(a) Comprehensive assessments shall provide recommendations
regarding the intensity of intervention, specific treatment protocol
needed, amenability to treatment, and the identified community risk.
(b) A comprehensive assessment as cited in subsections
(a) and (b) of this section shall be completed within 60 days of a
client's being accepted into treatment program. The assessment of
adult sex offenders shall include:
(1) mental status examination;
(2) clinical interview and social/developmental history;
(3) personality assessment;
(4) risk for re-offense assessment;
(5) sexual offense behaviors; and
(6) recommendations for case management, treatment
planning, and further assessments.
(c) Treatment Standards for Adult Sex Offenders. Licensees
shall adhere to the following standards when providing treatment to
an adult sex offender:
(1) cognitive-behavioral or other empirically supported
approaches shall be utilized in sex offender treatment groups;
(2) treatment groups shall not be less than 60 minutes
in length with no more than 12 clients per group;
(3) individual therapy, self-help groups, drug intervention,
or other therapies to address and treat individual risk factors and
problems specific to the individual shall be used as adjuncts to sexual
offense specific group treatment;
(4) a written individualized treatment plan shall identify
the issues, intervention strategies, and goals of treatment and shall
be prepared for each client;
(5) progress, or lack of progress needs to be based
on clearly specified objective criteria, refusal or failure to attend
or participate in treatment, failing to abide by the client's treatment
plans and/or contracts, or any disclosures regarding violations of
supervision, shall be clearly documented in treatment records. Licensees
shall provide and communicate this information to the appropriate
supervising officer in the justice system according to the referring
agency policy or pursuant to the court order;
(6) progress in treatment shall be based on specific,
measurable objectives, observable changes, and the demonstrated ability
to apply changes in relevant situations and comply with supervision
requirements. These changes shall be demonstrated by an increased
understanding by the client of his/her own deviant behavior, understanding
of current and sexual offense sequence, increase in pro-social behaviors,
compliance with supervision, increase in support systems, and victim
empathy;
(7) treatment progress reports shall be distributed
to the supervision officer, referring agency, and/or court on a regular
basis or as needed by the referring agency. Discharge reports shall
be issued according to the referring agency policy or pursuant to
the court order;
(8) when a client has attained the goals outlined in
the individualized treatment plan, there should be a gradual and commensurate
adjustment of interventions;
(9) a licensee may refuse to treat a client because
essential ancillary resources do not exist to provide the necessary
levels of intervention or safeguards;
(10) the licensee shall modify a client's treatment
plan or refer the client to a more comprehensive treatment program
when the licensee determines that a client is not making the necessary
progress in treatment in order to reduce the client's risk to the
community. The licensee shall notify the referring agency and/or the
court if the client's lack of progress places the community at risk;
(11) a licensee may decide to decline further involvement
with a client who refuses to address any critical aspect of treatment;
(12) a licensee may terminate services and facilitate
a transfer of a client from treatment based on a complaint or lawsuit
having been filed against the licensee by the client and/or the client's
representative(s);
(13) a licensee shall immediately notify the appropriate
authority when a client refuses or fails to comply with court-ordered
treatment or Texas Board of Pardons and Paroles ordered treatment;
(14) some degree of denial shall not preclude a client
from entering treatment, although the degree of denial shall be a
factor in identifying the most appropriate form and location of treatment;
(15) modifications in treatment and in expectations
for treatment outcomes may be required in instances of persistent
denial or failure to progress in treatment;
(16) a licensee shall not rely exclusively on self
report by the client to assess progress or compliance with treatment
requirements and/or conditions of probation or parole. Licensees shall
rely on multiple sources of information, which should include information
from collateral contacts, physiological methods, and other research-based
sexual interest assessments;
(17) physiological methods or measures of sexual interest
assessment shall not replace other forms of monitoring but may improve
accuracy when combined with active surveillance, collateral verifications,
and self-report. Penile plethysmograph (PPG) assessments in Texas
shall be conducted under the direction of a licensed practitioner
defined in Health and Safety Code, Chapter 1, §1.005. Licensees
should refer the client for a polygraph exam as soon as possible if
the client is suspected of engaging in suppression behaviors on the
PPG;
(18) polygraph examinations shall be used as a part
of a comprehensive treatment program and shall only be administered
by licensed polygraph examiners that meet and adhere to the "Recommended
Guidelines for the Clinical Polygraph Examinations of Sex Offenders"
as developed by the Joint Polygraph Committee on Offender Testing
(JPCOT) and/or the American Polygraph Association (APA) regarding
Post-Conviction Sex Offender Testing (PCSOT) Standards. It is primarily
the licensed sex offender treatment provider's responsibility for
preparing the client for any polygraph. Sexual history polygraphs
shall include all aspects of a client's sexual behaviors and a victim's
list that occurred prior to the offense of conviction. Licensed sex
offender treatment providers shall obtain the official offense report
(Occupations Code, Chapter 109, §109.054) and shall ensure the
polygraph examiner has the official offense report in order to administer
the instant offense polygraph examination. The sex offender treatment
provider shall recognize that the polygraph examiner is the authority
in determining if a polygraph is appropriate;
(19) informed consent shall be obtained prior to engaging
clients in aversive conditioning;
(20) licensees shall communicate and exchange information
with the Department of Family Protective Services-Child Protective
Services, Child Care Licensing, and with appropriate agencies regarding
the safety of a child or children in the primary residence in which
a sex offender resides;
(21) the safety of the children takes precedence and
the highest priority shall be given to the rights, well-being, and
safety of children when making decisions about contact between the
client and children. If the client has a history of deviant sexual
arousal and/or deviant sexual interest to or reported fantasies of
sexual contact with children, even if the client has not been convicted
of a sexual offense, the client should be restricted from having access
to children. Supervised visits may be considered if:
(A) it is determined that sufficient safeguards exist
to protect the child(ren);
(B) the sex offender has demonstrated control over
deviant arousal;
(C) it does not impede the sex offender's progress
in treatment; and
(D) if it is compliant with the court mandated or Texas
Board of Pardons and Paroles ordered conditions.
(22) treatment referrals should be offered to the non-offending
partners and children in cases where a parent or legal guardian has
been removed;
(23) family support and participation in the treatment
of the adult sex offender should be included when applicable and appropriate.
Sexual assault victims or vulnerable children shall be excluded until
such time as joint therapy is determined to be appropriate;
(24) the licensee shall make every effort to collaborate
with the victim's therapist in making decisions regarding communication,
visits and reunification. Contact shall be arranged in a manner that
places child/victim safety first. The licensee shall ensure that custodial
parents or legal guardians of the children have been consulted prior
to authorizing contact and that the contact is in accordance with
Court or Texas Board of Pardons and Paroles directives; and
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