Twitter Question Mandated Reporting

A Response to a Twitter Question

I was recently asked the following question on twitter:

“Can you address the complexities of mandated reporting related to the fact that adults typically have power of consent, other than elders and those with disabilities? With battered women or those abused as children it is possible to violate confidentiality and expose people to physical and emotional pain if they do not consent to a police report. Can you address this as a part of empowering adult survivors, balanced with cutting off access by predators?”

Mandated reporting laws are state laws. Therefore, I cannot advise you about what is required in your state. The first thing you need to do is find out what the laws are. For example, in about 18 states any person who suspects child abuse or neglect is required to report it. There are also mandated reporting rules for those working with the elderly or those who have disabilities. Anyone in the health or mental health professions is required to take mandatory reporting training. It would be wise for every church to learn from those in their midst who have taken the training in their state. The church should be known for its protection and care of the vulnerable. Child abuse of any kind should always be reported to those who are trained to investigate.

Another law that needs to be considered is the Tarasoff rule which requires psychotherapists to warn if a client threatens someone’s life. Due to a case in California, therapists need to also be concerned when a family member gives information of a reliable threat by a patient regarding someone else. Please educate yourselves on your state laws and professional requirements so you are clear about what is required. Consult with both the law and with your respective professional organizations. Churches should get training from an independent organization such as GRACE www.netgrace.org  so they learn how to protect the children and vulnerable in their community.

There are however, many situations where an adult is being abused in some way and the law does not mandate a report of any kind. The issues become quite complex when you are working with adults dealing with domestic abuse, drug/alcohol addictions, rape, those being prostituted or those seemingly trapped in abusive systems (families, churches). There is usually no mandated reporting. If the victim is in a counseling relationship confidentiality standards apply. In the arenas of both health and psychological care, reporting of domestic violence related injuries or threats interfere with the confidential nature of patient/provider relationships and can quickly undermine the victim’s trust in those who are the caregivers. It is very difficult as a therapist to work with someone who is going to leave your office and return to an unsafe environment. It is downright frightening. In a domestic abuse situation this is exacerbated when the victim is part of a church that teaches her that tolerating abuse is godly. She is confused. She loves her husband and wants it to get better. She listens to her church and yet, she feels like she cannot think straight. She knows what he is doing is wrong.

Number one, if there are children in the home who are being hurt by abuse or physically threatened or neglected due to addictions, it falls under mandated reporting. When there are no children we long to simply take charge and get the victim out regardless of what he/she wants. If we do that we break confidentiality, we make choices for them and silence their voice – which happens to be what the perpetrator does. One of the cardinal guidelines for working with victims of trauma (which I repeat to new therapists ad nauseam) is that what we do in the counseling office should be the reverse of what the abuser did. The abuser silenced voice, broke trust and took away any sense of power. We need to give back her voice, remain trustworthy (which includes confidentiality) and invite him/her to exercise power over their own choices. These “muscles” are often very weak. In order to build those muscles up we have to work little by little to affirm the fears (which are justified), the desire to get out, the small choices made along the way and the truth, as it is seeded, grows. Those who have been relentlessly abused and used come to believe the lies taught to them. It is hard work overtime that eventually replaces those lies with truth.

Another factor to consider is the increased danger when trying to leave their circumstances. In domestic violence homicides about 75% occur when the woman tries to leave. People are also in danger when attempting to separate from drug dealers and pimps who do not want to lose a source of money. If your life is endangered or any number of things consent is not possible because it is not safe to say no. We do not want to be the next person who does not allow them to say no. Outside the parameters of mandated reporting, building up the capacity of an adult to think things through and say no is critical. Most will start doing so when they say no to you – which from your perspective is neither safe nor wise.

It is very tempting when we work with an adult who is suffering abuse to forget that their consent to any action taken is vital to their healing. It can take a long time and much suffering before someone who has never had a voice learns that he or she can say no, leave, and protect themselves. It is hard to wait and watch the suffering. It is painful to see the confused thinking. It is angering when a church supports that confused thinking for then the victim has two systems to respond to. However, to wait, to invite, to walk with, to strengthen and to speak truth – though a painful and often costly road – will often result in an utterly transformed human being who has acquired some discernment, come to see that they are worthy of protection and can use their own voice to speak truth. But consider: we follow the Lord Jesus Christ who walks with us, arms extended, calling us to truth and safety. Yet we refuse choices that would feed our souls and instead choose those things that are destructive to us and others. He speaks truth, He invites again and again and little by little our eyes and hearts are opened and like the prodigal we run back to the Father. Our slow seeing, choosing and running develop muscles in us we would not have otherwise.

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