Last week’s MFT blog explored a complicated question on child abuse and neglect reporting. This week, we continue exploring the topic of abuse and neglect, but shift our focus to elders and dependent adults. In California, the laws regarding elder and dependent adult abuse overlap quite a bit with those for child abuse, but there are also some differences to keep in mind.
What are some of the key differences? While this is not an exhaustive list, a few to be aware of include:
1. Therapists are only mandated to report when the elders/dependents are residents of California. If, in your professional capacity, you become aware of elder/dependent abuse occurring outside of California, you are not required to make a report. In contrast, we are mandated to report child abuse and neglect to California authorities regardless of where the victim resides.
2. There are a total of seven categories of abuse and neglect that require us to report: physical abuse, abandonment, abduction, isolation, financial, neglect, and deprivation of necessary goods or services. In cases of child abuse and neglect, the law does not address abduction or financial abuse.
3. When, how, and where to report elder and dependent abuse and neglect will vary based on where it occurred, which is not the case with child abuse and neglect.
These are just a couple of the differences-and you want to make sure you know ALL of the differences for the exam. In TDC's programs, Amanda Rowan explains in further detail the differences in reporting requirements between elder and dependent adult abuse/neglect and child abuse/neglect and provides easy to understand guidelines for your reporting requirements as an MFT.
With this in mind, let’s take a look at our question of the week:
A therapist works with clients residing in a long-term living facility. One of the therapist’s newer clients shares in a session that he is upset because he witnessed an employee rough handling and yelling at one of the residents during their daily activities. In response to the employee’s actions, the resident appeared visibly shaken and began crying. He asks the therapist to please not say anything because he is concerned the employee will know he was the one to complain. Based on the information and concerns shared by the client, how should the therapist manage the ethical and legal obligations in this case?
A) Report the client’s concerns to management and follow the facility’s guidelines for reporting abuse
B) Ask the client for more detailed information regarding the incident before making a report and safety plan with the client.
C) Report the abuse to law enforcement and local ombudsman and process report with client.
D) Report the suspected abuse to a supervisor to address client’s concerns and safety plan with the client.
According to California law, therapists are required to report elder and dependent adult abuse or neglect when they have reasonable suspicion of abuse. Therapists are not required to be certain that abuse or neglect has occurred, nor do they need to investigate once the threshold of reasonable suspicion has been met. In addition, once we have enough information for reasonable suspicion, we must report to the appropriate authorities, even if we have concerns regarding the consequences our reporting could have on the client. Based on the information presented in this question, how would you proceed?
The best answer to this question is C. This question is not only asking how we would manage our legal obligations, but our ethical obligations as well. Based on the information presented, there is reasonable suspicion that abuse is taking place in the long-term care facility. When abuse occurs in a long-term care facility, we must file a report with law enforcement and the local ombudsman. In addition, the second half of answer C addresses our ethical obligations; processing the report will allow us to address any safety concerns and trust issues with our client. Answer A is incorrect because it is prioritizing management’s reporting requirements over the law, which may or may not match our legal mandate. Answer B is shifting toward investigation, which is not our role as therapist. Once there is reasonable suspicion, report what you know! Answer D, while addressing the client’s concerns, again ignores our legal mandate.
Which answer did you choose? Does the rationale fit with your understanding of the law and how you would work in the clinical setting? Or did you learn something new with this scenario? If you have any further questions feel free to check in with a TDC coach. We are here to support you all along the way. And if you came up with the same answer-great job! You are right on the right track to getting licensed.
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