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Home , Child abuse, Eliana Gil

The California & Reporting Law

Issues and Answers for Mandated Reporters

California Department of Office of Prevention

Table of Contents

Acknowledgements i

Introduction ii

The Reporting Law...... 1 Why What Who When To whom Immunity Other protections Liabilities Feedback

Identification ...... 7 Environment Problems Parental clues Physical indicators Behavioral indicators

Guidelines to Determine Reasonable Suspicion ...... 10 Assessment with a verbal child Neglect Emotional abuse Additional factors in the assessment process Assessment with a nonverbal child Assessment with the What to tell the /caretakers Assessment of false allegations

The Major Treatment Issues...... 16 Therapist’s reactions to working with abuse Helpful interventions Non-helpful interventions Questions Often Asked ...... 21 1. Who am I to say what is abusive? 2. What if I make a ? 3. What is the fine line between abuse and discipline? 4. What if the abuse occurred in the past? 5. What if an adult state he/she was abused as a child? 6. What about testifying in court? 7. What age child is most at risk of abuse? 8. What is the difference between children’s "normal" sex and sexual abuse? 9. What is the reporting responsibility regarding sexually active minors? 10. Are clergy mandated to report? 11. Are programs exempt from reporting? 12. May I make an anonymous report? 13. What happens after a report is made? 14. Does a positive toxicology screen at the time of delivery require a child abuse report? 15. Should a person’s culture be considered in determining if a report should be made? 16. What if a states their child is receiving treatment by spiritual means or not receiving medical treatment for "religious reasons"? 17. What if you are concerned about severing the trust relationship with a client? 18. What do you say to a client who is suspected of abusing a child? 19. In cases of domestic when there is a child in the home, is it reportable as child abuse? 20. Do you always tell the suspected abuser that you are making a report? 21. If you suspect abuse of a disabled child in a home or institution, is it reportable as child abuse?

Conclusions and Recommendations...... 29

Appendices...... 30 A. Department of Justice Reporting Form B. Required Statement of - Sample Employee Form C. Confidentiality Policies Statements & Agreement (Sample) D. Community Resources E. Statewide and National Resources

Bibliography ...... 36 Acknowledgements

The Office of Child Abuse Prevention is grateful to , Ph.D., for the work she did as the original author of this publication. We also wish to acknowledge the following people for their contributions: Diane Nissen, MSW, Allyson Kohl, LMFT; Catharine J. Ralph, LCSW; and Kim Ralph, MSW.

Edited by Patty Lough, MSW, LCSW, Ph.D. California Department of Social Services Office of Child Abuse Prevention

i

Introduction

This handbook was originally written to help mental health professionals understand the Child Abuse Reporting Law and be aware of their reporting responsibilities regarding child abuse. However, other mandated reporters, who come into with children, will also find the information helpful. , counselors, workers, animal control officers or any other professionals included as mandated reporters have an important role in child abuse reporting. Responsible reporting is in the best interest of the child and family.

The law mandates the reporting of child abuse by certain parties (see page 2, “Who Reports” for a complete list of mandated reporters). For various reasons, people who abuse children lack necessary internal control. Therefore, they need as many external controls as possible, until they are better able to restrain themselves. The reporting law is an external control which clearly states, “the abusive behavior is unacceptable and must stop.”

For the reporter, making a report of suspected child abuse is difficult. There are always nagging doubts about how the person suspected of abusing a child will react, what the outcome will be, and whether or not the report will put the child at greater risk. The best way to minimize the difficulty of reporting is to be fully prepared for the experience. One should feel reasonably comfortable with the reporting requirements and the process that is triggered by making a report. Knowing who to call for information and understanding your role in relation to your position (i.e. social worker, nurse, child care worker, clergy, etc.) is also helpful. Reporting suspected child abuse is a team effort involving professionals from a variety of disciplines, such as child protective services, police, medical personnel, etc.

Information contained in this publication is offered as an aid to mandated reporters in reporting suspected child abuse. It clarifies basic information. It is not meant to be all inclusive and cover all situations. Nor should it be considered legal advice. Some items, such as therapeutic interventions used by therapists, may not be useful to certain kinds of mandated reporters.

There are many professions included as mandated reporters; therefore, one should rely on protocols and training within one’s profession. If in doubt about what to do in a particular situation, additional information can be obtained through local child protective service agencies or local police departments. Additional resources, including toll free numbers and web sites, have been listed in the Appendix section.

ii

The Reporting Law

The first child abuse reporting law sexual abuse, neglect, or abuse in in California was enacted in 1963. out-of-home care. Child abuse does The early laws mandated only not include a “mutual affray between physicians to report physical abuse. minors,” “reasonable and necessary Over the years, numerous force used by a peace officer” under amendments have expanded the specified circumstances, or definition of child abuse and the that is reasonable and age persons required to report. appropriate and does not expose Procedures for reporting categories of the child to risk of serious injury. child abuse have also been clarified. (P.C. 11165.6, Welfare and Institutions In California, certain professionals Code (W&IC) Section 300.) are required to report known or suspected child abuse. Other 2. What to Report citizens, not required by law to report, The California Child Abuse may also do so. Reporting Law is found in Penal Code It is important for practitioners and Sections 11165-11174.3. The other mandated reporters to keep following is only a partial description updated on periodic amendments in of the statute. Mandated reporters the law. Your local Child Abuse should become familiar with the Prevention Council or Child Protective detailed requirements as they are set Agency (see Resources) has current forth in the Penal Code (P.C.). reporting law information. Under the law, when the victim is a child (a person under the age of 18) 1. Why Must You Report? and the perpetrator is any person The primary intent of the reporting (including a child), the following types law is to protect the child. of abuse must be reported by all Protecting the identified child may legally mandated reporters: also provide the opportunity to protect a. A physical injury inflicted by other other children in the home. It is than accidental means on a child. equally important to provide help for (P.C. 11165.6). the suspected abuser. The report of b. Child sexual abuse which abuse may be a catalyst for bringing includes sexual and sexual about change in the home exploitation. environment, which in turn may lower includes sex acts with children, the risk of abuse. intentional in the presence of children and child 2. What is Child Abuse? molestation. Sexual exploitation The Penal Code (P.C.) defines includes preparing, selling or child abuse as: “a physical injury distributing pornographic materials inflicted by other than accidental involving children, performances means on a child by another person.” involving obscene sexual conduct It also includes emotional abuse, and child . (P.C. 11165.1).

1 c. Willful cruelty or unjustified relation to , see , which includes the “Questions Often Asked” inflicting or permitting unjustifiable section.) physical pain or mental suffering, or the endangerment of the child’s 4. Who Reports? person or health. (P.C. 11165.3). Legally mandated reporters “Mental suffering” in and of itself is include a wide variety of positions, not required to be reported. which are as follows: However, it may be reported. a. Mandated reporters in public Penal Code11166.05 states: positions include: a ; an “Any mandated reporter who has instructional aide, a teacher’s aide, knowledge of or who reasonably or a teacher’s assistant employed suspects that mental suffering has by any public or private school, a been inflicted upon a child or that classified employee of any public his or her emotional well-being is school; an administrative officer or endangered in any other way may supervisor of child welfare and report the known or suspected attendance, or a certificated pupil instance of child abuse or neglect personnel employee of any public to an agency specified in Section or private school; an administrator 11165.9”. (The specified agencies of a public or private day camp; an include any police department, administrator or employee of a sheriff’s department, county public or private center, probation department if designated youth recreation program, or youth by the county to receive mandated organization; an administrator or reports, or the county welfare employee of a public or private department.) organization whose duties require d. Unlawful direct contact and supervision of or injury, willfully inflicted, children; any employee of a county resulting in a traumatic condition. office of education or the California (P.C. 11165.4). Department of Education, whose e. Neglect of a child, whether duties bring the employee into “severe” or “general,” must also be contact with children on a regular reported if the perpetrator is a basis; a licensee, an administrator, person responsible for the child’s or an employee of a licensed welfare. It includes acts or community care or child day care omissions harming or threatening facility, a headstart teacher; a to harm the child’s health or licensing worker or licensing welfare. (P.C.11165.2). evaluator; a public assistance f. Any of the above types of abuse or worker; an employee of a occurring in out-of-home care institution including, but not care (P.C. 11165.5). (For a limited to, foster parents, group discussion of newborns with a home personnel, and personnel of positive toxicology screen, or for facilities; a social information on child abuse in worker, probation officer, or parole

2 officer; an employee of a school Section 4980.03 of the Business district police or security and Professions Code; and department; any person who is an unlicensed , family and administrator or presenter of, or a child counselor intern registered counselor in, a child abuse under Section 4980.44 of the prevention program in any public Business and Professions Code, a or private school; a district attorney state or county investigator, inspector, or family employee who treats a for support officer unless the venereal disease or any other investigator, inspector or officer is condition, a coroner, or a medical working with an attorney appointed examiner, or any other person who pursuant to Section 317 of the performs autopsies (P.C. 11165.7). Welfare and Institutions Code to c. Mandated reporters in public represent a minor; or a peace protection positions include any officer, as defined in Chapter 4.5 employee of any police (commencing with Section 830) of department, sheriff’s department, Title 3 of Part 2 of this code, who county probation department, or is not otherwise described in this county welfare department. section; a firefighter, except for (P.C. 11165.7(a)(33)). voluntary firefighters. (P.C.11165.7) d. Mandated reporters in public b. Health care personnel who are contact positions include: mandated reporters include: commercial film and photographic a physician and surgeon, print processors, clergy, psychiatrist, psychologist, dentist, employees or volunteers of a resident, intern, podiatrist, Court Appointed Special Advocate chiropractor, licensed nurse, dental program, child visitation monitors, hygienist, optometrist, marriage, animal control officers or humane family, and child counselor, society officers. licensed clinical social worker or ¥ Commercial film and any other person who is currently photographic print processor licensed under Division 2 is any person who develops (commencing with Section 500) of exposed photographic film into the Business and Professions negatives, slides, or prints, Code; any emergency medical or who makes prints from technician I or II, paramedic, a negatives or slides, for person certified pursuant to compensation. The term Division 2.5 (commencing with includes any employee of such Section 1797) of the Health and a person; it does not include a Safety Code; a psychological person who develops film or assistant registered pursuant to makes prints for a public Section 2913 of the Business and agency. (P.C. 11165.7(a) (29)). Professions Code; a marriage, Commercial film and family and child counselor trainee, photographic print processors as defined in subdivision (c) of must report depictions of a child

3 under age 16 in an act of sexual by the time the required report is conduct (P.C. 11166 (d)). made” (i.e. the child is now an ¥ Clergy members means a adult). priest, minister, rabbi, religious ¥ A child visitation monitor practitioner, or similar includes any person who, for functionary of a church, financial compensation, acts as temple, or recognized religious monitor of a visit between a child denomination or organization. and any other person when the (P.C. 11166 (c)). monitoring of that visit has been ¥ Any custodian of records of a ordered by a court of law. clergy member (specified in (P.C. 11165.7(a) (30)). P.C. 11165.7(33) and 11166 (3) ¥ An employee or volunteer of a (A)). “On or before January 1, Court Appointed Special 2004, a clergy member or any Advocate program, as defined custodian of records for the in Rule 1424 of the Rules of clergy member may report to an Court. (P.C. 11165.7 (a) (34)). agency specified in Section ¥ Animal control officer means 11165.9 that the clergy member any person employed by a city, or any custodian of records for county, or city and county for the the clergy member, prior to purpose of enforcing animal January 1, 1997, in his or her control laws or regulations. professional capacity or within (P.C. 11165.7(a) (31)(A)). the scope of his or her ¥ Humane society officer means employment, other than during a any person appointed or penitential communication, employed by a public or private acquired knowledge or had a entity as a humane officer who reasonable suspicion that a child is qualified pursuant to Section had been the victim of sexual 14502 or 14503 of the abuse that the clergy member or Corporations Code any custodian of records for the (P.C. 11165.7(a) (31)(B)). clergy member did not previously report the abuse to 5. When Do You Report? an agency specified in Section Child abuse must be reported 11165.9. The provisions of when one who is a legally mandated Section 11172 shall apply to all reporter “…has knowledge of or reports made pursuant to this observes a child in his or her profes- paragraph.” sional capacity, or within the scope of Also, unlike other mandated his or her employment whom he or reporters the custodian of she knows or reasonably suspects records for clergy, Section 11166 has been the victim of child abuse or (3)(B) states: “This paragraph neglect…” (P.C. 11166(a)). shall apply even if the victim of “Reasonable suspicion” occurs the known or suspected abuse when “it is objectively reasonable for a has reached the person to entertain such a suspicion,

4 based upon facts that could cause a 7. Joint Knowledge Ð in a like position, Who Reports? drawing when appropriate on his or When two or more persons who her training and experience, to are required to report, have joint suspect child abuse.” (P.C. knowledge of a known or suspected 11166(a)(1)). Although wordy, the instance of child abuse or neglect, intent of this definition is clear: if you and there is agreement among them, suspect, report. the telephone report may be made by You must make a report the selected team member. A single immediately (or as soon as practically written report may then be made and possible) by phone. A written report signed by the reporting team member. must be forwarded within 36 hours of Where there is a failure by the receiving the information regarding the designated team member to make the incident. (P.C. 11166(a)). Written report, any team member who knows reports must be submitted on shall then be responsible to make the Department of Justice forms, which child abuse report. (P.C. 11166 (f)). can be requested from your local (police or sheriff’s department, (not including a school district police or 8. Immunity security department) or a county Those persons legally mandated to welfare department). (P.C. 11168). report suspected child abuse have See Appendix A. immunity from criminal or civil liability for reporting as required or authorized by the child abuse and neglect 6. To Whom Do You Report? reporting law. (P.C. 11172(a)). The report must be made to a county welfare department or probation department (if designated 9. Safeguards for Mandated by the county to receive mandated Reporters reports) or a police or sheriff’s No supervisor or administrator may department, not including a school impede or inhibit a report or subject district police or security department. the reporting person to any sanction. (P.C. 11165.9) (P.C. 11166(g)). Reports by commercial print and Persons other than those legally photographic print processors, are to mandated to report are not required to be made to the law enforcement include their names when making a agency having immediately report. (P.C. 11167 (e)). or as soon as practically possible. Reports are confidential and may (P.C. 11166(d)). be disclosed only to specified persons and agencies (P.C.11167.5).

5 10.Liabilities for Failure to Make 12.Licensing Requirement A Required Report. The state agency issuing a license A person who fails to make a to a person who is required to report required report is guilty of a child abuse must either send a punishable by up to six statement to the licensee which cites months in jail and/or up to a $1000 reporting requirements and the fine, or both. (P.C. 11166(b)). He or penalty for failure to report or print the she may also be found civilly liable for information on all application forms for damages, especially if the child-victim a license or certificate printed on or or another child is further victimized after January 1, 1986. because of the failure to report. (P.C.11166.5(b)(c)). (Landeros vs. Flood (1976) 17C.3d 399). 13.Feedback to Reporter After the investigation is 11. Responsibilities of Agency completed or the matter reaches a Employing Mandated Reporter final disposition, the investigating Any person entering employment agency shall inform the mandated which makes him/her a mandated reporter of the results of the investi- reporter must sign a statement, gation and any action the agency is provided and retained by the taking. (P.C. 11170(b)(2)). employer, to the effect that he or she has knowledge of the reporting law and will comply with its provisions (P.C. 11166.5(a)). See Appendix B for sample of form. Commercial film and photographic print processors and persons employed by child protective agencies as members of the support staff or maintenance staff and who do not work with, observe, or have knowledge of children as part of their official duties are not required to sign such statements. (P.C. 11166.5(a)).

6 Identification

Identifying where abuse occurs ¥ Has unrealistic expectations of requires the helping professional first child (e.g., toilet-training of a of all to believe that child abuse can 6-month-old) occur in any situation, regardless of ¥ Uses “out of control” discipline. socio-economic status, religion, ¥ Is unduly harsh and rigid about education, ethnic background, or other childrearing. factors. Secondly, there must be a ¥ Singles out as “bad,” willingness to inquire into the “evil,” or “beyond control.” possibility of abuse. There are four ¥ Berates humiliates, or belittles child basic areas in which abuse may be constantly. revealed: ¥ Turns to child to have his/her own 1) Environmental Problems, needs met. 2) Parental or Caregiver Clues, ¥ Is impulsive, unable to use internal 3) Physical Indicators in the Child, and controls. 4) Behavioral Indicators in the Child. ¥ Cannot see child realistically, A brief overview of these warning attributes badness to child, or signals follows. This is only a partial misinterprets child’s normal list. You may become aware of these behavior (e.g. Takes an ’s factors through interview, observation, as a sign of intentional or third-party reporting of these meanness). concerns. ¥ Is indifferent to child.

Environmental Problems Physical Indicators in the Child ¥ Hazardous conditions (broken Physical Abuse windows, faulty electrical fixtures, ¥ Fractures, lacerations, bruises that etc.). cannot be explained, or ¥ Health risks (presence of rats, explanations which are improbable feces, no running water, no heat, given the extent of the injury. etc.) or unsanitary conditions. ¥ (cigarette, rope, scalding ¥ Extreme dirt or filth affecting health. water, iron, radiator). ¥ Facial injuries (black eyes, broken Parental or Caregiver Clues jaw, broken nose, bloody or swollen ¥ Is unable/unwilling to meet child’s lips) with implausible or nonexistent basic needs and provide a safe explanations. environment. ¥ Subdural hematomas, long-bone ¥ Tells you of homicidal fractures, fractures in different thoughts/feelings toward child. states of healing. ¥ Tells you of use of objects (belts, ¥ Pattern of bruising (e.g., parallel or whips, clothes hanger) to discipline circular bruises) or bruises in the child. different stages of discoloration, ¥ Is unable to describe positive indicating repeated trauma over characteristics of child. time.

7 Neglect Physical Abuse ¥ , a child’s failure to ¥ Hostile or aggressive behavior gain weight at the expected rate for toward others. a normal child. A child who fails to ¥ Extreme fear or withdrawn behavior thrive may have medical or around others. psychosocial problems, or a ¥ Destructiveness (breaks windows, combination of these. sets fires, etc.). ¥ Malnutrition or poorly balanced diet ¥ Verbal abusiveness. (bloated stomach, extremely thin, ¥ Out-of-control behavior (angry, dry, flaking skin, pale, fainting). panics, easily agitated). ¥ Inappropriate dress for weather. ¥ Extremely offensive body odor. ¥ Dirty, unkempt. Sexual Abuse ¥ Unattended medical conditions (e.g. ¥ Sexualized behavior (has infected minor burns, impetigo). precocious knowledge of explicit sexual behavior and engages self Sexual Abuse or others in overt or repetitive ¥ Bruising around genital area. sexual behavior). ¥ Swelling or discharge from ¥ Hostility or . vagina/penis. ¥ Fearfulness or withdrawn. ¥ Tearing around genital area, ¥ Self-destructiveness (self-mutilates). including rectum. ¥ Pseudo-maturity (seems mature ¥ Visible lesions around mouth or beyond chronological age) genitals. ¥ Eating disorders. ¥ Complaint of lower abdominal pain. ¥ Alcoholism/drug abuse. ¥ Painful urination, defecation. ¥ Running away. ¥ Promiscuity.

Behavioral Indicators in the Child Children react differently to being Neglect abused. There is no one single ¥ Clingy or indiscriminate attachment. reaction that can be clearly associated ¥ Self imposed isolation. with child abuse; however, there are a ¥ Depression or passivity. number of possible behaviors which have been found to be consistently correlated with abuse. While some of Emotional Abuse these behaviors occur more with one ¥ Lacks self-esteem; puts self down type of abuse than another, they may constantly. overlap. ¥ Seeks approval to an extreme. The presence of any of these ¥ Unable to be autonomous (e.g., indicators does not prove the child is makes few choices, fears rejection). being abused, but should serve as a ¥ Hostile, verbally abusive, warning signal to LOOK FURTHER. provocative.

8 It is important to note here that a child who is being physically abused or neglected or sexually abused is also being emotionally abused . The best source of information is not what the child says but how the child behaves. Mandated reporters must stay alert and responsive to the child behaviors described above. Children will rarely report they are being abused; but, being unable to stop it, they frequently develop coping mechanisms and behaviors which bring them to the of others. These children tend to be fiercely loyal to their abusers, often demonstrating a pathological dependency on them. They may try to adapt and comply in order to please their abusers and may serve as caretakers to their abusers in order to avoid further abuse or rejection.

9 Guidelines to Determine Reasonable Suspicion

Reasonable suspicion means "that The assessment process is it is objectively reasonable for a dynamic; that is, it does not stop after person to entertain a suspicion, based a particular number of questions have upon facts that could cause a been asked. It requires active reasonable person in a like position, involvement on the part of the drawing, when appropriate, on his or mandated reporter to interpret clues, her training and experience, to observe non-verbal communication, suspect child abuse or neglect." In and develop and test hypothesis. other words, if a mandated reporter Most importantly, avoid jumping to has a reasonable suspicion that child conclusions. The process of abuse has occurred a suspected child assessment necessitates a abuse report is to be completed. willingness and ability on the part of Making an assessment of possible the mandated reporter to inquire child abuse entails collecting further. information in order to determine what An assessment can be done in the problem is, who is involved, and such a way that it naturally evolves how to proceed. The following are into collecting information about basic elements in the process: neglect and physical, sexual and ¥ Maintain a clear distinction between emotional abuse. It is extremely assessment for the purpose of important not to lead the child to say determining whether there are what they think you want to hear. grounds for reasonable suspicion Prompt them to give details in their and conducting an investigation of own words. Always be extremely the report. Only a child protective cautious to avoid using leading or agency or county designee can coercive questioning. conduct the investigation. One should rely on protocols and Assessment With a Verbal Child training within one’s profession in Two things are noteworthy when the assessment process. interviewing a child who is able and ¥ Be careful about promising willing to be verbal: first, creating an something that cannot be provided. environment that seems safe to the Often children will say there is a child; and second, providing opportu- secret they will share ONLY IF YOU nities for spontaneous disclosure PROMISE NOT TO TELL ANYONE through verbal and non-verbal ELSE. A mandated reporter cannot messages. keep this promise. If it is given, and Ask the child to describe a typical later the confidence is broken, the day. If assessing the home child is likely to feel betrayed and environment, ask the child to describe trust will be jeopardized. the house and who lives there. You

10 can pose questions such as: Who Code 11165.1. Particularly in the area gets up first? Who wakes whom? Do of questions about sexual abuse, people eat breakfast? Who makes mandated reporters should use breakfast? Who goes where? Does discretion. Detailed questioning about anyone stay at home? Go through sexual abuse will usually be asked by the coming home routine as well. See the investigating agency, such as if any patterns can be determined, Child Protective Services.) If e.g., who spends more time with appropriate, possible questions a whom, whether certain people are mandated reporter might ask include: isolated. Notice if the child’s voice or ¥ Do you like it when people hug affect seems to change when specific you? Is hugging a good thing or family members are discussed. bad thing? If it is a bad thing, what makes it bad? Physical Abuse ¥ Where do you sleep? Where do The presence of physical abuse others in your house sleep? What can be evaluated by asking what happens when you go to sleep? happens at home when people get ¥ What happens when you take a angry, drink or take drugs. (Physical bath? abuse is defined in Penal Code ¥ Does anyone ever touch you in a 11165.6.) To assess physical abuse way that makes you feel the mandated reporter may ask non- uncomfortable? Where do they leading questions such as: touch you? (If the child talks about ¥ What happens when you get in their private parts, use the child’s trouble? words for genitals, breasts, anus, ¥ What do people say or do when mouth). Does it make you feel they are angry? scared or sad? ¥ Does anyone throw objects? Who does this? Neglect ¥ Does anyone ever get mad enough The two types of neglect are to hit someone else? severe neglect and general neglect: ¥ What do they hit with? Who do ¥ “Severe neglect” means the they hit? If they do hit, do they use negligent failure of a person having hands, fists, belts or other objects? the care or custody of a child to Does anyone ever get hit hard protect the child from severe enough so that the blow causes malnutrition or medically diagnosed bruises or bleeding? How often nonorganic failure to thrive. “Severe does this happen? Is it scary? neglect” also means those situations of neglect where any Sexual Abuse person having the care or custody Sexual abuse can be assessed by of a child willfully causes or permits asking non-leading questions about the person or health of the child to touching and affection in the family. be placed in a situation such that (Sexual abuse is defined in Penal his or her person or health is

11 endangered, as proscribed by county probation department if Section 11165.3, including the designated by the county to receive intentional failure to provide mandated reports, or the county adequate food, clothing, shelter, or welfare department.) (See the medical care. (P.C. 11165.2) “Questions Often Asked” section ¥ “General neglect” means the regarding emotional abuse in relation negligent failure of a person having to domestic violence, question 19). the care or custody of a child to provide adequate food, clothing, Additional Factors in the shelter, medical care, or supervision Assessment Process where no physical injury to the child In addition to listening to the has occurred. (P.C. 11165.2) content of the response, it is important to observe changes in the child’s Questions regarding neglect can affect, tone of voice, body be asked to assess if basic needs are movements, breathing, eye contact being met. (In questioning, remember and to note whether the child changes that homelessness does not the subject abruptly. necessarily mean neglect.) Some If the child has given information questions to ask include: that leads to a reasonable suspicion ¥ Do you have food in your house? that he/she is being abused, let the What kind of food do you have? child know you are concerned about ¥ Do you have a coat to wear? Does what is going on (describe what the someone wash your clothes for child has revealed) and that it is you? important to get some help now. The ¥ Do you have electricity? child should be told what to expect once the decision to report is made (i.e., that parents will be called and Emotional abuse the Emergency Response Unit in the Emotional abuse is a new addition Child Protective Agency will be to the Child Abuse & Neglect notified, etc.). Reporting law. Penal Code 11166.05 Do not make any guarantees to states: “Any mandated reporter who the child about what will happen, but has knowledge of or who reasonably let the child know as much as suspects that mental suffering has possible. It is helpful to make the been inflicted upon a child or that his referral to the Child Protective Agency or her emotional while the child can listen. In this way well-being is endangered in any other the reporter’s reliability is confirmed. way may report the known or suspected instance of child abuse or neglect to an agency specified in Assessment With a Nonverbal Section 11165.9”. (The specified Child agencies include any police When children are not able to department, sheriff’s department, speak, they frequently will "act out"

12 their concerns in play. It is important telephone cords to physically punish to assess abuse based on extreme or their children. The use of objects persistent behaviors that are increases the likelihood that the child consistent with indicators of abuse. A may sustain injuries. child who is physically abused may be Some parents who were abused very physically abusive of dolls or as children may not recognize their other play materials, and have themes behavior as abusive. They may not of violence or death in his or her play hide this behavior since to them it is or drawings. A sexually abused child normal and acceptable. Other may focus on the doll's genitals, and abusive parents may think of their engage dolls in explicit sexual play. behavior as abusive, and may seek to Although this by itself doesn’t mean hide it, making up stories, or getting abuse is occurring. their children to protect them. The latter are obviously more difficult to assess, but looking at the entire Assessment With the Family family picture, and interviewing the If the entire family will be meeting children alone, may help with data with a mandated reporter, the family collection. members may be asked non- Parents are frequently frightened threatening questions about family life and angry when the referral is made similar to those questions asked of a to the authorities. But most parents verbal child (see "Assessment with a their children and do not want to Verbal Child"). hurt them. They are being abusive It must be recognized, however, because they are out of control. that if abuse is occurring in the family, They may also, either immediately or parents and other family members eventually, feel relief that steps have may not be inclined to discuss this been taken to protect their children. area of concern. Giving parents a confidentiality policy Frequently, meeting with the child (See Appendix C) and being matter- separately from the parents may be of-fact and confident about what helpful in gathering further information abuse is, will help tremendously in which may be relevant to the abuse undertaking the emotional and difficult situation. task of reporting. Also, the mandated If the parents/caretakers make reporter must clearly understand that statements such as "we know how to his/her responsibility is to make the take care of him," "we have a sure-fire assessment, determine if “reasonable cure for that," or similar references suspicion exists” and then report. regarding their strategies it THERAPISTS, AND OTHER is critical to get a clear description of MANDATED REPORTERS, ARE the parents’ behavior. These NOT RESPONSIBLE TO references may indicate that a parent INVESTIGATE OR COLLECT or caretaker is physically abusing a . The investigation is child. Parents sometimes use objects conducted by Child Protective such as belts, bats, pots and pans, or Agencies. When in doubt, call the

13 Emergency Response Unit in the informing parents is included in the Child Protective Agency and discuss section titled “Major Treatment the situation. Issues”.

Assessments of False Allegations What to Tell the Parents/Caretaker Probably among the most alarming Informing parents that a referral is situations which can occur are those being made is not legally required. in which a parent or caretaker is Indeed, in some instances it may be falsely accused of hurting or molesting contra-indicated by such things as a a child. Whether such experiences parent’s tendency to flee or exhibit are common or rare, their seriousness violent, erratic or psychotic behavior. must not be overlooked. The impact There are instances in which a child of a false allegation on an innocent may be at risk due to "telling." Advise individual can be devastating; it can the child welfare staff if a child is include rejection by family, criminal afraid to go home, may be in danger proceedings, imprisonment, and loss of further abuse or threats, or may be of employment. One who is falsely under pressure to change or retract accused may be unfairly subjected to his or her statement. (Dr. Roland suspicion and scrutiny in virtually any Summit has written an article "The of his/her undertakings or Child Sexual Abuse Accommodation relationships. Syndrome" which clearly explains the Recently, the issue of false child’s process of disclosure. See allegations, recovered memory and Selected Bibliography Section). The false memory have been discussed in child welfare staff will evaluate the the literature. (See Selected need to place the child in protective Bibliography Section). custody. Fictitious allegations appear to In most instances, however, the occur in two populations: parents should be told that a referral 1) “coached” children in custody is being made. If the child is at risk disputes, and due to disclosure, it is important to 2) adolescents who “make up” discuss this with the parents and convincing reports out of boredom, make a statement about further harm infatuation, or in an effort to to the child. “I know it probably retaliate. makes you angry or a little afraid that Every professional working with I’ve made this referral. You may even child abuse cases should stay abreast feel angry at your child, but it’s not OK of current research on improved to hit or hurt the child for telling.” Tell methods of interviewing and the parents the reasons for the treatment, maintain integrity by referral: “You seem to be behaving in assessing each case on its own an out-of-control way and I’m merits, and suspend judgments until concerned that you are hurting your all the information is gathered. child.” Further discussion on

14 Certain phrases tend to elicit an unlikely to be developed soon. In the immediate and uncritical response. meantime, professionals must Phrases such as,“I have a secret,” exercise ethical and responsible “Daddy’s doing something mean to behavior in assessing these cases. me,” and/or “I’m scared,” could Reliance on single-source indicate a range of experiences. It is techniques must be eliminated. For best to proceed slowly, maintaining example, children’s drawing, or their openness about the possibilities. play with anatomically detailed dolls, Child abuse is a reality, and it is or their specific behavioral responses very unlikely that young children, do not provide sufficient grounds to without prompting from adults, conclude that abuse has occurred. fantasize or about being abused. The most reliable evaluations include Not only do they tend to lack the the use of multiple techniques: motivation, they lack the cognitive psychological tests, clinical ability to conceptualize detailed sexual observations of the child alone, with activity. Children are more likely to lie parents and peers, collateral to protect an abusive parent than they information from learning programs, are to get themselves or a loved one medical personnel, and current or into trouble. previous psychologists, to name a The issue of “coached” children, few. An evaluation must give the child particularly during custody disputes, ample opportunity to show or tell if remains a major problem, and while there is trouble, and must to techniques for discovery of the truth elicit or encourage self-disclosure of are being developed a fool-proof frightening material. method which applies in all cases is

15 Major Treatment issues

This section offers useful the professional, parents or caregivers information, which may be helpful to may sense that they are being all mandated reporters other than just punished. A more useful approach is therapists. However, it is not meant to to consider the reporting as helpful to be inclusive of all situations, and it the family because it will protect the specifically addresses issues in the child (and the parents in the long run) client-therapist relationship. by getting them needed services. The attempt to convince the parents that Confidentiality they are being helped should be The statutory duty to report is not avoided because it is difficult for them excused or barred by the client/patient to see a report as helpful at the initial therapist or professional stage. confidentiality or ethics. Nevertheless, The fear that reporting will destroy all types of mandated reporters must the trust in the therapeutic relationship confront and overcome their own is understandable, however if the internal barriers to reporting. reporting is done in a clear and : Many professionals refuse nonthreatening way, clients will not be to believe child abuse exists. They as likely to feel betrayed. may think it happens only to the poor, Approaching suspected abuse as a the psychotic, the uneducated, or matter-of-fact mandatory duty to certain racial groups. This is simply protect children can help in not true. When professionals do not undertaking the emotionally difficult acknowledge the possibility of abuse, task of reporting. they miss the opportunity to stop the Family : Relatively few abuse. It is important to believe that of the large number of child abuse abuse can happen in any family reports lead to the removal of a child setting and to ask questions designed from his/her home. The current to explore this possibility when abuse emphasis of child welfare services is is suspected. on keeping the family intact by Rationalizing: Another danger is providing comprehensive services the professional’s acceptance of such as crisis intervention, respite unrealistic explanations for how an care, in-home counseling and injury occurred. If any doubts exist, homemaking, parenting education, no matter how small, assessment transportation, housing assistance, should continue, and/or consultation clothing, food, and utilities. The child should be sought. will be removed only if the child Betrayal: Some professionals feel protective professionals assess that that when they report clients for child there is imminent danger to the child abuse they are damaging the client- or if the caregivers are unable or therapist relationship because of the unwilling to provide a safe possible punitive consequences of environment for the child. such reports. If this notion is held by

16 The Therapists’ Reactions to the competitive relationship that may Working with Abuse exist between the abusive Everyone has a reaction to child parent/caregiver and the therapist abuse. Some cringe with disgust and regarding the needs of the child. and others cry with sadness If trust is established in the and empathy. It is crucial for therapeutic relationship, the client may therapists to examine their own see the therapist as a parental figure. attitudes and feelings toward abusive The more trust that is developed, the parents and abused children. It is greater is the client’s need to pull possible (and advisable) for them to away and make demands by testing acknowledge the discomfort or anger the therapist’s ability to set limits. The they may feel about the abuse, and client’s dependency needs may also yet prevent these feelings from surface, which may cause a interfering with their ability to be useful therapeutic crisis in a needy and to in treatment. frightened client. The client needs to Treatment may be ineffective if the experience and build trust and then therapist expresses angry or needs to be directed toward other judgmental feelings toward the client, people in his or her life with whom a which may reinforce a sense of similar experience can be created. “badness” or “unworthiness.”" Most abusive people have fragile egos and Helpful Interventions are very susceptible to . This Confidentiality Statements: does not preclude a therapist’s Parents and children should be making very strong and clear given a confidentiality statement at the statements about the abusive beginning of therapy. Contrary to the behavior, but these should be made in belief of some, making these a way in which the client is likely to statements does not seem to scare hear them. An effective phrase would clients away or inhibit them. be, “I know you love your children and These statements should be made want them to turn out to be productive both verbally and in writing. (See citizens; but it is not OK for you to hurt Appendix C). The confidentiality them, in order to teach them.” It is, of statements are best when included course, crucial for the therapist to with other guidelines regarding the provide clients with clear alternatives therapeutic relationship. Some to abusive behavior. The tendency to therapists have their clients sign a resort to old and familiar (abusive) copy of the confidentiality statements behavior will persist, and part of the and keep them in their files. The therapeutic goal is to replace the old clients may or may not ask questions behavior with new techniques. related to confidentiality. However, Another mistake therapists limits of confidentiality and what is sometimes make in working with considered reportable suspected child abusive situations is to see abuse should be explained both themselves as “rescuers” of the child. verbally and in writing to clients. Therapists must remain sensitive to

17 Suggested statements (meant The Use of : Contracts specifically for therapists) are: are written agreements between the To Parent: What we discuss in therapist and the client that specify therapy is confidential with two goals of therapy, with clear behavioral exceptions: one, if I think you are descriptions of expected outcomes. going to hurt yourself; two, if I The structure a provides think you are going to hurt is helpful for many reasons when someone else, including your working with abusive families. child. If either of these two Families in crisis respond well to incidents seems likely, I will need clearly specified objectives, in to take protective action, which addition, families can feel a greater will include calling appropriate sense of control if they are able to authorities. understand what behavior on their part will lead to their desired outcome. To Child: What we discuss in Often the clients are mandated by therapy is confidential with three court to attend therapy. In those exceptions: one, if I think you are cases, it is particularly helpful to use going to hurt yourself; two, if I contracts, so that it is clear among all think you are going to hurt agencies and individuals concerned someone else; and three, if I think what is expected. someone, including your parents, Limit Setting: Reporting are hurting you. When any of suspected child abuse is often an these things is going on, I will effective way of setting a firm limit need to let someone know and try regarding unacceptable behavior. to get additional help for you. Clients may feel cared for when a therapist sets limits on their In their statements about the limits self-destructive or self-defeating of confidentiality, therapists should be behaviors. Most abusers do not certain that their clients are aware that want to hurt their children. When child abuse, , and parents/caregivers abuse their threat of homicide are matters that children, their self-worth may be must be reported if they are negatively affected because the abuse suspected. The Tarasoff vs. Regents may reinforce their worst fears about of the University of California (1976) themselves. 17 Cal.3d 425 decision established Reporting can be a way to model that a therapist may be liable for the setting of limits. injuries resulting from a failure to Use of Authority: Many mental report their suspicions regarding these health professionals are trained to issues. Of course, these are all encourage clients to draw conclusions circumstances in which the and choose their own directions. In therapeutic and legal arenas overlap, abuse situations, however, the and the therapist must take therapist must feel comfortable with substantive action in the best interest his/her own use of authority to of the client or intended victims. maximize safety for both parent and

18 child. It may take some time before a Some clients will never admit to mental health professional is the abuse. comfortable making reports and “Stay With” The Client: After a explaining this decision to the client. report is made, it is important to The decision should be presented in a continue supportive contact with the firm and supportive manner. The client, rather than assuming that the therapist can tell the clients that job is done. The client who is a child he/she recognizes their feelings of will especially benefit from having helplessness and anger and that access to the therapist, since he/she will be available to help them frequently he/she is propelled into a take some control over their lives. child welfare system which can be Offering a matter-of-fact and perceived as insensitive and caring approach counters the demanding. message that the abuse is so The child who has been abused repugnant it must be kept hidden, or and is involved in the situation may that the therapist does not take the not only be dealing with his/her abuse, abuse seriously. but also may be dealing with the Facing Denial: It is common for process of investigation and abusive parents/caregivers to deny prosecution of the abuser. that they have been abusive. This is The client may need someone to to be expected. They have a great answer questions about the investi- deal to protect, and they are usually gatory or Court processes. As much feeling judged and exposed. The information as possible should be therapist should focus on assessment relayed to the family. of the individual’s strengths, Telling The Client A Report Is weaknesses, and concerns based on Being Made: Reporters are not an understanding of the underlying required by law to tell the client a family dynamics. report of child abuse is being made. (NOTE: The therapist is not the However, in the majority of cases, long arm of the law, particularly telling the client about the report is regarding investigation. While the therapeutically advisable. therapist can use the legal system In so doing, the therapist is effectively and cooperatively, it is not employing clinical leverage by using the therapist’s job to prove culpability authority to set a firm and necessary or collect evidence. However, limit. Reporting responds to the information gathered in the client’s nonverbal plea for help. The assessment regarding possible therapist can reassure the parent that child abuse can be used in the steps will be taken to help him/her investigation.) gain control so that the abuse does It is essential for the therapist not continue and lead to serious injury to create a safe and trusting of the child. environment conducive to Furthermore, if the therapist does self-disclosure, while consistently not mention the report to the client, raising the issue of denial. secrecy and tension can result which

19 may lead to the client feeling the therapist may attend and listen to suspicion, isolation, or betrayal. the case management meetings. In some cases, reporting may elicit Frequently, the therapist can be an extreme response from clients. It pivotal in obtaining supportive is contraindicated to inform people of services for the client. a report if the individual seems psychotic, has poor impulse control Non Helpful Interventions coupled with a history of violent Threats: Threatening the clients behavior, has a problem with alcohol with a report gives the impression that or drugs, or is likely to flee the area. reporting is a punishment and may It can be very beneficial to give further alienate the client from seeking clients the opportunity to make the needed services. reports themselves in your presence. Bargaining With Clients: (“I However, telling clients to report won’t report you this time, but if you themselves does not negate the do it again…I’ll have to”) gives the therapists mandate to report. message that sometimes it is all right Consultation/Coordination: A to be abusive, but other times it is not. team treatment approach can The client may find the double contribute to the optimal provision of message confusing, and his/her services and monitoring. behavior may escalate. Coordination of services can result Threats and bargaining are not in less to the family in crisis options for the reporter. The reporting and optimal use of each agency’s law states that reports must be made limited resources. Case conferences by those engaged in specified allow therapists and other caregivers professions when there is reasonable the opportunity to define expectations suspicion, knowledge or observation for change in areas of concern, and of child abuse. allow for definition of roles by the Hit and Run Ð Abandoning The many professionals involved in each Client: It is important to provide case. When a specific plan of action ongoing support to the client is designed by a multi-disciplinary throughout the investigation and team and defines the key players, it is follow-up services. easier to provide clear direction to the Arguing: Many clients will argue parents. The consultative team that they are not abusive since their approach is especially helpful when own parents did worse things to them. there is uncertainty as to whether or Have clients describe previous abuse not to report. and then explain that the reporting Remember, however, therapists laws have changed. Let them know are bound by confidentiality and that, were their parents’/caregivers’ should obtain client release forms, abusive behavior to occur today, it waiving confidentiality on specific would be reportable as child abuse. information. If no waiver is obtained, 1. Who am I to say what’s

20 Questions Often Asked

abusive? physical abuse and discipline? The health professional and If the discipline is excessive or other mandated reporters often forceful enough to leave injuries, feel reticent to label behavior as physical abuse has occurred. abusive. They may feel they The use of instruments increases have no right to pass judgment the likelihood of injuries as does on other people. However, if a the excessive punishment of reasonable suspicion exists, the young children. The intent of the protective action is beneficial to reporting law is not to interfere the parents as well, who may not with appropriate parental recognize their behavior as discipline, but to respond to abusive, or may be reluctant to extreme or inappropriate seek help. If in doubt, the discipline which is abusive. specific Penal Code sections Some parents hit their children in regarding child abuse can be places where injuries are not referred to. They are California visible (the buttocks, the thighs, Penal Code sections 11164 Ð the back) and yet may tell the 11174.3. They can be accessed therapist, or other mandated through the internet at reporter, that they use belts, http://www.leginfo.ca.gov/calaw.html whips or other potentially dangerous instruments. If you 2. What if I make a mistake? have reasonable suspicion of Dr. C. Henry Kempe, a pioneer abuse, even with no visible signs, in the field of child abuse you are required to report. Under prevention, once said he would California Welfare and Institutions rather apologize to a parent Code Section 300(a), reasonable because he made a mistake and age appropriate spanking to about reporting the abuse, than the buttocks where there is no apologize to a brain-damaged evidence of serious physical child because he did not report. injury does not constitute abuse. It is better to err in the direction of over-reporting than 4. What if abuse occurred in the under-reporting. It is important past? to note that mandated reporters There is no time limitation are immune pursuant to statute regarding the reporting of child if they make a report, but they abuse. If a victim is under age are liable if they fail to report 18, the abuse must be reported. when they have reasonable suspicion. 5. What if an adult states he/she

3. What is the fine line between

21 was abused as a child? believe that they provoke their The child abuse reporting law abuse or are better able to mandates a report when there is protect themselves or run away a reasonable suspicion or from abusive situations. Despite knowledge that minors may be in their age and size, adolescents need of protection. Therefore, are often just as vulnerable as childhood abuse of adults should younger children to physical, be reported if there is a sexual and emotional abuse and reasonable suspicion that there neglect. may be another potential child victim. (This does not impose 8. What is the difference between an investigatory duty on the children’s “normal” sex play professional.) and sexual abuse? The lack of contemporary 6. What about testifying in court? normative data regarding sexual The majority of cases do not go activity among young children to trial. When they do, and the makes differentiating between professional is required to testify, normal sex play and sexual it is important to remember that abuse difficult. It is clear, the testimony may be essential however, that very young children for the protection of the child. without exposure or experience The professional's effectiveness do not usually have substantial or and comfort as a witness may be detailed knowledge about sexual greatly increased by meeting with activity and that the child who the attorney at the earliest exhibits developmentally opportunity. inappropriate behaviors has probably either been exposed to 7. At what age is a child most at that behavior or has experienced risk of abuse? it. Exposure may have occurred All children are at risk of abuse, directly (by observing people but and toddlers are most engaged in those activities or by likely to sustain serious injuries having personally been involved) due to their fragility. The mortality or indirectly (through TV or rate is highest for children 0-2. pictures in a magazine). Some people are predisposed Factors to be considered in to respond more inappropriately addition to developmental to one age of child than to appropriateness include the another. For example, sexual dynamics of the situation. Was abuse of infants is more difficult , threat, or to fathom than sexual abuse of force involved? Were age and adolescents, yet it does occur. size of the children involved Adolescents are also at risk of similar? Even in cases involving abuse but may not receive children of similar age and size it needed help because people may is possible that the activity is

22 abusive if threats, force or fourteen who are of similar age coercion is present. need not be reported. Differences in emotional In the case of People vs. maturity and status must also be Iohn L., (1989) 209 Cal.App. 3d evaluated. For example, a child 1137, the court determined that who has been delegated the Penal Code Section 288(a) authority of “babysitter” by prohibits all sexual contact with parents has a distinct status or persons under the age of power advantage over other fourteen, regardless of the young children, even if the age person’s , if the offender differential is not large. is over age 14. Many assessment questions It should be noted that even in must be considered when light of these two decisions, professionals are presented with legally mandated professionals situations in which children are must report instances of sexual engaging in sexual activity. It is contact between children (under important to understand not only 18) if they suspect that the child the child’s knowledge base but has been sexually abused or also the sources of that exploited. It is also worth noting knowledge. In most cases of this that even in children over type, consultation is very helpful. fourteen the issue of consent must be carefully evaluated. A 9. When do you report sexual history of sexual abuse may lead activity between minors? a child to view further abusive The answer to this question situations as familiar and normal, can only be determined by a thus impairing that child’s ability comprehensive evaluation of the to protect him/herself from further situation. Two court cases abuse. address the question of whether a child sexual abuse report is 10. Are clergy mandated to report? warranted in the case of a child Yes. Beginning January 1, 1997, under fourteen who is sexually all clergy members are mandated active. In the case of Planned to report known or suspected Parenthood Affiliates vs. instances of child abuse to a Van de Kamp (1986) 181 Cal. child protective agency. Clergy App.3d 245, the court stated that members are exempt from sexual activity alone does not their mandated reporting imply sexual abuse. If, in the responsibilities only if the judgment of the reporting knowledge or reasonable professionals, there are no suspicion of child abuse was indications of actual sexual or obtained during a “penitential other abuse, then voluntary and communication”. consensual sexual behavior (P.C. 11165. ( c)( (1)). between minors under the age of “Penitential communication”

23 means a communication, assure the safety of a child and intended to be in confidence, provide services to keep the including, but not limited to, a family together. sacramental confession, made to Removing a child from the a clergy member who, in the home is an action taken only course of the discipline or when a child cannot remain there practice of his or her church, safely. Services provided to a denomination, or organization, family in which abuse is occurring has a duty to keep those may range from counseling to communications secret. respite care or the placement of a (P.C. 11166( c)(2)). family care worker in the home to provide role modeling and 11. Are alcohol programs exempt assistance to parents. If removal from reporting child abuse? becomes necessary, the Juvenile No. The exemption in effect until Court has several options for 1987 for federally-funded placement including the non- alcohol/drug programs has been custodial parent, relatives, foster withdrawn. Today all alcohol/drug homes and group homes, in that programs are required to make order, depending upon the appropriate child abuse reports. specific needs of the child. Parents should be reassured that 12. May reports be made the Court’s removal standards are anonymously? stringent. The Court will order Mandated reporters must identify the Child Protective Agency which themselves when making child provides child welfare services abuse reports. However, persons and the parents to work together not legally mandated to report for reunification as quickly as may make anonymous reports. possible. When abuse has occurred 13. What happens after a report is where the alleged perpetrator is made? not a member of the household Child Protective Agencies (county (for example, a welfare or probation department, molesting a child), law police or sheriff’s department) are enforcement is responsible for responsible for investigating the investigating the referral. The referral once it is made. Child Protective Agency will Emergency Response (ER staff investigate to determine if the from the child welfare or child is being protected in his/her probation agency) and law home. Once the agency has enforcement will work together, determined that the child is safe although their investigations will at home, then it may refer the be separate. When abuse has family for counseling or medical occurred within a family, ER’s care and to appropriate local emphasis in intervention is to community resources. A case of

24 out-of-home abuse is generally motion by a report. closed by the welfare or probation 14. Does a positive toxicology department, with the law screen at time of delivery enforcement agency continuing its require a child abuse report? investigation. A positive toxicology screen at When there is an allegation that the time of the delivery of an abuse (including general neglect) infant is not in and of itself a has occurred in a licensed day sufficient basis for reporting child care or out-of-home care facility, abuse. However, any indication the State or County licensing of maternal agency must report the alleged shall lead to an assessment of abuse to law enforcement, a Child the needs of the and child Protective Agency or the county pursuant to Section 123605 probation department. The (below) of the Health and Safety licensing agency then conducts Code. If other factors are present an investigation of the allegations. that indicate risk to a child, then a The licensing agency child abuse report must be made. investigations may be conducted A report based on risk to a child concurrently with the law which relates solely to the enforcement or CPS inability of the parent to provide investigations; however, the the child with regular care due to licensing agency should not a parent’s substance abuse shall interfere with these investigations. be made only to a county welfare Depending upon its finding, the department and not to law State licensing agency - (an enforcement. (P.C. 11165.13) agency within the California Department of Social Services 123605. (CDSS)) may temporarily (a) Each county shall establish suspend or revoke the facility’s protocols between county license. The CDSS action is not health departments, county dependent upon the outcome of welfare departments, and all the law enforcement or CPS public and private hospitals investigations or any civil action in the county, regarding the resulting from such investigations; application and use of an CDSS has only to have a assessment of the needs of, preponderance of evidence in and a referral for, a order to take action against a substance exposed infant to licensed care facility. a county welfare department Procedures in Child Protective pursuant to Section 11165.13 agencies vary from county to of the Penal Code. county. Therefore, it is important (b) The assessment of the to understand the local procedures which are set in

25 needs shall be performed by may appear to look like child a health practitioner, or a abuse, they may not be, when medical social worker. The done properly. Likewise, this needs assessment shall be same practice, if done improperly performed before the infant is or to excess, could constitute released from the hospital. child abuse. Other practices (c) The purpose of the which are generally acceptable assessment of the needs is within a particular native culture to do all of the following: are not acceptable within our (1) Identify needed services culture and would constitute child for the mother, child, or abuse, necessitating a child family, including, where abuse report. applicable, services to assist the mother to care 16. What if a parent states their for her child and child is receiving treatment by maintain the children in spiritual means or not their homes. receiving medical treatment for (2) Determine the level of “religious reasons”? risk to the newborn upon General neglect includes the release to the home and negligent failure of the person the corresponding level having the care or custody of the of services and child to provide medical care. intervention, if any, However, a child receiving necessary to protect the treatment by spiritual means newborn’s health and (Section 16509.1 of Welfare & safety, including a Institutions Code) or not receiving referral to the county medical treatment for religious welfare department for reasons, is not for that reason child welfare services. alone considered child neglect. (3) Gather data for An informed and appropriate information and planning medical decision made by purposes. a parent or guardian after consultation with a physician 15. Should a person’s culture be who has examined the minor considered in determining if a does not constitute neglect. report should be made? (P.C. 11165.2). Given the diverse culture we live in, mandated reporters should be 17. What if you are concerned encouraged to receive cultural about severing the trust competency training in order to relationship with a client? better understand cultural factors The primary concern has to be that need to be considered in the safety and security of the recognizing possible child abuse. child. When first making contact While some cultural practices with a client, a confidentiality

26 statement (See “Sample as non-judgmental as possible. Confidentiality Statements” This can be difficult. The more Appendix C) should be clearly the suspected abuser feels stated and given to the client in judged by statements that can be writing. This will prevent them interpreted as personal attacks, from feeling tricked in the event the less likely they are to accept something is revealed. One help to change their behavior. cannot ensure that the (See “Identification, Guidelines for “therapeutic trust” will remain. Assessment”, and “Major Being clear about one’s role and Treatment Issues” Sections.) responsibilities from the beginning, while ensuring the 19. In cases of domestic violence safety of the child will help further when there is a child in the the bond between client and home, is it reportable as child therapist. abuse? While each county handles this 18. What do you say to a client issue differently, domestic who is suspected of abusing a violence is being reported in child? some counties as emotional It is not a legal requirement to tell abuse (P.C. 11166.05). It is the client a report is being made. generally reported to Child However, if it is safe to do so, it is Protective Services when a child therapeutically advisable to tell is in the home by medical them in an honest and forthright personnel, law enforcement and manner. domestic violence units. Where When child abuse or neglect “a child is in immediate and are suspected, the following is present danger of abuse by a one possible intervention that a family or household member, mandated reporter may wish to based on an allegation of a use. This is one of many recent incident of abuse or threat possibilities and not all situations of abuse by the family or are the same: Begin by making a household member” a judge can statement about what you saw, order an emergency protective heard or believe that makes you order (California Family Code suspect abuse or neglect. Follow Section 6250). this with, “As a mandated If encountering a situation of reporter, I am required by law to domestic violence where there is report any reasonable suspicion concern about the safety and well of child abuse or neglect.” being of a child, contact your Just as important in the telling local Child Protective Service process is the tone of voice and agency or law enforcement manner one uses. The optimal agency. and least damaging way is to be 20. Do you always tell the

27 suspected abuser that you are disabled child in a home or making a report? institution, is it reportable as For clinicians and therapists, child abuse? making the decision to tell the Yes. Any suspected child abuse suspected abuser that you are or neglect should be reported. making a report is a highly Children with disabilities are sensitive and complicated issue. 3.4 to 7.7 times more likely to be This decision should be carefully victims of maltreatment than considered on a case by case non-disabled children. basis. There are times when having the suspected abuser, partner of the suspected abuser, or the alleged victim assist in making the report can be therapeutically empowering. At other times informing clients that you are making a suspected abuse report puts the alleged victim in greater danger of further abuse or can later damage the CPS or Law Enforcement Investigation. When in doubt seek consultation and/or call your local CPS hotline and ask for assistance.

21. If you suspect abuse of a

28 Conclusions and Recommendations

Child abuse is a problem with many intra-psychic, social and interpersonal aspects. It is usually "action language," that is, parents and others cannot always recognize and verbalize their needs and may use behavior rather than words to get help for themselves.

It is important that the mandated reporter not let denial, fear, or ignorance of laws or procedures interfere with providing help to the family or caregivers. Not everyone is able to work effectively with these situations. The responsible reporter faces his/her limitations or preferences, and, when appropriate, REFERS OUT to others better able or willing to provide treatment for these families and caregivers.

Most people who abuse their children can be successfully treated. The helping professional can become the appropriate and safe parent figure, the educator and limit-setter to the abusive person. No one can do the job alone. The responsibility can be shared.

Therapists are advised to familiarize themselves with the social service/legal system, the laws and the helping agencies in the community. Frequently, coordinating the therapy with other helping services will result in enhanced treatments.

Training and consultation are also highly encouraged for any professional working with child abuse. There are many excellent written materials, training programs, seminars and/or conferences, as well as local expertise, which can be consulted on the specifics of a case. Online materials, information, and resources are available via web site addresses listed throughout the Selected Bibliography, Appendix D, and Appendix E. Therapists are also advised to build a support system of peers with whom to discuss their own feelings as well as problematic aspects of cases.

There are many effective community services which can be complementary to individual or group therapy, and are invaluable to the clients who often have varied needs. Examples of community services (Appendix D) and statewide services (Appendix E) are included at the end of this handbook. Your local Child Abuse Prevention Council or Child Protective Agency will be familiar with existing local services.

29 APPENDIX A

30 APPENDIX A

31 Required Statement of Mandated Reporter Ð APPENDIX B Sample Employee Form Child Abuse and Neglect Reporting Law (P.C. 11166.5) Definitions: The following situations are reportable conditions: 1) Physical abuse, 2) Sexual abuse, 3) Child exploitation, and , 4) Severe or general neglect, 5) Extreme corporal punishment resulting in injury, 6) Willful cruelty or unjustifiable punishment, 7) Abuse or neglect in out-of-home care. Who Must Report: The following individuals are legally mandated reporters: (Refer to “Reporting Law” Section for a comprehensive listing). ¥ Child visitation monitors ¥ Health practitioners (nurses, physicians, etc.) ¥ Commercial or photographic print processors in specified instances ¥ Specified public positions (teachers, social workers, probation officers, etc.) ¥ Public protection positions (police, sheriff, CPS, etc.) ¥ Clergy members ¥ Fire fighters (except volunteer firefighters), Animal control officers, Humane society officers When to Report: A telephone report must be made immediately when the reporter observes a child in his/her professional capacity or within the scope of his/her employment and has knowledge of, or has reasonable suspicion that the child has been abused. A written report, on a standard form, must be sent within 36 hours after the telephone report has been made. To Whom Do You Report: You have a choice of reporting to the Police or Sheriff’s Department or the Probation Department or Child Welfare Agency. Each County has preferred reporting procedures. Commercial film or photographic processors report only to law enforcement. Individual Responsibility: Any individual whose occupation is named in the reporting law must report abuse. If the individual confers with a superior and a decision is made that the superior file the report, one report is sufficient. However if the superior disagrees, the individual with the original suspicion must report. Anonymous Reporting: Mandated reporters are required to give their names. Non- mandated reporters may report anonymously. Child protective agencies are required to keep the mandated reporter’s name confidential, unless a court orders the information disclosed. Immunity: Any legally mandated reporter has immunity when making a report. In the event a civil suit is filed against the reporter, reimbursement for fees incurred in the suit will occur up to $50,000 (P.C. Section 11172). No individual can be dismissed, disciplined or harassed for making a report of suspected child abuse. Liability: Legally mandated reporters can be criminally liable for failing to report suspected abuse. The penalty for this misdemeanor is up to six months in county jail, a fine of not more than $1,000 or both. Mandated reporters can also be civilly liable for failure to report. Notification Regarding Abuse: You are not legally required to notify the parents that your are making a report; however, it is often beneficial to let the parents know you are reporting for benefit of a future relationship. I understand that I am a legally mandated reporter. I have clarified any information listed above which I did not understand, and am now aware of my reporting responsibilities, and am willing to comply. I have also requested an explanation of reporting policies within this agency and understand them. ______32 Employee’s Name Witness (Supervisor) Date APPENDIX C Confidentiality Statements and Agreement (Sample)

A statement outlining confidentiality expectations between counselor and client is important in the beginning of a therapeutic relationship. A copy should be given to the client. Here is a sample:

Confidentiality: All information between counselor and client is held strictly confidential unless: 1. the client authorizes release of information with a signature; 2. the counselor is ordered by a court to release information; 3. a client presents a physical danger to self or others; 4. child abuse/ neglect are suspected; 5. In these latter two cases, I am required by law to inform potential victims and legal authorities so that protective measures can be taken.

This is a sample of a confidentiality agreement used by counselors.

Confidentiality Agreement

What is discussed in therapy is confidential unless and until you (client) give consent to its release, with two exceptions. I will need, and am compelled by law, to report to an appropriate other person(s) if: 1. I believe that you are in danger of hurting yourself or someone else, and 2. If there is reasonable suspicion that a child has been abused or neglected.

I (client) have read the foregoing, understand its content and agree to the conditions stipulated herein.

Client Signature: ______

Therapist signature:______

Date: ______

33 Community Resources APPENDIX D Parents Anonymous. Self-help groups for Parent Discussion Groups. Provide a forum in potentially abusive or abusive parents. Facilitators which parents may discuss child-rearing consist of a professional and a formerly abusive problems, gain peer support, and minimize their parent. Usually no fee/low fee, child care and isolation. transportation provided. http://www.parenthoodweb.com http://www.parentsanonymous.org/ Parents United. Self-help groups for sexually Community Mental Health Departments. abusive families. Consists of groups for offenders, Provide low-fee therapeutic services to families children, and . Also have groups for Adults and children. Available in every community. Molested as Children (AMAC). Comprehensive child Frequently serve a broad range of abusive sexual abuse program. Email: [email protected], families. Listings of Statewide 24-hour crisis http://members.tripod.com/~Parents_United/Chapters hotlines - /californ.htm http://www.dmh.cahwnet.gov/faq/hotline.asp Parental Hotlines. 24-hour Crisis telephone Family Resource Centers. Provide valuable assistance for persons under stress. Telephone child care information to parents who may counseling primarily, but can also provide home beoverwhelmed by the demands of parenting. visiting program and respite care. Usually offer Information and referral. Education. parent peer groups and other services. CHILD http://www.familyresourcecenters.net/ HELP USA HOTLINE - 24 hour. 1-800-422-4453. (Counseling + referrals + counseling available in 140 Private Mental Health Clinics/Therapist languages). Groups. There are many private therapists who now specialize in working with child abuse. Child Respite Care Programs. Programs which provide Abuse Prevention Councils or Child Protective care for children, elderly, or the sick when their Agencies are usually familiar with good referral caretakers “need a break.” Not a baby-sitting service. possibilities. Resources - Voluntary participation. http://www.planetpsych.com, http://www.chtop.com/calstate.html and http://www.4therapy.com and http://www.caregiver.org/CRC respite pdf.html http://psychology.com (lists 1,900 programs in California) Family Service Agencies. Many of these Parent-Infant Bonding (Perinatal Programs). agencies have taken a leadership role in child Designed to help new parents with bonding skills; provide parent education regarding the child's need. abuse prevention/treatment services. Therapeutic Early intervention services. services are available on a sliding fee scale. http://www.birthpsychology.com/index.html Emergency hotline information. offers 24-hour Child Abuse Prevention Councils. Provide hotline help and resource referral information. information and referral; educational services http://www.psch-net.org/hotlines including book and film library. Usually are United Way. offers information on local resources multidisciplinary in nature, and help coordinate within one’s own geographic area. service delivery. Provide visibility to the problem of http://www.national.unitedway.org/ child abuse. Listings in California by county: http://www.capcsac.org/crisisnumbers/councils.html California Legislative Information. Internet site Parent Education Classes. Designed to help designed to provide current legislative information parents gain a better understanding of child to the public. Includes legislators mail address development and learn skills for disciplining their and e-mail (under “Your Legislature).” children in a safe way. Practical parenting tools - http://www.leginfo.ca.gov/ http://www.positiveparenting.com/ 34 APPENDIX E Statewide Resources

Office of Child Abuse Prevention (OCAP) California Department of Social Services 744 P Street, MS 19-82 Sacramento, CA 95814 (916) 445-2771 Web site: http://www.dss.cahwnet.gov/cdssweb/OfficeofCh_1341.htm Web site for online mandated reporter training: http://cihs.sonoma.edu/web/camr/

Prevent Child Abuse California 926 J Street, Suite 717 Sacramento, CA 95814 (916) 498-8481 1-800-CHILDREN Web site: http://www.pca-ca.org/

California Child Care Resource and Referral Network 111 New Montgomery Street, 7th Floor San Francisco, CA 94105 (415) 882-0234 Web site: http//www.rrnetwork.org

Parents Anonymous 675 West Foothill Blvd., Suite 220 Claremont, CA 91711-3475 (909) 621-6184 Web site: http//www.parentsanonymous.org National Resources

National Clearinghouse on Child Abuse and Neglect (NCCAN) 330 C Street SW Washington, D.C. 20447 (800) 394-3366 Web site: http://www.calib.com/nccanch

Prevent Child Abuse America 200 S. Michigan Avenue, 17th Floor Chicago, Illinois 60604-2404 (312) 663-3520 Web site: http://www.childabuse.org

Parents United, International 615 15th Street Modesto, CA 95354 (209) 572-3446 Email: [email protected], http://members.tripod.com/~Parents_United/Chapters/californ.htm 35 Selected Bibliography APPENDIX F Physical Abuse/Child Abuse Summit, Roland, (1983) The Child Sexual Abuse Crossan-Tower, Cynthia. (1996) Understanding Accommodation Syndrome. In Child Abuse and Child Abuse and Neglect. 3rd ed. Boston, MA: Allyn Neglect: The International Journal, Pergamon Press, & Bacon. http://www.abacon.com/ Ltd., Vol. 7, pg. 177, 193. (Available in library periodicals section). Gil, D. (Dec., 2001) Violence Against Children. Family Violence and Child Abuse Physical abuse in the . Cambridge, MA: Chalk, R., King, Pl, (Eds.). (1998) Violence in Harvard university press http://www.hup.harvard.edu/ Families: Assessing Prevention and Treatment Krugman, R.D., Kempe, R.S., Helfer, M.E., The Programs. Committee on the Assessment of Family Battered Child. 5th ed. University of Chicago Press, Violence Interventons, National Research Council 1968, 1974, 1980, 1987, 1997. and Institute of Medicine. Washington, DC: National http://www.press.uchicago.edu/ Academy Press. http://www.books.nap.edu/ Understanding Child Abuse and Neglect. (1993) Crowell. N.A., Burgess, A.W., (Eds). (1996) Panel on Research on Child Abuse and neglect, Understanding . National Research Council Washington, DC: National (includes family violence) Panel on Research on Academy Press. http://www.books.nap.edu/ Violence Against Women, National Research Council. Washington, DC: National Academy Press. Wile, Vernon R. (1996) Working with Child Abuse http://www.books.nap.edu/ & Neglect: A Primer. (Child maltreatment, history, factors, treatment, prevention, and evaluation Child Abuse Prevention instruments). Thousand Oaks, CA: Sage Reiss, A.J., Jr., Roth, J.A., (Eds.). (1993) Publications. http://www.sagepub.com/ Understanding and Preventing Violence, Volume 1. Panel on the Understanding and Control Neglect of Violent Behavior, National Research Council. Cohn, F., Salmon, M.E., Stobo, J.D., (Eds.). (2001) Washington, DC: National Academy Press. Confronting Chronic Neglect: The Education and http://www.books.nap.edu/ Training of Health Professionals on Family Violence. Committee on the Training Needs of Waldfogel, Jane. (1998) The Future of Child Health Professionals to Respond to Famillly Violence, Protection: How to Break the & Board on Children, Youth, and Families. Washington, Neglect. Cambridge, MA: Harvard University Press. DC: National Academy Press. http://www.hup.harvard.edu/ http://www.books.nap.edu/ Interventions, Research and Policy Sexual Abuse Barker, N., Plum, H., Coale, H., Fontana, J.J., Hoffa, Campbell, J.C., (Ed.) (Oct. 1994) Assessing C., Riggs, R.S., Davis, L., Cathcart, C., McGovern, Dangerousness: Violence by Sexual Offenders, K., Farrell, J. (1998) Child Abuse & Neglect: An Batterers & Child Abusers. Thousand Oaks, CA: Interdisciplinary Method of Treatment. Dubuque, Sage Publications. http://www.sagepub.com/ IA: Kendall/Hunt Publishing Company. http://www.kendallhunt.com/ Laws, D. Richard, Hudson, Stephen M., , T., (Eds). Remaking Relapse Prevention With Sex Child Abuse & Neglect: A Look at the States - Offenders: A Sourcebook. Thousand Oaks, CA: 1999 Stat Book. (1995) Child Welfare League of Sage Publications. http://www.sagepub.com/ America. Washington, DC. http://www.cwla.org/pubs/

Child Welfare. (Journal resource), Child welfare league of America, Washington, DC. (202) 638-2952. E-mail: [email protected] 36 Dubowitz, H., (Ed.). (1999) Neglected Children: Freyd, J. (Jan. 1996) Betrayal Trauma: The Logic Research, Practice, and Policy. Child neglect, of Forgetting Childhood Abuse. (Psychogenic policy, evaluation, prevention, cultural competency. amnesia, lifelong effects of child abuse, & treatment). Thousand Oaks, CA: Sage Publications. Cambridge, MA: Harvard University Press. http://www.sagepub.com/ http://www.hup.harvard.edu/ Fontes, L.A., Interviewing Immigrant Children & Garbarino, J. (1999) Lost Boys: Why Our Sons Families About Child Maltreatment. (April 2000) Turn Violent and How We Can Save Them. New Thousand Oaks, CA: Sage Publications. York, NY: Anchor Books. http://www.anchorbooks.com http://www.sagepub.com/ Juvenile , Juvenile Justice. (2001) Panel on Guterman, Neil B. (2001) Stopping Child Juvenile Crime: Prevention, Treatment and Control, Maltreatment Before It Starts: Emerging Horizons Committee on Law and Justice, & Board on Children, in Early Home Visitation Services. Thousand Oaks, Youth, and Families, National Research Council, and CA: Sage Publications. http://www.sagepub.com/ Institute of Medicine Washington, DC: National Academy Press. http://books.nap.edu/ Krugman, Richard D., (Ed.), Leventhal, John, M. (Co-editor). Child Abuse & Neglect, The Lamb, Sharon (April 1996) The Trouble with . International Journal. (Journal resource) New York: Cambridge, MA: Harvard University Press. Pergamon. (Available in library periodicals section). http://www.hup.harvard.edu/ Lutzker, John R. (Nov. 1997) Handbook of Child Petersilia, J., Foote, J., Corwell, N., (Eds). (2001) Abuse Research and Treatment. Theory, law, Crime Victims with Developmental Disabilities: treatment, & sex abuse. Norwell, MA: Kluwer Report of a Workshop. Washington, DC: National Academic publishers. http://www.wkap.nl/prod/ Academy Press Press. http://books.nap.edu/catalog Macdonald, Geraldine M. (2001) Effective Parnell, T.F., O’Day, D. (July 1997) Munchausen by Interventions for Child Abuse & Neglect: An Proxy Syndrome: Misunderstood Child Abuse. Evidence Based Approach to Planning and Thousand Oaks, CA: Sage Publications. Evaluating Interventions. New York, NY: Wiley http://www.sagepub.com/ Books. http://www.wiley.com/ Pezdek K. & Bnaks, W.P. (1996) The Recovered National Data Archives on Child Abuse and Memory/False Memory Debate. , CA: Neglect. Cornell University Family Life development Academic Press.. http://www.academicpress.com/ Center, MVR Hall, Ithaca, NY. Stern, P. (Jan. 1997) Preparing and Presenting www.ndacan.cornell.edu National Data Analysis System: http//www.ndas.cwla.org Expert Testimony in Child Abuse Litigation. Thousand Oaks, CA: Sage Publications. Reece, R.M., M.D., (Ed.). (2000) Treatment of Child http://www.sagepub.com/ Abuse. Common Ground for mental health, medical, Straus, M.B. (1990) Abuse and Victimization and legal practitioners. John Hopkins University Across the Life Span. John Hopkins Series in Press. http://www.press.jhu.edu/ Contemporary Medicine and Public Health. John Wolfe, D.A. (June 1999) Child Abuse: Implications Hopkins University Press. http://www.press.jhy.edu/ for and . Thousand Oaks, CA: Sage Publications. Other http://www.sagepub.com/ Internet Resource for articles dealing with child abuse. (Site includes: neglect, emotional, physical, & Related Issues Sexual abuse). http://www.vachss.com/ (Resource Section) Bartholet, Elizabeth. (1999) Nobody’s Children: Abuse & Neglect, Foster Drift, and the Alternative. Boston, MA: Beacon Press. http://www.beacon.org/ 37

Printed and Distributed By:

State of California Department of Social Services Office of Child Abuse Prevention 744 P Street, M.S. 19-82 Sacramento, CA 95814 (916) 445-2771

Department of Social Services Website: http://www.dss.cahwnet.gov/cdssweb/default.htm

California home page: http://www.ca.gov

With funding provided by:

The State Children’s Trust Fund

The current California Child Abuse and Neglect Reporting Law (Penal Code 11164-11174.3) can be accessed on the internet at http://www.leginfo.ca.gov

This pamphlet provides current information about the subject of Child Abuse reporting laws to assist mandated reporters and others in determining their reporting responsibilities. It is not intended to be and should not be considered legal advice. In the event there are questions about reporting responsibilities in a specific case, the advice of legal counsel should be sought.

Printed May 2003 State of California , Governor

Health and Human Services Agency Kimberly Belshé, Secretary

Department of Social Services Dennis J. Boyle, Director

Children and Family Services Division Children’s Services Branch Office of Child Abuse Prevention

Pub 132 (1/05)