Minors, Abuse, and Confidentiality

February 26, 2013

Today’s post may come off as more of a rant and I’m sorry if it does. I have just had some frustrating experiences lately working with teenagers and possible abuse situations. In the State of Florida, (it may be the same in other states and/or countries-I know I have several subscribers outside of the U.S.- but I don’t want to make any assumptions and am choosing not to do the research here) as a counselor I am mandated to make a report to the Department of Children and Families (DCF) with the state when I have reason to suspect that a child, elderly person, or disabled person is being abused in some way. It is not our job to investigate, but just to report our suspicions and DCF is in charge of investigating. This is one of the few exceptions to confidentiality and this is the first thing I tell clients when I am seeing them for the first time.

The purpose of making counselors (and other professionals such as teachers) mandated reporters is that often times we are trusted individuals in the eyes of children and seen as a person that can be helpful to them. Many times when other people become aware of abuse they do not realize that they can make a report, who to make a report to, or if they do, there is a sense of diminished responsibility to do so as they are sure someone else has done so. Minors are also not able to make an informed decision for themselves on whether they want the information reported because they are vulnerable to pressures of outside people such as the perpetrator. The law is in effect to protect children from abuse. All of this I understand and agree with.

My frustrations, however, stem from the fact that this law often times stands in the way of individuals getting the mental health help that they need. Many times minors are afraid to tell someone, specifically a counselor, about the abuse because of the fear of it being reported. In fact, I have recently had the experience of losing clients who had reason to be in counseling because of their fear of me having to make a report to the hotline, or because we had to make a report to DCF. You may wonder why a minor may fear their abuse being reported when they should be happy to be taken out of that situation, and there are several reasons that I have heard. Minors are often afraid of the experience itself, of having to go to trial, being questioned, not being believed, and even about other people knowing about the abuse and formulating judgments about them based on the abuse. They are worried about the disruption to their life. They worry about the abuse intensifying or even being pulled out of their home. Again, you may wonder why being pulled out of their home would be a negative thing, but some fear going to a foster home that may be worse or just the fear of the change, and for others the abuse may have occurred a long time before and they no longer see themselves as in danger and may even have many other positives that out weigh the negatives in their eyes currently or in the past.

Some of these worries may be founded while others cannot be verified and may even be concluded on the fantasy of childhood. The problem is that we do not typically even get a chance to discuss these worries with the children and attempt to relieve some of these fears as they do not disclose the abuse to begin with, or do not return to counseling if they have and know that an abuse report has been made due to their fears. If a client never walks through my door or only does so once due to their fears, this obviously prevents me from helping them. And this is what is heart breaking to me.

I see the system as being broken due to the fact that it prevents these individuals from getting the help that they need and therefore they are set up to experience more abuse in the future. I guess the flip side is that if a DCF report is made and the allegations are founded, they will likely set up counseling as part of the case management. Unfortunately, however, at this point the client is often so distrustful of counselors that it becomes even harder to intervene and make a difference. I write all this because part of my role as a counselor is advocacy. I do not have answers to this problem thus far, but would love to hear other people’s views on the subject and ideas.