Sexual Abuse and Mandatory Reporting

BACKGROUND 

You are an occupational therapist and psychotherapist with your own private practice.  You have been treating a university student named Amanda, who has not been coping well for several months.  She has dropped several classes, struggling to get through the day, had little focus and purpose, was not eating, and was spending most of her time in her room by herself.The family physician has diagnosed her with depression and has also recommended she see a therapist to help.

Together, you have developed a trusting rapport and a safe therapeutic environment has been created. At the last session you and Amanda were exploring some of the emotions and thoughts related to her sadness and she tears up and starts sobbing. She tells you that one night, after an exam, she was out with some friends and unexpectedly ran into an individual that had previously treated her for some physical symptoms. She disclosed that during one of her sessions with the other provider they made sexual comments and actions towards her while she was in a vulnerable physical position.  She left the situation as quickly as she could and never returned.  Amanda explains that “all these emotions flooded back” when she saw the provider again.  Ever since this chance encounter she says she has been “falling apart.”

As an occupational therapist you understand the severity of the situation. You acknowledge a greater professional responsibility as this situation is an alleged sexual abuse of a client by another regulated health care professional. You have not encountered this before but know that there are mandatory reporting requirements. You go to the College website to understand your responsibilities, and also call and speak with a Practice Consultant. 

CONSIDERATIONS

Based on this information you determine that:

  • The mandatory reporting requirements in cases about sexual abuse include reporting within 30 days, or immediately, if ongoing risk of harm to clients or the public is suspected.
  • The information you have constitutes “reasonable grounds” considering that sexual abuse, as defined in the Regulated Health Professions Act, 1991 includes any of the following:
    • Sexual intercourse or other forms of physical sexual relations between the registrant and the client;
    • Touching of a sexual nature, of the client by a registrant; or
    • Behaviour or remarks of a sexual nature by the registrant towards the client. The term “sexual nature” does not include touching, behaviour or remarks of a clinical nature appropriate to the service provided.
  • That to proceed with a mandatory report you will need the name of the alleged abuser and must confirm if they are a registrant of a regulated health profession.
  • That you don’t need Amanda’s consent to file the report but will need her consent to provide her name to the regulator (however, providing her name is not mandatory).

OUTCOME

Over the next few sessions, you carefully explain that you have an obligation to report this incident.  If she tells you the provider’s name, you are legally required to find out if they are regulated and to file a report. You talk with her about the process.

At a subsequent session Amanda discloses the name of the provider. You confirm they are a regulated professional. You give Amanda the choice of filing the report together or you can do it independently.  She prefers that you go ahead and contact the regulatory college of the provider. You speak to a member of staff in the investigations service to file the report.

You ask staff what supports may be available to Amanda, and they tell you of their Sexual Abuse Therapy Fund that she may be able to access as stated under section 85.7 of the RHPA. The use of these monies needs to be approved by their Patient Relations committee but if approved, Amanda could select her own health care provider to provide the services approved.

You discuss the option of referring Amanda to a therapist that specializes in trauma-informed care and offer to keep working with her on developing some plans and coping for returning to school should she prefer. 

REFERENCES 

CONTACT

If you have any questions about this case, or have any ideas or requests for future cases, contact the Practice Resource Service: 1.800.890.6570/416.214.1177x240 or practice@coto.org.

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