How do you handle a case where a child discloses abuse during counseling?

• A. Keep disclosures confidential and do nothing.
• B. Immediate pharmacotherapy without reporting.
• C. Follow mandatory reporting laws, ensure the child’s safety, document disclosures, notify guardians as appropriate, and coordinate with child protection.
• D. Blame the child for disclosure.

Answer: (C)

When a child discloses abuse in counseling, safety and legal duties take precedence. Clinicians must follow mandatory reporting laws, which require notifying the appropriate child protection authorities or agencies. The immediate goal is to protect the child from further harm, assess risk, and implement steps to keep them safe, including coordinating with other professionals as needed.

Documentation is essential and should be precise: record what was disclosed, the date and time, who was present, and any observations or concerns. After determining the need to report, the clinician should inform and involve appropriate guardians as allowed by law and the guidance of child protective services, while continuing to support the child within a safety-focused plan. Collaboration with child protection helps ensure a thorough assessment, proper investigations, and ongoing safety planning.

Confidentiality has limits in these situations; information should be shared with those who need to know to protect the child and to comply with legal requirements.

This approach is preferred over options that would keep the disclosure secret and do nothing, pursue treatment like pharmacotherapy without addressing safety and reporting duties, or place blame on the child, all of which can leave the child at risk and undermine trust and appropriate care.