Understanding the Other end of the Leash: what Therapists Need to Understand About Their Co-Therapists

, Aubrey H. Fine

University of Wisconsin-Madison

California State Polytechnic University

During the summer of 2009, Dr. Patricia McConnell and Aubrey Fine talked to discuss her impressions of what therapists should be aware of while partnering with a therapy animal. The following is a synopsis of their conversation and some of the conclusions that were formulated.

Patricia McConnell, PhD, CAAB, is an Ethologist and Certified Applied Animal Behaviorist who has consulted with cat and dog lovers for over 22 years. She combines a thorough understanding of the science of behavior with years of practical, applied experience. Her nationally syndicated radio show, Calling All Pets, played in over 110 cities for 14 years. She is the behavior columnist for Bark magazine (“the New Yorker of Dog Magazines”) and Adjunct Associate Professor in Zoology at the University of Wisconsin-Madison, teaching “The Biology and Philosophy of Human/Animal Relationships.” She is the author of 12 books on training and behavioral problems, as well as the critically acclaimed books The Other End of the Leash, For the Love of a Dog and Tales of Two Species.

AHF: In your book The Other End of the Leash, you discuss dog owners’ needs to understand how their dogs think. What insights can you give our readers about dog behavior as it relates to animal-assisted therapy?

Patricia: In one sense, I’d say to people who are going into this field the same things that I would tell any owner, which is that so often our dogs are basically confused! After all, they’re individuals of one species trying to translate the communications of another species. And so, there are some general principles that are equally relevant in the field of animal-assisted therapy and intervention, as they are with any dog owner. First, it’s important to keep in mind that dogs primarily communicate with visual signals. Yes they vocalize, and yes, of course, they can respond to verbal cues and listen to what we say. Sound is truly an important part of our interactions with dogs. But vision trumps sound in both species (remember “a picture is worth a thousand words”?). I did some research on this issue in the early 90s, showing that, when asked to sit to the simultaneous production of a movement and a sound, puppies performed at much higher levels when presented with the movement by itself rather than just the sound. Every trainer will tell you that dogs are watching you all the time, and that yes, they can learn verbal cues, but that your movements are even more important.

That’s especially relevant to people with therapy dogs because so many human actions are misconstrued by dogs. A movement can mean one thing to a person, and something else to a dog. Hugging is a perfect example. One of the reasons why many dogs are not good prospects for being a therapy dog is that they appear to interpret a hug as a kind of a threat or a challenge for social status. At the least, it is something that makes them uncomfortable, whereas we give hugs to express affection. In this case it is easy for dogs and humans to miscommunicate. Therapy dog owners need to be on guard for that kind of miscommunication.

Not only can hugs can be threatening to dogs, but direct approaches or direct eye contact can be threatening to some as well. That’s why we need to condition and train our dogs to become comfortable with hugs and stares, and also to choose dogs with a personality that allows them to tolerate and even enjoy some of that. It also emphasizes why handlers need to be informed about canine ethology.

Another general principle for assistance dog owners to remember is the importance of reinforcing our dogs for doing what we want them to do, rather than focusing on what we don’t want them to do. The latter, regrettably, seems to be our default! Our tendency seems to be to wait for an animal to do something we don’t want and then correct it, rather than proactively teaching a dog what we do want them to do. Positive reinforcement for good behavior is much more successful and so much more communicative. For example, when we say “no” to a dog for jumping up, we haven’t told her what we want her to do. There are at least 20 other things she could do that would be wrong: she could chew on the wheelchair, urinate in the hallways or bark when she shouldn’t. How is she supposed to know what we want? The word “no” provides little information, and that’s what dogs need to be well behaved. Once you take the perspective of “I need to focus on teaching my dog what I do want her to do,” everything changes. Your whole relationship changes with your dog, because now you have a dog who can trust you to help her be right. If you have a working dog who desperately needs you to communicate clearly, then it is especially important. Always ask yourself: “what do I want?” when your dog does something you don’t want her to do. It’s your job to teach it to your dog, not hers to figure out on her own.

AHF: Do you have any suggestions on how you can prepare a therapy animal to greet various clients in a positive manner?

Patricia: The best approach is to set up training situations in which the dog could be reinforced for learning the correct behavior. If the dog, for example, is greeting too enthusiastically, then we should teach the dog that if he sits and lets the child come to him, keeping all four paws on the ground, wonderful things are going to happen. It’s not hard to train that, although of course it’s more difficult with some dogs than it is with others. Training polite greeting behavior requires knowing what the dog wants to work for and using that as reinforcement. Perhaps it’s a treat, or playing with a ball, or even being allowed to be petted by the visitor. In this case, for example, first teach the dog to sit in a situation with no distractions, and provide lots of reinforcement for it. Gradually start to ask the dog to sit when slightly distracted, but not overwhelmed with excitement. Next, start asking the dog to sit when there is somebody in view, and provide lots of high-quality reinforcement for a good response. Eventually, ask the person to approach you, and have them ask the dog to sit. If he does, instantly give the dog reinforcement. If the dog doesn’t sit and jumps up, the visitor (who should be a good friend who is “in” on the training) should immediately turn and walk away.

AHF: You seem to be emphasizing the critical importance of training as well as the use of successive approximation to shape behaviors of the dog and our own expectations. It seems logical that the animal needs to be well trained before being engaged as a therapy animal.

Patricia: You have hit the nail on the head! The key is to do the training in a step-by-step fashion just as we teach children to learn and perform anything new. Nobody puts a child down on a piano bench for the first time and expects them to play Beethoven’s fifth!

AHF: I agree whole-heartedly.

Patricia: We start training the kinds of responses we want outside of the situation in which we want them performed. Think of therapy or assistance work as an Olympic performance that requires hours and hours of practice. The key to success is starting outside of the therapy situation in a step-by-step way that increasingly approximates the kind of situation the dog will be in once he’s working.

AHF: Thank you for clarifying. We all need to respect our differences and realize that dogs respond differently than humans. Understanding the other end of the leash leads to a more reliable and enhanced relationship. Dogs aren’t humans with four legs. When you wrote that book The Other End of the Leash, what prompted you to write it?

Patricia: What prompted me to write The Other End of the Leash was two-fold. First, my life-long motivation has been to improve the relationship between people and animals. To me that relationship is a biological phenomenon that is one of our greatest blessings. It’s an amazing gift that we can either cherish or abuse. So one of my goals was to improve the relationship in a very general way between people and animals.

The other motivation relates to my desire to be a bridge between the scientists who study behavior and people who love animals, because it seems to me that there is a bit of a gap. There are many people in academia who study behavior, and learn so many amazing things about it, but yet there is still a bit of a black hole between that world and people who live with and love animals. I have always wanted to be a bridge between those two worlds. One way to do that is to observe communication (and miscommunication!) between people and dogs. So much of our miscommunication is based on our genetic predispositions to behave in certain ways. A good example of this, mentioned earlier, is hugging. Young children hug at a very early age, and all of the higher apes hug, for that matter—it’s just something we do; part of who we are inherently as a species. Of course there are cultural influences in affiliative behavior, but nonetheless, it’s a strong genetic predisposition. Having studied communication as an ethologist, I couldn’t help but notice how often there was a species difference in basic behaviors like hugging and greeting behavior, or play behavior and the expression of affection. The Other End of the Leash was written to help people understand how their behavior influences their dog’s behavior, in order to improve their relationship.

AHF: I think that this is an important topic because once we respect the differences and similarities of our species we truly can relate more effectively.

Patricia: Agreed! Absolutely.

AHF: What would be the key behaviors you would want to see in a dog that you would consider ready to work as a therapy animal?

Patricia: Good question. Perhaps the two most important aspects of behavior important in therapy dogs are as much related to personality as to training. Without question, the most important behavior in a good therapy dog is based on a personality trait we could call being affiliative to people. All of us who have had or worked with a lot of dogs know that, starting at a very early age, there are dogs that just seem to adore people. You know the ones I mean—they see a person walking down the street and go all gooey, wagging from the shoulders back, apparently thrilled to meet another human being. I have a Border Collie like that. When he sees an approaching person it’s as though he’s thinking “OH BOY! Look, there’s another one!”

However, I also see dogs that may be polite to strangers, but are not particularly happy to see them. What they really want is to meet another dog. They will run up to a group of dogs and people and greet the dogs but ignore their owners. There are actually quite a few dogs like that, and there is nothing wrong with it. Most of these dogs have strong bonds with their owners, but they’re not necessarily good prospects for therapy or assistance work, because they are not that interested in interacting with people outside of their own family. You can influence a dog’s interest in people through training and experience, but in my experience it is hard to overcome a dog who is born primarily interested in other dogs.

AHF: There are always dogs that are more compatible with others and I think that’s what you’re alluding to. But in fact, dogs still have a canine instinct to be around dogs as well. Are you stating that certain dogs would favor being around their own species?

Patricia: They do. I see dogs who love their owners, but really don’t care very much about other people. I’ve met hundreds of them in consultations and training classes, who greet you quickly, if at all, and then leave to interact with other dogs. That’s in contrast to the dogs who seem absolutely thrilled to meet another person. I was just talking recently to someone involved in animal-assisted activities who said that one of the common problems they encounter is dogs who are so bonded to their owner that they ignore the patient and they don’t really want to interact with other people that much. I think that speaks to this personality trait that I’m talking about, about this strong affiliation to humans, that is essential in a good therapy dog

The second trait, perhaps more obvious but still deserving attention, is the importance of dogs that are friendly but not overly reactive or active. I suspect that category actually includes a number of traits and behaviors which might be sorted independently, including general energy levels (from high or low) to overall confidence (from overally pushy to calmly secure to downright fearful). Certainly we know that shyness, or the fear of unfamiliar things, is strongly influenced by genetics as well as environment. Energy levels can also be altered substantially through training and maturity, but they have a genetic component as well. Thus, this category of “reactivity” is a big one, and requires a thoughtful evaluation of both breeding and experience in therapy work.


Figure 9.1 Here’s a lovely example of two very relaxed and happy individuals! Notice that their mouths are relaxed and open, and their eyes a showing true smiles (“Duchenne smile”), in which the smile moves upward and causes the eyes to close into a “happy squint.” The perfect faces to see on a therapy dog and its client!

AHF: One of the strengths of using dogs in therapy, which may be poorly understood by many, is the fact that dogs seem to have a keen ability to understand our behaviors. Some believe that dogs’ strengths in communicating with humans pertain to their predisposed ability to inspect our faces for critical information, for reassurance and for guidance. I believe that these are crucial traits that many dogs have developed to become keen observers of our reactions. I feel that these skills make dogs, especially therapy dogs, more responsive to our actions. Can you comment on this?

Patricia: That’s an excellent point, Aubrey. There is research showing that if a domestic dog is unable to solve a problem, she is quick to turn and look at her owner, as if for assistance. Wolves, on the other hand, do not, even if they have been hand raised by people and spend a great deal of time with them. There is no question that dogs are especially attuned to accepting humans as social partners…one great big multi-species pack as it were.

AHF: The next question has several elements integrated. At what age do you feel a dog is ready to work in therapy? How much training do you think an animal would need to be ready for this work so that we can protect the animal’s and patient’s welfare?

Patricia: I’m glad you asked because it’s a critical question. I suspect, although I don’t have any data, that at least some dogs are being asked to do this kind of work when they’re not ready for it. Keep in mind that dogs aren’t emotionally mature until they’re about three years of age. I think that is often forgotten. I’ve talked to a number of people who have had their dogs tested as therapy prospects and be rejected, but the dog was only a year and a half old!

There’s a lot of training that’s involved in a good working dog, and that takes time. Think of what we are asking of these dogs—it’s more than we would expect from most people. The dogs who can pull this off are amazing; we should be building statues in honor of them! Given how much we expect from them, it’s only fair to give them the kind of training that you would want if you were asked to do something that was difficult. And good training takes time.

We also need to give dogs time to develop emotional maturity. Good working dogs need time to develop emotional control and to be able to self handicap themselves. As an example, I was once lucky enough to watch the international herding dog trials in Scotland. This is the crème de la crème of Border Collie herding dogs in which they’re being asked to work under extreme pressure. It’s physically and emotionally demanding and the average age of the dogs competing was seven years old. That means that the average age of a dog who’s competing in the equivalent of the Olympics was a middle aged dog! I think that’s because the older dogs had the experience and the emotional maturity to know when to act and when to inhibit themselves. Therapy dogs have to make a lot of decisions as well, so, in a very general sense, I would suggest that dogs not be asked to do this kind of work until they’re older. Of course there are exceptions, I know of a dog who did an amazing job with one particular person when he was only a year and half old, but in general we need to let our dogs develop and mature before we expect too much of them.

AHF: Unfortunately, this is one of the mishaps that happens frequently. Some people want to start working with their dogs too early. Sometimes younger dogs with their zest and their sort of puppy features seem to be more intriguing and attractive for people. But I agree with you that many young dogs aren’t ready for the stressors that they will be placed in while working with a diverse group of individuals. Therapists, clinicians and those who volunteer with their animals need to realize that this isn’t about our love and admiration for our pets. We need to think of what is in the best interest of the patient and the therapy animal. We are talking about our trained co-therapists that need to be safeguarded from the stressors of their working environment. Safety for all involved must be of outmost importance! What specific things should clinicians look for in a good therapy dog? Are some breeds better than others? Would you suggest a certain gender over another, or to make decisions on an individual basis?

Patricia: I would love to see some research on the effect of sex on performance, but I anecdotally I haven’t seen any evidence of any effect.

Not long ago, I was asked by the editor of Bark magazine if males or females were easier to train, so I did some research and I put that question out on my blog. There is little to no research on the topic, but I got some fascinating answers from readers. They said: “females are easier,” and “males are easier,” and “females are smarter,” and “males are smartest!” No consensus there! The only real data we really have is that males tend to be more successful at high performance events like herding and retrieving. But we don’t know why, because there are many factors that go into that statistic. After all, females go into heat and have puppies, so they can’t work part of the year. In addition, professionals make more money if their male is successful than if their female is, so there may be a bias to putting more effort into training males than females. We simply don’t know if it has anything to do with the sex of the dog.

I can tell you that the people I’ve talked to locally who have therapy or assistance dogs have varying experiences. One person has had 4 males and 4 females and the males have been much better, but you can hear the opposite depending on who you talk to. In my area, the assistance dogs are half males, half females. My guess is that if sex has an effect, it’s relatively small. I suspect that personality, training and experience are much more important.

I think that might be true of a breed effect as well. I would guess that if somebody did the research, personality and training would come out as the most important factors. I wouldn’t be surprised if there wasn’t some breed effect, after all, some breeds are inherently more people oriented and some are designed to be hyper-reactive, but I think it primarily goes back to the individual dog. I love that you mentioned your 7 or 8 year old dog earlier, again, because I think so many people try out with their year and a half old puppy when their dog might be just perfect at 6 or 7 or 8. When one of my best herding dogs, Cool Hand Luke, was young, he’d sometimes lose his cool while working sheep, and cause trouble in some situations. But by the time he was 7 or 8, he developed an incredible sense of finesse and maturity that made him invaluable.

AHF: If you were getting a puppy, how do you evaluate early temperament traits that could be used as indicators for future therapy animals?

Patricia: Oh you asked the $64,000 dollar question! If someone could answer that question they could either be very happy or very wealthy—or both!

AHF: Sorry.

Patricia: No, its okay…it’s the question that everybody asks. And it’s the question we don’t have an answer to right now. My best answer is that all you can do is create a probability statement. You can get a puppy that has a higher probability of working out than another puppy. But it’s like the weather…just because there’s a likelihood of showers, doesn’t mean there’s going to be rain, right?

AHF: No, I think that’s a very good point, because it is all about probability and possible predictability. You often see breeds such as Golden and Labrador Retrievers, but I want to also highlight that you also see mixed breed dogs and other breeds of dogs becoming wonderful candidates. You shouldn’t have preconceived assumptions. I often have people calling and asking what breed you would recommend. Will you give a general answer or do you think there are certain species that are more aligned to becoming therapy animals?

Patricia: There are certain breeds of dogs that seem to be more common as assistance and therapy dogs. I think one of the reasons that Golden Retrievers are so popular, for example, is because so many of them have that high level of human affiliation that I was talking about earlier. In contrast, I see dogs of other breeds who are a bit more reserved, perhaps an example might be an Anatolian Shepherd, who was bred to be a bit cautious around strangers. So, again, it goes back to a probability statement. Some breeds will have a higher number of individuals who might be good therapy dogs, but even within breeds that are commonly used for assistance work, like Labradors and Goldens, for example, there are plenty of good dogs that aren’t right for the work. We all know individuals in those breeds who have super high energy levels and are too rambunctious. Or perhaps they’re fearful, or maybe they don’t have a lot of emotional control.

I do think that one of the reasons that Goldens and Labradors are so popular is that they appear to be what scientists call “neotenized,” or animals who still behave a bit like puppies even when they are grown up. You might think of them as “Peter Pan” dogs, who maintain that youthful joy and exuberance, even when they are middle aged. But again, we’re back to that probability statement, because it really is always about each dog as an individual.

AHF: Very good. Where does obedience training intersect with temperament and the individual quirks of the animal? We don’t want all the animals to be the same but we do want consistent behavioral reactions. To what extent can we enable an individual dog’s personality to work with AAT beyond some of the issues that we’ve talked about?

Patricia: This is an important question for everybody who is interested in having a therapy dog. Temperament is a critical factor, because no matter how good a trainer you are, it is not possible to change an individual’s temperament. After all, temperament is defined as behavioral predispositions that you are born with. Of course, you can influence how temperament affects behavior: that’s what personality is—personality is temperament plus experience. So you can certainly shape an animal’s behavior, but you can’t turn an animal who is genetically predisposed to be shy and fearful into a bold, confident animal. This, Aubrey, this is the biggest problem that I’ve seen with people who come to me and say “Help! I got this puppy to be a therapy dog and he’s terrified of the nursing home and I want you to fix it.” I had a psychologist come in once as a client, explaining that he had “an amazing dog that worked with troubled children, autistic children, and children with severe behavioral disabilities. The dog was virtually bomb proof and absolutely wonderful and I want you to help me find another one.” He stated repeatedly that his previous dog was “one in a million.” I wrote a column in Bark magazine reminding us all that “one in a million” means that they are…

AHF: One in a million

Patricia: Exactly! One in a million, as in: rare, hard to find, and difficult to replicate! I say this as a reminder that not all dogs can be therapy dogs, no matter how good a trainer you are.

That said, training and experience can have a profound effect on an individual’s behavior. And so it is crucial to socialize a puppy appropriately, to condition a puppy to enjoy different situations, and to help healthy neural connections form at an early age (even in utero, by the way—we’ve learned that in utero experiences can have a profound effect on how a dog reacts to stress). And so, both genetics and experience and training act as partners to create a dog who, we all hope, becomes a brilliant therapy dog who helps lots of people.

AHF: That’s an extremely good point. Although we have our personal admirations for our own animals, we need to put their work into a realistic perspective. The bottom line is that clinicians need to recognize that their animals need to be prepared to take on their very difficult roles.

Patricia: To add to that excellent point, I think it is critical for all of us to be on guard against projecting our own feelings onto the patient, or onto the therapy animal. You know just because we felt good about an interaction doesn’t mean the patient did. I’ve talked to people who were involved in some kind of animal-assisted activity and left glowing, just so happy to have done a good thing. Except, sometimes when you analyze the dog’s or the patient’s responses, they weren’t enjoying themselves as much as the owner. Years ago, when the Delta Society was first forming, I heard a talk at one of their conferences in which a survey was done after animal-assisted activities. The dog owners evaluated their interactions as overwhelmingly positive and useful. However, the patients were nowhere near as positive as the handlers in their response. Some of them enjoyed it; some of them did not, often because they felt that they didn’t have any choice in the timing of the visit or who came to see them.

I know that since then many of these issues have been discussed at length, including in your book, about how important it is to have patient acceptance and control. However, the main point stands that it’s critical not to project your feelings and your desires onto the patient or your dog. Some patients may not want the interaction, and some dogs may not enjoy the work. I’ve seen quite a few clients who came to me saying “I want this dog to be a therapy dog” and in five minutes I thought, oh dear, but the dog doesn’t want to be. It sounds like you have had similar experiences.

I think it is understandably hard for people to accept that the dog that they love so much may not be the perfect dog for this kind of work. This is true in other fields as well. People come to me and say “I want this dog to be an agility dog” and I’ll go watch the dog in an agility trial, and the dog looks miserable. He might be looking back at the car, tongue flicking, yawning, or other signs of stress. It can be hard for any of us to step back and be objective, but the more you know, the easier it is. And I think that’s why you, Aubrey, can look at your dog and say, “I love this dog, but this is not the right dog.” And I can look at my young 3-year-old Border Collie and say, “I love this dog so much I could just get teary-eyed talking about him and he’s a brilliant sheep herding dog at the farm…but he will never be a brilliant performing dog at a herding dog trial.” That’s just not who he is. It doesn’t mean I love him any less, and in a way, it allows me to love him more, by honoring who he is and not trying to make him something he’s not.

AHF: I think that’s really crucial. What are the signs that dogs may be stressed in doing any of the animal-assisted interventions that we’re talking about? For example, a colleague once shared with me an outcome she witnessed while her therapy dog was working with children with terminal illnesses. The dog seemed to demonstrate traits of being tired, which I believe could have been signs of stress. What do you recommend for therapists or clinicians to be aware of when trying to determine stress in their therapy while working? What provisions would you recommend to ameliorate or avoid these significant challenges for the animals involved?

Patricia: It’s a great question. I think everybody who does any kind of animal-assisted work should be a working ethologist, a Jane Goodall in the hospital or the clinic so that they know the signs of stress in their dogs. It’s true that some of them are relatively subtle. Everyone who does assistance work should look for behaviors like tongue flicks, where the tongue comes straight out the front of the dog’s mouth. Often that is a sign of low level anxiety. Yawning can also be a sign of low level anxiety. Of course, dogs yawn sometimes just like we do when they’re waking up, but a dog that is wide awake and yawning is often an uncomfortable dog. Sometimes dogs will turn their head and look away. Perhaps you ask them to get up on a bed or to greet somebody, and they stand still and turn their head in another direction. That’s often a sign of a dog saying I just can’t do this, I don’t want to interact.

We also should attend to any change in energy, whether it’s an increase or a decrease. It’s easiest for people to notice when their dog starts to look physically tired and becomes slower and less enthusiastic. But I think that it’s often easy to misinterpret dogs that start acting as if they had an overabundance of energy, or what I would call frantic energy. Dogs who are uncomfortable or nervous can seem wildly friendly or enthusiastic, when in reality they are the equivalent of someone babbling foolishly at a party because they are nervous. So it’s important to look at changes in energy level either way.

Every handler should know the general signs of tension and stress in dogs and also know his or her own dog, knowing their “baseline” behavior and what changes if they become agitated or less enthusiastic, for example. That requires being a really good observer, like a scientist in the field. You can train yourself to improve your observational skills by starting to watch for one individual behavior at a time. Perhaps one session you’ll notice tail position, and another you’ll focus on tongue flicks. Go to a vet clinic and sit in the lobby and look for tongue flicks so that your brain is programmed to notice them.

There’s an excellent video, by the way, by Suzanne Hetts and Daniel Estepp, on reading dog postures and expressions. It’s titled Canine Behavior: Observing and Interpreting Canine Body Postures. It’s the best video I’ve seen on helping people read the signs of discomfort in dogs. And no matter how much you already know, remember that the learning should never stop. Make sure that you stay up to date with the current changes in our understanding of animal behavior so that you can continue to enhance your relationship with your assistance animal.

AHF: Absolutely. Do you have any guidelines for the amount of time a dog should work on a given day?

Patricia: I don’t have a generic guideline, because it depends so much on each individual dog. I guess the only general guideline I have is to stop working before you think you should! One of the guidelines in any kind of animal training, when you’re training a new behavior or you’re counter conditioning a dog who has a behavioral problem, that is the second you stop and ask yourself, “Should I stop now…?”

AHF: You’re too late!

Patricia: Exactly! Or at least it is time to stop before going any further.

AHF: So it’s a way of thinking. It’s a prescription that if you’re going to do animal-assisted interventions you have to be cognizant or aware of the therapy animal that you’re working with. You must take into account how best you safeguard the integrity, the quality of life, the health, both physical and mental, of that animal.

Patricia: That’s right. That’s why another generic guideline is to always be cognizant of what you and I see as hard work for our dogs. Working dogs have so many decisions to make, and must always be self-inhibiting while dealing with new experiences and new people. Even if they love every single second of it, it’s still hard work. After all, I love my work too, and I know Aubrey that you do too, but it doesn’t


Figure 9.2 This dog’s face is the opposite of those in Figure 9.1. Notice that the mouth is closed, the eyes are rounded and the muscles between the eyebrows are contracted. This is the face of an anxious dog who is nervous or uncomfortable. A therapy dog with this expression on its face should immediately be removed from the situation.

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Feb 16, 2017 | Posted by in GENERAL | Comments Off on Understanding the Other end of the Leash: what Therapists Need to Understand About Their Co-Therapists

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