Maintaining Mental Health and Wellbeing

To this point in the course, you have considered various ways that therapy dog handlers can help program participants feel accepted and safe, as well as a variety of ways that trauma may be experienced and expressed by participants. While therapy dog programs take great care to ensure participants have a PAWSitive (positive) experience, we need to also recognize that providing therapy dog services in the community can influence the mental health of the therapy dog handlers.

Providing services to people in crisis from traumatic experiences can be emotionally draining. Negative health outcomes are commonly reported by service providers doing this type of work, including hospital staff (Fox, 2019), Registered Nurses (Delaney, 2018; Coetzee and Laschinger, 2017), public healthcare professionals (Rossi et al., 2012), psychiatric service providers (Roberts et al., 2022, Hernandez-Wolf, et al. 2015), researchers (Nikisher, 2018), and veterinarians (Harrison, 2021). In some cases, service providers can feel overwhelmed learning about the significant hardships people experience in their lives while building relationships with them, or by repeatedly being entrusted with descriptions of clients’ traumatic encounters. In other cases, service providers can experience feelings of emotional or mental exhaustion that coincide with the inadequacy or under-funding of programs and services that could improve the wellbeing and quality of life of individuals in need of assistance. As the following story from Stephanie Peachey shows, volunteer therapy dog handlers may also experience profound sadness overwhelmingly from situations they find themselves in, such as the passing of a program participant they developed a close relationship with.

Handler Story (Dude and Stephanie Peachy, featuring therapy dog in training Chewy)

Please watch the following video.

Written content and video by Stephanie Peachey

Providing Care for Care Providers

Stephanie’s story demonstrates that assisting therapy dog program participants can be immensely rewarding. At the same time hearing the difficult stories of therapy dog program participants has the potential to be immensely challenging. Some therapy dog organizations recognize this, and have policies and programs in place to provide therapy dog handlers with the necessary care and assistance. The Saskatchewan St. John Ambulance Therapy Dog Program learned about the importance of this first-hand in 2018 when its handlers offered front-line comfort and support to the victims and families of a large-scale provincial tragedy with a bus crash involving the Humboldt Broncos hockey team (handler Wendi shared about this in the prior module). Afterward, representatives from the Saskatchewan Society for the Prevention of Cruelty to Animals, Saskatchewan Health Authority Mental Health and Addiction Services, the University of Regina Faculty of Social Work, and the University of Saskatchewan did interviews with individuals who were part of the response, from emergency room personnel to therapy dog handlers. Six ‘essential actions’ were recommended to effectively integrate therapy dogs into a coordinated provincial trauma response (Dell et al., 2019).

Recommending that the wellbeing of individuals providing support be safeguarded is consistent with critical incident stress management opportunities provided by many organizations to its staff. The International Critical Incident Stress Foundation of Canada describes critical incident stress management as “a comprehensive, integrated, systematic, and multicomponent psychosocial support program [designed] to provide a sense of normalization, foster a sense of affiliation, as well as assist an impacted individual to re-establish their disrupted natural coping strategies” (ICISFC, 2020). Following the fatal Humboldt Broncos bus crash, the primary hospital involved systematically reviewed its critical incident stress management opportunities for staff and volunteers, including therapy dog handlers.

While critical incident stress management opportunities help organizations respond to particularly troubling incidents, being aware of day-to-day strategies for maintaining health and a positive outlook in the wake of more mundane negative experiences is just as important. The commonplace situations you get involved with as a therapy dog handler have the potential to ‘pile up’ and have an accumulative negative effect on your health over time. Think of it this way. If we approach a ‘critical incident’ as an extreme weather event like a blizzard, and your daily interactions with therapy dog program participants as single snowflakes, we can appreciate how small measures toward peer-support and self-care are just as meaningful as mandated emergency policies.

In the event of a blizzard, the sudden accumulation of snow can lead us to a situation where we depend on our city or town administration to get snow removal crews out to clear our streets and help get our lives back to normal. A typical visiting day as a therapy dog handler, on the other hand, may be more akin to the thin blanket of snow we often find covering our walkways throughout the winter months. Each snowflake could be equivalent to a troubling story a client has shared, an emotionally taxing institutional visit, or an empathetic response you felt because of the challenging circumstances an individual finds themselves in. It is not necessary to call city crews in to remove this thin blanket of snow, but it would be worthwhile to have the tools on hand to quickly clear the walkway yourself. Otherwise, neglecting to clear the walk over a series of days could contribute to weeks, and even months, of snow accumulation. Inevitably, you may find the snow that gathered over time to be as deep and troublesome as the downfall of a blizzard.

In Janelle Jakiw’s first video, she provides an overview of the tools you can use to clear your walkway after a day of light snow, discusses the benefits of coordinating snow removal plans with your neighbors, and shares information on how to plan your own snow removal routine. (By the way, if you don’t want to think about snow removal right now, we get it. Think instead about gathering grass clippings in the summer or accumulating leaves in Autumn!)

Program Participant Perspectives (Speaker – Janelle Jackiw)

Janelle Jakiw’s presentation will increase your awareness of strategies to assess and maintain your mental health by establishing peer support networks and developing your own self-care strategies. Janelle discusses the interconnected dimensions of health and how to maintain balance among them, elaborates on ways that therapy dog handlers can recognize feelings associated with secondary stress, compassion fatigue, and vicarious trauma, and provides insight into methods for maintaining balance at the emotional, physical, cognitive, social, and spiritual levels of health.

Please watch the following video.

Indigenous Perspectives on Health and the Medicine Wheel

Janelle’s description of the mental health continuum and the importance of maintaining balance between emotional, physical, cognitive, social, and spiritual domains of health aligns well with traditional Indigenous perspectives on health and wellness. Indigenous perspectives take a holistic approach to health and associate the wellbeing of human populations with that of the natural environment, including the land and animals. The medicine wheel illustrates how Indigenous worldviews associate good health with maintaining balance between spiritual, emotional, mental, and physical health. While different Indigenous cultures conceptualize the medicine wheel in unique ways, they commonly illustrate the interconnections between the four domains of health and other elements of the natural world (such as the four cardinal directions, the four seasons, and the four stages of the life cycle).

According to now passed Saskatchewan Elder Campbell Papequash, all types of experiences contribute to an individual’s experiences within the Circle of Life:

Note how Figure 4-2 depicts the role of animals in this medicine wheel, circle of life teachings, as shared by the late Elder Campbell Papequash (2012), which identifies the buffalo, bear, eagle, and thunderbird.

Figure 4-2: The medicine wheel (circle of life teachings) by Elder Campbell Papequash. Permission: Courtesy of course author Colleen Anne Dell, Department of Sociology, University of Saskatchewan.

(Re)discovering cultural identity and engaging with traditional heritage can serve as important forms of self-care for Indigenous populations. As described by Elder Jim Dumont of the Thunderbird Partnership Foundation (2014):

Take specific note of how connection to ‘beings of creation’ is a part of this definition of wellness. Now think about the therapy dog you work alongside and how they are likely considered a part of your own wellness, as might be your relationship to the land, environment and other animals around you, in addition to humans.

The Costs of Caring

Next, Janelle discusses concepts related to the ‘cost of caring too much’ that can be experienced by service providers, and likewise therapy dog handlers. We will review some of the important connections and differences between the four most common ‘costs of caring’ prior to moving on to our first module activity.

Please watch the following video:

We should take an additional minute here to consider several of the concepts Janelle discussed. While secondary stress, compassion fatigue, and vicarious trauma are interrelated, the ways in which they can have a negative influence on specific domains of mental health is important to recognize. Burnout can also have a negative impact.

According to the Canadian Medical Association (2020), burnout is “a psychological syndrome of emotional exhaustion, depersonalization and reduced personal accomplishment [that] typically emerges over time as a result of prolonged stress”.  In this sense, burnout refers to negative consequences related to a service provider dedicating too much time and focus to work, for example, and not enough time and focus to self-care.

Secondary stress (or, secondary traumatic stress) and compassion fatigue are both related to the practice where service providers strive to make emotional connections with clients by ‘considering others’ experiences’ and building bonds through empathy. Secondary stress occurs specifically when a service provider has a negative emotional reaction when learning about another persons’ traumatic experience or becoming informed about a traumatic event (NTCSN, 2022). Secondary stress for a therapy dog handler, then, is connected to what a handler feels given the empathetic bond they develop with therapy dog participants.

Compassion fatigue is more closely linked with experiences of emotional exhaustion related to service providers empathizing with many clients who share traumatic experiences (Psychology Today, 2022). Compassion fatigue is more directly related to the quantity of connections a service provider builds with clients. It occurs when an individual absorbs more stories than their emotional circuitry can handle, leading to overload and a lack of capacity to feel much of anything. Compassion fatigue is oftentimes associated with the ‘emotional residue’ service providers accumulate over a long span of time working with clients – small blankets of snowfall that go unattended – and contributes to the cost of caring affecting their capacity for emotional empathy. This is applicable to therapy dog handlers too.

Finally, vicarious trauma can be approached as the outcome associated with experiencing secondary stress and/or compassion fatigue to such an extent as to have an accumulative negative influence on several domains of the continuum of mental health. Vicarious trauma is reflected in the presence of symptoms across the domains of emotional, physical, cognitive, social, and spiritual health. Vicarious trauma can be understood as the unfortunate outcome of having neglected to tend to a series of light snowfalls, and now being faced with a looming snow pile equivalent to the outcome of a sudden, heavy blizzard.

Based on these definitions and recalling Janelle’s presentation, the following activity will help you distinguish between instances of burnout, secondary stress, compassion fatigue, and vicarious trauma.

The Significance of Support Networks

In Janelle’s next video she touches on the important role peer support networks can play in helping to maintain the health of therapy dog handlers. Given that your fellow therapy dog handlers may experience the ‘costs of caring’, including burn out, secondary stress, compassion fatigue, and vicarious trauma, establishing networks of mutual support can be a crucial resource for peer therapy dog handlers.

Please watch the following video:

Here, Janelle touches on the important concept of peer support. According to the Mental Health Commission of Canada (2013: 7), “[p]eer support is a supportive relationship between people who have lived experience in common…the experience that individuals or groups have in common is in relation to a mental health challenge or illness. This common experience might be related to their own mental health or that of a loved one”.

Strategies for Maintaining Self-Care

Janelle’s final video introduces strategies you can use to practice self-care, which centres around activities, relaxation techniques, and how to maintain positive thinking to ensure balance in your emotional, spiritual, social, physical, and cognitive health. It would be worthwhile – and useful for the activity that follows – to consider the types of activities you may want to include as part of your own self-care routine.

Please watch the following video: