I recently came across an astounding scenario in a standard ethics textbook. I use the term “astounding” because it presents an example of a clear, legal problem that is in reality not an ethical dilemma at all! I’m going to paraphrase the dilemma as follows:
You are a mental health professional conducting research concerning family relationships involving at least one minor child. As part of the research design you interview each family member personally. You also interview the family as a unit. During one such interview, with Mary, a nine-year-old, she tells you that her fifteen-year-old sister, Clara, has sex with her stepfather, Igor. What would you do?
The answer is clearly driven by the law. Most states impose a duty on members of the public to report suspected child abuse, including sexual abuse. Even if it were not a state-imposed requirement, the legal duty to practice reasonably competently as a mental health professional–as discussed in this website– demands reporting of the incident.
Comments are invited!
I’m not sure the legal question is all that clear here. Many states impose requirements only on certain categories of people considered to have adopted a duty of care toward children, such as doctors, teachers, babysitters, and the like. Moreover, mental health practitioner standards of care may not apply to researchers.
Second, there’s the question of whether the girl is a credible source of information about her sister’s sexual activities. People should always presume victims of sexual abuse are telling the truth when they themselves disclose abuse, but I’m less comfortable with extending that presumption to statements by family members of the alleged victim. This is especially an issue when the professional has only limited experience with the family member making the statement, as would be true in a research context.
I’m not saying that I wouldn’t ultimately report in this situation, but it doesn’t seem totally straightforward to me.
… at the very least, I would not make my decision until after interviewing Clara.
Thanks for your insightful comments. I want to stress first that my primary point is that the question of whether there is a responsibility to report this matter is a legal one. This suggests that all mental health professionals, including the researcher in our scenario, must be aware of the specific laws in their home jurisdictions governing this issue. In our scenario, the researcher is identified as a “mental health” professional, making it highly likely in a majority of states that the researcher would be subject to a duty to report in appropriate instances. In most jurisdictions, the rule governing the duty to report requires that there be a “reasonable suspicion” of child abuse/neglect. In many states this duty applies to all persons, not just those trained to recognize child abuse. Hearsay information, such as the child’s statement about her sister’s involvement in sexual activity in the present dilemma, can be sufficient to create a reasonable suspicion. Once the reasonable suspicion is created, I would argue that in most jurisdictions the law would compel revelation of this information to an appropriate authority, thus permitting a trained protective services professional to investigate the matter by talking to both children and either confirming or ruling out sexual abuse. In a sense, the law here requires in this situation that we err on the side of caution. In our scenario, I don’t think that the researcher has the training or competence to investigate the matter further by interviewing Clara. This would seem to me to present a grave danger that Clara could be gravely traumatized through the intervention of an untrained, albeit well meaning, individual. We certainly want someone to talk to one or both children, but we want that someone to have appropriate clinical skills.
Thanks again for your excellent observations!
Please see my reply to your last post! Thanks again for your valuable comments.
I want to thank you for your thorough and cogent analysis. I do think we need a more up-to-date analysis of the use of hearsay material in demonstrating reasonable suspicion. I would disagree with you that a mental health researcher (it’s safe to assume that he/she is a licensed social worker, psychologist or counselor) does not have a duty to report under the Pennsylvania law you cited. In your own analysis, you suggest that the researcher has probably received clinical training in interviewing children. Why then would such an individual therefore be excepted from Pennsylvania’s mandatory disclosure law?
In our scenario, if the matter is reported to child protective services, I quite agree that cps might well decide that the initital statement by Clara does not give rise to a duty to investigate further. If that’s the case, I’m comfortable leaving the ultimate decision to the best judgment of cps, instead of the reporter. You’re quite right about the danger of retraumatizing Clara regardless of who questions her, but I’d hate to see the researcher take on this questioning himself/herself without the assistance of cps. I will research the hearsay issue thoroughly in the hope that I can review caselaw on the subject and report back. Thanks again for your interest and the scholarship of your discussion.
In my last reply, I neglected to make two follow-up points to the comments you have so ably presented: First, in our scenario we must not rule out the possibility that the young girl actually witnessed inappropriate behavior between Clara and her stepfather. The researcher’s artful questioning of his research subject could well establish this point more clearly, in which event the hearsay rule becomes entirely irrelevant. Second, the legal duty to practice reasonably competently, as discussed in this website, would seem to compel the researcher to take such steps as are necessary to assess the situation with full clarity, at least to the extent that he understands the factual allegations that have been revealed to him. Remember that we must regard the researcher as someone who is not only conducting research but also a licensed member of one of the mental health professions, social work, counseling, or psychology. However, the researcher should refrain from engaging in an inquisition of Clara, and instead, in my judgment, should seek the judgment of trained child protective workers to complete the full assessment of the situation.
Sorry I lost track of this thread. I will respond to the hearsay issue in a comment on your new post, but I wanted to clarify that under Pennsylvania law it is not sufficient that the person who receives information be a trained mental health professional. The information must concern an individual “under the care, supervision, guidance or training of that person” or the agency for which the person works or is affiliated. Clara is not under the social worker’s care; she’s at best a participant in a study that consists entirely of interviews and does not involve the provision of mental health treatment. As a result this disclosure is not covered by the reporting statute.
I agree that careful follow-up questions to Mary will help clarify the professional’s duty to report. But I still respectfully disagree that failing to speak to Clara prior to reporting – something that’s usually considered acceptable even when the mandatory reporting law applies – would be a good exercise of professional judgment. In order to responsibly carry out her research, the professional must have had training in how to respond when a child discloses that they are currently being abused by a family member. It simply shouldn’t be true that CPS professionals’ training so vastly exceeds the interviewer’s that it’s contraindicated for the interviewer to even conduct an interview she was already planning to conduct for fear that she’ll say the wrong thing.
I don’t necessarily feel that the professional should “interrogate” Clara. She should complete the interview of Clara that she had already planned to conduct – again, something she clearly already has the training to do – and should alert Clara to Mary’s disclosure and to the fact that this will be reported. No matter how well “trained” CPS workers are, their involvement will be inherently more traumatizing if they come as a complete surprise. Moreover, because the professional already planned to interview Clara, conducting that interview as planned gives the professional an opportunity to ask Clara, without raising the suspicions of the family, whether she feels in immediate physical danger. This is information that whenever possible should be gathered prior to alerting CPS; to do otherwise could put the child at very serious risk.
, the etnire process needs to have the utmost scrutiny and transparency, to avoid further harming the child.
Deep thinking – adds a new dimensoin to it all.
I am relieved the church is finally being exposed for this sickening, systematic abuse. It is utterly shameful and it’s taken them so long to own up. My mother was sent away to a convent school during WWII when Belfast was the target of bombing raids. She suffered some pretty vicious physical and emotional abuse.