The Role and Scope of Practice of Veterinary Social Workers in Animal Shelters

Abstract

Animal shelters play a pivotal role in protecting pets in crisis and bringing families together. This paper adds to the work of Hoy-Gerlach and colleagues which outlined a three-tier framework for developing and training veterinary social workers (VSWs) to serve in animal shelters. Our research questions sought to explore the VSWs’ self-identified role (RQ1), and how VSWs self-identify their scope of practice (RQ2). Through these exploratory questions, our research aimed to advance knowledge about the state of VSWs in the animal-shelter setting. Methods: Using a purposive sampling strategy, an anonymous community practice survey (CPS) was emailed to VSWs working in animal shelters. Inclusion criteria included being over the age of 18, being currently employed in an animal shelter, and cognitive fluency in English. The survey yielded 25 responses with 14 included in the data analysis. Findings: The VSWs identified their role as supporting multiple groups, including clients and their practice community (i.e., colleagues). While most of their time was devoted to individuals from the community, they also supported the mental wellbeing of their team. Their work ranged from case management and psychoeducation to crisis intervention and suicide risk assessment. As there are no standards of practice for VSWs, each respondent used unique language to explain their role and scope of practice. Conclusions: The CPS was helpful in illuminating developing trends within the field, though a larger sample size is needed to gain a more nuanced understanding of self-identified needs of VSWs practicing in animal shelters and other related spaces.

1. Introduction

Domesticated animals, referred to as pets, are family members in the majority of American homes [1,2]. Animal shelters are a community resource for protecting animals in crisis, reunification post-crisis, and rehoming animals into families [3,4].

1.1. Veterinary Social Work

Veterinary Social Work (VSW) is social work at the intersection of the human–animal bond [5,6]. The practice may include animal assisted interventions (AAIs), grief and bereavement of pets, intentional wellbeing of those who care for pets, and addressing the link between interpersonal violence and animal abuse [6]. When referring to the practice of VSW, the professional has completed specialized training, either concurrent with a masters education, or a post-master’s certificate program. The field of VSW is a rapidly growing profession within North America, and reaching into the United Kingdom, Europe, South America, Australia, and Asia through education and professional-association efforts. While there is an increasing understanding of what VSW is, the employment opportunities, expectations, and burdens vary greatly by continent and geographic community. In short, the VSW education can benefit any licensed mental health clinician that intentionally seeks to support their clients at the intersection of the human–animal bond. However, explicit employment opportunities include veterinary clinics, humane societies/animal shelters, equine assisted services, and private practice with explicit AAI or pet-loss support offerings [7].

1.2. Review of Relevant Literature

A review of the relevant literature was conducted to aid the researchers in grounding the intent for the community practice survey (CPS), survey question development, and analysis of findings within the scope of current empirical research. Using the database ERIC, all accessible journals were included, no specific date range was set, and peer-reviewed, full-text available sources were collected. Using the keywords “veterinary social work” and “animal shelter*”, the search yielded 98 possible articles. After removing duplicates (n = 61), 37 were relevant to the current study, 11 were read in full, though only 6 were relevant to the scope of the current study and included in this review.

Loue & Vincent [8] and Holcombe and colleagues [9] provide a general overview of the VSW profession with specific mention of employment in non-traditional locations, such as animal shelters [8] (p. 645), and the lack of empirical research about this location as a needed site for VSW employment. While the work of Fawcett [10] focused predominantly on the ethics of animal shelters, explicitly linked to One Health One Welfare, the conversation about moral distress and unjust treatment of animal care workers was relevant to the findings of the surveys discussed herein. Fawcett [10] argues that the consistent exposure to, and observation of environmental harm, humane killing and population management, behavioral deterioration, and potential infectious diseases are associated with moral distress and compassion fatigue.

Marton and colleagues [11] published findings from a mixed-methods online survey of animal care workers (N = 139). Of those surveyed, 57% (n = 79) were associated with animal shelters. Mirroring the themes from Hoy-Gerlach and colleagues [5], Marton and colleagues [11] found “that nearly half of ACWs experienced symptoms of depression in the previous month. Over 66% indicated it was difficult to cope. Limited support often resulted in a disenfranchised loss” (p. 31). This finding is important to understanding the need for embedded mental health support for ACWs, which can be provided by VSWs. While there was explicit positive regard for a “support group”, the authors neglected to link this mental health outcome to the VSW profession. This finding speaks to the potential role and growth of the VSW practice.

In the same year, Arkow [12] published a narrative detailing the “six reasons why social workers should be cognizant of human–animal relationships” which included detailed action steps for inclusion of social-work training and practice in animal shelters. Arkow [12] details a strategy wherein VSW supports the mental health of animal care workers, and also the community, through cross-reporting of suspected animal abuse, reduction of relinquished pets by resourcing families with safety net supports, and engagement in creative animal-assisted intervention programming (i.e., Hope and Recovery Pet Program, see Hoy-Gerlach et al. [13]). In summary, others in addition to Hoy-Gerlach and colleagues [5] set the foundation for this study.

1.3. Research Aim

This current study extended the current empirical literature by advancing the understanding of the role and scope of practice of VSWs practicing in animal shelters towards developing practice standards. The intended outcome of the survey was to create a baseline of practice expectations. Hoy-Gerlach and colleagues [5] created a framework for incorporating VSWs into animal shelters, without geographic specificity. Using their research framework [5], this study explored the role of the veterinary social worker employed within animal shelters (RQ1), and how VSWs self-identify their scope of practice (RQ2). The aim of exploring these questions was to: 1. advance knowledge about the role of VSWs in animal shelters and 2. understand potential implications of working in this particular setting for human mental health and animal wellbeing.

2. Materials and Methods

As stated within the MedVet experience objectives: “We collaborate to develop long-term, sustainable relationships built on trust, communication, and mutual benefit” [14]. Animal shelters are a referral partner for collaboration to meet the needs of the community. Starting in 2023, MedVet led an exploration of VSW experiences in hospital medicine with the aim of addressing the knowledge gap through a series of surveys, called Current Practice Surveys (CPSs). The Vice President of Experience and Director of Veterinary Social Work at MedVet partnered with faculty at Cleveland State University (PI), the University of Pittsburgh (Co-I), and the International Association of Veterinary Social Work to create, administer, and analyze the CPSs. MedVet’s Director of Veterinary Social Work, who is a content expert for social work in animal shelters, spearheaded the creation of the questions. MedVet is the largest veterinarian-owned and -led emergency room/specialty network of hospitals in the United States.

2.1. Survey Construction

Three CPS surveys have been administered to date: (1) a scoping survey scoping where VSWs work (no resulting publications); (2) an in-depth survey for VSWs working in animal hospitals which explored the prevalence of veterinary social workers in veterinary medical spaces [15]; and (3) an in-depth survey for VSWs working in animal shelters, discussed herein, which aimed to explore the role and scope of practice by asking questions about education access, stress/moral injury, workload, and salary.

The individuals who organized the information for the surveys and created questions were white female professionals in veterinary medicine, administration in veterinary and human health care, and social-work veterinary practice. Locations of practice were primarily in the Midwest and Western United States. In drafting the survey, outside comment was obtained, particularly from three established VSWs, practicing in the Pacific Northwest, Southwest, and Southeastern United States.

The survey was modeled after the field of human healthcare and the work of the Beryl Institute [16]. Created in conversation with three VSWs working in animal shelters, the CPS development was informed by the professionals’ review of the prior survey. The content experts were then asked which of the questions from the prior survey related to their work, and what they felt was important for someone in their position/field to know? The literature reviewed aided the survey development by centering constructs such as educational attainment, peer support, self-identified mental health, and moral injury. In total, 114 questions were included in the survey. The CPS contained the following sections: Informed Consent, Your Shelter/Clinic (16 questions), Your Veterinary Social-Work Program (4 questions), Working with Pet Owners (14 questions), Community Partners (3 questions), Team Member Support (22 questions), Abuse and Neglect (12 questions), Documentation (8 questions), Interns (6 questions), Your Social-Work Program Structure (7 questions), and About You (12 questions). Some questions included logical skip patterns based on responses, and all questions were optional. Open-ended questions were included but the survey was primarily closed-ended questions. Closed-ended questions were multiple choice, Likert scale, and rank order. This survey was accessed through one link.

2.2. Survey Distribution

As noted by Hoy-Gerlach and colleagues [5], there is no official count of VSWs. There are a number of reasons why it has been difficult to measure the prevalence of VSWs: 1. some professionals were in VSW practice before the launch of a formal education program; 2. there are no standards of practice, code of ethics, or licensure requirement, thus there is no registry of practicing professionals, which also allows for use of the professional title without evidence of education; 3. membership to any association (i.e., the International Veterinary Social Work Association) is voluntary; and 4. VSWs are employed in a wide variety of practice settings, thus a survey of a single setting (i.e., animal shelters) only captures a small portion of those employed.

Even though there is no official count of employed VSWs, there is a peer-support list of over one hundred, North America-based, VSW professionals who predominantly work in animal hospitals and/or animal shelters. The list was initially created by the VSW at The Ohio State University as a means of pulling professionals together for virtual meet-ups. The list was current in 2023, with on-going efforts to update.

The survey was conducted in Qualtrics. Prior to distribution, IRB approval was sought and granted (IRB2024-39). An anonymous link was distributed via the University of Tennessee Knoxville–Veterinary Social Work listserv, the International Association of Veterinary Social Work e-newsletter, and by personal email from the research team to those known to be working in relevant positions. Those who received the survey had the opportunity to forward it to peers and colleagues. The survey was open for ten weeks (November 2023–January 2024), with two rounds of repeat emails going to the listserv to remind the VSWs of the survey.

2.3. Data Analysis

Although 25 respondents entered the survey, a review of the responses found that in some cases more than half of the questions were left unanswered by respondents. In some cases, respondents answered about half of the items and stopped and in other cases, respondents skipped over items at random. Due to lack of clarity as to whether data were missing at random or in a biased manner, we decided to include in the analytic sample only those who answered 50% or more of the items with the understanding that this reduced the size of an already small group and the ability to carry out multivariate analyses. There are no concrete rules for when to delete a case due to missing data. Retaining responses for those with fifty percent of questions answered is in alignment with federal survey methods [17]. This conservative approach of reducing the sample was chosen in lieu of using multiple imputations (MIs) because a relatively large number of observations (100) is needed to ensure reliable results of MIs. When dealing with a high proportion of missing data, smaller sample sizes can lead to increased bias and reduced accuracy in imputation. In this case, we followed guidance of Jakobsen and colleagues [18] and Mirzaei and colleagues [19] to use a deletion method and report the results.

We chose to use the original, raw data, rather than statistically curated data to complete the survey set. All analyses conducted were descriptive using the IBM SPSS version 28 application. Content analysis was applied for the open-ended questions.

3. Results

The respondents were primarily female (86%, n = 12) and White (92%, n = 22), with one individual identifying as Black and three individuals also identifying as Latinx. The majority used “social worker” as their professional title (79%, n = 11) but 3 individuals endorsed “counselor”, “psychologist” and “other” as their titles. The majority (72%, n = 10) had a master’s degree. Two respondents indicated that they had the VSW certificate while 4 did not, and 36% (n = 5) were in the process of obtaining the certificate with 3 planning to in the future.

Fifty-seven percent (n = 11) had at least five years of experience practicing in mental health before starting in the shelter. Interestingly, there was a greater number who were new to the VSW field with less than five years of experience (64%, n = 8), but a few respondents endorsed working between six and sixteen years in this area of animal-shelter social work. The majority reported that they were the only social worker in their shelter (71%, n = 13).

When asked in open-ended questions how and why they entered this field, the answers varied but a few trends were observed. Some respondents came into VSW when they identified the need from working on the “human” side, and an equal number said they moved into the position after working on the animal medical side as technicians or nurses or control officers. One respondent wrote: “I wanted to combine that (shelter interest) with my interest in law enforcement. Once realizing the lack of resources available for people experiencing animal cruelty charges, I decided to change my scope by going to SW school and working to provide resources for those individuals”.

Personal experiences were also mentioned as a motivating factor. Therefore, most respondents entered their VSW role because of seeing the need, either from a position of working with humans or animals, or from their personal experiences as a pet owner; they recognized the intersectional needs and responded.

3.1. RQ1: Understand the Role of the Veterinary Social Worker Employed Within Animal Shelters

The role of VSWs is not specific to one population, but rather bridges multiple groups including clients and their practice community (i.e., colleagues). Respondents shared that most of their time was devoted to helping pet owners from under-served communities (95%) and the public (84%), and working with other human service organizations (79%), suggesting that they are highly engaged in the community. Within the shelter, they worked with individuals surrendering their pets (79%), with the staff/team (74%), and with clinic clients (74%).

In the open-ended questions, they additionally reported working with certain sub-populations such as older adults, veterans, families experiencing violence, and/or those having extended hospital stays. Clients were referred to the veterinary social worker for many reasons (

Table 1. Reasons for referral to the veterinary social worker in the animal shelter (1, rarel; 3, sometimes; 5, always).

Reason	% Rarely	% Sometimes or Always
Client mental health support	33.3	66.7
Community referrals for humans	13.3	86.6
Community referrals for pets	20	80
Connect to resources within the shelter	20	80
Discharge planning	46.7	53.3
Diversion from shelter/keep pets in the home	26.7	73.3
Financial counseling and low-cost clinic referrals	20	80
Quality-of-life decision making	46.7	53.4
Situational de-escalation	13.3	86.6
Support for euthanasia	26.7	73.3
Support for grief	33.3	66.6
Suspicion of cruelty/neglect	40	60
Suspicion of violence in the home	26.7	73.4

), but primarily for de-escalation and crisis management, through community services referrals, for connection to community resources for pets, and for financial guidance. Potential clients were referred to the veterinary social worker when a family wanted to surrender their pet but had not considered other options (e.g., “relinquishment diversion”—a strategy to decrease the number of pets entering shelters), when the owner was struggling with a decision about euthanasia, or when there was concern about potential violence in the home.

Therefore, pet owners who are accessing services through an animal shelter often require assistance with basic needs such as housing and utility assistance, food resourcing (both humans and pets), medical care, and safety planning, which impact all in the home.

3.2. RQ2: How Do VSWs Self-Identify Their Scope of Practice

Sixty percent of respondents reported that they provide help and support for the members of the veterinary team in addition to clients of the shelter. For those who work with both groups, respondents estimated that at least a quarter of their work time was with the animal-shelter team. They self-identified as a low-key presence on the team: “Showing my face in the shelter keeps people aware of my presence”. The VSWs noted that gaining trust by being transparent and clear is critical to earning trust:

“Consistency and transparency are key to earning the trust of team members”.

“Open communication”.

“[K]eeping separate and staying neutral”.

Educating the team about the role of the veterinary social worker was also a consistent task: “I want them to understand my role and respect social work as a profession…: If they are unsure of what we can help with to please ask we may be able to do more things than they think we do”; “We can help. They don’t have to do this alone”.

Respondents identified instances that impacted mental health for the veterinary team included behavioral euthanasia, traumatic deaths, and returning pets to homes where they were likely experiencing housing instability or potential for neglect. Organizational challenges, such as abrupt terminations of staff, absence of career growth trajectory, low salary, and general understaffing also caused mental health stress to the veterinary team. Moreover, one respondent observed that “many of the people attracted to this work are living with serious trauma or mental illness”.

Table 2. Reasons for team members reaching out to the veterinary social worker in the animal shelter (1, rarely; 3, sometimes; 5, always).

Reason	% Rarely	% Sometimes or Always
Concern about an abusive relationship	44.4	55.6
Concerns about another team member’s wellbeing	22.3	77.7
Counsel on stressful family/personal relationships	0	100
Counsel on how to communicate with a team member or supervisor	11.1	88.9
Debrief about a client problem	22.3	77.7
Debrief about a personal problem	22.3	77.7
Debrief about a traumatic incident outside of work	22.3	77.7
Ethical or quality-of-life concerns about a client’s pet	0	100
Get help with homicidal ideation or intent	100	0
Get help with suicidal ideation or intent	33.3	66.7
Help with mental health/wellness (anxiety, depression)	11.1	88.9
Personal financial concerns	44.4	55.6
Pet loss support (their pet)	0	100
Quality-of-life concerns about their own pet	33.3	66.6

displays the reasons that staff reached out to the VSW.

Assessing staff suicide risk as a prevention strategy to minimize crisis is a crucial aspect of engagement. Twenty-two percent of respondents shared that they have performed a suicide risk assessment. Sixty-seven percent of the respondents endorsed the prompt that they were sought out by a team member to “get help with suicidal ideation/intent”. One respondent noted that their greatest accomplishment was putting a suicide prevention procedure in place in their shelter, which is not a common practice in animal shelters according to the respondents whose role included suicide prevention work.

Group psychoeducation sessions were facilitated by VSWs in addition to the one-on-one sessions as collective prevention work. In open-ended comments, the VSWs responded that the sessions most frequently delivered in a group were de-escalating crises, preventing or reducing compassion fatigue, setting boundaries at work and home, and developing sustainable self-care practices.

City and county governments may have contracts with animal shelters to assist with animal control and to investigate cruelty, abuse, and neglect cases. VSW involvement with abuse and neglect varies with approximately half (53%) sharing that they worked with animal control. Interestingly, the respondents stated that they saw cases of neglect daily, and that half of these cases were the result of limited access to care. The VSWs worked directly with the veterinary team to aid their understanding of lack of resources versus intentional neglect: “I have seen staff attitudes toward clients who are struggling to care for their pets improve since we started trauma informed care training” and “in some cases, that are not extreme abuse, reminding the team that poverty and abuse are not the same but can co-exist due to the circumstances. And reminding that neglect may not be that person’s intention but a product of their situation”.

4. Discussion

Competence and explicit training in human and/or veterinary medicine helps shelter VSWs become competent in practice. From the survey findings, it is evident that VSWs practice in a unique situation of servicing the animal-shelter team and clients of the animal shelter simultaneously, which may require advanced skills. Many of the respondents lacked advanced training in VSW, which could make working in an animal shelter a challenging first VSW position.

These findings parallel those of Hoy-Gerlach and colleagues [5]. From the outset, VSW education needs to be accessible within the social-work education program. A consistent curriculum for education and standards of practice would be advantageous for practitioners going forward. VSW is a specialty area of practice that requires field placement/internship, coaching, and mentorship. Related to this study, field placements need to be accessible in animal shelters with support and mentorship of a VSW. It can be argued that education only ramps up upon graduation. As such, the expansion of VSW content in social-work continuing education is necessary, and should be required. At a mezzo/macro level, social-work positions need to be created in animal shelters to employ social workers, supported by a sustainable living wage. These social workers then become agency supervisors to students in their field placements.

This mirrors the conversation in Callahan [9] which argues that starting the VSW education and training in the master’s level is potentially too late in the education experience, as most students enter into fieldwork in their first year of master’s level education.

VSWs navigate ethical issues, in alignment with the practitioners licensing body (i.e., NASW), such as respecting a client’s right to self-determination in relinquishing their pet or not, while validating a team member’s moral distress in the same situation.

Respondents indicated ambiguity in their role and lack of understanding of social work by the animal-shelter team, creating additional challenges. There is complexity in the workplace dynamic for social workers to walk the line between professional colleague and mental health support to colleagues, as exemplified in this comment about the need for “[B]eing clear about your role”. Based on the findings, the veterinary social worker is responsible for educating the team about their role and scope of practice. As such, there are boundaries that should be explicit in the practice of VSW in these settings. While it is appropriate to engage in crisis intervention, including screening for suicidality, the veterinary social worker should not be seeing a staff member on an on-going basis, but instead, engaging in “light touch” individual interventions and supporting and making referrals to mental health services. Having accessible and low-barrier employee assistance services to address the mental health needs and a shelter culture of self-care of the workforce is critical to the veterinary social worker maintaining their role boundaries [5,8,11,12,20].

Emergent in the data was the idea that veterinary social workers provide a safe space to talk. Talking about one’s mental health with transparency and vulnerability while at work may be challenging, and yet that is exactly what veterinary social workers are asking their team to do. Employees need to know that their peers and managers buy in to the veterinary social workers’ role (i.e., time) within the agency [20]. Ensuring that the services offered by the veterinary social worker are optional and not mandatory aids in ensuring conversation is honest, which in turn empowers employees to ask for what they need—mental health support. At the same time, this embedded mental health care support requires the veterinary social worker to manage dual relationships of serving the client and the animal-shelter team. For example, a team member may seek time with the VSW one day, and then work alongside that team member the following day while serving a client. At the very least, being a veterinary social worker in an animal shelter requires the ability to set and maintain professional boundaries.

Findings suggest that a solid grounding in mental health social-work practices, specifically in crisis management, building emotional resilience, and assessing suicidal risk serve as protective factors for VSW professionals. Even with protective factors in place, VSWs may still experience compassion fatigue and moral injury throughout their professional career [10]. As such, peer support groups and community-based learning may be opportunities to intervene early and effectively to address moral injury. For example, the veterinary medicine profession could mirror human medicine and apply a “grand rounds model” which is not yet discussed in the peer-reviewed literature as a potential opportunity for peer support. Again, consistent training and coaching is necessary to ensure longevity in the profession. Enhanced community relationships also allow for increased cross-reporting of human/animal cruelty, referrals to human resources, and the frequent connection to the macro-level issues that both humans and animals face. The challenges that pets face do not exist in a vacuum, but affect all members of a community (human and animal).

4.1. Limitations and Suggestions for Future Research

A major limitation of this study was the small sample size, but given the number of employees in the profession, this was not unexpected. Veterinary social work in animal-shelter settings is a new area of practice. As stated, there is no official count of VSWs. Cooperative peer tracking of VSWs and job postings through the peer support list shows there are very few paid positions for VSWs in animal shelters in the United States. This is not surprising given most shelters are non-profit or municipal agencies with limited budgets, compared to veterinary hospitals and specialty centers, where VSWs are more common. The researchers used all known lists and community contacts to disseminate the survey. Multiple emails were sent and a careful survey oversight reviewed daily the number of surveys submitted. Given the number of people on the current VSW listserv for practicing in animal shelters, a 10% response rate is fair and empirically sound.

While the questions were deemed important by practitioners, the time needed to take the survey, its length and lack of incentive for completion were deterrents. Future research should use a mixed-method approach with a shorter general survey coupled with structured one-on-one interviews. A staged incentive (small incentive for a basic survey and a larger incentive for participating in a structured interview with an interviewer) would likely result in a more robust response and coverage. Finally, as most VSWs support practice standards, appealing to VSWs in animal shelters to determine the future of their work may be a strong incentive to participate.

The lack of diversity in the VSWs surveyed is representative of the known employed persons, and also indicates a need to intentionally diversify the profession. While veterinary medicine and social work have professional initiatives to do so within their own fields [21,22], the VSW field needs to engage in action steps rather than relying on slow cultural change of professions at large. The overrepresentation of white, cis women may lead to challenges of perceived power and privilege by the clients they aim to serve. As with social-work practice, the foundation of anti-racist and anti-oppressive practice includes creating and supporting a VSW workforce that reflects the vulnerable and marginalized communities being served [23,24]. This is a current limitation and is an opportunity for future research.

4.2. Future Research and Practice

The CPS, with modification to the length of the survey, will be reissued to practicing VSWs within the next five years to study developing trends within the profession. Future CPSs will continue to explore VSW roles and scope of practice throughout the broader field of social work. An opportunity for further research is to expand the CPS to a broader audience of animal care workers who are in animal shelters as well as other community organizations.

Given that there are no known data about the number of practicing VSWs, any research that gets closer to understanding the breadth and depth of the profession is advantageous. While there currently are no standards of practice, code of ethics, or licensure requirement, nor registry of practicing professionals, any research that could advance the professionalization of VSW would be beneficial to practitioners. Standards of practice are needed, ideally in parallel to the broader social-work code of ethics, and in tandem with general VSW practice standards. Thus, two research and practice recommendations are to generate a listserv of all practicing VSWs, and to further the development of standards of practice and a code of ethics. Currently, both are being spearheaded by the International Association of Veterinary Social Work (personal communication, A. O’Reilly, 26 October 2024).

Shelters also may have expectations for a VSW, such as impacting intake and diversion rates and/or increasing services such as spay/neuter. Future research on the needs and expectations of a VSW in a shelter and the alignment with the NASW code of ethics, the aligned mental health profession’s code of ethics, and perhaps the Therapy Animal’s Bill of Rights [25] may be useful.

5. Conclusions

Often overlooked as a valuable core resource of the community, animal shelters have long served pets, whether through providing low-cost medical care, shelter for strays, protecting relinquished animals, or a host of other services. The animal care workers within these organizations may love their job, while also experiencing mental health challenges from the chronic trauma of the work. As such, VSWs have carved out a niche practice wherein they serve the community (i.e., pet owners) and animal care workers—a feat not undertaken within many professional spaces. While the formal role and scope of practice of the VSW may not be clearly defined, those in the practice of veterinary social workers are confident about their work and impact.