(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
Cont'd...
(25) if reunification is deemed appropriate by the victim's therapist, the process shall be closely supervised. There shall be provisions for monitoring behavior and reporting rule violations. A victim's comfort and safety shall be assessed on a continuing basis.
(d) Adult Laws. Licensees shall be familiar with and adhere to the criminal justice system and confidentiality laws concerning adult sex offender and victims of sexual assault. The legal citations include but are not limited to:
  (1) Occupations Code, Chapter 110;
  (2) Health Insurance Portability and Accountability Act, Title 45, Code of Federal Regulations (CFR), Parts 160 and 164;
  (3) Code of Criminal Procedure, Chapter 62, Sex Offender Registration;
  (4) Code of Criminal Procedure, Article 42.12;
  (5) Occupations Code, Chapter 109 (Specifically §109.051 and §109.052);
  (6) Code of Criminal Procedure, Chapter 56; and
  (7) Federal Justice for All Act of 2004.

Source Note: The provisions of this §810.64 adopted to be effective October 22, 2006, 31 TexReg 8520; amended to be effective April 24, 2011, 36 TexReg 2396; amended to be effective October 1, 2015, 40 TexReg 6748