PS508 Unit 6 Reporting and Duty to Warn Paper Example

A Belt, a Threat and a Federal Rule: A PS508 Unit 6 Paper on Mandated Reporting and Duty to Warn in Addictions Treatment

[Student Name]

Purdue University Global

PS508: Ethics for Addictions Professionals

Unit 6 Mandated Reporting and Duty to Warn Paper

[Instructor Name]

[Date]

The writer, the program, the families and every detail of the cases are composite and illustrative; the sources cited are real.

Two Cases in One Week

The first case came during a family session for Kyle, a 38-year-old client in treatment for methamphetamine use who has custody of two children. While Kyle stepped out to take a call, his 10-year-old son, Noah, said that his father "used the belt" on him the night before because Noah had lost a house key, and that it "left marks like stripes." When Kyle returned, Noah went quiet.

The second case came two days later. During an individual session, Pete, a 45-year-old fisherman in treatment for alcohol use, described a fight with a crewmate over a share of the season's catch and said, "He won't make it to opener. I've got a gun on the boat." The salmon opener was nine days away.

The two situations raise different legal and ethical duties, and the differences matter.

Mandated Reporting of Suspected Child Abuse

Every state names counselors and other mental health professionals as mandated reporters of child abuse and neglect. Henderson (2013) stresses three points that applied directly to Noah. First, a counselor reports once suspicion is reasonable and does not wait for certainty; the counselor is not an investigator and should not try to confirm what happened by questioning the child at length. Second, counselors resist reporting for predictable reasons, such as fear of damaging the therapeutic relationship, doubt about whether the evidence is strong enough and worry about what the child protection agency will do. Third, the report is the start of a process, and the counselor's clinical work continues after it.

Noah's statement, describing a belt and marks, met the threshold of reasonable suspicion. I did not ask Noah to show me the marks or to repeat the story. I wrote down Noah's exact words, informed the clinical director and called the state's child protection intake line within the hour, as our program's policy requires.

Does the Federal Confidentiality Rule Block the Report?

Our program's records are protected by the federal substance use confidentiality rule, which is stricter than HIPAA. A counselor new to addictions work might think it prevents a report. It does not. An explicit exception in the rule lets a program make the first report of possible child maltreatment that state law demands (U.S. Department of Health and Human Services, 2024). The exception covers the initial report. Kyle's chart itself stays protected: if child protection or a court later wants it, the program needs Kyle's signed consent or a specific order under the rule.

In practice, this meant I could tell the intake worker what Noah said, when and where, and that the family was known to our program. I did not share Kyle's diagnosis, drug test results or treatment history.

The rule let me protect Noah with a phone call while still protecting Kyle's treatment records from becoming evidence.

After the Report

Henderson (2013) recommends being honest with the client about the report whenever it is safe to do so. With the director present, I told Kyle the next morning that I had made a report, explained that the law required it and that I had shared only what Noah said, and said that I would continue to be Kyle's counselor. Kyle was angry and left early. Kyle returned two sessions later, and the incident became part of treatment, including parenting stress and the link between Kyle's methamphetamine use and anger.

Duty to Warn or Protect

Pete's statement raised a different question. Since the Tarasoff decisions in California, many states have adopted laws on what mental health professionals must or may do when a client threatens a third party. Those laws fall into three rough groups: states that make warning or other protective action mandatory after a serious threat to a known person, states that allow the clinician to disclose without making it mandatory, and states with no statute at all. Pabian et al. (2009) surveyed psychologists about their own states' laws and found that a large share misunderstood them, often believing they had a legal duty to warn where their state law did not impose one. The finding was a warning to me: my sense of what the law requires could easily be wrong.

So before acting on Pete's statement, I consulted the clinical director and the program's written policy, which was drafted with legal counsel and reflects our state's law. Under the policy, a credible threat to hurt a person who can be identified calls for protective steps, including notifying the person or law enforcement, and requires that the director approve any disclosure.

Deciding What Pete's Statement Required

I first assessed the threat with Pete in the same session. I asked what Pete meant, whether there was a plan and whether the gun was still on the boat. Pete said the remark was "just talk" but also confirmed the gun was loaded and that Pete and the crewmate would be alone on the boat for two days of preparation before the opener. The threat named an identifiable person, involved a weapon and had a time frame. Pete also had been drinking heavily that week.

The director and I decided that the threat was serious enough to act. We asked Pete to allow us to arrange for the gun to be stored off the boat, and Pete agreed to give it to the harbormaster's office. Pete refused to let us contact the crewmate. Following the policy, the director notified the police that a specific threat had been made against a named person, sharing only the threat and the timing. The disclosure was limited to what was needed to protect the crewmate.

Documentation

For both cases I documented the client's or child's words, the time, the people consulted, the policy relied on, what was disclosed and to whom, and the reasons. Documentation protects clients by showing that disclosures were limited, and it protects counselors by showing that decisions were reasoned.

Conclusion

These two cases show that mandated reporting and duty to warn are different duties with different triggers. A child abuse report is required on reasonable suspicion, and the federal substance use rule allows it while still protecting treatment records. Duty-to-warn law varies by state and, as Pabian and colleagues found, is often misunderstood, so the safest course is to rely on a written, legally reviewed policy and consultation rather than memory. In both cases, the ethical aim was the same: protect the person at risk while disclosing no more than necessary and keeping the client in treatment.

References

Henderson, K. L. (2013). Mandated reporting of child abuse: Considerations and guidelines for mental health counselors. Journal of Mental Health Counseling, 35(4), 296-309. https://doi.org/10.17744/mehc.35.4.x35610245863n034

Pabian, Y. L., Welfel, E., & Beebe, R. S. (2009). Psychologists' knowledge of their states' laws pertaining to Tarasoff-type situations. Professional Psychology: Research and Practice, 40(1), 8-14. https://doi.org/10.1037/a0014784

U.S. Department of Health and Human Services. (2024). Confidentiality of substance use disorder (SUD) patient records. Federal Register, 89, 12472-12631. https://www.federalregister.gov/documents/2024/02/16/2024-02544/confidentiality-of-substance-use-disorder-sud-patient-records