MERCK MANUAL

Veterinary Manual
Veterinary / Behavior / Behavioral Medicine Introduction

Treatment of Behavioral
Problems
By Gary M. Landsberg, BSc, DVM, MRCVS, DACVB, DECAWBM, Director,
Veterinary Affairs and Product Development, CanCog Technologies, and
Veterinary Behaviourist, North Toronto Veterinary Behaviour Specialty Clinic

In production animals, treatment focuses on group management, environmental or housing

modifications, and in some cases removing individual animals out of or to other groups.
Specifics are covered in the relevant species discussions.

In companion animals, the treatment of behavior problems varies with diagnosis and
prognosis. In general, the program begins with prevention and avoidance of problems, while
the owner develops effective strategies to modify the pet’s behavior so that it might gradually
be reintroduced to the problem situations while achieving a desirable outcome. Initially,
prevention is necessary to avoid further compromising the pet’s welfare and to ensure safety
in cases of aggression. Repetition of the behavior further aggravates the problem if the pet
successfully accomplishes its intended goal (eg, escape or retreat from the stimulus), while
each exposure in which the outcome is unpleasant can condition further anxiety.
Improvement is generally a slow and gradual process; therefore, owners must have realistic
expectations of what might be achieved. Modifications to the environment may be required,
so that the pet can be kept away from the stimuli (or the sights or sounds of the stimuli) that
incite the problem or from the areas in which the problem occurs. Modifying the pet’s
behavior is accomplished by applying the principles of learning and behavior modification,
primarily achieving and rewarding desirable outcomes along with use of products that
improve safety, reduce anxiety, or help to achieve the desired response more effectively (eg,
muzzles, head halters, no-pull harnesses, etc). Drugs and natural products may also be
indicated for some pets and some problems.

Behavior Modification Principles

The most commonly used behavioral techniques include habituation, extinction,
desensitization, counterconditioning, response substitution, and shaping. Flooding is often
talked about but seldom used because it is likely to make most animals worse. While
punishment is frequently used with varying degrees of success, few people correctly use this
technique, and there are both humane and safety issues with the use of positive punishment.
For punishment to be successful, the aversive stimulus (eg, startling with a loud noise,
spraying compressed air) must occur sufficiently close to the onset of the behavior that the
probability of the behavior occurring in the future is lessened. Often, punishment is more
about the owner’s anger than about changing the behavior. In addition, some dog owners
have been ill advised by training advice that advocates confrontation, with the intent of
asserting leadership (dominance). In fact, numerous studies have demonstrated that
punishment-based training and confrontational techniques are more likely to lead to fear,
avoidance, and increased aggression.

Most of the humane, passive, or positive techniques involved in behavior modification are
not hard to learn and together with preventive strategies are very successful. In fact, dogs
trained with rewards have fewer behavior problems, less fear, and less avoidance than dogs
trained with punishment. The following is a short review of the basic principles involved in
the techniques and their associated strategies.

Classical Conditioning:
The pairing of an unconditioned stimulus with a neutral stimulus results in a conditioned
stimulus and a conditioned response. Classical conditioning can occur in both positive and
negative ways. Examples of a positive conditioned emotional response are the pairing of a
clicker with favored treats (for clicker training) or a doorbell signaling visitors (for pets
enthused about meeting new people).

Problems arise when a fearful conditioned emotional response is established toward a

previously neutral stimulus (visual, odor, auditory, animate, inanimate) by repeated pairing
with a fear-producing stimulus. Once this occurs, the stimulus itself will elicit the fear
response, eg, a doorbell paired with the arrival of unfamiliar people (for pets fearful of
visitors), or a doorbell paired with verbal or physical discipline applied by the owner for
barking or jumping up (pinning, leash corrections). Similarly when a pet lunges or barks
when meeting new people on the street or at the front door, the use of positive punishment
to inhibit the behavior (such as choke collars, prong collars, shock, pinning) may condition a
new response in which unfamiliar people become a fear-evoking conditioned stimulus. A
visit to the veterinary clinic that may begin as a neutral situation may quickly become fear
evoking if it is associated with unpleasant outcomes or is further enhanced by owner anxiety.
In addition, all of the stimuli associated with the event (sights, sounds, smells) also become
conditioned stimuli for fear. In much the same way, rain, wind, darkening skies, and
lightning can quickly become conditioned fear-evoking stimuli for pets fearful of thunder.

Counterconditioning and Desensitization:

Counterconditioning involves the consistent and repeated pairing of a stimulus that evokes
an unpleasant response with something that is emotionally positive until a positive
association is made. To be successful, counterconditioning should be coupled with
desensitization in which the stimulus is minimized or reduced to a level that does not evoke
the fear response (eg, by reducing volume, increasing distance, changing the environment, or
modifying the stimulus to something less threatening). Once a positive association is made,
rewards can be paired with stimuli of gradually increasing intensity.
Desensitization and counterconditioning are extremely time consuming. The exercises must
be constantly repeated, so that the response is altered to a positive one. All stimuli that evoke
fear (sights, sounds, odors, tactile) must be considered. Clients often want both quicker fixes
and less work. However, moving too quickly provokes anxiety and sabotages any behavior
modification program.

Operant Conditioning:
Operant conditioning is a method based on making an association between a behavior and
consequences of that behavior. The results either increase or decrease the likelihood of
future responses. There are four types of behavior-consequence relations: positive and
negative punishment and positive and negative reinforcement. Reinforcement increases the
likelihood a behavior will be repeated, and punishment leads to a reduction in behavior.
Negative refers to the removal of a stimulus, and positive refers to the application of a
stimulus.

Positive reinforcement training occurs if behavior is increased by something applied

(generally something pleasant or appealing); negative reinforcement occurs if behavior
is increased by something removed (generally something unpleasant). In positive
reinforcement training, a reward should be given immediately and consistently until
the behavior is reliably repeated. If the behavior is to be trained on command or cue, a word
or hand signal should then be added before the behavior-reward sequence. Once learned,
behavior can be reinforced on a variable schedule, so that the period of time or number of
responses before the reward is given is varied. Rewards are used for positive reinforcement,
but a reward is not synonymous with positive reinforcement. A reward is anything desirable
to the pet, from an activity such as petting, walking, or play, to an item such as a toy, food,
chew, or treat. However, unless there is a clear relationship between the behavior and the
reward (timing, consistency, contiguity), then the reward does not achieve the goal of
positively reinforcing behavior.

Negative reinforcement must not be confused with punishment, because punishment

decreases behaviors and reinforcement increases behaviors. One example of negative
reinforcement is avoidance or escape behavior. For example, if an animal anticipates an
unpleasant outcome (eg, meeting another dog, veterinary visit), then the aversive outcome
will not occur if the animal retreats. Similarly, if the owner puts pressure on a head halter
until the desired behavior is achieved (eg, sit, back up), the release of tension is negative
reinforcement. One potential consequence of negative reinforcement is that if a pet’s threats
or aggression lead to removal of a stimulus (eg, dog, delivery person, owner), the behavior is
reinforced by the retreat of the stimulus.

Positive punishment occurs when a behavior decreases when something is applied

(generally something unpleasant), and negative punishment occurs when a behavior is
decreased when something is removed (generally something pleasant or appealing). In
positive punishment, if behavior does not decrease after the first few applications, then the
punishment is not being appropriately timed or the behavior is too strongly motivated to be
deterred by punishment. Positive punishment applied by a person (owner, trainer) is
intended to cause the pet to become fearful of repeating the behavior. However, a potential
consequence is that the pet becomes fearful or defensive to the punisher or to an
approaching hand. Relationships with people should always remain positive! Also, if an
unpleasant consequence occurs only when the owner is present, the behavior may continue
in the owner’s absence. Another problem with positive punishment is that punishment
paired with exposure to a stimulus (barking at cars, meeting other dogs on walks) can result
in a conditioned fear of the stimulus (see above).

Punishment cannot be used to achieve desirable behaviors, only to stop what is undesirable.
If the goal is to make the pet fearful of repeating a behavior (eg, garbage raiding, taking
things from counters, chewing plants) or to keep the pet away from an area (room, couch,
bed), then environmental punishment or pet-activated punishment (eg, motion detector
alarms or sprays, upside-down carpet runners, aversive tastes, double-sided tape, or bark-
activated sprays) or remote punishment (eg, spraying water while out of sight, remote-
activated alarm or spray) might be most appropriate. However, before focusing on how to
stop what is undesirable, the owner should first focus on providing a desirable alternative
(eg, where to sleep, where to climb, what to chew).

Negative punishment is the reduction of a behavior by the removal of something

pleasant. For example, if the pet is receiving affection or play when an undesirable behavior
begins (eg, play biting, mouthing, mounting), the immediate removal of the play or affection
will "negatively" punish the pet. However, unless the pet can determine what behavior leads
to the removal of play, the behavior may actually intensify because of frustration at not
receiving its reward.

Second-order Reinforcers:
Signals that can be used at a distance to convey that the reward is coming are second-order
reinforcers. Commonly used second-order reinforcers are words (eg, “Good dog!”), clickers,
or whistles. By repeatedly and continuously pairing these with a primary reward such as a
toy or treat, second-order reinforcers can elicit the same response that the reward would, as
long as the pairing is repeatedly maintained. Clicker training requires frequent practice and
excellent timing, but once achieved the animal can be reinforced each time the desired
behavior is observed. Clicker training is an excellent way to immediately “mark” desirable
responses, gradually shape new or more desirable behaviors (eg, longer, more relaxed), or
associate a positive emotional response with the stimulus. (A useful resource is
www.clickertraining.com.)

Premack Principle:
When a more desirable behavior is made contingent on a less desirable behavior, the less
desirable behavior is more likely to be repeated. Thus, the more desirable behavior serves as
the reinforcer. For example, if a pet wants to go out or cross the street for its walk, the owner
can train a sit-stay before each of these behaviors. A horse or dog that wants to walk ahead
can be taught that walking on a slack rein or leash will result in this behavior.

Overlearning:
Overlearning is the repeated evocation and expression of an already learned response. It is a
phenomenon frequently used in training for specific events but may be underused in
preventing fearful responses in dogs. Overlearning accomplishes three things: it delays
forgetting, it increases the resistance to extinction, and it increases the probability that the
response will become a “knee-jerk” one, or response of first choice, when the circumstances
are similar.

Shaping:
Shaping works through gradual approximations and allows the animal to be rewarded
initially for any behavior that resembles the desired behavior. For instance, when teaching a
puppy to sit, providing a food reward for a slight squat will increase the probability that
squatting will be repeated. This squatting behavior is then rewarded only when it more
closely resembles a sit, and finally, when it becomes a true sit. Shaping can also be used to
reward an increase in duration of or progressively more relaxed behaviors.

Extinction:
The ending of a behavior once all reinforcement is removed is termed extinction. For
example, if people pet a dog that jumps up on them for attention, the behavior continues; if
they stop, the dog will eventually extinguish its response because the reward is no longer
there. However, any form of intermittent reinforcement—even occasional petting of the dog
in response to its jumping—will prolong the performance of the response. Valuable rewards,
a long history of performance, and intermittent reinforcement all increase resistance to
extinction. Owners also must be prepared for the intensity of the behavior to initially
increase before it is extinguished. Giving in will make extinction even more difficult as the
animal learns that higher intensity behaviors achieve the desired outcome.

Habituation:
Habituation is a gradual lessening of a response to a stimulus. Usually this occurs with
repeated presentation of a stimulus whereby the animal learns that it does not signal
anything important. For example, horses placed in a pasture bordering a road may at first
run away when traffic passes but eventually learn to ignore it. Stimuli associated with
potentially adverse consequences are more difficult to extinguish with habituation than other
stimuli. In prey species, responses to sounds associated with predators would be difficult to
habituate, because they have been selected for and generally are adaptive. If the fear
response is too intense, instead of habituation the animal may become increasingly more
fearful of the stimulus. This is termed sensitization.

If an extended interval has occurred since the time an animal last experienced a stimulus to
which it had habituated, the animal may again react when reexposed to the stimulus. This is
termed spontaneous recovery.

Flooding:
This is used to treat fears of harmless stimuli by forcing the animal to stay in the presence of
the stimuli until the fear is extinguished. This procedure is seldom effective and has welfare
implications in dogs, because it initially enhances fear and cannot be stopped until all
physiologic and emotional signs of fear are gone. If done improperly, flooding may therefore
increase problem behaviors. In practice, a controlled level of flooding is quite often used as a
component of behavior modification, in which the stimulus is presented at a level that is low
enough to cause mild fear and the pet is not removed until it habituates. This can then be
combined with reinforcement, ie, the pet is positively reinforced or the stimulus removed
(negative reinforcement) when the fear response subsides or abates.

Response Substitution:
This involves the replacement of an undesirable response with a desirable one. For example,
high-value rewards can be used to train desirable target behaviors that are alternatives to the
undesirable behavior. However, if the behavior is part of the pet’s natural repertoire (eg,
greeting, barking), it can be particularly difficult to train alternative behaviors. Specific
examples of response substitution include training a dog to sit or lie down as an alternative
to jumping up, mounting, or play biting; or to sit, walk on loose leash, or back up for dogs
forging ahead or running out the door. Training should begin in a variety of environments
where success can be most readily achieved. The desired endpoint for the new response is for
the animal to be quiet and calm. Therefore, the owner must learn to read the look in the eyes,
body posture, facial expressions, and breathing to be able to gradually shape the desired
behavior. Training could then move to environments with increasing distractions and
locations where the problem is most likely to arise. Alternatively, the pet might be enticed to
engage in a behavior that is incompatible with the undesirable behavior, eg, teaching the dog
to fetch a toy when visitors arrive instead of jumping up.

To replace the undesirable behavior with one that is desirable, response substitution can be
coupled with desensitization by beginning training with stimuli of low enough intensity
while training the target behaviors (eg, relaxation) with high-value rewards. However, for
pets that are fearful or anxious, the focus should be on desensitization and
counterconditioning to change the pet’s emotional state rather than the behavioral response.

© 2018 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA