It is contra-indicated to inform parents about the report if the individual seems psychotic, has poor impulse control coupled with a history of violent behavior, has a problem with alcohol or drugs, or is likely to flee. It can be very beneficial to give clients the opportunity to make the reports themselves in the therapist's presence. A self-report, however, does not negate the therapist's mandate to report. Some communities have hospital-based child protection teams that perform these evaluations. Other communities rely on local hospitals or physicians in private practice.
Some States have protocols for medical examiners to follow.
The purpose of the evaluation is to examine the child for forensic evidence of recent or chronic trauma, to assess the possibility of sexually transmitted disease and pregnancy, and to provide medical treatment. Reassuring sexually abused children that their bodies are healthy is an important step in the recovery process. Mental health professionals are often concerned about revictimization of the sexually abused child through an insensitive medical examination. Sometimes they have made the assumption that these examinations are traumatic and have given this information to parents and children without having inquired about how the examinations are performed. This type of communication creates anxiety for the children, increases the difficulty of examining young children, and can prevent medical examiners from performing a complete medical examination.