin, S., & Mellanby, R. 2012).

The mental health concerns as well as the stressors that veterinarians face are not unique

to the united states: studies have shown similar findings in the UK, Australia, Denmark, France,

Japan, New Zealand, and Sweden (Platt et al. 2012). Parallels to these mental health concerns

and stressors can also be found in the physician community. In the U.S. physicians also show

elevated risk for suicide as compared to the general population and a meta-analysis found that

28% of residents experience depressive symptoms during training. Common stressors of

physicians include working long hours with heavy workloads (Moutier, C. 2018), adverse patient

events, interpersonal conflicts at work (Hu et al. 2011), and proximity to death, despair, and

disease (Gerada, C. 2016). Both groups have also stated stigma as being a barrier to seeking help

for mental health (Stoewen, D. 2015) (Moutier, C. 2018).

While we did not find any studies on the effectiveness or value of group therapy for

veterinarians, we did find support for group therapy for physicians. Group settings offer a feeling

of universality by allowing physicians to see colleagues who are also suffering: upon seeing

these colleagues participants may also experience an instillation of hope as they witness some of

these peers benefitting from treatment. Physicians can also experience a strong sense of catharsis

as they find redeeming qualities in colleagues who have made mistakes, become depressed, or

become burned out and realize that they too are redeemable (Myers & Gabbard 2008). We also

found that doctors-only groups are of great benefit to physicians’ mental health. These groups

can provide doctors with a space where they can safely become patients and feelings of

vulnerability can decrease with a realization of sameness to peer (Gerada, C. 2016). Physicians
and veterinarians face many of the same stressors as well as many of the same threats to mental

health, it is also possible that they could benefit from the same type of treatment.

In general group therapy has been found to be at least as effective as individual therapy

(Yalom & Leszcz, 2005 p.1) and the Centers for Disease Control and Prevention lists

connectedness (a feature of group therapy through group cohesiveness) as one of seven key

strategies to preventing suicide (Suicide: Prevention strategies 2019).

IV. Goal and Objectives

The primary goal of this group is to provide support and a sense of community and

connectedness.

o Building relationships

o Practicing healthy coping skills

o Develop healthy work balance

V. Basic Information

We are including active veterinarians and veterinary surgeons, but excluding veterinary

technicians or other employees who may work at a veterinary clinic or hospital. There is support

that when physicians were in doctor-only group therapy they benefitted from the safe

environment that was provided by a homogenous group and afterward sought further help in

heterogenous groups (Gerada, C. 2016). Clients must have a capacity and willingness to give and

receive feedback, examine their interpersonal behaviors, and to self-disclose (Yalom & Leszcz,

2005 p.234). Excluding clients with active pathologies (within reason I.e. no clients currently

experiencing psychosis) and clients who are experiencing a life crisis that would be better

addressed in other therapy formats (Yalom & Leszcz, 2005, p. 256). Screening process would
include interview(s) with both co-leaders present. 10 maximum participants at any given time.

Once a week (Wednesdays) at 6:15pm, at Mayuko and Merry’s private practice building in

group room 2 on the first floor. Fruit, water, and tea will be available. The meetings will be one

hour in length.

VI. Basic Group Rules

Attendance: encouraging participants to come to every meeting, while understanding that things

may come up to prevent attendance (if known ahead of time please inform the group as far in

advance as possible).

Confidentiality: all participants are expected to respect the confidentiality of their peers’

statements and behaviors: What happens in group stays in group.

Romantic coupling warning

VII. Possible Topics and/or Therapeutic Activities

Mindfulness

Psycho ed on depression, anxiety, burnout

Deep relaxation

Yoga

Visual art activities

Coping skills

VIII. Best Practices

Section A
Group workers have taken the precautionary steps to best form a counseling group for

veterinarians who are active in their field of work. Much consideration has been taken to develop

this group in guidance from the Best Practices from the Association for Specialists in Group

Work: Best Practice Guidelines (Thomas, Pender & ASGW, 2007). Ethical considerations have

been made and each member who are wanting to participate in the group must sign a consent

form to protect their own and other member’s confidentiality when sharing with the group. The

consent form will also be gone over in the group orally to reinforce what is expected from

members for confidentiality and limits that may exist in certain situations that may arise. Group

workers have though through activities that will be most beneficial for the group and other

resources will be provided by the group workers when needed. Group sessions will take place in

a privately owned space of the group workers to maximize privacy and lessen disturbances that

may cause a disruption. Screening of the members will be done to help making a homogenous

group of active veterinarians in the field. This is to be able to make a beneficial space for future

members that will be able to have some cohesiveness in the aspect that they are all active

veterinarians in the field that may share experiences that they face in their profession. Group

workers are aware of the continuous development that they must undergo to be able to keep

knowledgeable as well as keeping up with the best practices. Group workers will seek

supervision when having ethical concerns or personal problems that may arise in the future of the

group.

Section B

Group workers are aware that they are expected to monitor their strengths and weakness and

seek supervision when needed. They are trained in counseling group therapy and are competent
in their training to perform to the requirements of ASGW. Group workers will monitor the

progress of the group and adapt to the group’s needs as the members progress through sessions

and closer to the group goal. Group workers are aware of ethical considerations for social

relationships and will maintain professional boundaries with members that adhere to the ethical

codes of the ACA and ASGW. Group workers have an appropriate ethical decision making

model in response to ethical challenges that may arise that may determine the course of action

and behavior for selves and group. Group workers will help members find the meaning of

attending group sessions. Activities are made and implemented in the best interest of the group

members to help in them finding meaning to be a part of the group therapy sessions.

Section C

Group workers have implemented time for processing at the start and end of each session that

will be done. Group members will be able to have a moment to process with themselves as well

as being able to process with others. Group workers will be involved in this process with the

members however, will also have a moment to process outside with a supervisor or with each

other. Group workers will also be expected to reflect on sessions as a whole: member

dynamics/interactions and relationship between sessions. Group members will have consultations

with professional persons who are knowledgeable about group work to best support their

ongoing group.

IX. Special Considerations

If psychological needs of an individual are not able to be met by the group they will be referred

to individual therapy and/or a more appropriate counseling or psychotherapy group. If an

individual has concerns (especially about their psychological or physical health) they can consult

with either or both co-leaders. Ethical considerations include breaking confidentiality if there is a

threat of harm to self or others by any group member.

Sources:

Best, C. (2016). Mental health and the veterinary industry. EquiManagement, 62-64.

Gerada, C. (2016). Healing doctors through groups: Creating time to reflect together. British
Journal of General Practice. Retrieved from DOI: 10.3399/bjgp16X687469.
Hu, Y., Fix, M. L., Hevelone, N. D., Lipsitz, S. R., Greenberg, C. C., Weissman, J. S., &
Shapiro, J. (2011). Physicians’ needs in coping with emotional stressors. Arch Surg,
147(3) 212-217.
Moutier, C. (2018). Physician mental health: An evidence-based approach to change. Journal of

Medical Regulation, 104(2), 7-13.

Myers, M. F., & Gabbard, G. O. (2008). Psychodynamic psychotherapy. In The physician as a

patient: A clinical handbook for mental health professionals. (p. 147). Arlington, VA:

American Psychiatric Publishing, Inc.

Platt, B., Hawton, K., Simkin, S., & Mellanby, R. (2012). Suicidal behaviour and psychosocial

problems in veterinary surgeons: A systematic review. Soc Psychiatry Psychiatr

Epidemiol, 47, 223-240.

Simon, S., Balaban, S., & Doubek, J. (2019). Veterinarians are killing themselves. An online

group is there to listen and help. National Public Radio. Retrieved from
 https://www.npr.org/2019/09/07/757822004/veterinarians-are-killing-themselves-an-

online-group-is-there-to-listen-and-help.

Stoewen, D. (2015). Suicide in veterinary medicine: Let’s talk about it. Canadian Veterinary

Journal, 56, 89-92.

Suicide: Prevention strategies (2019). Retrieved from

https://www.cdc.gov/violenceprevention/suicide/prevention.html

Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy. Cambridge,

MA: Basic Books.