Clinical Behavioral Medicine For Small Animals, 1e

PUBLISHING YEAR: 1997

SUMMARY: Handbook of behavioural medicine for cats and dogs.

AUDIENCE: This one is definitely for the professional, and more for people on the clinical/research side of behaviour therapy than pure dog training. It’s also an ideal handbook for vets who are interested in behavioural treatments.

REVIEW 

By the time I’d finished reviewing the 1997 classic, the new one was out (2013). I skim-read the 2013 edition and mention it in the review too. But, except where I specifically say so, the review below concerns the 1997 edition.

The author: Karen Overall is a renowned board-certified veterinary behaviourist and a leading figure in the field. She has done a great job spreading the word on evidence-based behavioural interventions for cats and dogs. Karen Overall is a true giant in our industry and she has contributed immensely to disseminating specialist knowledge beyond the vet behaviourist community.

Style and contents: Anyone who’s anyone will quote Overall’s 1997 book. It’s a massive classic – and for good reasons as you’ll see. Its chapters on learning theory, the animal behaviour professions and psychopharmacology alone make it worth its weight in gold. (If you want to read about the controversy around canine psychopharmacology, read here.)

The book is extremely thorough, almost perfectly so. Its wide coverage of dogs’ and cats’ behavioural complaints is a work of beauty. Not only does it span wide but it also digs deep into the aetiology, treatment and prognosis of each condition. The medical approach is appealing given its high standards for accountability, systematics and evidence, and my care model is greatly inspired by it.

But what made the 1997 book a true landmark was its attempt at a DSM-like classification of behavioural conditions for companion animals. It is a serious attempt at an internally consistent system based on clinical and research data. It is still plagued by many definitional overlaps and ambiguities, but that’s the joy of nosology for ya… Don’t be expecting much better out of the DSM-V. Overall’s 1997 book has long been my go-to reference when I needed a formal diagnosis.

A short note on the 2013 edition: I leafed through it and the layout was a lot more breezy than the 1997 edition. It also used more colours. A very pleasant layout indeed.

I would love to see the decision trees for treatment and differential diagnosis expanded to include more conditions. Unless I am mistaken, these diagrams disappeared completely out of the 2013 edition?

One chapter struck me as too superficial and showed insufficient background research: the one on popular behaviour protocols. It implied that Grisha Stewart’s BAT induced stress. That surprised me as, if one technique is stress-averse (almost caricaturally so), it would have to be BAT. There are disadvantages to BAT, like with any technique, but stress is not one of them.

A professional rant: Like so many veterinary behaviourists (including Beata), Karen Overall has the nasty habit of discrediting non veterinarians working in animal behaviour therapy.

Not only does it make an insulting assumption about our skills, but it fails to recognize economic realities. Average Joe doesn’t have hundreds of dollars to spend on his dog’s behaviour. Yet, he can still get highly qualified advice from non veterinarians for most cases. Even in cases requiring some psychopharmacological help, licensed vets who know their left hand from an SSRI could collaborate with the qualified behaviour therapist. The patient would still get the best quality of care warranted by his/her condition. Complex cases could be referred to board-certified vet behaviourists, but a vet beh. would be an overkill for the majority of behaviour issues that get presented to us.

As far as I am concerned, if your therapist has a relevant university degree, a recognized specialization, a track record of successful cases and proof of keeping up with the latest findings, your dog is in very good hands unless he’s suffering from a very complex case.

Possible improvements: The book takes an occasionally simplistic and one-sided view of dog ethology with an inordinate reliance on the pack theory. I understand this got toned down in the 2013 edition.

The hand-outs are heavily detailed and would be result in zero client compliance if distributed as such. A lot more work needs to be done making the instructions client-friendly.

Too many of her protocols rely on keeping the dog under strict voice control, which is the equivalent of confinement and thus potentially lowers the aggression threshold. An inordinate focus on obedience (or ‘deference’ as it is called in the text) can massively backfire as it hides internal turmoil. In a similar vein, it may take owners unrealistically long to go through her step-by-step protocol for ‘relaxation’. The book lacks the pragmatic ‘behavioural first aid’ short-term approach of, say, Landsberg.

Presuming the audience are veterinarians, reviewing the basics of PD/PK (pharmacodynamics/pharmacokinetics) in the psychopharma section is a little cumbersome. This is yet another book that struggles under the weight of trying to cater to too many audiences and becomes huge as a result.

The verdict: If you’re involved in behaviour therapy or behavioural medicine, or if you are a behaviour-curious vet, Overall’s books are as much of a must-have as the DSMs in human psychiatry/psychology.  Piece of advice though: as a true reference junkie I read it line-by-line. Don’t be the idiot I was. Just read it as a reference – on an as-needed basis.

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