In this second edition of what has already become a classic text, Kalichman provides a comprehensive overview of the ethical and practical issues involved in mental health professionals’ duty to report suspected abuse. He discusses ethical and clinical details in considerable detail and produces a book which is rich and rewarding (and disturbing) to read.

The book begins with an introduction which lays out some of the ethical and professional dilemmas involved. The first chapter describes the laws about mandatory reporting in various states and grounds to oppose mandatory reporting. The next chapter views mandatory reporting as an ethical dilemma. This is followed by chapters on therapeutic and coercive uses of mandatory reporting, outcomes of unreported cases, outcomes of reported cases, guidelines for reporting suspected child abuse and research approaches. The book ends with a chapter on policy directions, a glossary, a directory of resources, hotlines, and a well-produced index.

The book does a wonderful job of discussing ethical dilemmas, with many excellent case examples. It provides a comprehensive overview of statutes and results of failure to comply with them. The examples of coercive use of mandatory reporting are sobering and of concern. The discussion of results of reporting and not reporting is similarly sobering. I appreciated the excellent bibliography.

Children and their families can be greatly helped by mandatory reporting laws and the investigations that can follow reports to county officials. They are sometimes hurt by them as well. For example, in some states, one is required to report suspected abuse that occurred as long ago as seven years; frequently, the abuse is still occurring, but sometimes it was an isolated episode, or the abuser has reformed. It can hurt a family to have such a situation investigated so long after the fact – though the intent of the investigation is to make sure the abuse is not recurring. The wording of some of the statutes is vague or poorly thought out. In some states, a person who forcibly grabs the arm of a young child to prevent her running in front of a truck has technically committed child abuse, though everyone would commend this person!

There are few negatives about this excellent book. I think the initial chapters present too strong a stand against mandatory reporting, but this stance changes a great deal as the book nears its finish.

This is a wonderful and wise book, which I heartily recommend to all trainees and more experienced clinicians in the mental health disciplines. It provides excellent, pragmatic advice about mandatory reporting and the ethics of this situation.

My own bias is to report whenever there is reason to suspect abuse. This stand is in compliance with the law, and I take it for pragmatic reasons as well: mental health professionals who are treating children and families come to believe, often, that they know what is “best”, but, in fact, we are for the most part not trained to discern what constitutes abuse and neglect, and often what seems to be trivial though technical abuse proves to be much worse once an investigation has been done by a professional trained to do this work. Clinicians in their offices do not have the resources or skills of trained investigators in this area, and they often conclude that abuse was an isolated incident when, in fact, that is sadly not the case. In taking this stand, however, I need to add that I am fortunate enough to live in a state where reporting mandates are clear and investigations are done sensitively, in a manner not to hurt families.

I strongly recommend this excellent book.

Lloyd A. Wells is a child and adolescent psychiatrist at the Mayo Clinic in Rochester, Minnesota. He has a particular interest in philosophical issues related to psychiatry and in the logic used in psychiatric discourse.

 Barnes and Noble.com say they can ship this book in 2-3 days. Click here: Mandated Reporting of Suspected Child Abuse: Ethics, Law and Policy, 2^nd edition