The Power of Language: Introducing An Alternate Paradigm in Veterinary Communication

1. 15/02/2012 1 The Power of Language:Introducing An Alternate Paradigm in Veterinary Communication Debbie Stoewen DVM, MSW Clarification of social location: This presentation represents a merging of the two disciplines, veterinary medicine and social work, in the area of �communication� in companion animal practice. In designing this presentation, I have borrowed from a key theoretical paradigm, worldview or philosophy found in certain communication practices in social work and applied it to communication in veterinary medicine. Consequently, in speaking to you here today, my position represents that of both a small animal clinician and a social work practitioner, promoting the appreciation for and adoption of a paradigm of practice found in social work to that of veterinary medicine. Clarification of social location: This presentation represents a merging of the two disciplines, veterinary medicine and social work, in the area of �communication� in companion animal practice. In designing this presentation, I have borrowed from a key theoretical paradigm, worldview or philosophy found in certain communication practices in social work and applied it to communication in veterinary medicine. Consequently, in speaking to you here today, my position represents that of both a small animal clinician and a social work practitioner, promoting the appreciation for and adoption of a paradigm of practice found in social work to that of veterinary medicine.

2. 15/02/2012 2 Paradigms/Worldviews: are the underlying explanations theories fundamental models or frames of reference used to organize our observations and reasoning to make sense of the world. (Babbie & Benaquisto, 2002, p. 32) Let�s start by taking a brief moment to look at exactly what a paradigm or worldview is. Read SLIDE.Let�s start by taking a brief moment to look at exactly what a paradigm or worldview is. Read SLIDE.

3. 15/02/2012 3 The Major Paradigms Regarding�Ways of Knowing and Understanding the World� Traditional/Modernist Worldview Alternative/Postmodern Worldview There are two central philosophies or major paradigms regarding "Ways of Knowing and Understanding the World�: the traditional/modernist worldview and the alternative/postmodern worldview. Now let�s consider our profession and examine the two paradigms or worldviews through the lens of veterinary medicine, recognizing from the start that veterinary medicine, borne of the medical model, is borne of the traditional/modernist worldview. There are two central philosophies or major paradigms regarding "Ways of Knowing and Understanding the World�: the traditional/modernist worldview and the alternative/postmodern worldview. Now let�s consider our profession and examine the two paradigms or worldviews through the lens of veterinary medicine, recognizing from the start that veterinary medicine, borne of the medical model, is borne of the traditional/modernist worldview.

4. 15/02/2012 4 Traditional/Modernist Worldview  Truth exists and can be known. Observing carefully will reveal the truth. Observers are separate from the observed. Reduction of larger parts will get closer to the truth. Problem-oriented � identify causes. Pathology-uncovering � disease/disorder can be uncovered. Past-oriented � causes lie in the past. Individuals operate independent of the environment. Causes are inside the individual. Experts give treatment. (Lankton & Lankton, 1998) The modernist worldview views truths as "out there," as tangible realities discoverable with careful, objective, and deductive observation and methodology. Being pathology-uncovering, it seeks to identify the causes of problems, diseases and disorders, recognizing causes as traceable to the past and problems as within the individual. Individuals are perceived to operate independent of the environment. The modernist approach purports the veterinarian to be hierarchically separated from the client system, providing treatment as an expert. The modernist worldview views truths as "out there," as tangible realities discoverable with careful, objective, and deductive observation and methodology. Being pathology-uncovering, it seeks to identify the causes of problems, diseases and disorders, recognizing causes as traceable to the past and problems as within the individual. Individuals are perceived to operate independent of the environment. The modernist approach purports the veterinarian to be hierarchically separated from the client system, providing treatment as an expert.

5. 15/02/2012 5 Alternative/Postmodern Worldview Truth is co-created. Participation is all that is possible � observation is participation. Observers are in the system they observe. Punctuation of the experience is basically arbitrary. Goal-oriented � focus on the desired differences. Health-discovering � helps build desired resources. Future-oriented � purpose lies in the present and the immediate future. Individuals and environments form an ecosystem. Problems occur reciprocally and cyclically between and among parts of the system. Change agents help create a context for problem-solving. (Lankton & Lankton, 1998) The postmodern worldview takes a different perspective. It sees truth not as an external and identifiable objective reality, but as co-created through dialogue. It sees the observer as inherently a part of the system being observed, objectivity being an impossibility. It believes that multiple perceptions are possible, depending on one's perspective. It focuses not on the past or the problem, but on the future and the possibilities, being health-discovering versus pathology-uncovering. It views the individual from an ecosystems perspective, recognizing layers of potential influences. It thus views problems as occurring reciprocally and cyclically between and among the different parts of the system. The postmodern worldview sees the veterinarian not as a separate expert, but as a collaborative "change agent" helping create a context for problem-solving. So how can we, as veterinarians, take advantage and make use of the best of both worldviews, both paradigms? Firstly, by continuing to apply the modernist approach to the mechanics of medicine � continuing to work from the medical model � and secondly, by complementing this with the postmodern approach to the art of medicine � communication. And just how do we do this? We need to firstly understand the four key ideas that relate to the postmodern worldview and then we can use this understanding as our entry point into veterinary practice.The postmodern worldview takes a different perspective. It sees truth not as an external and identifiable objective reality, but as co-created through dialogue. It sees the observer as inherently a part of the system being observed, objectivity being an impossibility. It believes that multiple perceptions are possible, depending on one's perspective. It focuses not on the past or the problem, but on the future and the possibilities, being health-discovering versus pathology-uncovering. It views the individual from an ecosystems perspective, recognizing layers of potential influences. It thus views problems as occurring reciprocally and cyclically between and among the different parts of the system. The postmodern worldview sees the veterinarian not as a separate expert, but as a collaborative "change agent" helping create a context for problem-solving. So how can we, as veterinarians, take advantage and make use of the best of both worldviews, both paradigms? Firstly, by continuing to apply the modernist approach to the mechanics of medicine � continuing to work from the medical model � and secondly, by complementing this with the postmodern approach to the art of medicine � communication. And just how do we do this? We need to firstly understand the four key ideas that relate to the postmodern worldview and then we can use this understanding as our entry point into veterinary practice.

6. 15/02/2012 6 The four key ideas that relate to the postmodern worldview: Realities are socially constructed. Realities are constituted through language. Realities are organized and maintained through narrative/storying. There are no essential truths. (Freedman & Combs, 1996, p. 22) Read SLIDE. They are generated through social exchange. In other words, language creates realities. We live our lives through stories and storying. Realities are a matter of perspective, multiple perceptions accepted as valid. Now taking these key ideas and bridging them to you as clinicians, I have two questions for you to consider: Read SLIDE. They are generated through social exchange. In other words, language creates realities. We live our lives through stories and storying. Realities are a matter of perspective, multiple perceptions accepted as valid. Now taking these key ideas and bridging them to you as clinicians, I have two questions for you to consider:

7. 15/02/2012 7 Questions for you to consider: �What realities do you want to create with your clients?� �How will you create them?� Read SLIDE. You are creating realities � the experiences your clients experience. You are creating them through the language you use and the stories you build with your clients. Read SLIDE. You are creating realities � the experiences your clients experience. You are creating them through the language you use and the stories you build with your clients.

8. 15/02/2012 8 Veterinary Medicine Meets Postmodernism The Postmodern Approach: A Methodology So holding these questions in our minds, let�s move forward and take a look at veterinary medicine as it meets postmodernism � a methodology. So holding these questions in our minds, let�s move forward and take a look at veterinary medicine as it meets postmodernism � a methodology.

9. 15/02/2012 9 Step One: Join the Client System Surrender the role of expert, and instead become a collaborator cofacilitator coparticipator cocreator codirector� to �co-author� the new story. Meet the client where the client is and start from where the client is. Minimize the �sterile space� typical of the medical model. When your client walks into your clinic, entering into its ways of being, your space, and your world of knowledge, to access needed expertise, it is not up to your client to join with you but for you to join with your client. This means giving up the role of expert and entering into their world while in your world � your domain. It involves an equalization of power. So� Read first section of SLIDE and move to second section. Joining the client where the client is, within the client's story, adds a whole other dimension of possibilities to the entire veterinary-client-patient exchange and experience. Read third section. [How do you join the client? By showing genuine interest in them and their pet; by asking personal questions regarding their relationship or lifestyle; by validating them both; by supportively collaborating the entire experience (working from a team approach).] When your client walks into your clinic, entering into its ways of being, your space, and your world of knowledge, to access needed expertise, it is not up to your client to join with you but for you to join with your client. This means giving up the role of expert and entering into their world while in your world � your domain. It involves an equalization of power. So� Read first section of SLIDE and move to second section. Joining the client where the client is, within the client's story, adds a whole other dimension of possibilities to the entire veterinary-client-patient exchange and experience. Read third section. [How do you join the client? By showing genuine interest in them and their pet; by asking personal questions regarding their relationship or lifestyle; by validating them both; by supportively collaborating the entire experience (working from a team approach).]

10. 15/02/2012 10 Step Two:Listen to the Client�s Story Listen from both paradigms. Listen on both a content and process level. Listen for the client�s meaning system. This includes the client�s world paradigm and value base the social location of the pet in the family the client�s relationship with you & your hospital Instead of simply listening to people's stories with an ear to 'taking a history� or 'offering a diagnosis and treatment plan,' I suggest that with one ear, listen as the modernist you are, and with the other, listen as a postmodernist! Listening with both ears, the modernist and the postmodernist, you will gain the fullest depth of perspective. You will be able to pick up on the fine details of the client�s story and meaning system, details that will then serve you well when you need to shape and integrate the veterinary story into their story. Pay attention not just to �the facts� but also the the dynamics of social exchanges, whether it be the human-to-human or the human-to-animal exchanges. Determining the meaning system within the story is of vital importance because this is where you will find where and how to connect with your client � this is where you work with clients. And again, you connect with clients in their meaning system, not yours. Remember too, that meanings determine the choices clients make for their pets. Sub-notation if questioned: How do we define the pet's social location? (role, family position � internal or external, and attachment dynamics) 1.��� It's role in the family (house pet, guard dog, hunting dog, working dog, show animal, breeding stock etc.), 2.��� It's hierarchical position within the family � including the changes within such (first "baby" now less tended to and relegated to lowest on the totem pole by the "real children," the child replacement for empty nesters, the "child" for yuppie couples, the traditional pet in the family there to teach children responsibility and the basics of life and death, an "animal" that is fed, watered and sheltered but holds it's rightful place outside (external to the family), a working (herder) dog and/or companion, a senior's sole living companion, the gay/lesbian couple's "children" etc.), 3.��� The level and kind of attachment (normative, disengaged, enmeshed), and 4.��� The differential dynamics of varying attachments by different family members holding different power positions. Instead of simply listening to people's stories with an ear to 'taking a history� or 'offering a diagnosis and treatment plan,' I suggest that with one ear, listen as the modernist you are, and with the other, listen as a postmodernist! Listening with both ears, the modernist and the postmodernist, you will gain the fullest depth of perspective. You will be able to pick up on the fine details of the client�s story and meaning system, details that will then serve you well when you need to shape and integrate the veterinary story into their story. Pay attention not just to �the facts� but also the the dynamics of social exchanges, whether it be the human-to-human or the human-to-animal exchanges. Determining the meaning system within the story is of vital importance because this is where you will find where and how to connect with your client � this is where you work with clients. And again, you connect with clients in their meaning system, not yours. Remember too, that meanings determine the choices clients make for their pets. Sub-notation if questioned: How do we define the pet's social location? (role, family position � internal or external, and attachment dynamics) 1.��� It's role in the family (house pet, guard dog, hunting dog, working dog, show animal, breeding stock etc.), 2.��� It's hierarchical position within the family � including the changes within such (first "baby" now less tended to and relegated to lowest on the totem pole by the "real children," the child replacement for empty nesters, the "child" for yuppie couples, the traditional pet in the family there to teach children responsibility and the basics of life and death, an "animal" that is fed, watered and sheltered but holds it's rightful place outside (external to the family), a working (herder) dog and/or companion, a senior's sole living companion, the gay/lesbian couple's "children" etc.), 3.��� The level and kind of attachment (normative, disengaged, enmeshed), and 4.��� The differential dynamics of varying attachments by different family members holding different power positions.

11. 15/02/2012 11 Step Three:Ask Questions Meaning ALWAYS lies between people and between words� this is the location where knowledge and understanding evolves. Formulate questions carefully to elicit knowledge and meaning in order to gain understanding. The identification of themes provides leverage! According to postmodernism�s understanding of meaning, meaning always lies between people and between words� Knowing this, we can only ever hope to gain an approximation of what is meant when we share words. And how do we gain this approximation? We ask questions. And as more questions are asked, and the meaning evolves and becomes clearer, themes become identifiable. The identification of themes can then provide you with leverage to better inject your story into theirs, increasing the chances to achieve successful outcomes. According to postmodernism�s understanding of meaning, meaning always lies between people and between words� Knowing this, we can only ever hope to gain an approximation of what is meant when we share words. And how do we gain this approximation? We ask questions. And as more questions are asked, and the meaning evolves and becomes clearer, themes become identifiable. The identification of themes can then provide you with leverage to better inject your story into theirs, increasing the chances to achieve successful outcomes.

12. 15/02/2012 12 Step Four:Be More and Do More! Do not just be rational, logical, objective clinicians concerned with the factual content pertaining to the patient � as promoted by the modernist paradigm� �but more! You can be more and do more by entering into the client�s story and meaning system and working from there! Read SLIDE (first half). Focus on becoming informed, insofar as possible, not just of the factual content that pertains to the patient, but of the story and meaning system of the client. Read SLIDE (second half). You can be more and do more � much, much more � by entering into the client's story and meaning system and working from there. This is strategic to successful practice!!! Read SLIDE (first half). Focus on becoming informed, insofar as possible, not just of the factual content that pertains to the patient, but of the story and meaning system of the client. Read SLIDE (second half). You can be more and do more � much, much more � by entering into the client's story and meaning system and working from there. This is strategic to successful practice!!!

13. 15/02/2012 13 It is the�Seamless Integration of Stories�that leads to optimal outcomes in every direction for all concerned: the patient! the client system! the veterinary team! Read SLIDE. Read SLIDE.

14. 15/02/2012 14 Is there a difference??? The Modern Veterinarian Subscribes to the medical model Is expert driven Is committed to �competent service delivery� The Postmodern Veterinarian Compliments & enhances the medical model with a relational model Is collaborative Is committed to �successful outcomes� Read SLIDE. In closure, I believe the incorporation of postmodernist appreciations and perspectives into veterinary medicine offers a broad challenge to the culture, traditions and the practices of veterinary medicine. It invites a re-examination and re-imagination of veterinary medicine as a helping profession. It informs a way of being in the world that does not separate professional and personal. It promotes a way of *thinking about, *experiencing, *being in relationship with, *talking with, *acting with, and *responding with the people you serve. I invite you to stretch your �ways of being� as a veterinarian to include those of both world paradigms. This, in itself, may require a paradigm shift in you. Thank you! Read SLIDE. In closure, I believe the incorporation of postmodernist appreciations and perspectives into veterinary medicine offers a broad challenge to the culture, traditions and the practices of veterinary medicine. It invites a re-examination and re-imagination of veterinary medicine as a helping profession. It informs a way of being in the world that does not separate professional and personal. It promotes a way of *thinking about, *experiencing, *being in relationship with, *talking with, *acting with, and *responding with the people you serve. I invite you to stretch your �ways of being� as a veterinarian to include those of both world paradigms. This, in itself, may require a paradigm shift in you. Thank you!

15. 15/02/2012 15 Future Developments and Directions of Postmodern / Social Construction Therapies�The postmodern social construction therapies present an ideological shift that has slowly evolved over the last 2-plus decades and do not represent a trend that will fade� The implications of this shift stretch far beyond family therapy, to other therapies and contexts outside the mental health discipline. Common among these therapies is their continuous evolution. The so-called originators and their colleagues and other thinkers and practitioners around the world continue to explore and extend the vast possibilities for therapy, education, research, organizational consultation, and medicine, as well as the complex social and cultural circumstances that challenge the earth we inhabit. (Anderson, 2003, p. 141)

16. 15/02/2012 16 Summary of the First Four Steps:The Postmodern Veterinarian� With one ear, listens as a modernist, and with the other, a postmodernist Pays special attention to the language exchanged between the client, veterinarian and patient, recognizing the role of language in creating realities Determines the story and meaning system of the client so as to best �inject� the veterinary story and meaning system Stretches his/her �ways of being� to include those skills and attributes of both world paradigms Read SLIDE. The skills, as derived from the theoretical bases of postmodernism, don�t just include ways of listening and interpreting, but also �ways of being,� of interacting and communicating with your client. And that brings us to Step Five� Read SLIDE. The skills, as derived from the theoretical bases of postmodernism, don�t just include ways of listening and interpreting, but also �ways of being,� of interacting and communicating with your client. And that brings us to Step Five�

17. 15/02/2012 17 Step Five:Use Your �Intentional Self� Use language intentionally! So often we use language without being aware of what we are "doing" while languaging � if you become aware, you then have the power to be able to use the skills at will, to intentionally apply yourself, and purposefully guide the client system towards good outcomes! ___________________ Read SLIDE. The next section represents a review of some skills and approaches specifically derived from some of the communication theories of postmodernism. You may already be using some of these skills, but may be using them without realizing or being aware that you are. However, if you become aware, you then have the power to be able to use the skill at will, to intentionally apply yourself, purposefully guiding the client system towards good outcomes. What story of hope, possibilities, and positive outcomes can be co-authored? What plan can be collaboratively arrived at? What first step � even the smallest step � can be taken? Will every possible perspective be explored? Will you recognize and put bias aside and merge as a part of the family? What ways can you encourage the family to merge as a part of the treatment team? What reality will be co-created through your intentional use of words? What words will you choose? Will you choose words of hope, possibility, and potential? What questions will you ask? Are there built in assumptions or presuppositions, and what are they? Do you know if they will get in the way? Have you asked the questions to source all possible resources the client may have? Have you adequately identified and named all the resources inherent in the patient � any and all unique strengths that can positively influence outcomes? Have you co-created the most balanced story? Have you identified the role and social location of the pet, and more importantly, how might you use this? �Language and languaging � languaging emphasizing both the activity and the power of language � inherently, intrinsically, and essentially interpersonal, are the ways we make meaning and exchange information. Read SLIDE. The next section represents a review of some skills and approaches specifically derived from some of the communication theories of postmodernism. You may already be using some of these skills, but may be using them without realizing or being aware that you are. However, if you become aware, you then have the power to be able to use the skill at will, to intentionally apply yourself, purposefully guiding the client system towards good outcomes. What story of hope, possibilities, and positive outcomes can be co-authored? What plan can be collaboratively arrived at? What first step � even the smallest step � can be taken? Will every possible perspective be explored? Will you recognize and put bias aside and merge as a part of the family? What ways can you encourage the family to merge as a part of the treatment team? What reality will be co-created through your intentional use of words? What words will you choose? Will you choose words of hope, possibility, and potential? What questions will you ask? Are there built in assumptions or presuppositions, and what are they? Do you know if they will get in the way? Have you asked the questions to source all possible resources the client may have? Have you adequately identified and named all the resources inherent in the patient � any and all unique strengths that can positively influence outcomes? Have you co-created the most balanced story? Have you identified the role and social location of the pet, and more importantly, how might you use this? �Language and languaging � languaging emphasizing both the activity and the power of language � inherently, intrinsically, and essentially interpersonal, are the ways we make meaning and exchange information.

18. 15/02/2012 18 Postmodernist Intentionality: The Applications "the performative use of language in veterinary affairs" 

19. 15/02/2012 19 �The reality that we attribute to the events, experiences, and people in our lives does not exist in the thing itself; rather, it is a socially constructed attribution that is created� and is shaped and re-shaped in language.� (Anderson, 2003, pp. 129-130)

20. 15/02/2012 20 Intentionally "mind your language" so as to prevent "iatrogenic injury," participating in practices that encourage, respect, validate, and open up possibilities, and avoiding those that discourage, invalidate or close down possibilities. Words and questions imply assumptions and have the power to create bias. Avoid language that insinuates blame, raises defenses, and discourages possibilities.

21. 15/02/2012 21 Recognize that we cannot help but lead clients � everything we say chooses one interest or direction over another, ultimately influencing outcomes. We need to watch what we say because what we talk about becomes real. We also need to watch how we say it since subtle nuances carry meaning.  Intentionally and actively lead clients in helpful directions, watching what you say and how you say it.

22. 15/02/2012 22 Intentionally use words to build people and build contexts with potential. Create not victims but heroes and heroines. The recognition of potential promotes the development of even more potential � potential potentiates potential � and people come to see their situations differently.

23. 15/02/2012 23 Intentionally build in assumptions so as to give clients subtle messages about your belief in their agency, potential and positive attributes.  Example: "How have you managed to do that?" By asking "How" we are implicitly inviting people to join in the powerful presupposition that they have personal agency.

24. 15/02/2012 24 Intentionally use language to draw forth capacities, positives, strengths, competencies, and expertise. Notice them, point them out, and underline them. Build the OK part of the client so the client can manage the non-OK part of the situation.

25. 15/02/2012 25 Intentionally and consciously monitor whether the conversation you are a part of is progressive, stable, or digressive. Adjust the direction, moving it towards the client, patient, and family's best interest, if the conversation has diverted from being constructive.

26. 15/02/2012 26 Talking about the problem can leave people going around in circles with their thinking and resultant actions. By talking about solutions and creating scenarios of possibility, people can then move in directions more satisfying and problems become lost or much less influential. Intentionally orient yourself towards "possibility talk." The client will then do the same, and together this will create a bias for possibility.

27. 15/02/2012 27 Intentionally listen closely to the client's language and use it to privilege their idiosyncratic understandings, convey respect, and keep them center stage. Such an approach places the clients' subjective experience over medical jargon and pragmatically privileges the clients' voice as the source of wisdom and solution.

28. 15/02/2012 28 Intentionally use language to indicate the presence of something, not the absence, and the start of something rather than the end of something. This creates a way of approaching the diagnosis from a place of resources and beginnings, both critical to the attainment of good outcomes.

29. 15/02/2012 29 Intentionally engage in future talk to generate not only confidence and optimism, but also move the client forward. Talking about the future, in itself, is a major step towards achieving that future.

30. 15/02/2012 30 If words of emotion are not perceived as separate entities that cause certain effects, they lose power. Add the possibility for change with words of emotions. Example: Client: "I'm devastated over this."  Vet: "I can see you're feeling devastated." Intentionally treat words of emotions as if they are verbs rather than nouns. This creates greater possibility for self-agency and empowerment.

31. 15/02/2012 31 Intentionally add a temporal component to unfreeze.  Example: Client: "I'm devastated over this." Vet: "It makes sense that you're feeling devastated right now." 

32. 15/02/2012 32 Intentionally add words to add the potential for perception versus absolute truth. Example: Client: "I'm devastated over this." Vet: "It most certainly can seem devastating."

33. 15/02/2012 33 Intentionally make use of pregnant silences. Silence, in itself, represents language. It too� speaks.

34. 15/02/2012 34 Intentionally apply language to open or close parts of stories. Open them to gain consciousness of unconscious scripts and create space for more potentiating narratives, and close them to avoid moving in unproductive circles. � �

35. 15/02/2012 35 It promotes a co-construction of the process and a co-supervision of "a joint project," resulting in greater relational connection and a closer approximation to the service the client wants, ultimately resulting in better outcomes. Intentionally engage in questions that elicit relational reflexivity.

36. 15/02/2012 36 Intentionally maintain a stance of being an "informed not-knower" for this will promote the curiosity to ask good questions� � questions that will make visible intended meanings and elicit the sources of those meanings.

37. 15/02/2012 37 Intentionally use language conscious of and building on the concept of recursiveness (actions and descriptions are circular). Doing so will help people become unstuck and move forward.

38. 15/02/2012 38 Intentionally re-phrase or re-frame or elaborate or build in analogy / metaphor if your client does not understand you� � because the onus of responsibility for clear communication is on you rather than on the client. Meaning is in the response.

39. 15/02/2012 39 Intentionally avoid colluding with a client � no matter how much you might agree � who expresses guilt and self-blame or reproach. Typically many unpredictable contributing situational factors exist, and hindsight is always 20/20. Guilt and blame will fragment the client�vet�patient system and/or get it stuck/mired, preventing forward movement towards best outcomes. The maintenance of relationship, within which problem-solving can move forward, is of primary significance.

40. 15/02/2012 40 Intentionally use cooperative rather than uncooperative language� � despite intruding or pressing thoughts. Relationship is the space wherein potential for good outcomes starts to become possible.

41. 15/02/2012 41 Intentionally avoid the use of "but," replacing it with "and." Build in inclusivity of realities, recognizing dualities, thus maintaining potential.

42. 15/02/2012 42 Intentionally make use of the words 'maybe', 'might', 'could', 'as if', and 'suppose' over the words 'is', 'does' and 'causes'. The inclusion of �tentativeness� leaves room for potential differences which together may result in the most optimal outcomes.

43. 15/02/2012 43 "We are creative wordsmiths, working� to sculpt new meaning, new possibilities, [and] new strengths with people [and their pets]." (Parton & O'Byrne, 2000, p. 78)

44. 15/02/2012 44 The theory and practice of veterinary medical communication may be substantially enriched by the incorporation of constructivist appreciations and perspectives as derived from the postmodern worldview. The formalized constructive therapies so derived include solution-focused, narrative, strategic, solution-oriented, collaborative language systems, reflecting team, interactional, and neo-Ericksonian (Hoyt, 1998; Hoyt, 2001). These therapies are "simple, optimistic, respectful, versatile, and effective" (Hoyt, 2001, p. 228) as well as collaborative and competency based. The constructivist approaches are founded on an understanding of the power of language and talking together with people to construct change" (Parton & O'Byrne, 2000, p. 45).

45. 15/02/2012 45 �The modernist perspective ultimately believes in a knowable, �real� world, the truth of which can be discovered through rational processes.The postmodernist perspective asserts that instead of certainties and �realities� which can be scientifically explored, �truth� or knowledge is created through language and meanings and is different for different people, depending on their experiences. Thus, instead of a single, knowable reality, postmodernist researchers speak of a plurality of voices, each with its own locally constructed reality. No single reality is more valid than another � indeed, diversity and difference should be celebrated.� (Alston & Bowles, 2003, p. 18)

46. 15/02/2012 46 "Social work is an applied science. The practice of social work derives from the ethical and accountable use of knowledge of human development and behaviour, social, political, economic and cultural institutions and their interaction. Social workers are educated in communication skills and understanding human dynamics from the individual to the societal level. The use of social work knowledge, skills and strategies assists in the achievement of optimum psychosocial functioning from the individual to the organizational level. The practice of social work includes, but is not limited to: policy and administration, clinical practice, social planning, community organization and research." (Ontario Association of Professional Social Workers, 1994)

47. 15/02/2012 47 ReferencesAlston, M., Bowles, W. (2003). Research for Social Workers: An Introduction to Methods (2nd Edn). New York: Routledge.Anderson, H. (2003). Postmodern Social Construction Therapies. In T.L. Sexton, G.R. Weeks, & M.S. Robbins (Eds.), Handbook of Family Therapy: The Science and Practice of Working with Families and Couples, (pp. 125-146). New York: Brunner-Routledge. Babbie, E., Benaquisto, L. (2002). Fundamentals of Social Research, First Canadian Edition. Scarborough, On: Thomson Nelson.

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