if patient claims abuse in counseling, do you encourage patient to report, or report it yourself

by Junius Berge 7 min read

You suspect a patient is being abused. What should you do?

31 hours ago  · What to consider before reporting. Before reporting suspected violence or abuse, the Code says physicians should: Inform patients about requirements to report. Obtain the patient’s informed consent when reporting is not required by law. Exceptions can be made if a physician reasonably believes that a patient’s refusal to authorize reporting ... >> Go To The Portal


Inform patients about requirements to report. Obtain the patient’s informed consent when reporting is not required by law. Exceptions can be made if a physician reasonably believes that a patient’s refusal to authorize reporting is coerced and therefore does not constitute a valid informed treatment decision.

Full Answer

What should a doctor do before reporting suspected violence or abuse?

Before reporting suspected violence or abuse, the Code says physicians should: Inform patients about requirements to report. Obtain the patient’s informed consent when reporting is not required by law.

What to do if a nurse suspects abuse or neglect?

If a nurse suspects abuse or neglect, they should first report it to a physician, nurse practitioner, or physician assistant. Notifying a supervisor may also be required, depending on the workplace. If the victim is with a suspected abuser, the exam should take place without that person in the room.

Do therapists have to report child abuse?

“If a client experienced child abuse but is now 18 years of age then the therapist is not required to make a child abuse report, unless the abuser is currently abusing other minors,” Mayo said.

Are patients in your exam room being abused?

Patients in your exam room may be experiencing one of a number of forms of abuse—domestic violence, human trafficking or other violence—and identifying those being abused can sometimes be tough.

What is your initial responsibility if you suspect that a patient has been abused?

If a nurse suspects abuse or neglect, they should first report it to a physician, nurse practitioner, or physician assistant. Notifying a supervisor may also be required, depending on the workplace. If the victim is with a suspected abuser, the exam should take place without that person in the room.

What can you do if you notice that a patient is suffering from abuse?

Discuss any suspicion of abuse sensitively with the patient, whether or not reporting is legally mandated, and direct the patient to appropriate community resources. Report suspected violence and abuse in keeping with applicable requirements.

How do you ask a patient if they are being abused?

How to AskDifferent patients may respond better to different approaches.Make sure to ask in a private environment and do not use family or friends as interpreters.See ethics and privacy section before you start discussion.Patients highly value compassion and the quality of being non-judgemental.

What is a goal for therapy in counseling abuse victims?

Rebuilding self-esteem is a common goal in therapy. Most forms of abuse can break one's confidence. Cognitive behavioral therapy can help you challenge unrealistic expectations of yourself.

What is the nurse's role in reporting the suspected abuse?

For nurses being a mandated reporter means that it is a nurse's responsibility to report any suspicions of child or adult abuse or neglect. If the story just doesn't fit, the nurse needs to be suspicious. If the child or adult suggest they have been abused, the nurse needs to report.

What are the nurse's ethical responsibilities for a client who is a victim of abuse neglect?

Under this principle, nurses have a duty to treat people with compassion and to respect the inherent worth and dignity of each individual. Victims of abuse have been violated in physical, sexual or emotional ways; nurses are expected to deliver care no matter how difficult or ugly the situation may be.

Should you ask someone if they are being abused?

Ask Without Asking So, now you're worried. You want to do the right thing and be there for your friend or loved one, but asking them if their partner is abusive isn't going to always be met with the most grateful of responses.

What would your course of action be if you were to witness the abuse of a patient?

If you witness or suspect that there is a risk of immediate harm to a person in your care, you should report your concerns to the appropriate person or authority immediately. You must act straightaway to protect their safety.

Why are patients reluctant to complain about their health care?

Martha Deed said there are so many barriers to a patient reporting harm -- emotional trauma and physical disabilities, feeling intimidated by providers, social pressure not to complain -- that a passive questionnaire is unlikely to elicit responses.

How do you counsel an abused victim?

If you witness abuse and believe the victim is at risk of serious harm, call 999. For all non emergencies, call 101 or, if you are a member of staff working in care or health settings, you can use report a safeguarding concern via our website. For anonymous reporting, use the CrimeStoppers website.

What is abuse counseling?

Definition. Substance abuse counseling refers to a type of intervention (action intended to alter the course of a disease process) to help individuals recover from abuse of alcohol (or other drug) by abstaining completely from the substance or cutting down on its use.

How do you deal with trauma abuse?

Six Self-Care Tips on Overcoming Abuse-Related TraumaRecognize the Effects of Trauma. Many effects of trauma stem from abuse. ... Understand the Importance of Healing. It's important to know that healing is key to overcoming trauma. ... Embrace Positive Affirmations. ... Exercise. ... Embrace Creativity. ... Don't Be Afraid to Seek Help.

What If My Child’s Counselor Makes a Child Abuse Report?

The greatest fear of many parents is that their child could make a vague statement that appears to indicate child abuse during a therapy session, and then be whisked away by child protective services before the parent has had an opportunity to explain the situation. The internet abounds with (often one-sided) horror stories, and some parents decide not to enroll their children in counseling based on this fear.

What If It Happened a Long Time Ago?

This means that even if an incident occurred many years ago, the child is not at risk of further harm or neglect, or the child is now an adult, the incident must still be reported by your child’s counselor.

What If It Was an Accident?

Accidental injury to your child is generally not considered child abuse unless that accident occurred because you were negligent or under the influence of drugs or alcohol. Every parent has moments where they accidentally bump their child, or where their child injures themselves during a moment of parental distraction, and these genuine accidents are not considered child maltreatment.

What is a mandated reporter?

Additionally, many states have laws that require mandated reporters (like your child’s counselor) to report the suspected abuse or neglect of other vulnerable populations, such as the elderly and the disabled. You can find your state's mandated reporting laws here.

Why do we remove children from our homes?

For this reason, removing a child from their home is a last resort intervention that is only used when it is determined through an investigation that a child is at immediate risk of further harm or neglect. In many cases, a child abuse investigation results in no change in a child’s immediate living situation, either due to the report failing to meet a state’s criteria for beginning an investigation or due to the investigation finding that the child is not at immediate risk of further harm or neglect.

When do you need to report child abuse?

Finally, many states require that a child abuse report is made if there is reason to believe that domestic violence is occurring in a child’s home, even if that child has not been physically harmed.

Can you file a child abuse report if you are not your own?

Similarly, if you report actions that would be legally considered abusive or neglectful toward any child in your care—such as a child you are babysitting, coaching, or providing daycare for—a child abuse report will be filed, even though the child in question is not your own.

What happens if a therapist fails to take reasonable steps to protect the intended victim from harm?

“If a therapist fails to take reasonable steps to protect the intended victim from harm, he or she may be liable to the intended victim or his family if the patient acts on the threat ,” Reischer said.

What happens if a therapist violates the ethics of the state?

Therapists are held to very high ethical standards by their governing state board and a violation of those ethics could result in fines, loss of licensure, or even jail time , said Walwyn-Duqesnay. While each state has its own set of guidelines and regulations on what its mental health professionals are required to report, there are common themes that transcend across the country.

What is the purpose of therapy?

Therapy is where you can share your deepest, darkest secrets, fears and vulnerabilities with the expectation that you won’t be judged and what you say won’t be shared. In fact, that’s the whole point of the whole process.

When do therapists file a report?

In the case of suspected child abuse, therapists must file a report if they have “reasonable suspicion” about child abuse.

Who does Cinéas say has to step in and report a situation when vulnerable people are threatened?

Cinéas said a therapist may have to step in and report a situation when vulnerable people are threatened, which could include children, elderly individuals and those living with a disability.

Do you have to report child abuse to a therapist?

“If a client experienced child abuse but is now 18 years of age then the therapist is not required to make a child abuse report, unless the abuser is currently abusing other minors,” Mayo said.

Can a therapist report a patient's intent to harm someone else?

A therapist may be forced to report information disclosed by the patient if a patient reveals their intent to harm someone else. However, this is not as simple as a patient saying simply they “would like to kill someone,” according to Jessica Nicolosi, a clinical psychologist in Rockland County, New York. There has to be intent plus a specific identifiable party who may be threatened.

What is the mandate of a nurse?

As mandated, they are trained to identify signs and symptoms of abuse or neglect and are required by law to report their findings. Failure to do so may result in discipline by the board of nursing, discipline by their employer, and possible legal action taken against them. If a nurse suspects abuse or neglect, they should first report it ...

What should a nurse do when treating a patient?

Nurses should provide a calm, comforting environment and approach the patient with care and concern. A complete head-to-toe examination should take place, looking for physical signs of abuse. A chaperone or witness should be present if possible as well.

Where is Amanda Bucceri?

Amanda Bucceri Androus is a Registered Nurse from Sacramento, California. She graduated from California State University, Sacramento in 2000 with a bachelor's degree in nursing. She began her career working night shifts on a pediatric/ med-surg unit for six years, later transferring to a telemetry unit where she worked for four more years. She currently works as a charge nurse in a busy outpatient primary care department. In her spare time she likes to read, travel, write, and spend time with her husband and two children.

Do nurses have to be able to connect victims of abuse?

While not required by law, nurses should also offer to connect victims of abuse to counseling services. Many times, victims fall into a cycle of abuse which is difficult to escape.

Do nurses have a responsibility to care for victims of abuse?

Employers are typically clear with outlining requirements for their workers, but nurses have a responsibility to know what to do in case they care for a victim of abuse.

Should a nurse report abuse?

The nurse should notify law enforcement as soon as possible, while the victim is still in the care area. However, this depends on the victim and type of abuse. Adults who are alert and oriented and capable of their decision-making can choose not to report on their own and opt to leave. Depending on the state, nurses may be required ...

What to do before beginning therapy?

Before beginning therapy clients or guardians (if the client is a minor) should be asked to read and sign a consent form that explains the circumstances under which your therapist must break confidentiality. If the client is a minor then the information should be clearly explained to the parent or guardian. If at any time you have questions about what is confidential and what is not, try not to be intimidated, and please be sure to get your questions answered.

Why do therapists need specific information?

Therapists need specific information in order to contact authorities. Most of the time professionals need specific information about a particular child who is at risk or who has been already harmed along with information about who is being abusive in order to take the step of filing a report.

Is everything you share with a therapist confidential?

Not everything you share with a therapist can be kept confidential. What an individual tells his or her therapist is confidential; however, there are limitations to the confidentiality between a therapist and a client. Laws in all 50 states require a therapist to contact authorities if a patient is a danger to him/herself, to others, ...

Do therapists have to inform clients of a report?

In addition, the therapist may not be required to inform a client or their family that a report is being made. You can ask ahead of time about how this would be handled should the therapist consider filing.

What to do if a therapist is unsure of whether a client discussion should be reported to law enforcement?

According to the APA, if a therapist is unsure of whether a discussion with a client should be reported to law enforcement or not, she should consult with other professionals in the mental health field or appeal to state or national mental health professional associations for advice on the matter. The code of conduct states that therapists are expected to reach out to others in the field whenever they are not clear about whether a client discussion goes beyond the protection of patient-therapist confidentiality.

What is the code of conduct for therapists?

The code of conduct states that therapists are expected to reach out to others in the field whenever they are not clear about whether a client discussion goes beyond the protection of patient-therapist confidentiality. References.

Why is information shared between a patient and a therapist confidential?

The information shared between a patient and therapist, in almost all cases, is meant to be kept confidential in order to build a trusting relationship. However, there are exceptions to this rule, as outlined by the American Psychological Association's Code of Ethics.

Can a therapist release confidential information?

Also, therapists may be asked to release confidential information shared by their clients during therapy to the judicial system if served with a court order, though they are bound to only reveal information that is absolutely mandated by the judge in the case and nothing more.

Do therapists have to report abuse?

According to the American Psychological Association's Code of Ethics, therapists should let their clients know that in the event the client discusses inflicting or being the victim of child abuse, inflicting or being the victim of elderly abuse, or posing a serious danger to themselves or to others, and the therapist believes these threats or allegations of violence to be valid, the therapist will have to report such discussions to law enforcement officials. Also, therapists may be asked to release confidential information shared by their clients during therapy to the judicial system if served with a court order, though they are bound to only reveal information that is absolutely mandated by the judge in the case and nothing more.

Can a therapist discuss a violent crime?

Though some people may think that anything goes in a therapy session, confessing or discussing plans for violent crimes cannot necessarily be kept confidential by therapists. As stated in their code of ethics, they have a duty to protect their clients from hurting themselves or others. However, it is also important to note that any misconceptions someone being treated might have about this should be cleared up at the beginning of therapy when the therapist discusses with the client the exceptions to their confidentiality privilege.

Do psychologists have to keep their patients' information confidential?

It is crucial for psychologists to do whatever they can to keep any information shared between themselves and their patients during therapy sessions confidential. However, psychologists must also protect the health and well-being of their patients, which means protecting them from hurting themselves, inflicting injury upon others, or being hurt by someone else.

When Do Therapists Have to Report Crimes?

This applies to both adult clients who may have committed crimes against their children or clients under 16 who have had crimes committed against them. If a counselor believes an adult client has abused or neglected a child, dependent adult or elder person , the therapist must report the crime. He also must report anyone he reasonably suspected to have viewed or downloaded child pornography.

What is confidentiality in a therapist?

Therapist Confidentiality: Crimes Involving a Psychologist. Additionally, the limits to therapist/patient confidentiality mean that a mental health professional is not required to keep discussions confidential if a patient tries to use them in order to commit a crime.

What happens if a therapist tells his therapist he can't stop thinking about raping?

But if he told his therapist that he can’t stop thinking about raping the teenage girl next door, she is legally required to report the crime to the girl’s parents or the police. These kind of limits to therapist confidentiality in criminal cases are not limited to the informed parties either.

What is diminished actuality defense?

While attorneys in rarely rely on the insanity defense, claiming diminished actuality is a common partial defense for those who did not have the actual specific intent to commit a crime because of their mental state and it may help you obtain reduced charges or a lighter sentence.

Do psychologists have to break confidentiality?

The most famous limits to therapist confidentiality and criminal situations is when a therapist is legally required to break confidentiality if he or she believes the patient may hurt himself or someone else. While the most obvious example of this is the mandatory institutionalization of someone who is likely to commit suicide, psychologists are also require to report patients to the police or victim if the patient indicates he or she will commit a crime against someone else.

Can a psychiatrist tell if a patient has ADHD?

For example, if a patient tells her psychiatrist that she has ADHD and needs a prescription for Ritalin, but the psychiatrist can tell she is lying simply in order to obtain pills to get high, the doctor is no longer restricted by patient/doctor confidentiality laws.

Can a therapist break confidentiality?

If the patient is a minor under 16 and the therapist has reason to believe that she has been the victim of a crime and the therapist believe s it is in her best interest to report the crime, the therapist can choose to break patient confidentiality.

What If It Happened A Long Time ago?

What If My Child Wasn’T Involved?

  • Sometimes children witness or hear about abuse or neglect that has happened to another child, such as a sibling, cousin, or friend. Your child’s counselor is also required by law to report these allegations, just as they would report the suspected abuse or neglect of their own clients. Similarly, if you report actions that would be legally consider...
See more on psychologytoday.com

What If It Was An Accident?

  • Accidental injury to your child is generally not considered child abuse unless that accident occurred because you were negligent or under the influence of drugs or alcohol. Every parent has moments where they accidentally bump their child, or where their child injures themselves during a moment of parental distraction, and these genuine accidents are not considered child maltreat…
See more on psychologytoday.com

What If My Child’S Counselor Makes A Child Abuse Report?

  • The greatest fear of many parents is that their child could make a vague statement that appears to indicate child abuse during a therapy session, and then be whisked away by child protective services before the parent has had an opportunity to explain the situation. The internet abounds with (often one-sided) horror stories, and some parents decide not to enroll their children in cou…
See more on psychologytoday.com

What If I Have More Questions?

  • If you have more questions about the reporting laws or procedures in your state, you can look up your local statutes through the Department of Health and Human Services' Child Welfare Information Gateway. Additionally, the child protective services agencies of most states maintain helpful websites where parents can learn more about their local child maltreatment reporting pr…
See more on psychologytoday.com