Changes

==Treatment==

==Treatment==

When dealing with cats who are exhibiting fear-related behaviour problems it is essential for owners to realise that the '''cat needs to feel in control of the situation''' and that forcing the cat to confront its fear is likely to lead to a worsening of the problem. However, since avoidance and escape are the primary defence strategies for the cat, it may in some cases it may be necessary to prevent escape from a room whilst desensitisation and counterconditioning techniques are applied. Instead, the cat is given hiding places in the room, so that it has enough control to feel safe, but is still present to be exposed to the stimuli being used in behavioural therapy.

When dealing with cats who are exhibiting fear-related behaviour problems it is essential that the '''cat needs to feel in control of the situation'''; forcing the cat to confront its fear is likely to lead to a worsening of the problem.  

There are four major areas that need to be addressed during any fear related problem:

However, it is sometimes necessary to repeatedly expose the cat to stimuli that it fears, in order to perform desensitisation and counterconditioning. It may therefore be necessary to prevent the cat from immediately escaping from the place where behavioural therapy takes place, so that the cat can gain appropriate experience. In such cases the cat must be given hiding places in the room, so that it has enough control to feel safe, but is still present to be exposed to the stimuli being used in behavioural therapy.

:1) The cat's '''environment'''

::It is paramount to remember that [[Effect of Environment on Feline Behaviour|the environment plays a major role in cat's ability to cope with fear and stress]].  

:1) '''Alter the cat's environment''', so that escape and avoidance behaviours are supported, and in all aspects of its life the cat has control over access to resources. This reduces general anxiety and stress, and supports behavioural therapy. In many cases, this is the most important aspect of treatment.

:2) '''Behaviour modification''' techniques

:2) '''Behaviour modification''' techniques can be used to provide the cat with positive experiences that reduce fear and increase its perception of coping. Examples include desensitisation and counterconditioning. Desensitisation involves repeated exposure to a previously fearful stimulus at below the threshold that elicits a fear response. An example might be exposing the cat to the presence of people at beyond its flight distance. Counterconditioning involves the creation of an association between a previously fearful stimulus and an appetitive stimulus (such as food or play). By repeatedly pairing the fearful stimulus with food, for example, the cat's emotional response is changed. Selecting appetitive stimuli that are of sufficient value to override even a mild fear response can be difficult in cats, and so it can be difficult to keep cats in the vicinity of the fear-inducing stimulus during processes such as counterconditioning. Both of these methods of controlled exposure must be performed carefully if flooding is to be avoided. Flooding involves sustained exposure to a fearful stimulus, at a level that elicits fear, until the animal ceases to respond to it. In flooding, responding ceases when the animal becomes physically and psychologically fatigued, which has been shown to intensify emotional responses, potentially leading to phobia and panic. Flooding is no longer a method used in veterinary behavioural therapy. For further information on practical aspects of behavioural therapy for fear problems see the problem-specific information linked below.  

::Examples of behavioural modification techniques include habituation, desensitisation, counterconditioning and controlled exposure. Selecting rewards which are of sufficient value to override the fear response can be difficult and, with a high priority for flight as a defence strategy in cats it can be difficult to keep cats in the vicinity of the fear-inducing stimulus during processes such as habituation. Flooding is also a risky approach since the panic induced by the lack of opportunity to escape can potentiate rather than ameliorate the condition. Controlled exposure, desensitisation and counterconditioning can be useful techniques and provided that the fear stimulus is diluted sufficiently it should be possible to over ride the flight response. Introducing a cat to an environment for desensitisation may require leading it in on a body harness and extending lead. The cat should be fully acclimatised to the harness and leash for several weeks before using it in a training situation. For further information on practical aspects of behavioural therapy for fear problems see the problem-specific information linked below.  

:3) '''Psychoactive medication''' may be necessary to reduce anxiety or fear to manageable levels. For cats that show high levels of fear or anxiety, changes to the environment may not be effective as the cat is unable to experience them (it remains hidden or is so inhibited that it does not explore its environment). For some cats, the range fearful stimuli is very broad or the stimuli are unidentifiable or unavoidable. In these cases, and for the animal's welfare, psychoactive medication is sometimes prescribed to facilitate adaptation to the environment and response to behavioural therapy.

:3) '''Pharmacological intervention'''

:4) The '''owner's reaction''' may need to be modified. Owners may unintentionally add to the cat's distress by mishandling it, often by trying to restrain the cat so that it does not escape. This is commonplace when the fear is of unfamiliar people or animals; owners will often hold a cat whilst allowing a visitor to pet it. Cats will appear to tolerate this, because their secondary species defence reaction is to freeze. However, the cat remains intensely fearful, and may attempt to attack the person restraining it, in order to escape. Owners are often surprised that cats handled in this way become less, rather than more, tolerant of visitors. Owner reinforcement of fear and anxiety should also be avoided, but this is a less common problem. However, some owners will use punishment to control cat's behaviour; scolding a cat for eliminating in an inappropriate location, for example. This merely increases stress for the cat and increase the likelihood that it will become secretive, avoidant and mistrustful of its owners.  

::There a number of reasons why medication may be indicated in cases of feline fear. Cases involving central nervous system pathology, in relation to neurotransmitters, may require medication on a long-term basis and, in situations where the fear-inducing stimuli are either unidentifiable or uncontrollable, long-term or recurring medication may also be indicated. In other cases where medication is necessary as an adjunct to behavioural therapy due to the severity of the fear response and the adverse effect that it has on the learning process, the usual aim is to have short-term drug support.  

:4) Modifying the '''owner's reaction'''

::The final part of the equation when dealing with feline fears is to modify the owner’s reaction to the cat’s behaviour. Unintentional reinforcement of fears is most likely to occur in cats when they flee and escape the stimulus, but owner interaction, both vocal and tactile, may be seen by some cats as reward for their response. Punishment is always going to be counterproductive and techniques designed to make the animal “confront its fear” such as flooding have limitations which have already been discussed.