Mandated Reporting – Child Abuse

Mandated Reporting – Child Abuse

Sexual and child protection laws in New Jersey, such as the S.L. 2019-245, have mandated that all people and workers in healthcare settings, including social workers and behavioral psychologists, report cases of child abuse. The mandated reporting includes any suspicions that a child or children may be subjected to direct abuse or actions that may be termed abusive to the child’s physical and mental well-being. However, social workers and psychologists have varied experiences with mandated reporting. This article presents an assessment of an interview with Dr. J.B.K., a licensed clinical social worker (LCSW) and a behavioral therapist working with Advance Counseling Center based on a mandated report she made. Her practice focuses mostly on children, preteens, and teenagers. The interview assessment identifies the experiences of behavioral therapists and psychologists with mandated reporting.

Experiences of the Interviewee

According to Dr. J.B.K., the case she reported involved a 6-year-old girl from a family she has been working with for the last two months. She made the mandated report as per New Jersey’s directives on mandated reporting. She had noted certain behaviors the child displayed that indicated possible abuse. She then followed up and determined that there was a reasonable need to make the reporting and ensure that the child was safe. She then contacted the New Jersey Division of Child Protection and Permanency (DCP&P) via the provided portal. In the report she made, she defined the behaviors and concerns the child displayed and the scratches on her body she had noticed. She expressed her concerns about the safety and welfare of the little girl. However, the interview highlights that making the mandated report is not an easy decision an LCSW makes. Dr. J.B.K., in response to a question on how she felt when she knew she had to make the mandated report, noted that “It was indeed a difficult decision, and I felt a mix of emotions. I felt concerned for the child’s safety.” At the same time, she noted, “I also had a sense of responsibility to ensure the child’s well-being. At the same time, there was a level of anxiety about the potential impact this report could have on the child and the family involved.” Although the New Jersey laws on child protection require that any suspicions of child abuse be reported immediately, Dr J.B.K. notes that she had to collect information and evidence on the girl being abused and made the reporting once she had enough information to suspect abuse reasonably.

The interview with Dr. J.B.K. highlights both negative and positive experiences specialists in the behavioral health field have with mandated reporting. One experience and concern identified is the emotional impact mandated reporting has on the behavioral specialist, the individual abused, and the family and people involved. Dr. J.B.K. noted that she had mixed feelings about making the mandated report. Firstly, although she has never experienced any retribution for making a mandated report, she noted that retribution for such a report is a valid concern for many professionals in the field. She advises that it is best to follow the proper procedures provided by the New Jersey laws in the interest of child and sexual abuse individuals.

It is clear from the interview that clients may feel betrayed if they learn that the health professional they sought assistance from has reported them. This alone has the potential to break all trust the client had in the therapist and, in most cases, leads to a breakdown in the therapeutic relationship that had developed. This can also hinder open and honest communication in therapy in the future. For instance, Dr. J.B.K. noted that after making the report, the New Jersey Division of Child Protection and Permanency (DCP&P) officials contacted her and came to check on the child. The family accused her of being jealous of their family and wanted to take their child away. The woman of the family, as Dr. J.B.K. noted, “…she called me a witch and a family breaker.” Furthermore, Dr. J.B.K. added, “She said she was stupid to trust me thinking I would make her family well.” The girl’s mother further noted that Dr. J.B.K. betrayed her after she was open with her. This shows that behavioral specialists and clinical social workers such as Dr. J.B.K., despite having reasonable concerns for the safety and well-being of the individuals involved, also face the risk of breaking doctor-client confidentiality and privacy. Arguably, although mandated, making mandated reports clearly raises ethical concerns related to confidentiality and privacy. In the behavioral health field, confidentiality and privacy define the doctor-client relationship, which is essential for positive outcomes in psychotherapy (Centeno-Gándara, 2021).

Additionally, as the interview with Dr. J.B.K. highlights, professionals in the behavioral field experience a complex environment of practice that is prone to major conflicts between ethical and legal perspectives of mandated reporting. Dr. J.B.K., as she stated, must balance her duty to protect all of her vulnerable clients as well as remain obligated to maintain the trust and privacy of their clients. Regardless of the legal requirements to make mandates reporting, health professionals are required to abide by their ethical obligations to maintain confidentiality and protect client autonomy (Pozgar, 2019). Dr. J.B.K. noted that, although necessary, it is hard to deal with the outcomes of making mandated reporting. This case made her feel like a betrayer and a family breaker, but she also feels she always must do the necessary, and that is what makes her work meaningful. These experiences may negatively impact the physical and mental well-being of behavioral therapists and social workers, with a negative impact on their job satisfaction and meaningfulness of work. As such, this creates the need to find approaches that increase the meaningfulness of work for occupational therapists in mental health as well as their work-related well-being for better work satisfaction and improved professional identity (Scanlan & Hazelton, 2019).

Summary

Dr. J.B.K.’s experiences from the interview highlight some of the challenges mandated reporting creates in the behavioral health field. The emotional impacts and the conflicts mandated reporting creates between the legal and ethical perspectives of practitioners in the field significantly affect client trust, therapy outcomes, and future client-therapist relationships. It further creates safety concerns for the individuals involved and the therapist. Regardless, it is important to weigh in between the legality and ethics of mandated reporting to ensure that mandated reports align with the ethical and legal principles that guide practice in the field.

References

Centeno-Gándara, L. A. (2021). Improving the physician-patient relationship utilizing psychodynamic psychology: A primer for health professionals. Health Psychology and Behavioral Medicine, 9(1), 338–349. https://doi.org/10.1080/21642850.2021.1914052

Pozgar, G. D. (2019). Legal and ethical issues for health professionals (5th ed.). Jones & Bartlett Learning.

Scanlan, J. N., & Hazelton, T. (2019). Relationships between job satisfaction, burnout, professional identity and meaningfulness of work activities for occupational therapists working in mental health. Australian Occupational Therapy Journal, 66(5), 581–590. https://doi.org/10.1111/1440-1630.12596

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Interview one person in the behavioral health field who has made a mandated report. This may be someone you already know, or it could be someone from your community. To find practitioners in your community, check out the Psychology Today website link in the Topic Resources folder.

Include the following questions in your interview:

How did you make the report?
What did you report?
What type of report was it (e.g., protective services or law enforcement)?
How did you feel when you realized you would need to make the report?
How much time did you have between identification of the need to report and reporting?
How much time does your state give you to make the report?
Have you ever feared retribution? What do you do when you fear retribution?
Write a 500-750-word assessment of your interviewee’s experience. Include the original dialogue where it would be helpful to the understanding of your investigation. Include a 75-100-word summary of your thoughts and concerns regarding reporting and being a mandated reporter.