| (a) These standards delineate research-based practices
for developmentally delayed clients. Licensees shall subscribe and
adhere to the following tenets for developmentally delayed clients:
(1) the assessment and treatment of developmentally
delayed clients shall be conducted in the context of the family and
support system;
(2) managing the risk, behavioral interventions, and
the imposition of appropriate external controls shall be a priority
for clients with disabilities;
(3) licensees should guard against justifying sexually
deviant behavior by indicating that the developmental disability for
any client has any relation to his or her victim typology; and
(4) developmentally delayed clients shall be given
the opportunity to exercise their right to make a voluntary and informed
decision to participate in treatment. While clients may refuse to
participate in or attend treatment, the client shall be informed of
the consequences of such a decision. A client shall be fully informed
of the nature of the treatment, the benefits, and the available options.
Written consent to proceed with treatment shall be obtained by an
interdisciplinary review and the parent or legal guardian.
(b) Assessment Standards for the Developmentally Delayed
Client.
(1) licensees shall adhere to the provisions of §810.63
of this title (relating to General Assessment Standards for Adult
Sex Offenders and Juveniles Who Commit Sexual Offenses);
(2) a comprehensive assessment as cited in this section
shall be completed within 60 days of a client's being accepted into
treatment program;
(3) the assessment shall be developmentally and age
appropriate;
(4) the assessment shall be sensitive to any cultural,
language, ethnic, developmental, sexual orientation, gender, medical,
and/or educational issues;
(5) The assessment shall determine the client's level
of functioning, appropriate treatment interventions, and facilitate
the development of an individualized treatment plan. Assessments shall
be individualized and efforts shall be made to acquire the following
information:
(A) current level of functioning:
(i) intellectual, neurological, cognitive, and behavior
functioning;
(ii) level of planning the crime of conviction;
(iii) expressive and receptive language;
(iv) social judgment, adaptive skills, and moral reasoning;
(v) sex education and sexual history;
(vi) adaptive behavior;
(vii) criminal history;
(viii) attention deficit;
(ix) ability to function in groups;
(x) support systems (Department of Aging and Disabilities
and/or Department of State Health Services-Behavioral and Community
Mental Health agency involvement, family involvement, social involvement);
(xi) environmental or contextual factors that contribute
to or maintain the behavior; and
(xii) history of physical, emotional and/or sexual
victimization.
(B) official documents concerning the instant sexual
offense report/offense description:
(i) age and relation to the victim(s);
(ii) details of the offense;
(iii) past criminal behavior and/or sexually inappropriate
behavior;
(iv) sexual history and deviant sexual interest; and
(v) the extent of denial and cognitive distortions.
(C) pertinent history:
(i) developmental history;
(ii) family, marital, relationship, and personal background;
(iii) past criminal behavior and/or sexually inappropriate
behavior;
(iv) sexual history and deviant sexual interest; and
(v) the extent of denial and cognitive distortions.
(D) medical, psychological and/or psychiatric/hospitalization
history;
(i) educational history;
(ii) occupational history;
(iii) substance use or abuse;
(iv) self-destructive behaviors, self-mutilation, and
suicide attempts; and
(v) history of truancy, fire-setting, abuse of animals,
and running away.
(6) If a plethysmograph is conducted with this population,
caution shall be used regarding interpretation and validity.
(7) If visual reaction time measures are utilized,
the measures shall only be used with clients who have an IQ score
sufficiently high to achieve valid and reliable test results.
(8) If polygraphs are utilized, prior to administering
polygraph examinations a licensed sex offender treatment provider
shall collaborate with the polygraph examiner and the supervision
officer to assess the client's ability to understand the concepts
of truthfulness, deception, or lying and the capacity to anticipate
negative consequences based on deceptive responses. Licensed sex offender
treatment providers shall:
(A) recognize that it is primarily the licensed sex
offender treatment provider's responsibility to prepare the client
for any polygraph;
(B) obtain the official offense report prior to administering
the instant offense polygraph (Occupations Code, Chapter 109, §109.054);
(C) include all aspects of a client's sexual behaviors
and a victim's list for sexual history polygraphs;
(D) ensure that the polygraph is administered on a
voluntary basis and with informed consent unless court ordered; and
(E) recognize that the polygraph examiner is the authority
in determining if a polygraph examination is appropriate.
(c) Treatment Standards for the Developmentally Delayed
Client.
(1) treatment shall be developmentally and age appropriate;
(2) treatment components for developmentally delayed
clients should be based on those used in treating non-developmentally
delayed clients but tailored to address the learning limitations and
special issues confronting these clients;
(3) treatment programs shall address the barriers encountered
by the client;
(4) cognitive behavioral therapeutic approaches shall
be paired with the cognitive strengths and weaknesses of the client;
(5) treatment should include concrete skill building
related to social interaction, social skills, sexual behavior, and
sex education;
(6) clients with disabilities shall be offered treatment
that is appropriate to their developmental capacity, their level of
comprehension, and the ability to integrate treatment components;
(7) progress in treatment and ability shall be determined
by the client integration of the components of treatment;
(8) group treatment shall be based on the client's
level of functioning in a group setting;
(9) licensees shall use more individually oriented
behavioral interventions coupled with empirically supported approaches
for clients whose level of functioning is determined to be inappropriate
for group treatment;
(10) licensees should be provided a reasonable alternative
toward identifying risk situations or behaviors and appropriate interventions
for clients unable to conceptualize the components of treatment;
(11) if treatment groups are utilized for developmentally
delayed clients, groups shall not be less than 60 minutes in length
with no more than 8 clients per group;
(12) treating developmentally delayed clients shall
be based on a multidisciplinary approach and empirically supported
approaches that includes, but is not limited to, the client, treatment
provider, supervision officer, and if applicable the following: the
family, guardian, custodian, school officials, law enforcement, child
protective services, and the victim's therapist;
(13) a written initial individualized treatment plan
shall identify the issues, intervention strategies, and goals of treatment
and shall be prepared for each client within 60 days of beginning
treatment. Treatment plans should be updated at least annually;
(14) 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. This
information shall be provided and communicated to the appropriate
supervising officer in the justice system according to the referring
agency policy or pursuant to the court order;
Cont'd... |
