Child Maltreatment

When to Refer

  • Once maltreatment has been identified and reported as mandated, the primary care provider needs to work with social service agencies to ensure that timely and appropriate mental health services are provided to the child or teen and the family. Referrals to mental health professionals are indicated for both the child or teen and the family. It is frequently up to the primary care provider to encourage follow-up with referrals.
  • After the primary care provider has made a referral to a protective service agency, his or her ongoing involvement is extremely important. Because the consequences of child maltreatment may extend throughout the child’s or adolescent’s life, comprehensive treatment and collaboration among all health professionals involved is crucial.
    • Provide the child’s or teen’s medical, developmental, and social history to protective agency staff
    • Provide continuity of care when possible
    • Become familiar with mental health professionals in your community who treat children, teens, and families who have suffered abuse or neglect so that you can make referrals for the following services, as appropriate:
      • Mental health referrals for the child or adolescent and the family
      • Individual and/or family treatment
      • Parent education/support groups
      • Assessment of the child’s or teen’s school needs
    • Maintain ongoing collaboration with mental health professionals:
      • After making a referral for mental health and protective services and obtaining releases for the exchange of information, remain in close contact with all parties involved in the child’s or adolescent’s care.
      • Encourage follow-up with mental health treatment.
      • Follow confidentiality guidelines whenever communicating with other professionals, agencies, and schools.
    • Maintain ongoing collaboration with the child’s or adolescent’s school:
      • Closely monitor any decline in the child’s or teen’s school functioning.
      • With appropriate permission, work with school personnel to meet the child’s or teen’s needs and supportively address concerns that may arise.
      • Consider making a referral for neuropsychological testing for a child or teen who experiences persistent school difficulties.
  • Treatment approaches that are collaborative, coordinated, and comprehensive, and that involve both the parents and the child or teen, are most effective in preventing the negative outcomes associated with child maltreatment. (See Bright Futures Case Studies for Primary Care Clinicians: Physical Abuse: The Father’s Hand Print; Sexual Abuse: Margaret’s Secret; Neglect: The Silent Cry.).