(a) Licensees shall subscribe and adhere to the following tenets regarding juveniles with sexual behavior problems:      
        (1) licensees shall recognize that some children before age 10 begin displaying sexually inappropriate behavior with others and children may duplicate sexual behavior they have witnessed on the part of other children, older siblings, and/or adults;       
        (2) licensees shall recognize that juveniles are distinct from their adult counterparts;       
        (3) licensees shall recognize that sexual arousal patterns of juveniles appear more fluid and less firmly established than those of adult sex offenders and relate less directly to their patterns of offending behavior;       
        (4) licensees shall recognize that juveniles who display sexually abusive behavior are heterogeneous; juveniles are children first with developmental needs, but also have special needs and present special risks related to their abusive behaviors; and       
        (5) licensees shall recognize a holistic approach when treating juveniles with sexual problems.       
      (b) Assessment Standards for Juveniles Who Commit Sexual Offenses.      
        (1) Licensees shall adhere to §810.63 of this title (relating to General Assessment Standards for Adult Sex Offenders and Juveniles Who Commit Sexual Offenses).       
        (2) Comprehensive assessments shall provide a comprehensive treatment plan and recommendations regarding the intensity of intervention, specific treatment protocol needed, amenability to treatment, and the identified community risk.       
        (3) A comprehensive assessment shall be completed within 60 days of a client's being accepted into a treatment program. The assessment shall include:                  (A) mental status examination;                   (B) clinical interview and social/developmental history;                   (C) personality assessment;                   (D) risk for re-offense assessment;                   (E) recommendations for case management, treatment planning, and further assessments.         
        (4) If phallometric assessment or aversive treatment techniques are utilized with persons 17 years of age or younger, informed consent for such assessment and treatment shall be obtained from the juvenile who commits sexual offenses and written consent for such assessment and treatment shall be obtained from the juvenile's parents or legal guardians. The procedures shall be reviewed and approved by multi-disciplinary professionals or institutional advisory group. Stimuli shall be specific for use with adolescents.       
        (5) A signed informed consent of disclosure of information shall be obtained from the parent(s) or legal guardian(s) in order to exchange information. Assent from the individual being evaluated shall be obtained whenever possible.       
      (c) Collateral Information. The treatment provider shall make a reasonable effort to obtain relevant collateral information.     
      (d) Polygraphs. The licensed sex offender treatment provider is primarily responsible for preparing the juvenile for any polygraph.     
      (e) Assessment Recommendations. The following issues shall be addressed when formulating recommendations:      
        (1) the strengths, risks, needs, and the degree to which a juvenile is capable and willing to manage risk; and       
        (2) co-morbidity, placement, education/vocational needs, parent or guardian and family issues, substance abuse issues, and supervision.       
      (f) Treatment Standards for Juveniles Who Commit Sexual Offenses.      
        (1) Treatment shall incorporate both cognitive/behavioral and reoffense prevention plans to reduce recidivism. A multifaceted program shall be age and developmentally appropriate and shall include but is not limited to the following:                  (A) group cognitive behavioral treatment;                   (B) individual therapy, family therapy, drug intervention, or other therapies to address and treat individual risk factors and problems specific to the juvenile;                   (C) chaperon training for parents/guardians;                   (D) family reintegration therapy; and                   (E) polygraphs (Family Code, §54.0405 Juvenile Probation).         
        (2) the treatment program for juveniles shall include a comprehensive individualized assessment as cited in subsection (b)(1) - (5) of this section, progressive levels of treatment, reoffense prevention plans, and for youth in residential treatment, transition into the community, and aftercare;       
        (3) treating juveniles shall be part of a multidisciplinary collaborative approach that includes but is not limited to the juvenile, the juvenile's family/guardians, treatment provider, juvenile probation officer, custodian, school officials, law enforcement, juvenile detention officers, institutional staff, mental health case workers, polygraph examiners, child protective services, victim advocates, and the victim's therapist;       
        (4) licensees shall focus on the juvenile's existing strengths and positive support system to promote pro-social behaviors and facilitate change;       
        (5) licensees shall utilize developmentally appropriate treatment strategies for juveniles with intellectual and cognitive impairments;       
        (6) the primary goals of treatment shall be to assist juveniles in gaining control over their sexual behavior problems, enhancing the juveniles overall functioning, increasing their pro-social interactions, preventing further victimization, halting development of additional psychosexual problems, and developing age-appropriate relationships;       
        (7) if treatment groups are utilized for non-developmentally delayed juveniles with sexual behavior problems, groups shall not be less than 60 minutes in length with no more than 12 clients per group;       
        (8) 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 every 6 months;       
        (9) 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's policy or pursuant to the court order;       
        (10) monthly treatment progress reports shall be distributed to the supervision officer, referring agency, and/or the court. Discharge reports shall be issued according to the referring agency policy or pursuant to the court order;       
        (11) when a juvenile has attained the goals outlined in the juvenile's individualized treatment plan, there should be a gradual and commensurate adjustment of interventions;       
        (12) 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;       
        (13) modifications in treatment and in expectations for treatment outcomes may be required in instances of persistent denial;       
        (14) clients who remain in significant denial and/or are extremely resistant to treatment after the finite period of extension determined by the treatment provider and supervision team should be reassessed for appropriate placement in alternative treatment and/or interventions;       
        (15) 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 juvenile resides;       
        (16) the safety of children/victims 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 juvenile and children. If the juvenile has a history of sexual arousal to reported fantasies of sexual contact with children of a particular age/gender group, supervised visits may be considered if:                  (A) it is compliant with the court mandated conditions;                   (B) it is determined that sufficient safeguards exist including but not limited to safety plans approved by the treatment provider and supervision officer;                   (C) the juvenile has demonstrated control over sexual impulses and destructive behaviors;                   (D) it does not impede the juvenile's progress in treatment;                   (E) the parent(s), guardian(s), or custodian(s) have demonstrated the ability and willingness to supervise the juvenile effectively and ensure the safety of other children in the home; and                   (F) the victim's therapist or Guardian Ad Litem (if applicable) are involved in the decision making process.         
        (17) 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 ensures the child/victim safety first; and       
        (18) 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.       
      (g) Juvenile Laws. Licensees shall be familiar with and adhere to the juvenile justice system and confidentiality laws concerning juveniles who commit sexual offenses and the 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) Texas Family Code, Title 3, Chapter 51 et seq;       
        (4) Texas Family Code, §153.076, Duty to Provide Information;       
        (5) Code of Criminal Procedure, Chapter 62, Sex Offender Registration;       
        (6) Occupations Code, Chapter 109 (Specifically §109.051 and §109.052);       
        (7) Code of Criminal Procedure, Chapter 56; and       
        (8) Federal Justice for All Act of 2004.       
     Source Note:        The provisions of this §810.65 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