Can the Placebo Effect Apply to Training and Behavior Modification?

To be perfectly honest, when we initially had the idea for this article, we weren’t quite sure where we were going with it.  It’s funny how what seemed to be several unrelated events of the last several days suddenly came together to point us in the right direction.

The first was a relatively recent article in the Journal of the American Veterinary Medical Association on placebo effects.  The researchers were investigating the placebo effect in the treatment of lameness due to arthritis in dogs (Conzemius and Evans 2012, Vol. 241 (10): 1314-19).

Just so we are all on the same page, a definition of the placebo effect is "a beneficial effect in a patient following a particular treatment that arises from the patient’s expectations concerning the treatment rather than from the treatment itself"*.  In contexts in which the patient has no understanding of the treatment (such as in dementia patients, very young children AND pets) caregiver placebo effects are possible.  The definition used for caregiver placebo effect in the arthritis paper was “a sham medical intervention that causes pet caregivers (owners or veterinarians) to believe the treatment they provided to the pet improved the pet’s condition.” 

A sham treatment simply means the intervention mimics the “real” treatment but without the therapeutic effects.  In the arthritis study for example all dogs were given identical appearing pills but dogs in the control/placebo group received pills without the active ingredient that was under study. 

The standard against which the subjective assessment of lameness was compared to was made using a platform that measured how much force, or weight, the dog put on the affected limb as it was led across the platform at a trotting pace.  The study was double-blinded, meaning that neither the owners nor the researchers evaluating the dogs knew which dogs were in the placebo group and which were receiving the active medication.

The results showed an astounding placebo effect of 57% for owners and on average 42% for veterinarians (in other words owners and veterinarians reported their dogs’ lameness improved 57% or 42% of the time, respectively, when the objective measurement of lameness showed the dogs were the same or worse).

So why is this paper important for trainers, behaviorists, and behavior consultants?  The first thing that comes to mind is in evaluating the effectiveness of pheromone sprays, herbal, and scent remedies.  The potential for the placebo effect here is huge, because first, few of these interventions have been subjected to double blinded controlled studies (for an exception see Denenberg and Landsburg’s paper on DAP collars in puppies), and second practitioners using them usually fail to collect both before and after data of specific behavior measures.

The second reason the caregiver placebo affects is important ties in with another recent event for us (watching a demonstration of dogs trained using remote shock collars at a home show) and the ensuing discussion on Suzanne’s Facebook page.  Let’s take the “medical” out of the definition of caregiver placebo effect from above – “an intervention that causes pet caregivers (owners or veterinarians) to believe the treatment they provided to the pet improved the pet’s condition”.

Now let’s apply that to what often happens when various methods (severe leash and collar corrections, “dominance pinning”, or a remote shock collar used at a high intensity) are used to do nothing more than suppress unwanted behaviors WITHOUT first teaching the dog what to do using positive reinforcement methods.

The owners see behavior suppression, and if what they want is a behavior to STOP then by their standards they’ve “improved their pet’s condition”.  Of course they don’t see the fear, stress and anxiety behaviors that often accompany behavior suppression obtained by unnecessarily harsh, confrontational or painful methods.  

Based on our definitions, it could be argued we are seeing a type of caregiver placebo effect.  But for this interpretation to be valid, what we need is that objective measure of improvement, similar to the force platform used to evaluate lameness.  Rather than behavior suppression being the objective measure, we should routinely ask our clients at the outset what they want their dogs to do instead.  Instead of “I want my dog to stop lunging at other dogs on walks” our measure of success should be “I want my dog to walk calmly by my side without signs of fear or anxiety when we pass other dogs”.  And then we add behavior descriptions of “calm”, “fear” and “anxiety”, which means we should routinely be teaching our clients to observe and interpret their dog’s body language during every behavior or training appointment.

Now if the outcome from a painful or confrontational intervention is a dog that shakes, has its ears back and tail down, pants, has dilated eyes as it hugs its owners leg, and is clearly is afraid to look anywhere but up at the owner when walking by a dog we can’t really deem this to be the improvement we were aiming for.

Another application of this is that we should ask our clients to measure  the behavior they see – the number of lunges and barks, the numbers of calm passes by other dogs before, during and after training – so that they have a more objective measure of how their dog’s behavior is changing.  Without that, the clients’ biases can skew their perceptions of the changes that might occur.

This is really an example of applying the scientific method for conducting research to measuring the effectiveness of our training and behavior modification methods.  We conducted a webinar course describing in detail how to do this that was available to our members of Behavior Education Network as a member benefit and available for paid registration to non-members at PetProWebinars.com.  The course even included several forms for keeping track of various behavior measures, homework sheets for owners, and more. 

Purchase the course now On Demand at PetProWebinars.  If you are a BEN member, log in and click on the link to the course on the Pro Members Only page. 

*The American Heritage® Dictionary of the English Language, Fourth Edition copyright ©2000 by Houghton Mifflin Company. Updated in 2009.
 

7 Comments

  • Sue Alexander

    Reply Reply January 15, 2013

    While I don’t use positive punishers often, when I do use them I do count and I do measure.

    Before putting a hot wire on the top of our dog yard fence, Eco would jump the fence approximately 90% of the time he was put out there; that is to say every time that he was put out there unless it was breakfast time when he would go out and come back in for food.

    We installed the hot wire and he jumps the fence 0% of the time. This is an effective treatment because it accomplished the desired effect; it stopped my dog from jumping our fence and risking being in traffic.

    Admittedly, using this, there was fallout. For three weeks, he would not go anywhere near the fence; the middle of the yard and the door to the house was his domain. Now, two years later, he uses the whole yard and has never jumped the fence since it went up.

    From my perspective, this choice I made was the best alternative to keep my dog safe from the risks of running into traffic and my horses safe from my dog chasing them. The three week cost of finding the edge of the yard itself aversive was worth it in my opinion. I am certain that if you asked Eco, he would say it was not worth it, because he liked jumping the fence and getting in with the horses, however, he doesn’t understand the greater risk of getting hit by a car if he went out into traffic.

  • Suzanne & Dan

    Reply Reply January 23, 2013

    Good example Sue – one of the criteria for the use of “aversives” in the Guidelines for Humane Dog Training document published by The Delta Society is the risk/benefit assessment. Does the benefit of using the ‘hot wire’ (keeping your dog from being hit by a car and/ or endangering your horses) outweigh the risk of the potential side effects and unpleasant experience of the hot wire. We would argue you’re correct – benefits outweighed the risk.

    The only comment we would make is that it that there there are definitely training procedures that could have been done that would have minimized or even prevented your dog’s fear of most of the yard for three weeks. Luckily your dog figured it out, but in some cases of avoidance procedures implemented incorrectly, animals never do – they are too scared to repeat a behavior that frightened/hurt them in the past so they never learn where the limits of the “bad” thing really are.

  • Greg Gibbs

    Reply Reply January 29, 2013

    In addition to R+/P- training, I would have suggested using Coyote Rollers instead of electricity. I have seen these work first-hand, and it better fits the LIMA (Least Invasive Minimally Aversive) model. However, without knowledge of this particular product. . .

  • Susan

    Reply Reply January 30, 2013

    I recently came across this interesting article about the placebo effect in humans, and I thought you might find it interesting. There is new research on how it might have some real effect in humans. Not applicable to animals, but it does point out how much we do not yet know.

    http://harvardmagazine.com/2013/01/the-placebo-phenomenon

  • Suzanne & Dan

    Reply Reply January 30, 2013

    Susan – we took a look and it is an interesting article. Obviously pets can’t have expectations about the effects of medical treatments they receive, but it certainly brings up again interesting possibilities about caregiver placebo effects. Would be interesting to replicate the Harvard study, giving pet care givers different sorts of expectations and see how they report the sham treatments affected their pets.

  • Suzanne & Dan

    Reply Reply January 30, 2013

    Well Greg, we understand that your comment is in response to Sue’s, but keeping dogs in the yard or predators out is not what really the point of our article. But we decided to approve your comment because we had never heard of coyote rollers and thought they might be of interest to our readers. Anyone who’s interested can go to CoyoteRollers.com and see for themselves. However – we won’t post any more comments about the product here because that’s really off-topic from the article.

  • Gitta

    Reply Reply January 31, 2013

    It seems to me, owner willingness to learn about canine body language and stress signals is not always there. Quite often I come across owners who waited too long, have become too frustrated to take the longer route. They want to stop the problematic behavior NOW. Of course, this is exactly the selling point for shock collars.

    I can’t find it now, but I do remember a fairly recent study showing the big gaps in owners’ ability to interpret stress signals correctly. How could we use/measure/count stress signals if the owners don’t even know what to look for? I do agree, we as professionals need to be “bean counters”. I don’t see too many owners willing to keep training records. How accurate would they be (thinking of the unintentional false reporting in diet journals people are told to keep)? I have used videos in the past to show dog behavior, owner behavior and to compare from week to week. The drawback: small cameras don’t always capture the important signals.

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