Mandatory Reporting

What Is Mandatory Reporting?

All licensed therapists in the United States are mandatory reporters — legally required to report suspected abuse or neglect to designated authorities. This obligation overrides client confidentiality and exists in all 50 states, though specific requirements vary by jurisdiction.

What Must Be Reported

Child Abuse and Neglect

All states require reporting of suspected:

• Physical abuse
• Sexual abuse
• Emotional or psychological abuse
• Neglect (failure to provide adequate food, shelter, supervision, medical care, or education)

The reporting threshold is reasonable suspicion, not certainty. You do not need to verify that abuse occurred — that is the role of investigating authorities.

Elder and Dependent Adult Abuse

Most states require reporting of suspected abuse of elderly adults (typically 65+) and dependent adults, including:

• Physical, sexual, or emotional abuse
• Financial exploitation
• Neglect or abandonment
• Self-neglect (in some jurisdictions)

Other Reportable Situations

Depending on your state:

• Abuse of individuals with disabilities
• Human trafficking
• Certain communicable diseases
• Gunshot or stab wounds

How to Make a Report

1. Contact the appropriate agency. For child abuse: your state’s child protective services hotline. For elder abuse: adult protective services
2. Make the report promptly. Most states require reporting within 24-48 hours of forming the suspicion
3. Provide the information you have. You are not expected to investigate — report what you know
4. Follow up with a written report if your state requires it (many require written follow-up within 36-48 hours)

Documentation

Document in your session notes:

• The information that triggered your suspicion
• The date and time of the report
• The agency contacted and the name of the person who took the report
• Any case or reference number provided
• The client’s response when informed of the report (when clinically appropriate to disclose)

Managing the Therapeutic Relationship

Discuss the limits of confidentiality during informed consent at the start of therapy. When a report becomes necessary, transparency with the client — when safe and appropriate — preserves the therapeutic relationship better than the client discovering the report from the investigating agency.