Case Presentation

Self-Disclosure of Abuse Brian visited the nurses of ice in his middle school one morning several times. He was a frequent visitor, she reported, so his multiple visits this one particular morning did not raise any suspicions in her mind. It was during his fourth trip that morning, however, when he announced to her that his father had beaten him with a belt the night before. Brian's family had a contentious relationship with the school district for a variety of reasons, so this self-disclosure of abuse was a delicate one indeed. The school nurse reported Brian's statements to the school principal who was unclear as to how to proceed, considering the sensitive nature of the issue that was superimposed on a difficult home-school relationship. Fears of a lawsuit and of other repercussions from the family clouded her thinking for the moment. The first person she consulted with was the school counselor who had experienced most of the contact with the family ever since Brian's arrival in the school one year earlier. She asked the counselor to speak with Brian and to proceed with the appropriate CPS referral. The school counselor asked Brian's classroom teacher to send him to the counselor's of ice after his lunch period had ended. In sensitive matters like this, the counselor always tried to be as unobtrusive as possible in singling out students for a visit to her of ice, lest other classmates suspect that something dire was up with their friend. Confidentiality and privacy issues are paramount, particularly in cases of child maltreatment. Brian himself was considered somewhat of an oddity by his peers, since he lacked those social skills typical for his age group. Although not disliked by them, they viewed him as just a bit "dif erent," and they were not inclined to invite him to many of those weekend birthday and holiday parties that included so many of his other classmates. When Brian entered the counselor's of ice, he looked perplexed as to the purpose of his visit. He had been in the counselor's of ice many times before, but he usually was the one who initiated the visit, dropping in from time to time to talk about nothing of great consequence. This visit was dif erent, he suspected. Intervention School counselor: Hello, Brian. Please take a seat. Brian: Sure. Why did you want to see me? Am I in trouble? SC: No, of course not, Brian. I just wanted to talk with you about something, that's all. B: Should I close the door (looking nervously at the entrance to the office)? SC: Yes, Brian. I would like to talk with you about what you told the school nurse this morning. B: What do you mean? SC: She told me that you said that your father beat you with a belt last night. B: Oh, that! No, I was only kidding! Nothing like that really happened. My father's a great guy; he would never do that to me! I was just kidding! (Brian averted eye contact with the counselor and started to stare at the floor while uttering his protest. He was noticeably agitated.) SC: Brian, one of my jobs here as counselor is to do what I can to make sure that all children in this school are safe and that no one hurts them. B: You mean, like, other kids, bullies, people like that? SC: Yes, certainly, but I also mean parents; they also don't have the right to hurt their children, even though they love them and want them to behave. B: So, a father, I mean, a parent can hit their kids and still love them, right? SC: Yes. It's just that are better ways for a parent to deal with their children's behavior without hitting or hurting them. B: Oh. 115 SC: I'm wondering if that might not be true for your father; you know, loving you and hitting you sometime? B: (Sitting silently with his eyes welling up with tears.) SC: (Allowing for a period of silence first) Is it, Brian? B: (Starting to cry) I just don't want to get him in trouble, and I don't want to be taken out of my home! I'll just tell everyone that I made it up before! Can't we just keep this a secret? SC: Remember what I told you once before, Brian? There are many things that a counselor can keep secret or confidential, but when a counselor learns that children are thinking of hurting themselves or someone else, or if they themselves are being hurt, then the counselor must break confidentiality and tell other people in order to make sure that those children are safe. Do you understand? B: Yes, but it's not his fault! He has used the belt before, but last night I talked back to him and made him mad, so he hit me more than he usually does. I just don't want to get him in trouble for something that I did. SC: Brian, when a child is hurt by a parent, it's never his fault. Parents are adults and have to learn ways of disciplining their children without hurting them or humiliating them. It sounds like your father has to learn other ways to deal with you when you talk back or do other things that children do. B: Now what are you going to do? SC: Brian, the law says that I or anyone else who works in a school has to contact a group of people called Child Protective Services if they suspect that a child has been hurt. I will make the phone call now and tell them all that you have told me and the school nurse. They then will either come to the school to meet with you first or make direct contact with your father. The way they proceed will be their decision. Their job is to help families by having them change the ways they deal with their children. B: But, I won't be in trouble, will I? SC: No, Brian. The caseworker who visits you or your family will try to make sure that you don't get in trouble for telling us what happened. In fact, what you did was a very hard thing to do; it took a lot of courage to come forward to tell us what happened. I also will be here when the caseworker comes and sit with you, if that's OK with you. B: Sure. Case Conceptualization/Crisis Resolution The counselor then made the phone call to the agency.

Whattype of crisisis this adolescent(s) experiencing (developmental, traumatic, existential, or psychiatric)?

What are twoguidelinesto follow in considering the treatment options for this/these adolescent(s)?

Does mandated reporting apply in this case?

Identify twoimplicationsof this trauma both individually and collectively/communally.

Identify at least twocommunity resourcesthat exist in your local setting appropriate for adolescent care following the specific crisis faced.

Offer aconclusion