MANDATED REPORTING

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“We are all mandated reporters,” said Mary Kreitz, trauma program manager and group services director for Child and Adolescent Behavioral Health, speaking during at a training session.

What does a mandated reporter mean and how does this apply to me?

If you as a clinician suspect that a child has been abused or is being abused or neglected, you as a clinician are legally required to report the abuse.

When reporting an abusive situation, what information does the clinician need to have when answering the questions over the phone?

Kreitz said Child Protective Services is likely to ask for this information:

The name and address of the child you suspect is being abused or neglected
Age of the child
Name and address of the parents or caretakers
Name of the person you suspect is abusing or neglecting the child and the address if available;
Reason you suspect the child is being abused and neglected
Any other information which may be helpful to the investigation

Kreitz said, “Even if the abuse took place a year ago, you should still call and make sure the abuse was actually reported and the details you heard have been reported. You may be presenting new facts to the case. Then document that you made the report.”

After a clinician has filed a report, what is the next step?

Following a report that is made, a caseworker from Jobs and Family Services (JFS) and/or a local law enforcement officer will be assigned to investigate the report. From there, the child may be referred to The Children’s Network, which is Stark County’s Child Advocacy Center. They have a multidisciplinary team (MDT) of professionals working together in one location to help children and their families cope with abuse, witnessing violence or human trafficking.

The Children’s Network of Stark County is a Child Advocacy Center. Partners working through the network include: Stark County Prosecutor’s Office; County-wide law enforcement; Stark County Family Court; National Children’s Alliance & Ohio Network of Children’s Advocacy Centers; Akron Children’s Hospital CARE Center; Child & Adolescent Behavioral Health; Lighthouse Family Center; and Stark County Jobs & Family Services.

Family Advocate

When a family comes to The Children’s Network after a report has been made, a family advocate will be assigned to the family. The Family Advocate stays with the family throughout the whole investigation and legal process. The Family Advocate will make sure families understand every step of the process and connect the family with resources they need for recovery. Even after the JFS case is closed, the advocate is allowed to maintain contact.

Forensic Interview

The purpose of the forensic interview is to create a safe space for a specifically trained interviewer to address abuse allegations in a neutral, fact-finding, developmentally appropriate manner. These interviews are legally sound, non-duplicative and non-leading. The forensic interviewer conducts each interview using a nationally recognized protocol. The only two people in the room are the child and the interviewer. All interviews are video and audio recorded so the child does not have to repeat this in court. MDT members observe the interview from another room.

The Medical Exam

A specialized nurse practitioner from Akron Children’s Hospital CARE Center may conduct a medical exam. This exam is similar to a having a routine check-up. Any bruises or marks on the body are photographed and documented. Physical conditions or injuries will be treated.

Trauma or Sexual Abuse Evaluation

This evaluation may be referred if the child is not able to give a clear disclosure due to fear, anxiety, developmental level, inability to understand questions or vague communication style. This assessment is more in-depth and will take place in two to three sessions.

Prosecuting the Case

The assistant prosecutors meet regularly with MDT to determine whether the case is appropriate for prosecution. Some cases are handled informally and some cases are not strong enough for prosecution. The prosecutor also helps prepare the child and/or parents if testifying in court is necessary.

There are protocols for clinicians to take on what you can and should do after a report of suspected abuse or neglect has been made.

What not to do:

Do not question the child about the abuse or probe for more details about what happened.
Do not coach the child on what to say.
Do not ask siblings or other children in the home if they were abused too

Here is what you can do:

If the client wants to tell you what happened; listen supportively
Validate the client’s bravery for telling someone about what happened
Help the client feel safe
If the client is nervous about the forensic interview or abuse evaluation, reassure that the interviewer/assessor is a safe person; reassure the client they are not in trouble; that this will not hurt; and to be honest
If the client wants you to come along as support when they go for an interview/evaluation, model being pleasant and cooperative with other professionals; if you seem uncomfortable talking, the client will likely follow your lead; if possible, it would be best to get a release for Children’s Network; and remember that you can speak to other health care professionals working with our clients.
Reassure the client the abuse is not their fault; that experiencing abuse does not make you bad or weird; validate that there are many reactions to abuse, none are “wrong” and validate the client’s feelings.

For clinicians who are doing Trauma Focused-Cognitive Behavioral Therapy do not start processing the client’s narrative until all parts of the investigation (forensic interview, medical exam, trauma and sex abuse evaluations) are completed. You are able to work on other parts of the model – psychoeducation, relaxation skills, affect regulation skills and cognitive coping skills.

The final message is don’t stop working with client if they are sent to Children’s Network. This is an important piece for investigating what happened. We are in a much better position to meet the needs of the client when we are all working together.

To report an incident, call 330-455-KIDS (5437).

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SEASONAL AFFECTIVE DISORDER

By Mary M. Kreitz • November 21, 2024

For many people changes in the seasons also bring changes in mood, energy, sleep, weight and appetite. Some researchers have found that as many as 90% of people report noticing these types of changes in themselves. However, for some people, the changes are so intense that they interfere with the person’s ability to function in their daily life. Seasonal Affective Disorder or SAD is a type of clinical depression that occurs with a consistent seasonal pattern. The symptoms of SAD are the same as those for other depressive disorders; what is different is that the symptoms begin every year around the same time, last for several months, and then go away for the rest of the year. The most common form of SAD is what is known as winter-pattern SAD in which depressive symptoms start in the fall or early winter and end in the spring. Another less common form is known as summer-pattern SAD and is associated with depressive symptoms that occur during the spring and summer months and improve in the fall.

ELECTION ANXIETY

By Mary M. Kreitz • November 6, 2024

The 2024 election has brought a lot of fear and stress into the lives of people throughout the country. A recent survey by the American Psychological Association found that 77% of adults in the US are worried about the future of the nation, 73% reported feeling stressed out about the economy and 69% reported feeling stressed about the presidential election. When adults are feeling this high of a level of stress, you can bet that children and adolescents are feeling it too.

TRUSTED ADULT

By Daniel Mucci • October 1, 2024

Are you a trusted adult to your child or someone’s child in your life? What are the characteristics of a trusted adult? Trusted adults are viewed by children or adolescents as a safe figure that listens without judgment, agenda or expectation, but with the sole purpose of supporting and encouraging positivity within a young person’s life. Today’s youth identify a trusted adult as someone who is willing to listen and engage, rather than lecture and give orders. Young adults are interested in having open conversations about mental health, social media, bullying and sharing their own experiences.

LET YOUR LIGHT SHINE

By Daniel Mucci • September 9, 2024

Child and Adolescent Behavioral Health’s (C&A) The Canton Repository Let Your Light Shine presented by the Massillon Eagles FOE #190 is Sept. 21 at the DoubleTree by Hilton, Canton, from 6-9 p.m. The 19th annual event supports the youth mental health programs and services C&A provides each year to our 4,100 clients.

WHY PRIDE MATTERS FROM A BEHAVIORAL HEALTH PERSPECTIVE

By Mary M. Kreitz • June 18, 2024

You have probably heard the scary statistics. LGBTQ+ youth are at higher risk for serious mental health problems (such as anxiety and depression) than their non-LGBTQ+ peers. They’re more likely to consider suicide, more likely to attempt suicide and more likely to engage in non-suicidal self-harm.

HOPE AND HOPELESSNESS

By Dr. Robert Willoughby • June 4, 2024

Hope and hopelessness play a large role in the phenomenon of suicide and depression including that of children and adolescents (Liu, et al., 2021). On the positive side I am always reminded of the use of hope to overcome hopelessness in stories reminiscent of a hero’s journey. Stories, where in the face of insurmountable odds, one digs in deep to find themselves, their own hope, and the hope of others joining together to help whilst overcoming trials and tribulations (Campbell, 2011).

988 IS LIFELINE IN A MENTAL HEALTH CRISIS

By Dan Mucci • May 16, 2024

Suicidal ideation is on the rise nationwide, especially among teenagers and college-age students. Post COVID, adolescents are struggling to handle a variety of situations and have limited coping skills to help them through the challenges. One of the biggest challenges is loneliness.

STARK COUNTY SCHOOLS MENTAL HEALTH AWARENESS

By Dan Mucci • April 16, 2024

The sixth annual Stark County Schools Mental Health Awareness Week is May 6-10 Child and Adolescent Behavioral Health (C&A), CommQuest Services and Pathway Caring for Children will partner to bring positive mental health awareness to more than 53,000 students and 7,000 support and administrative staff in all 18 Stark County School districts.

UNDERSTANDING RACE IN SOCIETY AND THERAPY: CHILDREN AND ADOLESCENTS’ EXPERIENCES

By Chris Alpert • November 16, 2023

In the film, I’m Not Racist… Am I? as introduced and explored in first of this three-part blog post series, the participants engaged in multiple workshops that address race and racism. Interpersonally, the group of students grapple with their own differences and similarities, which impact the content and emotions they share with each other. There are several moments in the film that demonstrate the clear differences in the participants’ understanding of race. In the first workshop, the students were exposed to the idea that all white people are inherently racist seeing as American society was founded on principles meant to support white people (see more on structural racism here, here, and here for further understanding). Several white students in the film became emotional during that workshop. Most students remained quiet. Following this workshop, a black student and a white student were filmed independently of each other in their own homes and discussed the workshop and what they learned with their families. The white student discussed the differences between structural racism and bigotry with her mother and struggled to identify with the principles taught in the training. The black student stated to his mother how almost everything spoken in that workshop applied to him. The student further discussed his feelings by stating how overt racism is and yet how “subliminal” it is at the same time. How can something be so in your face and yet under your feet simultaneously? I immediately reflected on the dialectic of something being so clear and yet so vague. The film continued to grapple with student differences. At the beginning of the film, one white male student discussed with his mother how he feels that all individuals, if they apply themselves wholeheartedly, have the same chance of success regardless of their skin, gender, sexuality or other demographic factors. As a white man myself, I must confess that when I was in high school, I had the same mindset. How could it be different? Especially when I was reading mythic bootstrap literature in high school classes. Sure, the harder you work the more you deserve, but that statement does not work for all Americans. I had not accounted for racial factors that inhibit the growth of others, not to mention socio-economic factors, nationalities, citizenship status, gender and age. I continued to reflect on these statements and connected them to my experience in high school in New York City. In the wake of the Black Lives Matter movement responding to the murder of George Floyd, multiple private progressive schools in New York, including the one I went to, suffered scrutiny from students and alumni who identify as black, indigenous people of color (BIPOC). Multiple Instagram accounts surfaced with the handle “BLACK AT [school name].” I read the posts in 2020, and again before writing this post, and remembered feeling horrified knowing these acts of racism, bigotry and microaggressions happened all around me. This was subliminal to me, yet overt to others.