It has long been recognized by clinicians who work with children and adolescents that the entire family of the “identified patient” is relevant to the intervention whether or not the family members are actually present in the room. Only recently, however, are clinicians becoming aware that animals, especially companion animals, are an integral and important part of the family system as well. As a result, clinicians are beginning to ask about relationships with animals and incorporate aspects of these relationships into their interventions. In most cases, there is no direct contact by the clinician with the animal but the animal is, nonetheless, “present” and acknowledged in many ways. Companion animals may be spontaneously described when the child is talking about daily routines or events (“I was late because my dog, Bitsy, hid my shoe,” “Mom was mad because I forgot to change my gerbil’s litter,” “My cat scratched me”). Companion animals may be invoked by children to describe an aspect of themselves (“I’m a real cat lover,” “I hate yippy little dogs. My dog is really big”).
Frequently, however, the child’s experiences that are relevant to the well-being of both the child and the animal go undetected by clinicians because we do not ask specific questions about animal-related experiences. Typical “screening” questions among mental health providers are often as follows: “Do you have any pets? Oh—you have a dog. That’s nice. What is your dog’s name? Snoopy? That’s a nice name.” Thus ends the exploration and conversation about pets in the child’s life. Asking focused questions can provide very useful information about the environments that the child and the animal share and contribute to developing more effective interventions.
I work in the area of childhood trauma and maltreatment. Not surprisingly, my focus is on early detection of settings where children are at risk for abuse or neglect. Adding the questions about animal-related experiences to the assessment and treatment of children and families has been invaluable in fostering awareness and developing interventions that prevent further victimization of both the child and the pet. In this chapter, I will discuss the following:
Why it is important for clinicians to routinely assess the child’s animal-related experiences.
Use of a questionnaire to assess animal-related experiences.
Clinical examples of interventions that have addressed the animal-related experiences of children and adolescents in the larger context of therapy.
14.2 Why it is important for clinicians to routinely assess the child’s animal-related experiences
14.2.1 Most children have pets or live in homes where there are pets
A recent survey reports that pets are found in approximately 62% of homes in the USA (American Pet Products Manufacturers Association, 2009–2010). Pet ownership rose from 1998 to 2005 with 90 million cats and 74 million dogs as companion animals, an increase of 17% and 18%, respectively (APPMA, 2005–2006). The number of companion animal cats and dogs has continued to rise and now totals 93.6 million cats and 77.5 million dogs (APPMA 2009).
Nearly 75% of American families with school age children have at least one companion animal (Humane Society of the United States, 2004) and the majority of pet-owning households contain children. Indeed, one study found that families with children present were the most likely to own pets (Bulcroft, 1990). In another report, approximately 90% of school children had pets (Kidd and Kidd, 1985). Thus, clinicians who work with children will frequently encounter children who have had experiences with pets.
14.2.2 Pets share the daily lives of household members
Pets often are considered to be members of the family (Bonas et al., 2000; Cain, 1983; Enders-Slegers, 2000; McNicholas and Collins, 2001; Sable, 1995). In a 2005 survey, 84% of American pet owners regarded their animals as family members. Forty-one percent of dogs share their owners’ beds as do up to 51% of cats. Americans spent a record $34 billion on pet products and services according to Census Bureau tracking of retail sales, exceeding spending on hardware and jewelry (American Pet Products Manufacturers Association, 2005–2006).
Holidays are celebrated by giving pets presents or treats. Birthdays and funerals of pets are memorialized (Davis, 1987; Dresser, 2000; Serpell, 1986). Pet owners have photographs of their pets and, frequently, children are photographed with the family pet. The environment in which the pet lives is usually the same environment in which the child lives. As a result, the clinician is afforded a valuable opportunity to obtain relevant information about the family setting by asking a series of questions about the pets in the household. Thus, I recommend that clinicians seek information from children and teenagers about their experiences with pets and other animals as routinely as we ask about their experiences with siblings, parents or friends.
14.2.3 Children often will talk about their pets’ experiences before they disclose their own experiences
Children’s animal-related experiences are a bonus for the clinician because often children will talk about what happens to pets in their homes more willingly than they will share what happens to other family members or, especially, to themselves. Because children are less likely to censor the information they give about their pets, they inadvertently reveal incidents or settings that put them at risk for abuse or neglect. A 15-year-old boy was asked if there was a stressful time when his favorite dog had been a source of comfort to him. He replied, “Yeah. After my stepdad beats me my dog jumps up and licks my tears.” The clinician had no idea that the boy’s stepdad was beating him.
Sharing the experiences of a pet can become a window on the world that the child inhabits. For example, during a school-based presentation on domestic violence and safety, fourth grade students were asked only one animal-related question: “Do you think your pet is safe at home?” One boy volunteered that he and his older brother each had a cat. He became teary as he shared that his older brother would tease and hurt the younger boy’s cat, sometimes strangling it and often throwing the cat at the boy. Then the fourth grader went on to reveal that the older brother would hit and strangle him when their mother was not home. The teacher reported these concerns to the school counselor. Clinicians who do not inquire about animal-related experiences are missing potentially critical information about a child’s environment and experiences that place their clients at risk for abuse or neglect (Boat et al., 2008).
14.2.4 The behavior that harms the animals is the same behavior that harms the human
Since the mid-1990s, the links among animal cruelty, child abuse and domestic violence have received important attention both in professional literature and in the media. Anecdotal and research evidence link acts of cruelty to animals with acts of cruelty to humans (Arkow, 1996; Felthous and Kellert, 1987; Kellert and Felthous, 1985). One study noted that in homes where children were physically abused, pets were significantly more likely to be abused. Furthermore, and importantly, inhabitants of these physically abusive homes were 11 times more likely to be bitten by the family dog (DeViney et al., 1983). Clinicians must be aware of these data on dog bites because dog bites to children aged five to nine have been designated as a major public health problem in the USA (Centers for Disease Control, 2000). The statistics on dog bites in the USA are alarming! Fifty percent of dog bite victims are children under the age of 12 and 70% of fatal dog bite attacks involve children (American Veterinary Medical Association, 2001). The important point for clinicians is that when children are bitten in their own home, this may be an indicator of a physically abusive or otherwise chaotic household. When children are bitten in a friend’s or neighbor’s home, we need to wonder about issues of abuse, supervision and safety in that household.
Knowing the breed of the dog that a family has chosen has implications for risk assessment and intervention. Recent research demonstrates that ownership of high-risk dogs is a significant marker for general deviance as measured by number of convictions in a court of law (Barnes et al., 2006). For example, owners of dogs that were unlicensed and cited as vicious by breed or behavior had an average of 5.9 criminal convictions compared to an average of 0.6 convictions for owners of dogs that were licensed and not deemed vicious by breed or behavior. Failure to license a dog was predictive of child endangerment, harm to a juvenile, violation of safety restraint of a child and contributing to juvenile unruliness convictions. Both failure to license a dog and owning a high-risk breed of dog should be included in professional assessments of risk to children and other vulnerable individuals.
Because the behavior that harms the animal is the same behavior that harms the human, it is not surprising that research documents that both children and animals are at risk in homes where there is domestic violence (Ascione, 1998; Ascione et al., 2004). The majority of pets in homes where battering occurred were threatened with harm or actually killed by the batterer and the majority of children witnessed the abuse to the pet. Children continued to be exposed to potential harm because their mothers remained in the home to protect the pet rather than seek safe shelter for themselves and their families. Twelve independent studies report that between 18 and 48% of battered women have delayed their decision to leave, or have returned to their batterer, out of fear for the welfare of their pets or livestock (Ascione, 2007).
Clinicians, including medical personnel, who treat children should routinely screen for domestic violence and the safety of pets (Boat, 2000). The following questions can be useful:
Parent screening (interview the parent alone)
“Do you ever feel unsafe at home?”
“Has anyone at home hit you or tried to injure you in any way?” (Questions a and b have a sensitivity of 71% and a specificity of 85% in detecting domestic violence, Eisenstat and Bancroft, 1999.)
“Has anyone ever threatened or tried to control you?”
“Have you ever felt afraid of your partner?”
“Has your partner ever hurt, or threatened to hurt, any of your children?”
“Do you have pets? If so, has your partner ever hurt or said that he/she would hurt your pets?”
“Where are the guns kept in your house?” (This question is deliberately phrased as a presumptive question. The respondent can always deny that there are guns in the house.)
Child screening (interview the child alone)
“What happens in your house when your mother and (father figure or partner) get angry with each other?”
“Is there any hitting in your house?”
“Have you or (siblings) ever been hurt?
“Do you have any pets?” “Has anyone ever hurt or threatened to hurt your pet?”
“Do you ever worry about bad things happening to your pet?”
Just as the majority of children in violent families witness domestic violence, the majority of children in violent pet owning homes also witness pet abuse (Ascione, 1998). Exposure to animal cruelty can have a significant impact on the developing child, including promoting desensitization and decreasing empathy, reinforcing the idea that the child, like the pet, is expendable, damaging the child’s sense of safety and confidence in the ability of adults to protect him or her from harm, accepting physical harm as part of allegedly loving relationships, fostering the seeking of empowerment by inflicting pain and suffering and leading to the imitation of abusive behaviors.
Again, clinicians must take into account that some of the disturbed and disturbing behaviors exhibited by children may be related to their witnessing cruelty to animals. A particularly pernicious and vicious form of child and animal abuse is forcing the child to kill or maim a pet. In a poignant video titled Both Sides of the Coin (1991), a man who is in treatment for his violent temper describes getting his first dog, Lassie, when he was three years old. Lassie was his best friend. Each year Lassie would have puppies and each year, when the puppies began to be noisy and move around, his brutal uncle would kill them. The man recalls that when he was 12 years old, his uncle made him kill the puppies himself. The man describes holding the puppies underwater until they quit moving, then putting their bodies in a gunny sack and hiding them in the barn. He says, with a breaking voice, that he will never forget the pain and the guilt he felt. He could no longer relate to being a child and began burning down grain elevators and derailing trains. “I started acting out my pain!”
Exposure to pet abuse in the context of domestic violence can also contribute to neurobiological deficits occurring in children who witness domestic violence. One result is that the brains of children exposed repeatedly to traumas such as witnessing domestic violence are significantly smaller, resulting in serious problems in social, emotional and intellectual functioning (DeBellis, 1999; DeBellis et al., 1999). As clinicians we cannot afford to miss these important animal-related connections that place our clients at greater risk for abuse or neglect.
14.2.5 Attachment to a pet is both a positive and a potentially negative experience for a child
The child’s experience of attachment to a companion animal provides important information to the clinician. When a child reveals that he or she has a favorite pet, we know that this is a positive sign of an ability to connect with another living creature. However, clinicians must be aware that caring about a pet can make the child more vulnerable to loss. Bulcroft (1990) describes an interview with a 70-year-old man in a senior center, an interview that was assessing intellectual functioning, not targeting animal-related experiences. The author asked the man to recall one of his most vivid childhood memories. With tears in his eyes, the man related that when he was eight years old, he saw his dog, Ben, killed by a stray bullet while they were hunting. Attachment to, and loss of, pets can have a lasting impact.
A teenager described how her beloved dog was killed by her stepfather after the dog tried to protect her from this man who was raping her. Another child had to give his dog away when he was moved into foster care. Sometimes the story includes threats of harm or harming the pet in order to coerce the child to comply “If you tell anyone what I did, I will kill your kitty.” “If you don’t have sex with me, I will sell your horses.” “You have been a bad boy and to punish you, one of your puppies must die. You choose the puppy that I will kill or I will kill all of them.”
In the aftermath of the Gulf Coast’s Hurricane Katrina in September 2005, we have been poignantly reminded of the intensity of attachment and the fear of losing a pet. Many survivors endangered their own lives by refusing to evacuate unless they could take their pets. This reality led to the passage of the Pets Evacuation and Transportation Standards Act (PETS, 2006). This law requires that state disaster plans include provisions for household pets and service animals in major disasters in order to apply for FEMA funding.
Attachment is good. Clinicians can build on the caring feelings that a child has for a favorite pet and promote empathy and gentleness. But clinicians must also be aware about the downside of attachment and assess whether the child has experienced loss of a pet or threats of loss of a pet. Sometimes the loss, especially if it is repeated, overwhelms the child’s coping abilities and the child may detach from any investment in animals in order to protect him- or herself from feeling such pain again.
14.2.6 Use of a questionnaire to assess for animal-related experiences
The Childhood Trust Survey on Animal-Related Experiences
It is useful to have a set of questions available to guide the assessment of the child’s experiences with animals. The Childhood Trust Survey on Animal-Related Experiences (CTSARE) is a 10 item screening questionnaire for children, adolescents and adults that asks about experiences of ownership, attachment, loss, cruelty and fears related to pets and other animals (see Appendix A; also see Boat et al., 2008; Boat, 2002). A longer version of the CTSARE has been adapted for use in several studies (Baker et al., 1998; Flynn, 1999; Miller and Knutson, 1997) and is available in a chapter by Boat (1999). The validity and reliability of CTSARE have not been established. This instrument should be used as an interview guide and administered orally so the interviewer can use follow-up questions to obtain additional information as appropriate. The questions that are found in the CTSARE are described below:
Questions 1 and 2 inquire about past and present ownership of pets. Data support that pets rarely survive more than two years in homes that have few resources and several risk factors for child abuse or neglect (DeViney et al., 1983). Frequently, the inhabitants of these homes list many pets and a high mortality and turnover rate. When asked what happened to all the pets he had listed, one teenager shrugged and said “I don’t know. Either grandma got rid of them or they’re dead.” When several pets have “just disappeared,” a caution flag should be raised that the family may be in need of help. Inability to care for pets adequately may indicate that resources are lacking to care for other family members.
Question 3 seeks information about whether the child has, or has had, a favorite pet as an indicator of attachment. Lack of any special relationship with a pet may signal a child who is divested from, or never formed, close relationships.
Question 4 asks about a difficult or stressful time when a pet was a source of comfort or support. Children often readily disclose situations where they felt vulnerable, sad or frightened when they are focused on their pet (Doyle, 2001).
Questions 5 and 6 address issues of the pet having been hurt, worries about something bad happening to the pet and losing a pet. Responses to these questions can offer a window into the child’s home environment and assist in focusing the intervention.
Question 7 focuses on the training and discipline approaches used with the pet. Look here for harsh methods of behavior management.
Questions 8 and 9: seeing someone hurt an animal can have a significant impact on witnesses. Sometimes a child or adult is prevented from helping a sick or injured animal. This is a potentially devastating experience. It may be important to question others to get adequate information about the child himself hurting animals or pets. Parents, neighbors, or teachers with classroom pets may observe harsh treatment of an animal. Teachers may overhear a child talking about seeing or committing cruel acts, or read about worrisome behaviors around animals in the writings of their students.
Question 10 underscores the need to know if a child has ever been badly frightened or hurt by a pet or other animal. The trauma of being chased, pinned or bitten by a dog can shape a life-long negative response to dogs. This question also can reveal a home or neighborhood where a child may be at greater risk to be harmed by an animal. Examples include the child having access to dogs that are chained outdoors, dogs that are running freely and the presence of higher risk dogs.