Hawaii: CSAC (Certified Substance Abuse Counselor) Set Two

The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule establishes national standards to protect individuals’ medical records and other personal health information. It applies to covered entities, including healthcare providers, health plans, and healthcare clearinghouses. While HIPAA generally requires a signed authorization for the release of protected health information (PHI), there are exceptions. One exception is for disclosures required by law, such as mandatory reporting of child abuse or neglect. If a CSAC in Hawaii has a reasonable suspicion of child abuse or neglect, they are mandated by law to report it to the appropriate authorities, even without the client’s consent. This reporting is not a violation of HIPAA because it falls under the “required by law” exception.

Hawaii’s regulations, specifically those pertaining to CSACs, mandate a duty to warn and protect when a client presents a serious and imminent threat to a clearly identifiable victim. This duty arises from the ethical obligation to prioritize the safety and well-being of both the client and the community. The determination of “serious and imminent threat” necessitates a careful assessment of the client’s statements, behaviors, and history. The “clearly identifiable victim” requirement means the counselor must be able to reasonably ascertain who is at risk. The counselor must then take reasonable steps, which may include notifying the intended victim, law enforcement, or other appropriate authorities. Failure to act appropriately could result in legal liability and ethical sanctions. The standard of care requires the counselor to act as a reasonably prudent counselor would under similar circumstances. The decision to breach confidentiality must be carefully considered and documented, balancing the client’s right to privacy with the safety of potential victims. Consultation with supervisors or legal counsel is advisable in complex cases.

Hawaii Administrative Rules (HAR) §321-172 mandates reporting suspected child abuse or neglect. This duty falls upon CSACs in Hawaii. The “reasonable suspicion” standard is crucial; it doesn’t require proof, only a justified belief based on professional observation. Failing to report constitutes a violation of the law and ethical standards. The counselor’s primary responsibility is to protect the child, overriding client confidentiality in this specific situation. Consulting with a supervisor is a prudent step to ensure proper procedure and documentation, but it does not absolve the counselor of their individual reporting responsibility. Delaying the report to gather more evidence is unacceptable, as it puts the child at continued risk. Documenting the suspicion is essential for legal and ethical protection, but it’s secondary to the immediate need to report. Understanding the specific reporting procedures outlined by the Hawaii Department of Human Services (DHS) is vital for all CSACs. The obligation to report stems from a legal and ethical duty to protect vulnerable individuals, specifically children, from harm.

Hawaii Revised Statutes (HRS) §321-271 mandates reporting suspected child abuse. In this scenario, Kai hears from a client, Leilani, about potential neglect of her children by her neighbor. Leilani’s information is secondhand and lacks concrete evidence. The ethical and legal considerations involve balancing Leilani’s confidentiality with the duty to protect children. While unsubstantiated rumors generally don’t trigger mandatory reporting, the counselor must assess the credibility of the information. Because Leilani is a client, her statements hold more weight than a random passerby. Neglect, even if suspected, falls under the purview of child abuse in Hawaii. Therefore, the counselor should investigate further to determine if there is reasonable cause to suspect neglect before making a report. Consulting with a supervisor and documenting the process are crucial steps. Directly reporting based solely on Leilani’s unsubstantiated account would be premature. Ignoring the information entirely would be negligent. Informing the neighbor would breach Leilani’s confidentiality and potentially endanger her. The key is a measured response involving further assessment and consultation. This requires understanding the nuances of Hawaii’s specific laws and ethical guidelines for CSACs. The correct action involves a balance between protecting potential victims and respecting client confidentiality, guided by professional judgment and legal obligations within the Hawaiian context.

Hawaii Administrative Rules (HAR) Title 16, Chapter 95, governs substance abuse counselor certification. Section 16-95-17 addresses confidentiality. While it doesn’t explicitly define a blanket exception for all “quality assurance” activities, it allows for disclosure when required by law or regulation. Furthermore, the concept of “duty to warn” established in case law (though not explicitly codified in HAR 16-95) creates an ethical and potential legal obligation to breach confidentiality if a client poses an imminent threat to themselves or others. The key lies in balancing the client’s right to privacy with the counselor’s responsibility to protect potential victims and adhere to legal mandates. The specific details of the quality assurance review, the nature of the client information, and the potential harm all factor into the ethical decision-making process. Consultation with a supervisor or legal counsel is always recommended in such situations. The counselor must also consider HIPAA regulations, which permit disclosure for healthcare operations, which can include quality improvement activities, but only to the extent necessary and with appropriate safeguards. Counselors should always prioritize client safety and act in accordance with ethical guidelines and legal requirements, documenting their decision-making process thoroughly.

Hawaii Revised Statutes (HRS) §321-271 mandates reporting of suspected child abuse or neglect. This duty supersedes general confidentiality principles in substance abuse counseling. The counselor, therefore, must prioritize the safety and well-being of the child. Consulting with a supervisor is advisable to ensure proper procedure and documentation, but the reporting requirement is paramount and cannot be delayed indefinitely. While gathering more information from the parents might seem helpful, it cannot come at the expense of timely reporting. Delaying the report to obtain parental consent would be a violation of HRS §321-271. While exploring family therapy is a valuable long-term goal, it doesn’t address the immediate legal obligation to report suspected abuse. The counselor’s primary responsibility is to adhere to the legal requirements outlined in Hawaii law regarding child welfare, even when it conflicts with client confidentiality. The ethical decision-making process must prioritize the child’s safety and comply with the mandatory reporting laws of Hawaii. Understanding the interplay between confidentiality and mandatory reporting is crucial for CSACs in Hawaii.

Hawaii Administrative Rules (HAR) §321-172 mandates reporting suspected child abuse or neglect. This duty to report supersedes confidentiality in cases where there’s reasonable cause to believe a child’s health or welfare is endangered. Failure to report constitutes a misdemeanor. The scenario involves Keanu, a CSAC, who observes signs of possible neglect in the home environment of a client’s child. While maintaining client confidentiality is crucial, the law prioritizes the child’s safety. Keanu must report his concerns to the Department of Human Services (DHS) Child Protective Services (CPS). Consulting with a supervisor is advisable to ensure proper documentation and adherence to protocol, but the primary responsibility is to report. Ignoring the signs or solely relying on the client’s self-report would be a violation of the mandated reporting law and ethical guidelines. Choosing to address it only within the therapeutic setting is insufficient.

Hawaii Administrative Rules (HAR) §321-172 mandates reporting suspected child abuse or neglect. This duty supersedes general confidentiality rules for CSACs. The scenario describes a situation where a client, Ikaika, discloses past abuse of his child. The crucial element is the potential for *ongoing* risk to the child. Even if the abuse occurred in the past, Ikaika’s substance use disorder presents an increased risk of relapse and future harm. Therefore, the CSAC has a legal and ethical obligation to report this information to the appropriate authorities, such as the Department of Human Services (DHS) Child Protective Services (CPS). Failure to report could result in legal penalties for the CSAC. The therapist must also document the disclosure, the steps taken, and the rationale behind the decision. Consultation with a supervisor or legal counsel is advisable, but does not negate the immediate reporting requirement. It’s vital to understand that the “duty to warn” typically applies to imminent threats of harm to *identifiable* victims, whereas mandatory reporting laws address broader concerns of child safety. The *best* course of action prioritizes the child’s safety while adhering to Hawaii state law.

Hawaii Revised Statutes (HRS) §321-261 mandates reporting suspected child abuse or neglect. This duty to report supersedes client confidentiality, even in the context of substance abuse counseling. Failure to report when there is reasonable cause to believe a child’s health or welfare has been or may be further threatened constitutes a violation of the law. The scenario describes a situation where a counselor, Leilani, receives information from a client, Keanu, indicating potential neglect of his children due to his substance use and inability to provide adequate care. The key factor is the “reasonable cause to believe” the children’s welfare is threatened. This doesn’t require absolute certainty, but a credible basis for concern. Therefore, Leilani has a legal and ethical obligation to report her concerns to the appropriate authorities, such as the Department of Human Services (DHS) Child Protective Services (CPS) in Hawaii. The counselor’s primary duty is to protect the well-being of the children, which outweighs the client’s confidentiality in this specific situation. Ignoring the potential neglect would be a direct violation of HRS §321-261 and ethical guidelines for CSACs in Hawaii.

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) provides specific criteria for diagnosing substance use disorders. A key element is that the individual must exhibit a *pattern* of problematic substance use leading to clinically significant impairment or distress. This is evidenced by a cluster of cognitive, behavioral, and physiological symptoms. The severity of the disorder (mild, moderate, or severe) is determined by the number of criteria met. A single instance of heavy drinking, even if it leads to negative consequences, does not automatically qualify as a substance use disorder. The scenario highlights the importance of using the DSM-5 criteria systematically to make an accurate diagnosis.

Hawaii Administrative Rules (HAR) 17-682.1-103 governs confidentiality for substance abuse treatment records, aligning with 42 CFR Part 2 but potentially having stricter state-specific interpretations. Informed consent must include a clear explanation of the limits of confidentiality, particularly regarding mandatory reporting laws in Hawaii. In Hawaii, mandated reporters, including CSACs, are required to report suspected child abuse or neglect under Hawaii Revised Statutes (HRS) § 350-1. The duty to warn and protect arises when a client poses an imminent threat to a clearly identifiable victim, as outlined in relevant case law and ethical guidelines for counselors in Hawaii. Dual relationships are generally prohibited due to the potential for exploitation and impaired professional judgment, as detailed in the CSAC code of ethics. Ethical decision-making models, such as the Corey, Corey, and Callanan model, provide a structured approach to resolving ethical dilemmas, considering legal requirements, ethical principles, and client welfare. Cultural competence involves understanding and respecting diverse cultural beliefs and practices related to substance use and treatment, ensuring culturally appropriate interventions. Client rights include the right to access their records, participate in treatment planning, and receive respectful and ethical care, as outlined in relevant regulations and ethical guidelines. This scenario requires navigating the complexities of confidentiality, mandatory reporting, and ethical decision-making within the specific legal and ethical context of Hawaii. The best course of action is to consult with a supervisor or legal counsel to ensure compliance with all applicable laws and ethical standards while prioritizing the safety and well-being of all parties involved.

Understanding the stages of group development is crucial for effective group facilitation. Tuckman’s stages of group development include Forming, Storming, Norming, Performing, and Adjourning. During the Storming stage, conflict and tension often arise as members assert their individuality and challenge the group’s structure and norms. This can manifest as disagreements, power struggles, and resistance to the facilitator’s leadership. While conflict can be uncomfortable, it’s a normal and necessary part of the group process. The facilitator’s role is to manage the conflict constructively, rather than suppressing it or avoiding it altogether. Encouraging open communication, setting clear boundaries, and helping members to find common ground can help the group move through the Storming stage and into the Norming stage.

Hawaii Administrative Rules (HAR) §321-172 outlines specific requirements for reporting suspected child abuse or neglect. A CSAC in Hawaii is a mandated reporter and must report if, in their professional capacity, they have reason to believe that a child has been subjected to abuse or neglect. This duty supersedes confidentiality in cases where a child’s safety is at risk. The “reason to believe” standard is lower than “proof beyond a reasonable doubt.” The report must be made immediately by phone and followed up with a written report to the Department of Human Services (DHS). Failing to report can result in legal penalties. The scenario highlights a conflict between client confidentiality and the legal obligation to protect a child. It tests the understanding of the duty to report and the legal consequences of failing to do so in Hawaii. It is important to understand that the duty to report is triggered when there is reasonable suspicion, not just concrete evidence. It’s also crucial to know that the report must be made to the proper authorities (DHS) and within the required timeframe (immediately). The scenario also touches upon the importance of accurate documentation and the potential legal ramifications of failing to adhere to mandatory reporting laws in Hawaii.

Hawaii Revised Statutes (HRS) §321-261 outlines the specific requirements for mandatory reporting of suspected child abuse or neglect. This statute places a legal obligation on CSACs in Hawaii to report instances where they have reasonable cause to believe that a child’s health or welfare has been or may be further threatened by the actions or omissions of a parent, caregiver, or another individual. The “reasonable cause to believe” standard requires more than a mere suspicion but less than absolute certainty. It is based on the information available to the counselor at the time. Failure to report suspected child abuse or neglect, as mandated by HRS §321-261, can result in legal penalties, including fines and potential criminal charges. More importantly, it constitutes a serious ethical violation, potentially harming the child and undermining the counselor’s professional integrity and credibility. The counselor’s primary responsibility is to protect the well-being of the child, even if it means breaching confidentiality to a certain extent. The duty to report supersedes the client’s right to confidentiality in situations involving suspected child abuse or neglect. It’s important for CSACs to document the reasons for their belief, the information they relied upon, and the steps they took to report the suspicion to the appropriate authorities, such as the Department of Human Services (DHS) Child Protective Services (CPS) in Hawaii. A report made in good faith grants immunity from liability.

Relapse prevention planning is a crucial component of substance abuse treatment. A comprehensive relapse prevention plan includes identifying triggers (internal and external cues that can lead to relapse), developing coping strategies to manage those triggers, building a strong support system, and establishing a plan for managing cravings and urges. “Recovery capital” refers to the resources an individual has available to support their recovery, including social support, financial stability, housing, and employment. A strong relapse prevention plan also includes strategies for managing high-risk situations and addressing negative emotions. The plan should be individualized to the client’s specific needs and circumstances and should be regularly reviewed and updated. It’s important to remember that relapse is a process, not an event, and early intervention can prevent a full-blown relapse.

Hawaii Revised Statutes (HRS) §321-271 mandates reporting of suspected child abuse or neglect. This duty supersedes general confidentiality rules applicable to CSACs. The scenario involves a client, Leilani, disclosing information about her partner, Kai, potentially abusing their child. The CSAC’s primary responsibility is to protect the child. Therefore, the CSAC must report the suspected abuse to the appropriate authorities, such as the Department of Human Services (DHS) Child Protective Services (CPS). Failure to report would be a violation of HRS §321-271 and could result in legal consequences for the CSAC. This duty to report exists even if the information is obtained during a counseling session and would otherwise be considered confidential. The CSAC should also document the disclosure and the subsequent report. The ethical decision-making model prioritizes the safety and well-being of the child, which takes precedence over the client’s confidentiality in this specific situation. Ignoring the potential abuse would not only be unethical but also illegal. The CSAC should also inform Leilani about the mandatory reporting requirement and the reasons for it, maintaining transparency while prioritizing the child’s safety.

Duty to warn and protect laws are complex and vary by jurisdiction. In general, these laws require mental health professionals to take reasonable steps to protect individuals who are at risk of being harmed by their clients. This duty arises when the therapist determines, or reasonably should have determined, that a client presents a serious danger of violence to a specifically identified individual or individuals. The specific requirements for fulfilling the duty to warn and protect vary by state. Some states require the therapist to warn the potential victim directly, while others allow the therapist to notify law enforcement or take other steps to protect the victim. In this scenario, the therapist has a duty to warn and protect the intended victim. Notifying the police is a reasonable step to take in this situation, as it can help to protect the victim from harm. However, the therapist should also consider other steps, such as warning the victim directly or seeking a court order to hospitalize the client. The MOST appropriate course of action will depend on the specific circumstances of the case and the applicable state laws.

This question assesses understanding of the importance of professional development and supervision. Regular supervision is crucial for CSACs to maintain ethical practice, enhance their skills, and prevent burnout. Supervision provides a safe space to discuss challenging cases, receive feedback, and address any personal issues that may be impacting their work. While continuing education (option b) is also important, it does not provide the individualized support and guidance offered by supervision. Networking (option c) and self-care (option d) are valuable, but they are not substitutes for the structured and focused support of supervision. Option a accurately reflects the primary benefits of engaging in regular supervision.

Community resources and support systems are essential components of successful substance abuse recovery. These resources can include support groups (e.g., AA, NA), mental health services, housing assistance, vocational training, and legal aid. Non-profit organizations often play a vital role in providing these services, particularly for underserved populations. Building community partnerships is crucial for ensuring that clients have access to a comprehensive network of support. Counselors should be knowledgeable about local resources and be able to effectively refer clients to appropriate services. The role of family and friends in recovery should also be recognized and supported. Advocacy for policy change is important for addressing systemic barriers to accessing treatment and support services. Therefore, connecting clients with community resources and support systems is a key aspect of effective substance abuse counseling.

Hawaii Administrative Rules (HAR) § 17-892.1-13 outlines the requirements for client records, including confidentiality and access. It mandates secure storage, restricted access, and detailed documentation of disclosures. HAR § 321-321 details the reporting requirements for suspected child abuse, requiring counselors to report reasonable suspicion to the Department of Human Services. The duty to warn and protect, stemming from the Tarasoff ruling and adapted in Hawaii, necessitates counselors to take reasonable steps to protect a potential victim when a client poses a serious threat of violence. Informed consent, as per ethical guidelines, must be obtained before treatment, ensuring clients understand the nature of treatment, risks, and alternatives. Dual relationships are addressed in ethical codes, prohibiting relationships that could impair objectivity or exploit the client. Ethical decision-making models, like the one proposed by Corey, Corey, and Callanan, involve identifying the problem, reviewing relevant ethical codes, consulting with colleagues, generating potential courses of action, evaluating the consequences, selecting the best course of action, and evaluating the results. Cultural competence requires counselors to understand and respect cultural differences, adapting their approach to meet the client’s needs. Client rights, including the right to confidentiality, informed consent, and treatment, must be protected and advocated for. In this scenario, Leilani’s disclosure of domestic violence triggers both the duty to protect (if a credible threat is made) and mandatory reporting if children are involved. The counselor must navigate these legal and ethical obligations while prioritizing Leilani’s safety and well-being, adhering to relevant Hawaii statutes and ethical guidelines. Consultation with a supervisor or legal counsel is advisable to ensure compliance and ethical practice.

Hawaii Revised Statutes (HRS) Chapter 321, specifically addresses public health regulations, including those related to substance abuse treatment. HRS §321-171 outlines the confidentiality requirements for patient records in healthcare settings. While it doesn’t explicitly detail “duty to warn” in the same way as some other states’ statutes (like California’s Tarasoff ruling codified in law), the general principles of duty to protect a potential victim when a client poses an imminent threat are still applicable within the context of ethical guidelines for CSACs in Hawaii. This arises from a combination of professional ethical codes and common law principles related to negligence. A CSAC’s decision to breach confidentiality in such a situation would need to be carefully considered, documented, and justified based on the specific circumstances, including the severity and immediacy of the threat, the identifiability of the victim, and the availability of less intrusive means of averting the harm. Consultation with a supervisor or legal counsel is essential. The legal basis is not a specific statute mandating “duty to warn” in the Tarasoff sense, but rather the broader legal and ethical responsibility to prevent foreseeable harm. The question is testing the nuanced understanding of how ethical guidelines interact with general legal principles in the absence of a specific “duty to warn” statute.

Trauma-informed care recognizes the widespread impact of trauma and incorporates knowledge about trauma into policies, procedures, and practices. A key principle is ensuring physical and emotional safety for clients. This includes creating a safe and predictable environment, avoiding triggers that could re-traumatize the client, and building trust through transparency and consistency. Asking a client to repeatedly recount traumatic experiences in detail without proper preparation and support can be re-traumatizing and should be avoided.

Relapse prevention planning involves identifying triggers, developing coping strategies, and building support systems. High-risk situations are those that increase the likelihood of relapse. These situations can be internal (e.g., negative emotions, cravings) or external (e.g., social situations, environmental cues). In this scenario, attending a party where alcohol is served presents a significant external trigger for someone in early recovery from alcohol use disorder. It exposes him to readily available alcohol and social pressure to drink, increasing the risk of relapse. While other options might present challenges, the party environment poses the most immediate and direct threat to his sobriety.

Hawaii Administrative Rules (HAR) Title 16, Chapter 95, governs substance abuse counselor certification. Specifically, HAR §16-95-10 outlines the ethical standards expected of CSACs. A core tenet is maintaining client confidentiality, which is further reinforced by HIPAA regulations at the federal level. This confidentiality isn’t absolute. Duty to warn and protect arises when a client poses an imminent threat to themselves or others. This duty overrides confidentiality. The Tarasoff case established the legal precedent for duty to warn. In Hawaii, this principle is codified in case law and interpreted within the context of HAR §16-95-10. The counselor’s responsibility involves assessing the credibility and immediacy of the threat. If the threat is deemed credible and imminent, the counselor must take reasonable steps to protect the intended victim. This might include notifying the potential victim, law enforcement, or arranging for the client’s hospitalization. Failing to act appropriately can expose the counselor to legal liability and ethical sanctions. The counselor must carefully document the assessment process, the rationale for their decision, and the actions taken. Consultation with a supervisor or legal counsel is advisable in complex situations.

A CSAC working in a rural community on the Big Island of Hawaii is treating a client, Leilani, for alcohol use disorder. Leilani is a respected elder in her Hawaiian community and holds traditional cultural beliefs about healing and wellness. The CSAC, who is not of Hawaiian descent, recognizes the importance of incorporating culturally relevant practices into Leilani’s treatment plan. This requires the CSAC to engage in cultural humility, which involves acknowledging their own cultural biases, being open to learning about Hawaiian culture, and respecting Leilani’s traditional beliefs. The CSAC might collaborate with a cultural practitioner (kahuna) to integrate traditional healing methods, such as ho’oponopono (a traditional Hawaiian practice of reconciliation and forgiveness) or la’au lapa’au (traditional Hawaiian herbal medicine), into Leilani’s treatment. The CSAC should also be mindful of communication styles and social norms within the Hawaiian community, such as the importance of direct eye contact and respectful language. Building trust and rapport with Leilani requires the CSAC to demonstrate genuine interest in her culture and a willingness to adapt their counseling approach to align with her values and beliefs. This approach ensures that Leilani’s treatment is culturally sensitive and more likely to be effective.

Hawaii Administrative Rules (HAR) §321-172.5 governs the confidentiality of substance abuse treatment records, aligning with federal regulations 42 CFR Part 2. In a scenario where a client, Keanu, presents an imminent risk of harm to himself due to a recent relapse, the “duty to warn” supersedes standard confidentiality protections. This exception allows a counselor to disclose necessary information to prevent harm. However, disclosure must be limited to essential information and only to individuals who can reasonably prevent the threatened harm. Consulting with a supervisor or legal counsel is crucial to ensure compliance with both ethical guidelines and legal requirements under Hawaii state law. The counselor must document the rationale for breaching confidentiality, the information disclosed, and the individuals to whom it was disclosed. This action is taken to protect Keanu’s life, balancing the ethical duty of confidentiality with the legal and ethical obligation to prevent harm. The counselor should also consider involving emergency services if the risk is immediate and severe. This decision-making process emphasizes client safety while adhering to the strictest interpretation of privacy laws possible under the circumstances.

Hawaii’s regulations, specifically those related to mandated reporting, require CSACs to report suspected child abuse or neglect. This duty supersedes general confidentiality in situations where a child’s safety is at risk. The assessment of “imminent risk” is crucial. “Imminent risk” does not simply mean potential future harm; it requires a reasonable belief that the child is in immediate danger. Failing to report when such imminent risk is present constitutes a violation of Hawaii’s laws and ethical standards for CSACs. Consultation with a supervisor or legal counsel may be advisable in complex situations, but the ultimate responsibility for reporting rests with the counselor. The specific reporting procedures are detailed in Hawaii Revised Statutes (HRS) Chapter 350, which outlines the process for reporting suspected child abuse or neglect to the Department of Human Services (DHS). The counselor needs to understand the definition of child abuse and neglect as defined by HRS 350, including physical abuse, sexual abuse, emotional abuse, and neglect. The counselor also needs to be aware of the immunity from liability provided to mandated reporters who report in good faith. Furthermore, the counselor should document the reasons for their decision to report or not to report, including any consultations with supervisors or legal counsel. This documentation can be crucial in demonstrating adherence to ethical and legal standards.

The Stages of Change Model (also known as the Transtheoretical Model) describes the process of intentional behavior change. The stages are: Precontemplation (not considering change), Contemplation (considering change), Preparation (planning to change), Action (implementing change), Maintenance (sustaining change), and Termination (change is ingrained). Individuals may cycle through these stages multiple times. Motivational Interviewing (MI) is often used to help individuals progress through the stages. Understanding a client’s stage of change is crucial for tailoring interventions and setting realistic goals.

Hawaii Administrative Rules (HAR) 17-682.1-102(a) states that a CSAC shall safeguard the confidentiality of information received from a client in the course of providing substance abuse counseling services, unless disclosure is required or permitted by law. This includes information obtained during assessment, treatment, and aftercare. The duty to warn arises when a client presents a clear and imminent danger to themselves or others. In Hawaii, this duty is codified in case law and statutes relating to mental health professionals, and while not explicitly stated for CSACs, the ethical principle of beneficence (doing good) and non-maleficence (doing no harm) compels a similar standard of care. In situations involving child abuse or neglect, Hawaii Revised Statutes (HRS) § 350-1.1 mandates reporting by any person who suspects such abuse or neglect. HRS § 321-361 outlines the requirements for reporting communicable diseases, including HIV/AIDS, to the Department of Health, but only by healthcare providers, not CSACs unless they also hold another qualifying healthcare license. The ethical decision-making process involves assessing the situation, identifying ethical principles involved, consulting with supervisors or colleagues, and documenting the decision-making process. In this case, the client’s statement about potentially harming his neighbor constitutes a credible threat that triggers the duty to warn. Consulting with a supervisor ensures that the counselor is making an informed decision and protects both the client and the potential victim. The counselor must balance the client’s confidentiality with the safety of the potential victim, and documenting the steps taken ensures accountability and adherence to ethical standards.

Hawaii Revised Statutes (HRS) §321-261 mandates reporting suspected child abuse or neglect. This duty extends to CSACs. Failure to report constitutes a misdemeanor and potential civil liability. The “reasonable suspicion” threshold is crucial; it doesn’t require certainty, only a belief based on observable facts that abuse or neglect *may* be occurring. This is a lower standard than “probable cause.” HRS §321-261(a) states: “Any person who knows or has reason to believe that a child has been subjected to abuse or neglect shall immediately report the matter orally to the department of human services or to the police department.” The scenario involves Kaimana, a CSAC, who observes bruising on a client’s child during a telehealth session. While telehealth presents challenges in direct observation, visible bruising constitutes a factual basis for suspicion. Kaimana’s awareness of the bruising triggers the mandatory reporting requirement. Delaying the report to gather more “concrete” evidence would violate HRS §321-261, as the law emphasizes immediate reporting upon reasonable suspicion. Consulting with a supervisor is prudent, but it does not supersede the legal obligation to report. Waiting for the next in-person session is unacceptable, given the potential for ongoing harm to the child. The law prioritizes the child’s safety and well-being, mandating swift action when there’s a reasonable basis for concern.