As mandated reporters, clinicians must report allegations of child abuse to child protective services (CPS). If the clinician has been working with the client or clients for a significant period of time and developed a good client-therapist relationship, reporting is undoubtedly a stressful event. To complicate matters, when a mandated reporter is contacted by agencies other than CPS requesting additional information, the question is, has the assumed confidentiality been breached? Although regulations have been written to address such cases, in real practice, mental health professionals may find themselves in difficult situations where the path to proceed is unclear.
In this blog/article, I will explain how I believe some of those situations should be approached. Please be aware that my opinions and assumptions may be flawed, but such opinions and assumptions are just that, opinions and assumptions. Please consult with another colleague, your state board, or/and get legal advice if you find yourself facing such dilemmas.
AGAIN, LET ME CLARIFY, IN NO WAY AM I EXERTING THAT I AM AN EXPERT IN WHAT I AM ABOUT TO WRITE. ON THE CONTRARY, IT IS MY OWN CONFUSION ABOUT SUCH INCIDENTS THAT MOTIVATED ME TO WRITE THIS BLOG/ARTICLE.
This is how I understand the written regulations and ethical guidelines: The identity of a mental health professional must remain confidential when in the duty of acting as a Mandated Reporter he/she reports allegations of child abuse to Child Protective Services. Thus, I believe the Mandated Reporter should only be contacted by CPS if additional information is needed, and should not be contacted by other individuals or agencies involved in the investigation. And if a professional is contacted by such individuals or agencies, the clinician should not breach confidentiality unless mandated by a court of law to do so, and in a court of law.
It is probably fair to say that mental health professionals understand that the Mandated Reporter is obligated by law to contact CPS and make a report if there is reasonable suspicion that child abuse has occurred. After the report has been made, if the alleged victim is referred by CPS to another agency (e.g., law enforcement), or to a hospital for further evaluation, that referral becomes part of the follow up investigation, and such follow up investigation should be separate from the obligated act of reporting by the Mandated Reporter (initial report). And I think this is the part that is most confusing for some clinicians. I believe most – if not all – clinicians understand that it is standard protocol for CPS, law enforcement, and hospitals/clinics to share relevant information, so that they can ascertain whether child abuse has occurred. Additionally, if the alleged victim is referred by CPS to a hospital and/or to a law enforcement agency, personnel from such agencies are by definition going to conduct an investigation. If these agencies attempt to contact the Mandated Reporter during the course of the investigation, that act of contacting the Mandated Reporter indicates that the identity of the mandated Reporter has been compromised.
I believe timing plays an important role in how clinicians react to such inquiries from non-CPS agencies. For example, if the Mandated Reporter is contacted one month after the report was made, most clinicians would assume that any disclosure at this point would indicate that the clinician would be breaching confidentiality, regardless of how his or her identity as a Mandated Reporter was compromised. But when the clinician is contacted within, let’s say, 24 hours to 48 hours by law enforcement or by a hospital after the report was made, that may become confusing to even the most experienced clinician, because the clinician could assume such inquiry as part of the initial report.
If the clinician is contacted by agencies other than CPS, I believe the clinician should not disclose any information and instead contact CPS management and request clarification about what’s the agency’s policy regarding protecting the mandated reporters or reporting party’s identity. Additionally, in such cases, I believe the Mandated Reporter must request an explanation as to whether CPS staff have any information how the identity of the Mandated Reporter was breached.
To conclude, as a final reminder, please remember that my opinions about how the reporting process should develop are just that, personal opinions.
Written by Julio Reyna, Psy.D.
Initially posted on 11/19/2009