Updated: BBS legal opinion improves, doesn’t fix, child abuse reporting issue

California mandated child abuse reporters would no longer need to discriminate against gay or lesbian youth. But the legal opinion is just that: An opinion.                                                                                                                                                                                                                                                                                                            

A legal opinion announced on Thursday by the California Board of Behavioral Sciences appears to go partway to resolving the problem of discriminatory reporting of child abuse.

The opinion, prepared at BBS request by legal counsel for the Department of Consumer Affairs, essentially says that oral sex, anal sex, and object penetration should be treated the same as vaginal intercourse when considering abuse reporting. If two minors of similar ages (as defined by the law; see the age combination descriptions in this earlier post) engage in consensual acts without evidence of coercion or other signs of abuse, those acts are not reportable.

BBS Executive Director Kim Madsen announced at Thursday’s Policy and Advocacy Committee meeting that she would make the full legal opinion public. While the opinion does not carry the weight of law, it should be helpful for therapists seeking to understand when the BBS expects child abuse reports to be made, and when the therapist can rely on their own judgment as to what is abusive.

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Your comments are welcomed. You can post them in the comments below, by email to ben[at]bencaldwell[dot]com, or on my Twitter feed.

As landmark California law heads to court, few support reparative therapy for minors

SB1172 would prevent licensed therapists from trying to change the sexual orientation of minors.                                                                                                                                                                                                                                                                                                            

JudgesTools IconTwo lawsuits (Pickup v Brown and Welch v Brown) have sought to stop the implementation of SB1172, California’s landmark bill passed last year that outlaws the practice of reparative therapy on minors. Though one of these suits did lead to an injunction preventing 1172 from taking effect until the legal challenges could be sorted out, things aren’t looking good for those who would like it to remain legal for licensed therapists to try to turn gay kids straight.

Here is a list of all those who have filed amicus (“friend of the court”) briefs in support of SB1172, as of the February 10 listing on the federal appeals court’s web page for this case. I’ve put the major professional mental health associations in bold. (Full disclosure: I’m on the AAMFT-CA Board of Directors, and represented the organization in a lot of work on SB1172 and the brief onto which AAMFT-CA signed.)

American Association for Marriage and Family Therapy – California Division
American Civil Liberties Union of Northern California
Rt. Rev. Marc Handley Andrus, Episcopal Bishop of California
California Council of Churches
California Faith for Equality
California Network of Metropolitan Community Churches
California Psychological Association
Children’s Law Center of California
City and County of San Francisco
Dependency Legal Group of San Diego
Dr. Jack Drescher
East Bay Children’s Law Offices
Equality California
First Amendment Scholars
Health Law Scholars
Justice and Witness Ministries
The LGBTQ-Affirmative Therapist Guild of Utah
Legal Advocates for Children and Youth
Legal Services for Children
Los Angeles Gay & Lesbian Center
Los Angeles Youth Network
National Association of Social Workers
National Association of Social Workers – California Chapter

Parents, Family and Friends of Lesbians and Gays
Public Counsel
St. Paul’s Foundation for International Reconciliation
Survivors of Sexual Orientation Change Efforts
The Trevor Project
Truth Wins Out
Unitarian Universalist Legislative Ministry California
United Church of Christ

Quite a list, eh? Lawyers, scholars, local government, mental health professionals, churches, and advocacy groups, all on the same side. And here is a list of all those who have filed amicus briefs in support of using therapy to try to turn gay kids straight, and asking that the law be struck down:

National Legal Foundation

While the points of emphasis are a bit different from one brief to the next, those briefs in support of SB1172 make a number of compelling arguments. The restriction on reparative therapy isn’t unique, as California already restricts a variety of health care practices; the legislature made a well-informed decision in rejecting the practice of reparative therapy among minors; reparative therapists can’t claim free speech as a defense here, since many professional restrictions are by their nature restrictions on speech (like the rules requiring therapists to maintain confidentiality for their clients); and on and on. Basically every argument made by those who support reparative therapy gets demolished. They’re interesting reading, and a good preview of the legal arguments on both sides.

The two cases will be heard together in April at the US Ninth Circuit Court of Appeals. Obviously, the number of groups on either side of the issue will not decide the case, but the level of consensus here at least says something about just how far on the fringes reparative therapy has become.

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Your comments are welcome, either in the comments below, via email to ben[at]bencaldwell[dot]com, or to my Twitter feed.

California’s ludicrous new elder abuse reporting law

California law has changed dramatically for mandated reporters of suspected elder or dependent adult abuse. The good news: The changes only impact some instances of abuse. The bad news: The law is a needlessly complex mess.                                                                                                                                                                                                                                                                                                            

Elderly couple with ear muffsWhile the California legislative process often works quite well — witness the passage of SB1172 — a pair of other bills that got far less attention this year will also impact the practices of MFTs, LCSWs, and LPCCs (and all psychotherapists) in the state.

California’s requirements for mandated reporting of elder and dependent adult abuse have changed significantly. These changes have already taken effect, because one of the bills putting the changes into place was marked as emergency legislation. The new law replaces what had been a single standard for when and to whom reports are sent with five different standards based on the specifics of the situation — specifics that, under the law, mandated reporters are not required to investigate.

“Wait, what?” is a fully appropriate response here.

Assembly Bill 40 began in 2011 as a response to an information-sharing problem. When elder or dependent adult abuse takes place in a long-term care facility (such as a nursing home), mandated reporters could report to either law enforcement or the county ombudsperson (a sort of resident advocate for those in long-term care). However, there were problems with information-sharing between ombudspersons and law enforcement, so AB40 initially would have required mandated reporters to send their written reports of suspected abuse to both.

It was a dumb and expensive way to solve the information-sharing problem, forcing therapists to take the time to make duplicate reports rather than just fixing the information flow between ombudspersons and law enforcement. Some of California’s mental health professionals jumped in to oppose the measure.

But it moved forward anyway, with the support of ombudspersons and law enforcement organizations. AB40 was amended many times through its journey through the legislature, and many of the same changes were proposed in Senate Bill 1051. Where the process ended is this:

As of today (because SB1051 was marked emergency legislation, it took effect September 27, 2012, immediately upon the Governor’s signature), mandated telephone reports of suspected elder or dependent adult abuse in California must be made “immediately or as soon as practicably possible” in some cases, “immediately, and no later than within two hours” in others, and within 24 hours in others. Written reports must be sent to various combinations of law enforcement, adult protective services, county ombudspersons, and facilities’ licensing agencies — requiring triplicate reporting in some instances. Filing reports via Internet appears to be allowed in some instances and not others. And the acceptable time frames for written reports will now vary as well, from 2 hours to two working days. These combinations are based on:

  • Whether the abuse took place in a long-term care facility
  • Whether the abuse was physical abuse
  • Whether the abuse resulted in serious bodily injury
  • Whether the abuse was caused by a resident with a physician’s diagnosis of dementia

For the problems that existed with the old standard, at least mandated reporters could be reasonably expected to know who they needed to report to, and when. The new standards are simply too complex to be held in memory, and will likely result in many reports being sent to the wrong places at the wrong times.

It’s bad law.

But it is currently the law of California. So mandated reporters will need to be able to determine where their reports should go and when.

I’ve put together a flowchart of reporting timelines and report recipients; a thumbnail appears below, and the full-size, non-pixelated version is part of my ebook, Basics of California Law for LMFTs, LPCCs, and LCSWs (2013 edition). Use the link for more information or to order.

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Your feedback is welcome, through the comments here, by email to ben [at] bencaldwell [dot] com, or to my decidedly non-abusive Twitter feed.

California may become first state to limit “reparative therapy”

Senate Bill 1172 would stop licensed therapists from providing reparative therapy to minors. It awaits Governor Brown’s signature or veto.

California Capitol-fromSWUpdated 9/30/12 – Governor Brown signed the bill into law. It takes effect January 1, 2013.

Senate Bill 1172, a proposed California law that would prevent licensed therapists from offering so-called “reparative therapy” to minors, has passed the state Assembly and Senate and is currently on Governor Jerry Brown’s desk. The Governor has until the end of this month — less than a week away — to sign or veto the bill.

If he signs it, California would be the first state in the US to take such action. Other states are eyeing the California bill closely, with some planning to propose similar bills. Gay rights organizations are also paying close attention to the bill, and have been pushing the Governor to sign it.

“Reparative therapy,” also sometimes known as “conversion therapy” and referred to in the bill as “sexual orientation change efforts,” is a form of therapy that aims to help people distressed by same-sex attraction change those attractions and ultimately become more heterosexual. The therapy was pioneered by Dr. Joseph Nicolosi, who suggests in his original book on the topic that same-sex attractions are unhealthy.

All the major professional associations in mental health have issued statements discouraging their members from using reparative therapy, though none has gone so far as to declare the practice inherently unethical. (See statements from the AAMFT, ACA, APA, CAMFT, and NASW; there’s a nice history of associations’ stances on the topic here.) These statements typically cite the lack of research support for any therapy succeeding in altering sexual orientation, and the serious risk of harm that comes to gay and lesbian clients when a therapist tells them that their sexuality is wrong or unhealthy.

However, the therapy remains practiced by a number of mental health professionals, who offer anecdotal reports of clients who say they were helped by the approach.

While professional associations are usually loath to accept government intrusion into clinical practice, it is noteworthy that all of the major professional associations in mental health in California are now either neutral on the bill or actively supporting it. All were initially opposed, but as the language of the bill has been amended, all have dropped their opposition. Here is where the major mental health professional associations currently stand:

AAMFT-CA: Support

The American Association for Marriage and Family Therapy, California Division was (with NASW-CA) one of the first associations to move from opposition to support. (Full disclosure: I’m the current Legislative and Advocacy Committee Chair for AAMFT-CA, and I’ve worked a great deal on this bill.)

NASW-CA: Support

The National Association of Social Workers, California Division was (with AAMFT-CA) one of the first associations to move from opposition to support.

CPA (Psychologists): Support

The The California Psychological Association had initially joined three other organizations (Psychiatrists, CAMFT, and CALPCC) in jointly oposing the bill. While all four organizations have since dropped their opposition, CPA appears to be the only one of the four to move to a position of support.

CALPCC: Neutral

The California Association of Licensed Professional Clinical Counselors has dropped its opposition, though the bill is not currently mentioned anywhere on the group’s web site.

CAMFT: Neutral

The California Association of Marriage and Family Therapists has dropped its opposition to the bill. The CAMFT web site includes a relatively soft caution to its members about the use of reparative therapy (referred to here as “sexual orientation change efforts”) but otherwise does not address the bill.

CPA (Psychiatrists): Neutral

The California Psychiatric Association has officially withdrawn its opposition to the bill, citing a 1998 statement of the American Psychiatric Association which reads in part, “The American Psychiatric Association opposes any psychiatric treatment, such as ‘reparative’ or ‘conversion’ therapy, which is based upon the assumption that homosexuality per se is a mental disorder.”

Whatever your stance on the bill, both sides are suggesting you contact Governor Brown’s office directly to let him know. The Governor’s office can be reached by phone at 916-445-2841, by email here, or on Twitter at @JerryBrownGov.

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Your comments are welcome. You may post them in the comments section below, via email to ben [at] bencaldwell [dot] com, or to my Twitter feed.