Law and Ethics Quiz #2

Corporal Punishment Child Abuse

"unlawful corporal punishment or injury" willfully inflicting upon any child any cruel or inhuman corporal punishment or injury resulting in dramatic condition

Child Abuse: Primary Goals

- protect the child - provide help for the suspected abuser

Who can be a victim?

- spouse -sexual/ dating or used to date/ intimate partners -cohabitants -children -family members

What happens if you don't report and the abuse results in death or great bodily injury?

-1 year in jail -$5,000 fine -both -you can get sued

Punishment for not reporting child abuse:

-6 months in jail -$1,000 fine -both You can be sued.. statute of limitations 7 years after child reaches maturity

Childhood Problems leading to Child Abuse

-Language delays -intellectual/ academic problems -socialization problems

Involuntary Hospitalization 5150

-client poses immediate threat to themselves and cant/wont receive appropriate care -therapist can begin the process but cant invoke involuntary hospitalization only licensed physical/ other professional can make final determination -may be held for 3 days -after 72 hours, the patient can be held up to 14 more days if they still poses possible harm to oneself -a person cannot stay more than 14 days if they voluntary agree to continue

cultural issues affected the occurrence

-cultural costumes -value of virginity -family harmony -belief in physical punishment -invisibility to authorities

sexual exploitation

-depicting a minor engaged in obscene acts -preparing, selling, or distributing obscene matter including a minor -employing a minor to preform obscene acts -promoting, assisting, using, persuading, inducing a child to engage in prostitution, or a live performance involving obscene sexual conduct

What are some problems resulting sexual Abuse?

-depression -suicidal thoughts -PTSD -substance abuse -eating disorders -dissociation -sexualized behavior (higher frequency in sexual behavior) (American Medical Association: Women-20% Men-8-15%)

Child Attachments: Secure

-explores, misses parents, greets parents actively (secure base)

Recommendation for orders of protection

-keep with you at all times -copy to local police -call police if spouse breaks protective order -keep all proof of possible breaking of law (threats, messages, letters, voicemails) -give copy to helpful family members, friends, neighbors, and everyone listed in protective order)

Do you have to report sex between teenagers?

-less than 3 years apart= misdemeanor -more than 3 years apart= felony mandated reports of sexual abuse are required for children under 18 (14-17) where there is sexual assault, sexual abuse, or sexual exploitation

Increase frequency of contact

-low risk clients--> Higher risk soon -Therapist will encourage more phone calls, more often visits, more contact -this way therapists can ensure that the symptoms will not worsen

**What happens if you get sued anyways?

-mandated reporter may present a claim for reasonable attorney fees -state wants to encourage mandated reporters to report

Physical effects of child neglect

-nonorganic failure to thrive -psychomotor delays -growth problems -school failure -mental retardation -poor muscle tone -flat/boldt on the back of the head (i think thats an old law) -lack of smiling/babbling -smaller brain -lower intelligence

Who do you report Child Abuse to?

-police or sheriff (not school related) -DCFS or CPS

Sexual Abuse: Sexual Assault...

-rape -statutory rape -rape in concert -incest -sodomy -lewd or lascivious act -oral copulation -intentional touching of genitals or intimate parts (above or under clothes) -sexual penetration -child molestation -intentional masturbation of the perpetrator's genitals in the presence of a child

What are some of the adolescent problems resulting from abuse?

-runaways -social isolation -academic problems -delinquency -PTSD -substance abuse -psychiatric disorders: -OCD -Paranoia -Anxiety -Depression

Severe Neglect

-severe malnutrition -medically diagnosed nonorganic, failure to thrive - willfully causing or allowing child to be placed in danger to his/ her health (e.g. food, clothing, shelter, medical care)

Comments about your session

-take notes (you won't remember everything) -clients: what did therapist do to make you feel that they are listening/ interested -How did you explain informed consent -How long did you wait before you started giving advice? -if you conclude during session that this is reportable, do you tell the client you are going to report? did you explain this ahead of time?

What if 2 or more persons are required to report?

-upon mutual agreement one member of a team may report and sign the report -any member who has knowledge that the member designated to report failed should mak report

Determining whether to report or not

-when the mandated reporter in his or her professional capacity or within their scope of practice has knowledge of or observed suspected child abuse

American Law uses 3 burdens of Proof

1) Beyond a reasonable doubt- criminal court 2)Clear and convincing- civil court 3) preponderance- (Juvenile court) (probable cause)- (needed for an arrest) "reasonable suspicion" is less than "probable cause"

Elder:

65 years or older california tax law: for other than a temporary or transitory purpose

Rates of Sexual Abuse by Gender

American Medical Association: -Girls prior to the age of 16- 20% -Diana Russell- 32-36 % -David Finkelhor- 18% -Boys 8% (probably low as boys tend to under report) girls have an easier time reporting than boys do!

What is Physical Abuse?

Any person suffering from any wound our other physical injury inflicted by his or her act or inflicted by another where the injury means of a fire arm Or Any person suffering from any wound or other physical injury inflicted Where the injury is the result of assault or abusive conduct

Suicidal Clients

Assessment risk evaluation of client's intentions to follow through with suicidal plan Intervention is a reasonable step for the therapist to apply with suicidal client

Film developers/ print/ photographer etc.

Do count as mandated reporters

Divorced Parents

It is an best practice to get a written agreement from the parents of minor Joint custody may mean that the parents need to agree on the child receiving treatment together You will not be in legal trouble for taking the parent at their words, but keep in mind that the other parent my have no knowledge or would agree for their child to receive treatment

Are you mandated to report emotional abuse?

No: you may report reasonable suspicion that a child is suffering serious emotional damage (e.g. anxiety, depression, withdrawal, or untoward

Who can report?

Not you!! (MFTs are NOT mandated reporters This will be a branch in patient confidentiality health practitioner employed in a health facility who in their professional capacity and the scope of their employment knowledge provides physical condition to a patient they suspect to have been abused

What is domestic violence?

Physical Sexual Financial Abuse Psychological Abuse -instilling fear through intimidation/ threat Stalking -in person or through technology Emotional Abuse -deflating victims self worth -constant criticism or name calling -controlling victims' abilities

Domestic Violence

When an individual exerts power or control over an intimate partner through repeated force and abusive behavior Distinguished private intimate relationship

When does an MFT get to report domestic violence?

When the violence is inflicted on a minor, elder, or dependent adult -If child is a witness of domestic violence (discretion is advised) Difference between emotional damage and emotional abuse "unjustifiable mental suffering?" an abuser puts a minor's "person or health in danger

Prevalence of Reported Physical Abuse in the United States

White-8.7% A/A-16.4% Latino- 9.0% Native Americans-15.1% Asian American- 6.5%

Is there abuse or neglect that is specific to out-of-home care?

Yes: Physical injury or death inflicted upon a child by another person (not accidental, or out of specific to other categories e.g. sexual abuse, neglect)

Reporting domestic Violence

a telephone report should be made immediately (ASAP) Written report within 2 working days -must include suspicion injury Report to local law enforcement Failure to report= crime

Elderly abuse

any knowing, intended or careless act that causes harm or serious risk of harm to an older person (physically, mentally, emotionally, or financially

How soon do you have to report child abuse?

as soon as possible by telephone- ask for et way to submit written form and to whom (Fax/ Person/Mail) Written report within 36 hours As soon as possible you need to submit written report

Cultural Issues in Sexual Abuse

beliefs about virginity beliefs about sex and sexuality sexuality being taboo Americans at times prevent themselves and family members from reporting child abuse some asian communities value the experience of taking a girls virginity, renew their usefulness, increase virility, bring good health, and longevity, luck, and success, cure sexually transmitted diseases value of virginity may also increase the girl's vulnerability to those who believe in the midst of virginity, lead to higher probability of sexual abuse

Rights of 12-17 year old clients

consent for counseling/treatment consent to disclose information to parent/ guardian authorize release of information to others access records hold/waive privilege

Reasonable Suspicion

consulting with colleagues use judgement Must report, even if therapist is unsure, 1) client with mental illness or dementia 2) therapist reasonably believes the abuse did not happen 3) therapist knows of no evidence that supports claim

conservatorship

court case where judge appoints a responsible person/organization to care for another adult

Victim Suggestions

develop safety plan- ways to remain safe while in abusive relationship (contact friend or family member) Order protective orders- *emergency order: can last up to 7 days *temporary order: 20-25 days *permanent order: usually lasts 5 years Empower and inform client that he or she can report violence on his/ her own

Disorganized/disoriented

disorganized in parents presence, may freeze with trancelike expression, hands in the air, complains while crying, leans away

Serious bodily injury

extreme physical pain substantial risk of death loss or impairment of function -body parts, oregon, mental state requiringing medical intervention (hospitalization, surgery, physical rehabilitation)

Child Attachments: Avoidant

fails to cry on separation, avoids and ignores parent during reunion, no proximity seeking, motionless

General Neglect

failure to provide -adequate food -clothing -shelter -medical care -supervision where no physical injury to child has occurred

What kind of findings can CPS or DCFS make? UNFOUNDED

false, there is no child abuse occurring

Where does bias come from?

family religion ethnic groups country hard wiring in infancy

Voluntary Hospitalization

if client suicidal/ in immediate danger hospitalization is necessary clients normally prefer voluntary hospitalization

Cultural Issues

important to understand different cultures (in best practice) another important part is bias, we all carry bias

How to report domestic violence?

in the case that domestic violence turns into a child/elder/dependent adult abuse, you would report Child Abuse to DCSF or Elder abuse to law enforcement or ombudsperson

Parents who do not provide medical care to child (e.g. refrain from treating cancer or vaccinations)

it does not count as neglect if the child is receiving treatment by spiritual means or religious purposes

Sexual exploitation in photography

knowingly allowing ta child to engage or assist in sexual conduct for film, photograph, negative, slide, drawing, painting or other pictorial object is illegal.

what is the role of acculturation?

language meaning of different life events values family structures with less acculturated families intervention may call more psycho-education about parenting

Informed Consent (working with minors)

minors of 12 or older can independently consent to their own mental health care if: -therapist deems them mature enough -trainee- must notify supervisor within 24 hours of meeting with minor immediately if the minor is in danger to self or others if minor consents independently, parents do not have to pay for sessions as they cannot be forced to pay for services they do not consent to

What cultural issues affect the therapist?

misunderstanding discrimination miscommunication professional tolerance for same cultural clients cultural sensitivity

what cultural issues affect the therapist?

misunderstanding discrimination miscommunication professionals tolerance for same cultural clients cultural sensitivity

Sexual Abuse and Culture

more common among girls than boys most prevalent in africa Rates of sexual abuse among cultures: 1) A/A 2) N/A 3) White 4) Hispanic

What kind of findings can CPS or DCFS make? SUBSTANTIATED

more likely than not, child abuse abuse has not occurred

Child Neglect

most prevalent form of child abuse -real issue is poverty, not race or ethnicity -neglect or maltreatment of a child's welfare -negligent treatment or maltreatment of a child by person responsible for child's welfare causing the child harm or threat of possible harm

What kind of findings can CPS or DCFS make? INCONCLUSIVE

not unfounded, but findings are inconclusive... insufficient evidence

"Reasonable Suspicion"

objectively reasonable for a person to entertain a suspicion. based on facts that could cause a reasonable suspicion in a like position with their knowledge and experience to suspect of child abuse or neglect

Filling Report:

outside of a long-term care facility phone, online, writing Inside a long-term care facility -non physical abuse - physical abuse Keep copy of the written report seperate from client record

3 levels of cultural consideration

parenting practices- spanking, using belt, standing in the corner for hours the limits with each culture social harm- poverty, poor health care, lack of proper housing -out of parents' control

What is reportable?

physical abuse: -assault, battery, deprivation, sexual, restraint Abandonment Abduction -outside of california Isolation Financial Abuse Neglect -hygiene -medical care -health and safety hazard -malnutrition and dehydration

Mandated Reporters

professionals whose careers are with children *commercial film and photographic print processors required to report possible child pornography

Parental Units and consent

receiving consent if parents are together, divorced, minor is adopted or parents are invisible

Intervention- Steps

requires special training in suicide assessment and intervention must use the least intrusive way to stop the threat balance between safety and confidentiality *when breaking confidentiality, only give information that is necessary for those to know to keep client safe

Dependent Adult

same residency requires as elder any individual between ages 18-64 cannot complete normal activities or understand their rights due developmental, mental or physical disability

Ombudsperson

serves two purposes: -receive and work to resolve complaints from individual long-term care resistant

Reporting abuse to supervisor/ administrator instead?

that does not substitute reporting child abuse to the police or DCFS. You still must report!

Assent agreement

the informed consent form gets signed by a parent but explained to both parents and the minor minor signs a non-binding assent agreement rather than something legally binding

What if your supervisor or administrator tells you not to report?

this is an individual decision, they cannot make you not report

what is not reportable?

voluntary sexual activity between children who are both under 15 y.o and who are of similar age and sophistication is not a crime pregnancy of a minor does not constitute reasonable suspicion, unless female is under 16 and male is over 21 you do not need to ask the age of an adolescent's partner

Child Attachments: Resistant

wary or distressed with little expression, preoccupied with parent, cannot gain comfort by parent

confirmatory bias

what we think about another culture, may help us disregard other information

Negligence

when suing therapist there are four parts that must be proven to the court "duty, breach, causation, and harm/ damages"

Standard of Care (Elder Abuse)

when they have observed or have knowledge or have been told by an elder or dependent adult/ experienced of an incident that reasonably appears to constitute physical,financial abuse, isolation, abandonment or neglect reasonable suspicion by practitioner

Physical Abuse

willful harm or endangerment of child's health -willfully causing or permitting a child to suffer -inflicting unjustifiable physical pain or mental suffering -endangering the health of a child

Signing agreement for treatment

you only need one parent to sign if no parent is available then someone who lives in the home with minor can sign a caregiver affidavit form We are covered in "good faith" belief we are not responsible if the person claims ti be able to give consent

Manded reporter criminal liability

you will not be penalized for reporting suspected child abuse that turned out to be false. Even if mandated reporter reported abuse outside of their professional capacity or outside scope of employment