State v. Rutherford , 2018 Ohio 2638 ( 2018 )


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  • [Cite as State v. Rutherford, 
    2018-Ohio-2638
    .]
    IN THE COURT OF APPEALS OF OHIO
    FOURTH APPELLATE DISTRICT
    PIKE COUNTY
    STATE OF OHIO,                 :
    :    Case No. 17CA883
    Plaintiff-Appellee,       :
    :
    vs.                       :    DECISION AND JUDGMENT
    :    ENTRY
    CLINTON RUTHERFORD,            :
    :
    Defendant-Appellant.       :    Released: 06/26/18
    _____________________________________________________________
    APPEARANCES:
    Timothy Young, Ohio State Public Defender, and Stephen P. Hardwick,
    Assistant Ohio State Public Defender, Columbus, Ohio, for Appellant.
    Robert Junk, Pike County Prosecuting Attorney, and Michael A. Davis,
    Assistant Pike County Prosecuting Attorney, Waverly, Ohio, for Appellee.
    _____________________________________________________________
    McFarland, J.
    {¶1} Appellant Clinton Rutherford was convicted of rape and gross
    sexual imposition after a bench trial in the Pike County Court of Common
    Pleas in February 2017 and now appeals the judgment entry of sentence
    journalized April 18, 2017. On appeal, he asserts the trial court erred in
    permitting an unlicensed psychological counselor to testify as to certain
    statements made by the victim. Based upon our review of the pertinent Ohio
    case law, we find no merit to Appellant’s argument. Accordingly, we
    Pike App. No. 17CA883                                                                                   2
    overrule the sole assignment of error and affirm the judgment of the trial
    court.
    FACTS
    {¶2} In November 2015, Appellant’s 7-year-old daughter, “L.R.,” was
    being prepped for a tonsillectomy when a nurse noticed fresh vaginal
    bleeding. Upon further examination, it was determined that L.R. had
    abrasions inside her vagina and outside on the vaginal area. These findings
    were reported to Pike County Children’s Services, and an investigation
    ensued. L.R. was removed from the home where she lived with her parents,
    Appellant and Amber Rutherford, her siblings, and other extended family.1
    {¶3} L.R. and her siblings went to live with a foster family in a nearby
    county. Her parents had supervised weekly visits. In January 2016, L.R.
    began receiving counseling for mental health issues upon referral to the
    Woodland Center, a facility in Jackson, Ohio. In March 2016, L.R. made
    revelations during a group counseling session at her school, regarding
    Appellant, which were reported to the appropriate authorities.
    {¶4} Appellant was subsequently interviewed by Major Tracy Evans
    of the Pike County Sheriff’s Department. During a second interview,
    Appellant explained that he had been having sex with his wife but
    1
    The Rutherfords and their three children lived in the basement of Appellant’s mother-in-law’s house.
    Appellant’s mother-in-law lived upstairs with her significant other and his adult son.
    Pike App. No. 17CA883                                                                               3
    mistakenly touched L.R.’s vagina with his penis. Appellant blamed the
    mistake on his being overmedicated. Appellant and his wife were thereafter
    indicted jointly on various felony counts:
    1) R.C. 2907.02(A)(1)- Rape of a child under ten years of age;
    2) R.C. 2907.05(A)(4)- Gross sexual imposition;
    3) R.C. 2919.22(B)(2)- Endangering children;
    4) R.C. 2919.22(B)(2)- Endangering children;
    5) R.C. 2921.04(B)(2)- Intimidation;
    6) R.C. 2921.31(A)- Obstructing official business; and,
    7) R.C. 2919.22(B)- Endangering children.2
    {¶5} Appellant and his wife pleaded not guilty to the charges at
    arraignment. Their cases were later bifurcated for purposes of trial. Prior to
    Appellant’s jury trial, he elected to have a bench trial. At the
    commencement of Appellant’s trial, the State of Ohio orally moved to
    dismiss both counts of child endangering contained in counts three and four
    of the indictment. The court granted the motion.
    {¶6} During Appellant’s trial, the State presented testimony from
    Brittany Bakenhaster, L.R.’s counselor at the Woodland Center; Dr. Sathish
    Jetty, a pediatrician; Holly Wiggins, an investigator for Pike County
    2
    Counts five and six also charged Amber Rutherford. Count seven charged only Amber Rutherford.
    Pike App. No. 17CA883                                                                           4
    Children’s Services; and Major Evans. Several State’s exhibits were
    admitted into evidence, including Appellant’s videotaped interview with
    Major Evans. At the close of the State’s evidence, the defense made a
    Crim.R. 29 motion as to counts one, two, five, and six of the indictment.
    The court granted the motion as to count five, intimidation.
    {¶7} The defense presented testimony from L.R.’s foster parent, Heidi
    Harris. Ms. Harris testified in detail about many troubling behaviors she
    observed in L.R.3 Some of these behaviors were violent to herself or others.
    Ms. Harris often observed L.R. “rough-housing” or “brawling” with her
    brothers. Ms. Harris also testified she saw L.R. remove her Barbie dolls’
    clothes and rub the dolls together while explaining “that’s what you do when
    you are naked.”
    {¶8} Appellant also testified in his own defense. Appellant denied
    ever engaging in any type of sexual activity with L.R. He testified she liked
    to play rough with her brothers, riding toy trucks downhill and climbing
    trees. He testified he observed her, 48-hours prior to his interview with
    Major Evans, “messing with herself with her fingers” and with her Barbie
    dolls. He testified when he met with Major Evans, he thought he was
    hopeful that the meeting would lead to getting his children back and
    3
    During her testimony, Ms. Harris reviewed notes she and her husband had made regarding their
    observations of L.R. and her brothers while in their care.
    Pike App. No. 17CA883                                                                                   5
    reuniting the family. Appellant explained that he lied to Major Evans during
    the interview because he felt trapped and degraded. He felt he had no choice
    and he made the statement incriminating himself so “at least the children
    could go back to their mother.” At the close of trial, the court found
    Appellant guilty on count one, rape, and count two, gross sexual imposition.
    Appellant was found not guilty as to count six, obstructing official business.4
    {¶9} Appellant was sentenced on April 4, 2017 and resentenced on
    April 18, 2017 in order for the court to impose a mandatory period of post-
    release control. This timely appeal followed. Additional facts gleaned from
    the trial testimony are set forth below, where pertinent.
    ASSIGNMENT OF ERROR
    I.       “THE TRIAL COURT ERRED BY PERMITTING AN
    UNLICENSED PSYCHOLOGICAL COUNSELOR TO
    TESTIFY ABOUT HEARSAY STATEMENTS THAT
    L.R. ALLEGEDLY MADE.”
    STANDARD OF REVIEW
    {¶10} “Decisions involving the admissibility of evidence are reviewed
    under an abuse-of-discretion standard of review.” State v. Wright, 4th Dist.
    Lawrence No. 16CA24, 
    2017-Ohio-9041
    , at ¶ 24, quoting Estate of Johnson
    4
    The April 18, 2017 judgment entry of sentence reflects that count seven of the indictment charged only
    Amber Rutherford. As explained in In re Helfrich, 5th Dist. Licking No.13CA20, 
    2014-Ohio-1933
    , at ¶ 35,
    we may take judicial notice of the Pike County Court of Common Pleas website which reflects that on
    March 15, 2017, Amber Rutherford pleaded guilty to count six, obstructing official business. On that same
    date, counts five and seven were dismissed as to Amber Rutherford. See
    http://pikecountycpcourt.org/eservices, accessed April 25, 2018. Therefore, all counts of the indictment
    have been resolved and no issue exists as to the finality of the April 18, 2017 judgment entry.
    Pike App. No. 17CA883                                                          6
    v. Randall Smith, Inc., 
    135 Ohio St.3d 440
    , 
    2013-Ohio-1507
    , 
    989 N.E.2d 35
    ,
    ¶ 22, citing State v. Hancock, 
    108 Ohio St.3d 57
    , 
    2006-Ohio-160
    , 
    840 N.E.2d 1032
    ; State v. Morris, 
    132 Ohio St.3d 337
    , 
    2012-Ohio-2407
    , 
    972 N.E.2d 528
    , ¶ 19. Thus, an appellate court will not disturb a trial court's
    ruling regarding the admissibility of evidence absent a clear showing of an
    abuse of discretion with attendant material prejudice to defendant. State v.
    Green, 
    184 Ohio App.3d 406
    , 
    2009-Ohio-5199
    , 
    921 N.E.2d 276
    , ¶ 14 (4th
    Dist.).
    {¶11} When, however, an appellant alleges that a trial court's
    evidentiary ruling was “ ‘based on an erroneous standard or a
    misconstruction of the law,’ ” an appellate court reviews the trial court's
    evidentiary ruling using a de novo standard of review. Wright, supra, at
    ¶ 25, quoting Wray v. Wessell, 4th Dist. Scioto Nos. 15CA3724 and
    15CA3725, 
    2016-Ohio-8584
    , at ¶ 13, citing Morris at ¶ 16, quoting
    Castlebrook, Ltd. v. Dayton Properties Ltd. Partnership, 
    78 Ohio App.3d 340
    , 346, 
    604 N.E.2d 808
     (2nd Dist.1992); accord Estate of Johnson at ¶ 22
    (reviewing admissibility of evidence by first examining whether, as a matter
    of law, statute applied, and then once threshold question concerning
    applicability of statute resolved, reviewing whether trial court abused its
    discretion); Med. Mut. of Ohio v. Schlotterer, 
    122 Ohio St.3d 181
    , 2009-
    Pike App. No. 17CA883                                                          7
    Ohio-2496, 
    909 N.E.2d 1237
    , ¶ 13 (stating that “[w]hen a court's judgment
    is based on an erroneous interpretation of the law, an abuse-of-discretion
    standard is not appropriate”); Painter and Pollis, Ohio Appellate Practice,
    Appendix G (2015) (stating that although trial court decisions involving the
    admission of evidence are generally reviewed as a discretionary matter, but
    they are subject to de novo review if a clear legal rule applies. “For
    example, a trial court does not have discretion to admit hearsay into
    evidence”).
    LEGAL ANALYSIS
    {¶12} In Appellant’s sole assignment of error, he essentially asserts
    that the trial court abused its discretion by admitting inadmissible hearsay
    evidence into the record. The hearsay statements at issue were allegedly
    made by L.R. to her counselor, Brittany Bakenhaster, during group therapy.
    At trial and relevant to this appeal, Appellant objected specifically to Ms.
    Bakenhaster’s testimony that L.R. made the following statements to her:
    “I used to live in Waverly, with my mom and dad. My dad
    touched me one time, and I got taken away. He knew he would
    get in trouble after he touched me. He never touched me
    again.”
    ***
    “My dad shouldn’t have done that to me. I was told by people
    that my dad had sex with me because he made me
    bleed.”(Emphasis added.)
    Pike App. No. 17CA883                                                          8
    ***
    “[S]ex is for big people, it’s not for little kids. That’s
    something that big people do. I don’t understand why my dad
    would do something like that to me. I don’t see my dad
    anymore. The services people took me from my mom and dad
    and now I live with my foster parents. Emma is my foster
    mom. I glad (sic) that I am not touched like that anymore. If
    anybody ever tried to hurt me like that again, I would kick them
    in the nuts, if they are a boy.”
    ***
    “I would hurt the woman differently if the woman ever tried to
    touch me. Nobody’s ever going to hurt me like that again.”
    {¶13} Appellant sets forth the issue for review as to whether
    psychological counseling is legitimately considered to be medical treatment.
    However, he further criticizes the hearsay statements as being made by an
    “unlicensed” psychological counselor. Based upon our review of Ohio law
    in this area, we find that the hearsay statements admitted into evidence at
    Appellant’s trial were permissible in that the questionable statements were
    made to a case manager assisting a psychological counseling team and were
    made for the purposes of diagnosis and treatment of mental issues.
    {¶14} Statements made outside of the courtroom, offered at trial to
    prove the truth of what they assert, are generally inadmissible as “hearsay”
    unless an exception applies. State v. Knauff, 4th Dist. Adams No. 10CA900,
    
    2011-Ohio-2725
    , at ¶ 27; Evid.R. 801(C); Evid.R. 802; State v. DeMarco,
    Pike App. No. 17CA883                                                         9
    
    31 Ohio St.3d 191
    , 195, 
    509 N.E.2d 1256
     (1987). Out-of-court statements
    made for purposes of medical diagnosis or treatment are hearsay, but are
    admissible in court under the hearsay exception provided in Evid.R. 803(4).
    
    Id.
     Such statements are only admissible “insofar as reasonably pertinent to
    diagnosis or treatment.” Evid.R. 803(4). 
    Id.
    {¶15} At Appellant’s trial, Ms. Bakenhaster began by testifying that
    she has a bachelor’s degree in psychology, a master’s degree in school
    counseling, and a master’s degree in professional counseling with pending
    licensure. Ms. Bakenhaster is employed as a case manager at Woodland
    Center. Woodland Center is an agency for treatment of children with mental
    issues by staff psychologists and psychiatrists.
    {¶16} Ms. Bakenhaster further testified that Woodland provides
    individual and group counseling. She began working with L.R. in group
    counseling at L.R.’s school in January 2016. Children come into the group
    because of behavioral reasons or trauma-based issues. Ms. Bakenhaster
    testified when she receives information through counseling, she provides it
    to her superiors. Ms. Bakenhaster is supervised by staff psychologist Mary
    Brown.
    {¶17} Ms. Bakenhaster testified she had a treatment plan for L.R. and
    her group. The plan implemented creative measures for helping the children
    Pike App. No. 17CA883                                                                                  10
    express the emotional pain they experienced. Ms. Bakenhaster discussed the
    group treatment plan with Mary Brown. The ultimate purpose for Ms.
    Bakenhaster’s counseling with L.R. was to help her: (1) have better self-
    esteem; (2) understand that there are good people in the world; (3)
    understand that she can trust people; (4) learn to communicate positively
    with others; and, (5) understand that she can express her thoughts and
    concerns in a safe environment.
    {¶18} At trial, defense counsel objected to any questioning regarding
    discussions L.R. may have had with Ms. Bakenhaster about her father,
    Appellant. Defense counsel referred to Ms. Bakenhaster as an “unlicensed
    counselor.” However, the prosecutor argued that Ms. Bakenhaster’s
    statements were admissible pursuant to Evid.R. 803(4) because she acted as
    an assistant gathering information for the purpose of psychological
    treatment. On appeal, Appellant emphasizes that the hearsay statements
    were critical to the State’s case, given that the only medical testimony
    regarding L.R.’s injuries was not specific so as to identify a source of injury,
    and also given that Appellant’s interrogation by Major Evans was coercive.5
    5
    The State’s brief in response provides an in-depth discussion regarding the legitimacy of Major Evans’
    interview with Appellant. We first note that parties must comply with the Ohio Rules of Appellate
    Procedure. If not, App.R. 12(A)(2) permits us to disregard those assignments of error that are not
    separately argued. Prokos v. Hines, 4th Dist. Athens Nos. 10CA51, 10CA57, 
    2014-Ohio-1415
    , at ¶ 63.
    Here, Appellant did not raise any issue with regard to Major Evans’ interview under a separate assignment
    of error. “While appellate courts have the option to address two or more assignments of error at once, the
    parties do not.” In the Matter of B.M., 4th Dist. Hocking No. 16CA12, 
    2017-Ohio-7878
    , at ¶ 22; Powell v.
    Pike App. No. 17CA883                                                                                  11
    {¶19} For the reasons which follow, we find the trial court did not
    abuse its discretion when admitting L.R.’s out-of-court statements to Ms.
    Bakenhaster, a case manager who provided group counseling for mental
    health issues to L.R. at her school. We begin by setting forth the parameters
    for admission of hearsay statements under Evid.R. 803 (4). In this court’s
    decision in State v. Knauff, 
    supra,
     we observed that when deciding whether
    hearsay is reliable enough for admission under Evid.R. 803(4), courts look at
    several factors. Id. at ¶ 28. We observed:
    “The first ‘factor’ is the “selfish-motive” doctrine, i.e., “the
    belief that the declarant is motivated to speak truthfully to a
    physician because of the patient's self-interest in obtaining an
    accurate diagnosis and effective treatment.” Id. quoting State v.
    Muttart, 
    116 Ohio St.3d 5
    , 2007–Ohio–5267, 
    875 N.E.2d 944
    ,
    at ¶ 34, citing State v. Eastham, 
    39 Ohio St.3d 307
    , 312, 
    530 N.E.2d 409
     (1988) (Brown, J., concurring). Another factor
    courts consider is the medical professional's subjective reliance
    on the statement, because “physicians, by virtue of their
    training and experience, are quite competent to determine
    whether particular information given to them in the course of a
    professional evaluation is ‘reasonably pertinent to diagnosis or
    treatment [,]’ and are not prone to rely upon inaccurate or false
    data in making a diagnosis or in prescribing a course of
    treatment.” Id. at ¶ 41, 
    530 N.E.2d 409
    , quoting King v. People
    (Colo.1990), 
    785 P.2d 596
    , 602. In Muttart, the Supreme Court
    of Ohio observed that the professional reliance factor is of
    “great import” in cases of child abuse. Id.”
    Vanlandingham, 4th Dist. Washington No. 10CA24, 
    2011-Ohio-3208
    , at ¶ 24; Keffer v. Cent. Mut. Ins.
    Co., 4th Dist. Vinton No. 06CA652, 
    2007-Ohio-3984
    , at ¶ 8, fn.2. Since Appellant did not set forth a
    separate assignment of error and separate arguments regarding the interview, we are permitted to disregard
    the issue and we hereby choose to do so.
    Pike App. No. 17CA883                                                         12
    {¶20} In Knauff at ¶ 29, we also cited Muttart’s “non-exhaustive list
    of additional factors that a court should weigh when considering whether
    out-of-court statements obtained from a young child are admissible under
    this exception”:
    “(1) Whether medical professionals questioned the child in a
    leading or suggestive manner and whether the medical
    professional followed proper protocol in eliciting a disclosure
    of abuse;
    (2) Whether the child had a reason to fabricate, e.g., a pending
    legal proceeding or bitter custody battle;
    (3) Whether the child understood the need to tell the medical
    professional the truth; and
    (4) Whether the age of the child could indicate the presence or
    absence of an ability to fabricate a story. Id. at ¶ 49, 
    875 N.E.2d 944
    .”
    {¶21} In the case presently before us, the trial court initially sustained
    counsel’s objections and required additional foundational testimony. Ms.
    Bakenhaster continued, testifying that children are allowed to talk about
    alleged abuse as part of a treatment plan in order to address their pain.
    Through “draw therapy,” where children are encouraged to draw their
    parents, the counselors can learn “family dynamics.” Using this
    information, the treatment plan can address problem behaviors.
    Psychologists make suggestions based upon what is learned from the “draw”
    or “play therapy.” Psychologists may question the child’s medications, how
    Pike App. No. 17CA883                                                         13
    the child is progressing, how treatment is affecting the child, and suggest
    additional resources. The psychologists enter the data she gives them into
    the database.
    {¶22} Ms. Bakenhaster encouraged L.R. to express her feelings
    through draw and play therapy. Ms. Bakenhaster also testified if L.R. or
    other children made statements during group therapy sessions, she would
    begin to look for marks or evidence on the body in order to make a further
    report. If additional evidence supported a disclosure, she would report to
    Children’s Services and discuss with Mary Brown.
    {¶23} Ms. Bakenhaster testified L.R. disclosed quite a bit of
    information in March 2016 while Ms. Bakenhaster was conducting a group
    therapy session at the school and while she was encouraging the children to
    draw and express what was going on in their lives. She testified that the
    disclosures L.R. made to her were entered in the database, stored, and
    reviewed with the staff psychologist as part of her treatment. Ms.
    Bakenhaster opined that the disclosure showed L.R. was progressing in her
    treatment and more able to trust her. Ms. Bakenhaster concluded her direct
    testimony stating she discussed the disclosed information with her
    supervisor and incorporated the information into L.R.’s treatment plan. Part
    Pike App. No. 17CA883                                                          14
    of the treatment plan was simply continuing to talk with L.R. about what had
    happened to her.
    {¶24} Appellant argues that L.R.’s statements were used for purposes
    of psychotherapy but not for medical treatment. Appellant emphasizes that
    psychotherapy is not medical treatment under Evid.R. 803(4) because
    psychotherapists cannot practice medicine. However, as we observed in our
    decision in State v. Wilson, 4th Dist. Adams No. 99CA672, 
    2000 WL 228242
     (Feb. 18, 2001), at *7, Evid.R. 803(4) is not limited to statements
    relating to physical condition. Statements made during the course of a
    psychological examination may also be admissible provided that the purpose
    of the examination is to diagnose or treat the victim's psychological
    condition. Id. at *7. See State v. Vaughn (1995), 
    106 Ohio App.3d 775
    , 780;
    State v. McWhite, 73 Ohio App.3d (6th Dist.1991), 323, 329-330. And,
    Evid.R. 803(4) does not require that the statements be made to a specific
    type of health care provider as long as made for purposes of diagnosis or
    treatment. Id. at *7. Thus, a statement may still be within the scope of the
    exception if it is directed to other physical and mental health professionals,
    including nurses, psychiatrists, psychologists, and therapists. Id., citing State
    v. Chappell (1994), 
    97 Ohio App.3d 515
    , 530, 
    646 N.E. 2d 9441
     (8th
    Dist.1994).
    Pike App. No. 17CA883                                                       15
    {¶25} We considered the requirements of Evid.R. 803(4) in an older
    case in this district, State v. Robison, 4th Dist. Pickaway No. 85-CA-12,
    
    1986 WL 11935
     (Oct. 22, 1986). Robison was found guilty of felonious
    sexual penetration and felonious assault after his natural daughter, aged
    seven, was rushed to the hospital bleeding profusely from the vagina, and
    with multiple bruising on her body and extremities. On appeal, Robison
    contended that Evid.R. 803(4) did not include statements made to a
    psychologist. We disagreed.
    {¶26} We pointed out the record revealed that the child was referred
    to the county mental health facility by her guardian ad litem and by the
    county children's services for psychological evaluation and therapy. She has
    been diagnosed as having an over anxious disorder, and as needing
    psychological treatment. The child's eventual statement came as a natural
    result of therapy.
    {¶27} We disagreed with Robison’s contention that Evid.R. 803(4)
    does not include statements made to a psychologist. We observed that
    Evid.R. 803(4) does not specify to whom the statement must be made.
    Further, the statements were made as part of the emotional healing process,
    and as such, were made for the purposes of medical treatment.
    Pike App. No. 17CA883                                                          16
    {¶28} Robison also contended his identity as the perpetrator of the
    girl's injuries was not a statement that is pertinent to diagnosis or treatment.
    We again disagreed, observing at *5:
    “Careful consideration of the purpose and scope of the child's
    therapy leads us to believe that in this instance, the identity of
    the perpetrator is pertinent to medical diagnosis. * * * An
    important part of diagnosis and treatment is to discern the
    source of injury and trauma to a child, and to isolate the child
    from that influence. 4 Weinstein, Evidence (1981) 803(4)(01) p.
    803-129 states:
    ‘* * * in the case of a statement made for treatment the test is
    not only whether the declarant thought it relevant (thereby
    establishing reliability), but also whether a doctor would have
    reasonably relied upon such statement in deciding upon a
    course of treatment.’ We believe Dr. Jones would have a
    responsibility to rely upon the child's statement in shaping the
    course of therapy for her, and in making any recommendations
    as to her placement in a foster home or a return to her family. In
    a child abuse case like the one at bar, the identity of the
    perpetrator makes a marked difference in the doctor's ability to
    help the child, and is integral to medical diagnosis and
    treatment.”
    {¶29} Our later decision in Knauff, supra, provided similar general
    guidance. Knauff was convicted by a jury of rape of his five-year-old
    daughter. On appeal, he argued a videotape interview of his daughter by a
    social worker was not admissible as it constituted hearsay. After receiving a
    report from the Adams County Sheriff’s office, a social worker, Cecelia
    Friehofer at the Mayerson Clinic at Cincinnati Children's Hospital, evaluated
    the child and recorded a one-hour interview. Knauff argued his daughter
    Pike App. No. 17CA883                                                        17
    could not have known her statements on the videotape were made for the
    purposes of medical treatment.
    {¶30} At trial Friehofer discussed the general methodology behind a
    “forensic interview. She explained that one purpose of the lengthy interview
    was to gain as much information as possible so that the child would not have
    to discuss the abuse with others. Another purpose of the interview was to
    gain information so that medical staff could make appropriate decisions
    concerning necessary physical or mental health treatment. Because Knauff’s
    daughter advised Friehofer: “[T]hat's why I'm here – to see a doctor,” we
    found her statement satisfied the foundational requirement.
    {¶31} Knauff also contended that many other questions and answers
    in the interview went beyond what was necessary to provide the child’s
    medical provider information about physical symptoms. Knauff in essence
    disputed whether the professional reliance component of reliability was
    present because the Friehofer and the child discussed other topics such as
    weather, school, and locations where there abuse occurred. We observed,
    however, that Friehofer testified about additional purposes of the interview
    such as to provide recommendations not only for a course of physical
    treatment but also for recommendations on “therapy” and “psychological
    assistance.” We observed:
    Pike App. No. 17CA883                                                         18
    “Friehofer used the hour-long interview with the then five-year-
    old victim to gain an understanding of the type and extent of
    abuse D.K. experienced. True, many of her answers went
    beyond what was necessary to conduct a basic physical
    examination. But all of D.K.'s statements, even those tangential
    or unrelated to the physical effects of the abuse, reasonably
    assisted Friehofer and subsequent medical professionals with
    the information necessary to prescribe a proper course of
    physical and mental treatment for the child. In fact, the record
    reflects that D.K. underwent at least two months of counseling
    sessions prior to the trial.”
    {¶32} At trial, the State directed the trial court to State v. Fread, 12th
    Dist. Butler No. CA2013-03-045, 
    2013-Ohio-5206
    . Fread appealed his
    conviction for domestic violence perpetuated against his 13-year-old step-
    son, C.R. After speaking with police, C.R. had given a statement to a
    psychologist, Dr. Knight. One of his arguments on appeal was that Dr.
    Knight’s testimony regarding C.R.’s statements to him was inadmissible
    hearsay not subject to the 803(4) exception on the basis of medical diagnosis
    or treatment. The Fread court observed at ¶ 18:
    “This court has previously held that statements made during the
    course of a psychological examination are admissible to the
    same extent as statements made to a treating physician,
    provided that the purpose of the psychological examination is
    the diagnosis and treatment of the victim's psychological
    condition, rather than gathering evidence against the accused.
    State v. Vaughn, 
    106 Ohio App.3d 775
    , 780 (12th Dist.1995).
    In addition, the determination of whether Evid.R. 803(4)
    applies is based upon the purpose for which the statement was
    made rather than whether the person to whom the statement was
    made subsequently testifies as a lay witness or an expert.
    Finally, it is irrelevant whether diagnosis or treatment actually
    Pike App. No. 17CA883                                                         19
    occurs for Evid.R. 803(4) to apply. All that is required is that
    the statements were made for the purpose of diagnosis or
    treatment.”
    {¶33} Appellant has directed us to the Sixth District’s decision in
    State v. McWhite. 
    73 Ohio App.3d 323
    , 329, 
    597 N.E.2d 168
     (6th
    Dist.1991), arguing that McWhite cautioned against a “literal reading of
    Evid.R. 803(4) and, therefore, Evid. R. 803(4) should be limited to
    statements made to medical personnel. Upon review of McWhite, we fail to
    see how this case supports Appellant’s argument. In 1988, McWhite was
    indicted on two counts of aggravated murder of his girlfriend and her minor
    daughter. McWhite’s 3-year-old son Jake was found at the murder scene
    with marks on his neck suggesting attempted strangulation. McWhite was
    eventually tried and convicted by a jury.
    {¶34} Dr. Scully, a clinical psychologist, testified at trial that he had
    treated Jake for emotional and behavioral problems and that during
    treatment sessions Jake mentioned the events leading up to the murders of
    his mother and sister. Jake’s recollections were crucial in that he was the
    only witness present other than the defendant and a co-defendant when
    Jake’s mother and sister were killed. However, Jake could not testify as a
    witness since he was found incompetent. Before Dr. Scully took the stand,
    defense counsel made a continuing objection on the record to anything Dr.
    Pike App. No. 17CA883                                                        20
    Scully would testify to regarding statements made to him by Jake. The trial
    judge noted on the record that the objection was to apply to all testimony of
    Dr. Scully. Dr. Scully testified to various incriminating statements Jake told
    him during counseling.
    {¶35} On appeal, McWhite challenged Dr. Scully’s testimony on two
    grounds, one being that the trial court allowed Dr. Scully to opine as to
    Jake’s veracity. The trial court found merit to this argument. Relevant
    however to this appeal, McWhite also argued that the trial court erred in
    admitting Dr. Scully's testimony under Evid.R. 803(4) since Dr. Scully was
    a clinical psychologist and not a medical doctor. The McWhite court
    commented that Evid.R. 803(4) does not explicitly limit its scope to
    statements regarding the declarant's bodily condition. Weissenberger's Ohio
    Evidence (1991) 55, Section 803.48. McWhite at 
    73 Ohio App.3d 329
    .
    McWhite further noted that the Staff Note to Evid.R. 803(4) is silent on the
    issue of whether or not a clinical psychologist's testimony is admissible. 
    Id.
    {¶36} In its opinion, the McWhite court discussed at length the
    compelling interest safeguarding the physical and psychological well-being
    of minor victims. Citing State v. Boston, 
    46 Ohio St.3d 108
    , 
    545 N.E.2d 1220
     (1989), the McWhite court noted at 329:
    “As child abuse cases increase throughout the country at an
    alarming rate it has become apparent that psychological
    Pike App. No. 17CA883                                                          21
    counseling is just as important in treating child victims of crime
    as is medical treatment for the child's physical injuries. To
    unequivocally exclude clinical psychologists and other
    professionals from the scope of Evid.R. 803(4) is to ignore the
    reality that these people are trained professionals qualified to
    render objective opinions on the probability that a child has
    been subjected to abuse. These professionals play an invaluable
    role in cases involving very young children like Jake McWhite.
    Moreover, the language of Evid.R. 803(4) focuses on the
    declarant's motivation in making the statement, rather than to
    whom it was made. We believe that the syllabus of Boston does
    not preclude the testimony of clinical psychologists and other
    professionals in cases involving child victims of crime. Rather,
    it is in keeping within the spirit and purpose of Evid.R. 803(4).”
    {¶37} McWhite further contended that at the time of his treatment,
    Jake was too young to understand the necessity of being truthful with Dr.
    Scully. Citing our decision in Robison, the appellate court pointed out that
    Jake met with Dr. Scully approximately one hundred times over a one-year
    period. As he progressed in his treatment, young Jake began to refer to Dr.
    Scully as “Dr. Terry,” clearly recognizing the doctor as an authority figure.
    We believe as in Robison, supra, that at some level young Jake understood
    that he was receiving help from Dr. Scully and he was therefore motivated to
    tell the truth. The McWhite court found no merit to the appellant’s argument
    that the hearsay statements of Jake were improperly admitted because Dr.
    Scully was not a medical doctor.
    {¶38} In State v. Jett, 11th Dist. Portage No. 97-P-0023, 
    1998 WL 258166
    , the appellate court also cited the principles set forth in Chappell,
    Pike App. No. 17CA883                                                        22
    Vaughn, and McWhite. Jett was convicted by a jury of the sexual
    penetration of a four-year-old girl. The Jett court noted that although most
    hearsay declarations offered into admission under Evid.R. 803(4) will have
    been made to a physician by a patient seeking medical diagnosis or
    treatment, the rule does not require that such a declaration be made to a
    physician or be about bodily condition. See Weissenberger, Ohio Evidence
    (1997) 403-404, Sections 803.47 and 803.48. There the victim’s mother
    contacted a psychologist regarding defiant behavior of the victim and her
    young brother. Eventually, the victim told the psychologist that the mother’s
    live-in boyfriend had touched her private parts.
    {¶39} The Jett court observed that a trial court must consider the
    circumstances surrounding the making of the hearsay statement. However,
    Jett ultimately concluded that since there was insufficient evidence
    indicating that the victim was aware that her statements were made for the
    purpose of psychological diagnosis or treatment, the statements should have
    been excluded on the basis that they fell outside the scope of Evid.R. 803(4).
    In Jett, the trial court’s judgment was reversed and Jett’s case remanded.
    {¶40} In State v. Tillman, 12th Dist. Butler No. CA2003-XX-XXXXXXX-
    Ohio- 6240, Tillman was indicted for rape of a child under ten and gross
    sexual imposition after M.C., a friend’s child, told a social worker that
    Pike App. No. 17CA883                                                           23
    someone had “put a finger in her.” He was convicted by a jury. On appeal,
    Tillman argued the trial court erred in permitting the state’s psychological
    assistant to testify regarding his evaluation, diagnosis, and various hearsay
    statements made by M.C.
    {¶41} While this case differs in that the witness was qualified as an
    expert, the appellate court referenced the same principles as previously cited
    in Vaughn. See also State v. Goins, 12th Dist. Butler No. CA2000–09–190,
    2001–Ohio–8647. The appellate court thus found that based upon the
    circumstances surrounding the social worker’s interview with M.C., the
    interview with the victim was conducted so as to recommend treatment for
    the victim, even though he may not have made the ultimate diagnosis. Id. at
    24.
    {¶42} Applying the Muttart factors in this case, we find L.R.’s
    statements were made in the context of group therapy and for the purpose of
    diagnosis and treatment of the mental issues she had been having. Our
    review of the record demonstrates an absence of evidence to suggest Ms.
    Bakenhaster questioned L.R. in a leading or suggestive manner. L.R. made
    the statements to Ms. Bakenhaster in group counseling. Ms. Bakenhaster
    had facilitated discussion about family dynamics through draw and play
    therapy.
    Pike App. No. 17CA883                                                          24
    {¶43} Furthermore, Ms. Bakenhaster’s testimony revealed the
    statements were made after approximately 2 months in therapy. Ms.
    Bakenhaster opined that she had established a level of trust at the time L.R.
    made her statements, which had not been previously established. Similar to
    the analysis set forth in McWhite, supra, we perceive this fact as suggesting
    that L.R. understood the need to tell the truth and that she was telling the
    truth for the purpose of receiving some sort of help.
    {¶44} However, Appellant has also pointed out that Ms. Bakenhaster
    is not a licensed psychologist or psychotherapist. A similar issue was raised
    in our own decision in State v. Wilson, supra. Wilson was charged with one
    count of penetration and one count of rape based on allegations from his
    five-year-old former stepdaughter Alexandria. Alexandria and her mother
    testified at trial. Her mother testified she first took the child to a
    psychotherapist, Mrs. Harffman, when her behavior changed. Ms. Harffman
    testified that Alexandria revealed during a counseling session that she had
    been sexually abused. Defense witnesses however testified to instances of
    sexual activity they had observed. Wilson testified and denied sexually
    abusing Alexandra. He was convicted by a jury of both charges.
    {¶45} On appeal, Wilson challenged Alexandria’s competency to
    testify, the admissibility of certain exhibits, the sufficiency of the evidence,
    Pike App. No. 17CA883                                                         25
    and his consecutive sentence. Relevant to this appeal, Wilson argued that
    the trial court erred in admitting State's Exhibit 3, an examination report
    from the SAM Clinic prepared by Amy Herbert. The trial court found the
    exhibit admissible under Evid.R. 803(4), essentially summarizing that the
    court may admit a child's statements if they are made for purposes of
    medical diagnosis or treatment and there is no evidence to cast doubt upon
    the child's motivation for making the statements.
    {¶46} Wilson specifically argued that the exhibit should not have been
    admitted because there was no testimony regarding the qualifications of
    Amy Herbert. We reiterated the principles of Chappell, Vaughn, and
    McWhite. We concluded, however that:
    “As to State's Exhibit 3, there was testimony from Ms. Herbert
    that she was employed as a graduate intern at the SAM Clinic
    and that her duties were to interview Alexandria and then
    discuss Alexandria's statements with the doctor for purposes of
    her examination. Furthermore, State's Exhibit 3 includes Ms.
    Herbert's signature followed by the letters LSW, which
    indicates that Ms. Herbert is a licensed social worker. See State
    v. Dumas (Feb. 19, 1999), Franklin App. No. 98AP-581,
    unreported (holding that statements made to a social worker
    whose duty was to interview children and provide the
    information to the medical staff were admissible pursuant to
    Evid.R. 803(4)). Ms. Herbert was acting as part of the medical
    team for purposes of treating Alexandria. Both Ms. Harffman
    and Ms. Herbert are licensed social workers who were
    diagnosing and treating Alexandria. The fact that they are not
    medical doctors does not per se require exclusion of the
    reports.” Wilson, supra, at *7.
    Pike App. No. 17CA883                                                          26
    {¶47} In the present case, although Ms. Bakenhaster was not a
    licensed psychologist or psychotherapist, she was acting as part of a medical
    team for purposes of treating L.R. Ms. Bakenhaster testified as part of her
    employment, she conducted group counseling and any information she
    received regarding L.R. or any other child in the group, was entered into a
    database. Ms. Bakenhaster and her supervisor, the staff psychologist,
    professionally relied on the statements in reviewing L.R.’s treatment plan.
    Under these circumstances, we do not find the hearsay statements were
    improperly admitted.
    {¶48} For the foregoing reasons, we find no error or abuse of
    discretion by the trial court’s admission of L.R.’s out of court statements.
    As such, we overrule the sole assignment of error and affirm the judgment of
    the trial court.
    JUDGMENT AFFIRMED.
    Pike App. No. 17CA883                                                        27
    JUDGMENT ENTRY
    It is ordered that the JUDGMENT BE AFFIRMED and that costs be
    assessed to Appellant.
    The Court finds there were reasonable grounds for this appeal.
    It is ordered that a special mandate issue out of this Court directing
    the Pike County Common Pleas Court to carry this judgment into execution.
    IF A STAY OF EXECUTION OF SENTENCE AND RELEASE
    UPON BAIL HAS BEEN PREVIOUSLY GRANTED BY THE TRIAL
    COURT OR THIS COURT, it is temporarily continued for a period not to
    exceed sixty days upon the bail previously posted. The purpose of a
    continued stay is to allow Appellant to file with the Supreme Court of Ohio
    an application for a stay during the pendency of proceedings in that court. If
    a stay is continued by this entry, it will terminate at the earlier of the
    expiration of the sixty day period, or the failure of the Appellant to file a
    notice of appeal with the Supreme Court of Ohio in the forty-five day appeal
    period pursuant to Rule II, Sec. 2 of the Rules of Practice of the Supreme
    Court of Ohio. Additionally, if the Supreme Court of Ohio dismisses the
    appeal prior to expiration of sixty days, the stay will terminate as of the date
    of such dismissal.
    A certified copy of this entry shall constitute the mandate pursuant to
    Rule 27 of the Rules of Appellate Procedure.
    Hoover, P.J. & Harsha, J.: Concur in Judgment and Opinion.
    For the Court,
    BY: _____________________________
    Matthew W. McFarland, Judge
    NOTICE TO COUNSEL
    Pursuant to Local Rule No. 14, this document constitutes a final
    judgment entry and the time period for further appeal commences from
    the date of filing with the clerk.