In Simmers v. State, 943 P.2d 1189 (Wyo. 1997), the defendant was convicted in Wyoming of twelve counts of second-degree sexual assault involving three child victims. Prior to trial, the district court determined that one victim, S.S., was not competent to testify. The State then offered the testimony of the social worker who counseled all three victims regarding statements made to her by S.S. The court admitted the testimony under the medical diagnosis or treatment exception. The defendant appealed, arguing, inter alia, that the social worker was improperly permitted to offer hearsay evidence in her testimony. On appeal, the Supreme Court of Wyoming determined the trial court did not err because the statements were made to a medical professional or professional counselor and the expert's testimony provided the proper foundation. That is, the statements were consistent with the purposes for which the witness became involved with the victim and the witness relied on the statements for diagnosis and treatment. The Court delineated several factors the trial court might consider in applying the totality of the circumstances, including whether any overt or implied threat or promise was directed to the defendant. In Simmers, the defendant argued his impaired mental ability when combined with the detective's non-adversarial, friendly interrogation style and promise of possible probation made the interview coercive. The Court upheld the denial of his suppression motion, finding no evidence in the record tending to indicate that Simmers was unusually susceptible to coercion or easily influenced by the detective. The Court also addressed at length the issue of coercive activity by law enforcement. The Court applied the following standard: "Is the confession the product of an essentially free and unconstrained choice by its maker? If it is, if he has willed to confess, it may be used against him. If it is not, if his will has been overborne and his capacity for self-determination critically impaired, the use of his confession offends due process." The Court recognized that a finding of coercion or overreaching by law enforcement does not necessarily require evidence of violence, threats, overt intimidation or misconduct, and that the inquiry is a fact-sensitive one. Id. In Simmers, the Court identified the following circumstances for consideration in applying the totality of circumstances test: The atmosphere and events surrounding the elicitation of the statement, such as the use of violence, threats, promises, improper influence or official misconduct, the conduct of the defendant before and during the interrogation and the defendant's mental condition at the time the statement is made, whether the defendant was in custody or was free to leave and was aware of the situation; whether Miranda warnings were given prior to any interrogation and whether the defendant understood and waived Miranda rights; whether the defendant had the opportunity to confer with counsel or anyone else prior to the interrogation; whether the challenged statement was made during the course of an interrogation or instead was volunteered; whether any overt or implied threat or promise was directed to the defendant; the method and style employed by the interrogator in questioning the defendant and the length and place of the interrogation; and the defendant's mental and physical condition immediately prior to and during the interrogation, as well as educational background, employment status, and prior experience with law enforcement and the criminal justice system. (Simmers, 943 P.2d at 1195-96.)