# IN THE SUPREME COURT O F TEX AS

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# C O M M IT M E N T O F 

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## P E T I T I O N F O R 

## R E V I E W F R O M T H E 

## C O U R T O F 

## A P P E A L S F O R T H E 

## N I N T H 

## D I S T R I C T O F 

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## Argued Novem ber 8, 2011

J U S T I C E 

## H E C H T 

## delivere d the opinion of the Court.

We consider in this case what qualifica tions an expert must have to testify reg arding whether

a person is a sexually violent preda tor and there fore subject to civil co m m i t m en t for outpatient
trea tment and supervision. L ike the court of appea ls, though for differ ent rea sons, we conclude that 1 

## the exclusion of expert testimony in this case re quires a ne w trial.

I A The Texas Civil Commi tment of Sex ually Violent Predators Act of 1999 define s a sexually violent pred at o r (“SVP”) as “a repe at sexually violent offe nder [who] suffe rs from a behavior al abnorma lity that makes the person likely to eng ag e in a preda tory act of sexual violence.” The Act 2

_ _ _ S

. W

. 3 d

_ _ _ ( T e x . A p p . – B e a u m o n t 2 0 1 0 )

. 1
T E X
. H E A L T H & S A F E T Y C O D E § 8 4 1

. 0 0 3 ( a )

. 2

## define s “beha vioral abnorma lity ” as “a cong enital or acquir ed condition that, by aff ecting a person’ s emotional or volitional capa city , predisposes the person to commit a sexually violent offe nse, to the
extent that the person become s a menac e to the health and safe ty of anoth er person.” A person 3 

## found to be an SVP in a civil court proce eding must be order ed committed to outpatient trea tment and super vision. 4 

## Be fore the State files suit, a person must be administratively deter mined to be an SVP. The 5 

## Act require s that deter

mination to be informed by an expert’s “clinica l assessment based on testing for psy chopathy , a clinical interview, and other appropr iate assessments and techniques”

. Once suit 6 

## is filed, the Act g ives both the State and the person the rig ht to a further expert examination. I f the 7


## person is indigent, a

nd the trial cour

t determines that e x pert ser vices a re ne cessa

ry , the court must appoint an expert and a

pprove r easona

ble compensa tion to be paid by the State. 8 

## The Act does not presc ribe the qualifica tions for experts to testify whether a person has the behavior al abnorma lity require d for an SVP. I t does provide that “[a] person who suffe rs from a behavior al abnorma lity as deter mined under this chapte r is not beca use of that abnorma lity a person

I d

. § 8 4 1

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. 3
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. § 8 4 1

. 0 8 1 ( a )

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T h e d e t e r m i n a t i o n m u s t b e m a d e , a t t h e r e c o m m e n d a t i o n o f a m u l t i d i s c i p l i n a r y t e a m , b y e i t h e r t h e T e x a s 5 D e p a r t m e n t o f

C r i m i n a l J u s t i c e f

o r a n i n m a t e , o r b y t h e D e p a r t m e n t o f S t a t e H e a l t h S e r v i c e s f o r s o m e o n e a d

j u d g e d n o t g u i l t y b y r e a s o n o f i n s a n i t y . I d

. § § 8 4 1

. 0 2 1

- . 0 2 3

. I d

. § 8 4 1

. 0 2 3 ( a )

. 6
I d

. § § 8 4 1

. 0 6 1 ( c ) , 8 4 1

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I d

. § § 8 4 1

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- ( d ) , 8 4 1

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. 8 

### 2

## of unsound mind for purposes of Section 15-a, Article I , Texas Constit ution.” Section 15-a provides 9 

## in part that “[n] o person shall be committed as a person of unsound mind except on competent medical or psy chiatric testimony .” Thus, in the L eg islature’s view, an expert used to assess 1 0 

## whether a per son is an SVP is not constituti onally require d to be a phy sician. The State must bring SVP commitment proce eding s in “a Montgome ry County district court other than a family district court”

. There are seven district courts in Montgome ry County

. One 1 1 1 2 

## is require d to give pref

ere nce to f

amily case s. One other , the 435th District Court, is required to

1 3


## g ive pref ere nce to SVP commitment proce eding s. At prese nt, most such proce eding s are assig ned 1 4 

## to that court. B I n September 1982, Michae l Way ne Boha nnan, then 26, marr i ed , an d employ ed as a machin i s t , rode his bicy cle past K.C.’s home sever al times and watche d her inside throug h a window. One evening , he donned a ski mask and car ry ing a larg e knife, enter ed the home throug h the rea r door, wa l k ed d o wn the hallway past a room in which a child was sleeping , and enter ed

I d

. § 8 4 1

. 1 4 6 1 ; s e e a l

s o i d

. § 8 4 1

. 0 0 1 ( “ T h e l e g i s l a t u r e f i n d s t h a t a s m a l l b u t e x t r e m e l y d a n g e r o u s g r o u p o f 9 s e x u a l l y v i o l e n t p r e d a t o r s e x i s t s a n d t h a t t h o s e p r e d a t o r s h a v e a b e h a v i o r a l a b n o r m a l i t y t h a t i s n o t a m e n a b l e t o t r a d i t i o n a l m e n t a l i l l n e s s t r e a t m e n t m o d a l i t i e s . . . . T h e l e g i s l a t u r e f u r t h e r f i n d s t h a t t r e a t m e n t m o d a l i t i e s f o r s e x u a l l y v i o l e n t p r e d a t o r s a r e d i f

f e r e n t f r o m t h e t r a d i t i o n a l t r e a t m e n t m o d a l i t i e s f o r p e r s o n s a p p r o p r i a t e f o r i n v o l u n t a r y c o m m i t m e n t u n d e r [ t h e T e x a s M e n t a l H e a l t h C o d e ]

. ” )

.

T E X
. C O N S T
. a r t
. I , § 1 5

- a . 10
T E X
. H E A L T H & S A F E T Y C O D E § 8 4 1

. 0 4 1 ( a )

. 11
T E X
. G O V ’ T C O D E § § 2 4

. 1 0 9 , 2 4

. 1 1 0 , 2 4

. 3 9 9 , 2 4

. 4 6 1 , 2 4

. 5 0 5 , 2 4

. 5 6 2 , a n d 2 4

. 5 7 9

. 12
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. § 2 4

. 5 6 2

. 13
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. § 2 4

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### 3

## K.C.’s bedroom. She was ly ing on the bed, rea ding a newspa per. Boha

nnan forc ed her to perf

orm oral a nd vag inal sex, t hen lef

t. L ooking ba ck on it, Boha nnan testified in this case that he thoug ht he would g et some satisfac tion or self-f ulfillment out of raping K.C., and in some way , he expected K.C., 27, to “like being rape d”. Some three wee ks later, Boha nnan was driving around on his lunch brea k when he saw P.H., 27, enter her home . He stopped, put on his ski mask, picked up his knife, a nd walked thr oug h the front door. P.H. wa s with a g roup of children, whom Boha nnan made her move to another r oom. He then took P.H. to her bedroom and forc ed her to pe rfor m or al and vag inal sex. He now rec alls, as before, he thought he would g et s ome s atisfac tion from raping P.H., “may be .

. . fee l more of a man”. Boha

nnan was appre hended and in 1983 pleade d g uilty to two counts of ag g rava ted rape with

a dead l y we ap o n , and was sentenc ed to 25 y ear s’ imprisonment. Court paper s sug g est that he committed a third rape for whic h he wa s not charg ed, but B ohannan de nies it. I n 1991, Boha

nnan was rele ased on mandatory supervision. I n April 1992, he was char g ed with attempting to kidnap a nine-y ear -old g irl in a K-Mar t, and in Fe bruar

y 1993, he pleade d g uilty , though he now denies he committed any crime. His mandatory supervision was revoke d and he was returne d to prison. I n 1998, Boha

nnan was ag ain rele ased on mandatory supervision, and in 2000 he moved to South Carolina to live with his mother. Whil e ther e, he w as convicted of ex posing his g enitals to an eig ht-y ear -old g irl in a toy store and se ntence d to three y ear s’ imprisonment. Boha nnan denie s that the alleg ations were true. I n 2002, he wa s returne d to prison in Tex as.
4

## I n 2004, Boha nnan was rele ased o n mandatory supervision a third time. But in 2006, his rele ase was ag ain revoke d, this ti me for viewing child pornog raphy on a computer in a county law library

. He was enrolled in sex offe nder thera py at the time. Boha

nnan denies that the char g es wer e true. Boha

nnan testified that he now knows that the rape s wer e wrong and devasta ting to the lives aff ecte d. C After rec eiving from the Texas Depa rtment of Criminal J ustice a psy cholog ist’s repor t that Boha nnan is an SVP, the State petitioned for his commitment. The State desig nated two experts to testify at t rial: Dr. J ack Randall Price, a board- cer tified fore nsic psy cholog ist, and Dr. Michael R

. Ara mbula, a board- cer

tified fore nsic psy chiatrist. Boha nnan desig nated Dr. Anna Shursen, whose doctora l deg ree is in family scienc es and family th er apy . Shursen is licensed in Texas as a profe ssional counselor and as a sex offender

trea tment provider. 1 5 1 6

S e e T E X
. O C C
. C O D E § 5 0 3

. 3 0 2 ( a ) ( “ A p e r s o n q u a l i f i e s f o r a l i c e n s e [ a s a p r o f

e s s i o n a l c o u n s e l o r ] i f t h e 15 p e r s o n : ( 1 ) i s a t l e a s t 1 8 y e a r s o l d ; ( 2 ) h a s a m a s t e r ’ s o r d o c t o r a l d e g r e e i n c o u n s e l i n g o r a r e l a t e d f i e l d ; ( 3 ) h a s s u c c e s s f u l l y c o m p l e t e d a g r a d u a t e d e g r e e a t a r e g i o n a l l y a c c r e d i t e d i n s t i t u t i o n o f h i g h e r e d u c a t i o n a n d t h e n u m b e r o f g r a d u a t e s e m e s t e r h o u r s r e q u i r e d b y b o a r d r u l e , w h i c h m a y n o t b e l e s s t h a n 4 8 h o u r s a n d m u s t i n c l u d e 3 0 0 c l o c k h o u r s o f s u p e r v i s e d p r a c t i c u m t h a t : ( A ) i s p r i m a r i l y c o u n s e l i n g i n n a t u r e ; a n d ( B ) m e e t s t h e s p e c i f i c a c a d e m i c c o u r s e c o n t e n t a n d t r a i n i n g s t a n d a r d s e s t a b l i s h e d b y t h e b o a r d ; ( 4 ) h a s c o m p l e t e d t h e n u m b e r o f s u p e r v i s e d e x p e r i e n c e h o u r s r e q u i r e d b y b o a r d r u l e , w h i c h m a y n o t b e l e s s t h a n 3 , 0 0 0 h o u r s w o r k i n g i n a c o u n s e l i n g s e t t i n g t h a t m e e t s t h e r e q u i r e m e n t s e s t a b l i s h e d b y t h e b o a r d a f t e r t h e c o m p l e t i o n o f t h e g r a d u a t e p r o g r a m d e s c r i b e d b y S u b d i v i s i o n ( 3 ) ; ( 5 ) e x c e p t a s p r o v i d e d b y S u b s e c t i o n ( b ) , p a s s e s t h e l i c e n s e e x a m i n a t i o n a n d j u r i s p r u d e n c e e x a m i n a t i o n r e q u i r e d b y t h i s c h a p t e r ; ( 6 ) s u b m i t s a n a p p l i c a t i o n a s r e q u i r e d b y t h e b o a r d , a c c o m p a n i e d b y t h e r e q u i r e d a p p l i c a t i o n f e e ; a n d ( 7 ) m e e t s a n y o t h e r r e q u i r e m e n t p r e s c r i b e d b y t h e b o a r d

. ” )

.

T o b e l i c e n s e d a s a s e x o f f e n d e r t r e a t m e n t p r o v i d e r , a p e r s o n : m u s t b e l i c e n s e d t o p r a c t i c e i n T e x a s a s a 16 p h y s i c i a n , p s y c h o l o g i s t , c o u n s e l o r , o r o n e o f s e v e r a l o t h e r s p e c i f i e d p r o f e s s i o n a l s ; m u s t h a v e 1 , 0 0 0 h o u r s o f c l i n i c a l e x p e r i e n c e i n t h e a r e a s o f a s s e s s m e n t a n d t r e a t m e n t o f s e x o f f e n d e r s w i t h i n a s e v e n - y e a r p e r i o d ; a n d m u s t h a v e 4 0 h o u r s o f c o n t i n u i n g e d u c a t i o n t r a i n i n g w i t h i n t h r e e y e a r s . S e e 2 2 T e x . A d m i n . C o d e § 8 1 0

. 3 ( c )

. 

### 5

## Trial in the case was set for J anuar y 16, 2009, in the 435th District Court. On Dec ember 15, 2008, a visiting judg e in that cour t refuse d to allow Shursen to testify as an e x pert in anothe r SVP commitment pr ocee ding, In re Dodson

. Thoug h Shursen had testified a dozen times in other such

case s, the judg e stated on the rec ord that she was “not qualified to pr esent an opinion” on whether

someone is an SVP. On Dec ember 24, the State moved to exclude Shursen’s testimony in this case for the same rea son, having previously moved for an extension of time to file such a motion past the deadline set by the court’s docket control order

. On J anuar y 8, the reg

ular judge of the 435th District Court g rante d an extension and order ed the motion to e x clude to be hear d the first day of trial. On J anuar y 2 0 , afte r a jury was impaneled and sworn, the judge conducte d a leng thy hear ing on the State’s motion, and at the end of the day , announce d that he would take the matter under advisement overnig ht. The next morning the court g rante d the motion, finding that “Shursen lacks the fore nsic training and experience to a nswer the ultimate question”, viz, “whe ther [Bohannan] suffe rs from a behavior al abnorma l i t y t h at predisposes him to commit preda tory acts of sexual violence.” Boha nnan moved for a continuance for want of evidenc e, which th e court denied, and the State
proce eded to pr esent its case

. Price testified that he enter ed prac tice in 1983 and turned to fo re n s i c work in 1990. He
teac hes at the University of Texas Southwestern Medica l Center at Dallas, the Southern Methodist Un iversity Dedman School of L aw, and Richland College , and has written extensively o n profe ssional subjects. He stated that he ha s made fr om 25 to 30 SVP assessments, and in three to five of them, found that the individuals did not have the requisite behavior al abnorma lity

. Ba sed on prison rec ords and a two-hour persona l i n t er v i ew, Price conclude d that Boha nnan does have a
6

## behavior al abnorma lity

. Using the Diag nostic and Statist ical Manual of Mental Disorder s (“D SM”),

he diag nosed Boha

nnan as having “par aphilia not otherwise specifie d” — in lay terms, sexual devianc e — and “per sonality di s o rd er n o t otherwise specifie d”. Price applied two actua rial tests widely used to evalua te a sexual offe nder’ s risk of rec idivism : the Static-99 and the Minnesota Sex Offe nder Scree ning Tec hnique (“MnSOST”). Price score d Boha nnan a “5” — modera

tely high risk — on the Static-99 and a

“10” — hig h risk — on the MnSOST. Ara mbula testified that he g radua ted from medical school, beg an training in g ener al
psy chiatry , and ap p l i ed fo r a license to prac tice in the l ate 1980s. He teache s at t he University of Texas Hea lth Science Center at San Antonio. He stated that he has done 16 or 17 SVP assessments in the last three y ear s, and in t wo o f t h em , fo und that the individuals did not have a behavior al abnorma lity

. Ba sed on available rec ords and a three -hour per s o n al i n t erview, he conclude d that Boha nnan does have a behavior al abnorma lity

. He diag no s ed Boha nnan with “par aphilia not otherwise s p ec ified with fea tures of pedophilia, sadism, and exhibi tion” and with “per sonality disorder not otherwise specifie d with fea tures of antisocial conduct”

. Ara mbula did not use actua

rial
tests in evalua

ting Boha nnan but conclude d that he was at a high risk of reof fending in part beca

use his sexual misconduct has continued since the rape s, despite the thera py he has rec eived, an d h as involved children. Shursen testified outside the prese nce of the jury that she has been in private prac tice since 2000, providing behavior al thera py trea tment for sex offe nders. She stated that she has rec eived more than a 1,000 hours of training , sees more than 100 clients each week, and has m ade 18 SVP

7

## assessments. L ike Price and Ara mbula, she revie wed a ll of Boha nnan’s rec ords and interviewe d 1 7 

## him persona lly

. She score d him a “5” on the Static-99, the same as Price, and an “8”, a littl e lower,

o n t h e M n SOST. She also deter mined from another diag nostic protocol, the Har e Psy chopat h y Checklist, that Boha

nnan is not psy chopathic. S h u rs en t estified that in her opinion, based on Boha nnan’s rec ords, her interviews with him, the actua rial tests, and her experience in t h e fi eld, Boha nnan does not have a behavior al abnorma lity “at this time”. She was not asked to elabor ate on the qualifica tion. The jury found that Boha

nnan suffe rs from a behavior al abnorma lity , as define d by statute, that predisposes him to eng ag e in a preda tory act of sexual violence. The trial court issued an order of civil commitment. 1 8 

## Boha nnan appea led, as Dodson had in the other case in which Shursen’s testimony had been excluded. The court o f ap peals decide d Dodson first. I t held that the statutory definition of 1 9 

## behavior al abnorma lity has two separ ate components: an a cquire d or cong enital condition, and a 2 0 

## predisposition to commit a sexually violent offe nse. The second element, the court noted, was also 2 1

S h e t e s t i f

i e d t h a t s h e f

o u n d a b e h a v i o r a l a b n o r m a l i t y i n 2 0 t o 3 0 % o f t h e s e c a s e s , t h o u g h t h e r e c o r d d o e s n o t 17
r e f l e c t a s p e c i f

i c n u m b e r . B o h a n n a n w a s o r d e r e d t o r e s i d e i n s u p e r v i s e d h o u s i n g , n o t t o c o n t a c t h i s v i c t i m s , n o t t o p o s s e s s a l c o h o l o r 18 o t h e r d r u g s , t o p a r t i c i p a t e i n t r e a t m e n t , t o s u b m i t t o t r a c k i n g b y a G P S m o n i t o r , n o t t o c h a n g e h i s r e s i d e n c e o r l e a v e t h e S t a t e w i t h o u t c o u r t a p p r o v a l , n o t t o b e i n t h e p r e s e n c e o f c h i l d r e n , t o n o t i f y h i s c a s e m a n a g e r o f a n y c h a n g e s i n s t a t u s , a n d t o p r o v i d e b l o o d a n d h a i r s a m p l e s f o r t h e S t a t e ’ s D N A D a t a B a n k

. S e e T E X
. H E A L T H & S A F E T Y C O D E § § 8 4 1

. 0 8 1

-

. 0 8 3

. I

n r e D o d s o n , 3 1 1 S

. W

. 3 d 1 9 4 ( T e x . A p p . – B e a u m o n t 2 0 1 0 , p e t
. d e n i e d )

. 19
T E X
. H E A L T H & S A F E T Y C O D E § 8 4 1

. 0 0 2 ( 2 )

. 20
D o d s o n , 3 1 1 S

. W

. 3 d a t 1 9 9

. 21 

### 8

## part of the definition of an SVP — someone “likely to eng ag e in a preda tory act of s ex ual violence.” The court conclude d in Dodson that while medical evidenc e is ne cessa ry to pr ove the 2 2 

## exis tence of a condition, it is not nece ssary to prove a predisposition to sexually violent behavior

. 2 3 

## S o m eo ne like Shursen, trained in apply ing actua rial tests evalua

ting the risk of rec idivism , and experience d in rec o gn i z i n g that risk among her patients, is qualified to testify whether a person satisfied that part of the definition of behavior al abnorma lity

. The court deter mined that the 2 4 

## exclusion of Shursen’s testimony was harmful err or and rema nded the case for a new trial. I n the 2 5


## prese nt case , the cour

t rea ched the same re sult for the same r easons. 2 6 

## We gr anted the State’ s petition for revie w. 2 7


## II To beg in with, we do not ag ree with the court of appea ls’ bisection of the statutory definition of beha vioral abnor

mality . The de finition, ag ain, is this: “B ehavior al abnorma lity ” means a cong enital or acquir ed condition that, by aff ecting a person’ s emotional or vo l i t i o n al capa city , predisposes the person to commit a sexually violent offe nse, to the extent that the person become s a menac e to the health and saf ety of anothe r per son. 2 8

T E X
. H E A L T H & S A F E T Y C O D E § 8 4 1

. 0 0 3 ( a )

. 22
D o d s o n , 3 1 1 S

. W

. 3 d a t 1 9 9

- 2 0 0

. 23
I d

. a t 2 0 0

. 24
I d

. a t 2 0 2

- 2 0 4

. 25

_ _ _ S

. W

. 3 d

_ _ _ ( T e x . A p p . – B e a u m o n t 2 0 1 0 )

. 26
T e x . S u p . C t
. J

. ( J u n e 1 0 , 2 0 1 0 )

. 27
T E X
. H E A L T H & S A F E T Y C O D E § 8 4 1

. 0 0 2 ( 2 )

. 28 

### 9

## Boiling it down, a behavior al abnorma lity is “a

. . . condition that

. . . predisposes” sexually violent

conduct. The modifier, “pre disposes”, qualifies and descr ibes “condition”. The require d condition is the predisposition. The condition has no ot h er q u al i t i es, other than that it can be cong enital or acquir ed. The condition and predisposition are one and the same. The definition might more clea rly be wr itten: “B e h a v io r a l a b n o r ma li ty ” me a n s a cong enital or acquir ed predisposition, due to one’s emotional or volitional capa city , to commit a sexually violent offe nse, to the extent that the per son become s a mena ce to the he alth and saf ety of anothe r per son. The condition and predisposition cannot be sepa ra t e t h i n gs, as the court of appea ls tried to make them. The conce rn reg arding the predisposition is, of course , the heig htened risk of offe nse. That

conce rn is reiter ated in the statut o ry definition of an SVP as “a repe at sexually violent offe nder [who] suffe rs from a behavior al abnorma lity that make s the person likely to engage in a predatory
act of sexual violence .” The court of appea ls in Dodson took this reiter ation as further indication 2 9 

## that the predisposition (or risk) and the condition require d for a behavior al abnorma lity are separ ate things. We think a car eful analy sis of the definition of an SVP does not support the court’s position. Substi tuting the definition of “beha vioral abnorma lity ” for that ter m in the definition of an SVP y ields this: A person is a sexually violent preda tor
. . . if the person . . . suffe rs from [a cong enital or ac quired c ondition

I d

. § 8 4 1

. 0 0 3 ( a ) ( e m p h a s i s a d d e d )

. 29 

### 1 0

## {Qualifier A} that, by aff ecting a p er son’s emotional or volitional capa city , predisposes the person t o co m m it a sexually violent offe nse, to the extent that the person be comes a

menac e to the hea lth and safe ty of anothe r per son] {Qualifier B} that makes the person likely t o en gage in a preda tory act of sexual violence. We see only two possible diffe re n ce s i n the two qualifiers. One is that a predisposition to misconduct may not make a person likely to eng ag e in it, or vice versa , that a person may be likely
to eng ag e in misconduct though not predisposed to do so. We think the import of predisposition and l i k elihood is exactly the same: incre ased risk. An incre ased likelihood of misconduct indi ca t es a predisposition, and a predisposition threa tens incre ased likelihood. I n this reg ard, the two qualifiers

are the same. The other possible diffe renc e betwe en them is that a mena cing offe nder may not be preda tory , or vice versa , that a predator may not be a menac e. I f such a distinction were possible, and we do not think it is, nothing in the Ac t sugg ests that it is intended. Thus, Qualifier B simpl y explains or restate s Qualifier A. I ts inclusion in the definition of an SVP cer tainly does not sug g est that Qualifier

A is a sepa

rate element of

the def inition of behavioral a

bnormality

. Acc ording ly , we conclude that whether a person “suff ers from a behavior al abnorma lity that makes the person likely to eng ag e in a preda tory act of sexual violence” is a single , unified issue. 3 0


## III As alre ady noted, the Act does not presc ribe the qualifica tions an expert must have to opine on whether

a per son is an SVP, and it contains only two provisions releva

nt to the issue.

T E X
. H E A L T H & S A F E T Y C O D E § 8 4 1

. 0 0 3 ( a ) ( 2 )

. 30 

### 1 1

## One is the s tatement that “[a] person who suffe rs from a behavior al abnor mality

. . . is not beca use of that abnorma lity a person of unsound mind”. The obvious purpose of this provision, 3 1 

## entitled “Certa in Ex pert Testimony Not Required” , is to express the L eg islature’s view that medical and psy chiatric testimony , a constitutional prer equisite for committing a person of unsound mind, 3 2 

## is unnece ssary in SVP proce eding s. The statutory provision was added to the Act afte r, and perha ps in response to, the court of appea ls’ decision to the contra ry in an ear ly case . Boha nnan arg ues that 3 3 

## the statute overr

ules the court’s decision, but while the L eg islature may cer tainly state its view of a constitutional provision, an authoritative construction is a matter for the courts. The State does not 3 4 

## addre ss the issue but obviously takes the position by its trial conduct — rely ing on the opinion of a psy cholog ist — that irrespe cti v e of whether the constitution require s medical evidenc e for commitment of an SVP, it does not rende r other expert testimony inadmissible. Thus, both parties
ag ree that the constitution does not prec lude evidenc e in a n SVP commitment proce eding from an expert who is not a phy sician. Acc ording ly , we assume without deciding that the constitution is no impediment to the admission of non-medica l expert testimony in an SVP commitment proce eding

. 3 5

I d

. § 8 4 1

. 1 4 6 1

. 31
T E X
. C O N S T
. a r t
. I , § 1 5

- a . 32
B e a s l e y v . M o l e t t , 9 5 S

. W

. 3 d 5 9 0 , 5 9 8 ( T e x . A p p . – B e a u m o n t 2 0 0 2 , p e t
. d e n i e d ) ; b u t c f

. D u d l e y v . S t a t e , 7 3 0 33 S

. W

. 2 d 5 1 , 5 4 ( T e x . A p p . – H o u s t o n [ 1 4 t h D i s t
. ] 1 9 8 7 , n o w r i t ) ( “ W e d o n o t i n t e r p r e t t h e [ c o n s t i t u t i o n a l ] p h r a s e
‘ c o m m i t t e d a s a p e r s o n o f u n s o u n d m i n d ’ a s i n c l u d i n g a p e r s o n c o m m i t t e d a s a n a l c o h o l i c . R a t h e r , w e v i e w t h e c o n s t i t u t i o n a l p r o v i s i o n a s p e r t a i n i n g t o a p e r s o n s u f f e r i n g f r o m m e n t a l i l l n e s s . . . . ” )

. W

. O r a n g e - C o v e C o n s o l

. I n d e p . S c h

. D i s t

. v . A l a n i s , 1 0 7 S

. W

. 3 d 5 5 8 , 5 6 3 ( T e x . 2 0 0 3 ) ( “ T h e f i n a l a u t h o r i t y 34 t o d e t e r m i n e a d h e r e n c e t o t h e C o n s t i t u t i o n r e s i d e s w i t h t h e J u d i c i a r y . ” ) ( c i t i n g M a r b u r y v . M a d i s o n , 5 U

. S

. ( 1 C r a n c h ) 1 3 7 , 1 7 6

- 1 7 8 ( 1 8 0 3 ) , a n d L o v e v . W i l c o x , 2 8 S

. W

. 2 d 5 1 5 , 5 2 0 ( T e x . 1 9 3 0 ) )

.

A n d w e e x p r e s s n o v i e w o n w h e t h e r t h e c o n s t i t u t i o n r e q u i r e s t h a t c o m m i t m e n t b e b a s e d o n m e d i c a l o r 35 p s y c h i a t r i c t e s t i m o n y . 

### 1 2

## The other provision of the Act rele vant to expert qualifica tions states that at the

administrative stag e, an “expert shall make a clinical assessment based on testing for psy chopathy ,
a clinical interview, and other appropr iate assessments and techniques”

. Obviously , the expert 3 6 

## must ha ve the training and experience nece ssary to perf orm as require d — to test for psy chopathy , to conduct a clinical interview, and to empl o y o t h er appropr iate evalua tive proce dures. The Act
g ives no rea son to think t hat the qualific ations of trial experts should be any differ ent. Absent more specific statutory direc tion, we apply the g ener al rule, whic h is that an expert
must be qualified “by knowledg e, skill, experience , training , or education” to “assist the trier of fac t to understand the e vidence or to deter mine a fa ct in issue”. That a w itness has knowledge , skill, 3 7 

## expertise, or training does not nece ssarily mean that the witness can assist the trier- of-f act. Ex pert testimony assists the trier- of-f

act when t he expert’s knowle dg e and e x perie nce on a rele vant issue

are bey ond that of the aver ag e juror and the testimony helps the trier- of-f act understand the evidenc e or dete rmine a f

act issue. 3 8 

## Credentials are important, but cre dentials alone do not qualify an expert to testify

. We have observe d, for example, tha t “ a medical license does not a utomatically qualify the holder ‘to testify

as an expert on ever

y medical que stion.’” “Tria l courts must ‘ensur[e] that those who purport to 3 9

T E X
. H E A L T H & S A F E T Y C O D E § 8 4 1

. 0 2 3 ( a )

. 36
T E X
. R

. E V ID
. 7 0 2

. 37
K

- M a r t C o r

p . v . H o n e

y c u t t , 2 4 S

. W

. 3 d 3 5 7 , 3 6 0 ( T e x . 2 0 0 0 ) ( c i t a t i o n s o m i t t e d )

. 38
R o b e r t s v . W i l l i a m s o n , 1 1 1 S

. W

. 3 d 1 1 3 , 1 2 1 ( T e x . 2 0 0 3 ) ( q u o t i n g B r o d e r s v . H e i s e , 9 2 4 S

. W

. 2 d 1 4 8 , 1 5 2 39 ( T e x . 1 9 9 6 ) ) ; s e e a l s o G a m m i l l v . J a c k W i l l i a m s C h e v r o l e t , I n c . , 9 7 2 S

. W

. 2 d 7 1 3 , 7 1 9 ( T e x . 1 9 9 8 ) ( “ J u s t a s n o t e v e r y p h y s i c i a n i s q u a l i f

i e d t o t e s t i f

y a s a n e x p e r t i n e v e r y m e d i c a l m a l p r a c t i c e c a s e , n o t e v e r y m e c h a n i c a l e n g i n e e r i s q u a l i f i e d t o t e s t i f y a s a n e x p e r t i n e v e r y p r o d u c t s l i a b i l i t y c a s e . ” )

. 

### 1 3

## b e ex p erts truly have expertise conce rning the actua l subject about which they are offe ring an

opinion.’” The test is “whe ther ‘the offe ri n g party [has] establish[ed] that the expert has

4 0 

## “knowledg e, skill, ex perie nce, training , or education” reg arding the spec ific issue bef ore the court which would qualify

the expert to g ive an opinion on that par ticular subjec t.’” 4 1


## I n evalua ting an expert’s qualifica tions, it is important to keep in mind that expert testimony

mus t b e rele vant and reliable

. “To be rele vant, t he proposed testimony must be sufficiently tied 4 2


## to the fac ts of the case that it will aid the jury in resolving a fac tual dispute.” Deter mining whether 4 3 

## an expert’s theor

y or tec hnique is reliable r equire s considera tion of all pertinent fa ctors, including (1) the extent to which the theory has bee n or ca

n be tested; (2) the extent to which the technique relies upon the subjective interpre tation of the expert; (3) whether

the theory

has bee n subjected to pe er r eview a nd/or publication; (4) the technique ’s potential ra te of e rror ; (5) whether the underly i n g t heory or technique has been g ener ally acc epted as valid by the re levant scie ntific community ; and (6) the non-judicial uses w hich have been ma de of the theory or tec hnique.

G a m m i l l , 9 7 2 S

. W

. 2 d a t 7 1 9 ( q u o t i n g B r o d e r s , 9 2 4 S

. W

. 2 d a t 1 5 2 )

. 40
R o b e r t s , 1 1 1 S

. W

. 3 d a t 1 2 1 ( q u o t i n g B r o d e r s , 9 2 4 S

. W

. 2 d a t 1 5 3 )

. 41
S t a t e v . C e n t

. E x

p r e s s w a y S i g n A s s o c s . , 3 0 2 S

. W

. 3 d 8 6 6 , 8 7 0 ( T e x . 2 0 0 9 )

. 42
E

. I

. d u P o n t d e N e m o u r s & C o . v . R o b i n s o n , 9 2 3 S

. W

. 2 d 5 4 9 , 5 5 6 ( T e x . 1 9 9 5 ) ( i n t e r n a l q u o t a t i o n s o m i t t e d )

. 43 

### 1 4

## These fac tors may be difficult to apply to an opinion that is based heavily on an expert’s individual

skill, experience , or training

. I n no case , howeve r, may expert testimony be admitted when “‘the re is simpl y too gr eat a

n analy tical g ap betwe en the da ta and the opinion prof fer ed.’” 4 4


## I n SVP commitment proce eding s, the only fac t issue to be resolved by the trier- o f- fa ct i s whether a person has the behavior al abnorma lity require d for an SVP. T h e ap p ro ach of all three experts in this case was consistent with the l ittle guidanc e provide d by the Act. All ag ree d that in assessing whether a person has the behavior al abnorma lity for an S VP, all available information should be considere d, and that the person should be interviewe d. They also sug g est that a medical diag nosis should be made and actua rial risk tests should be applied. Stil l, “[o] pinions about behavior

. . . and psy cholog y depend larg ely on the subjective interpre tation of the expert”, and opinions “too 4 5 

## depende nt upon [an expert’s] subjective g uesswork” must be excluded. The expert’s experience , 4 6 

## knowledg e, and tr aining are cruc ial in determining whether the expert’s opinions are admissible. A medica l diag nosis of a person’ s mental health may cer tainly inform an assessment of whether he has an SVP’s behavior al abnorma lity , but the p r in c ip a l issue in a commitment proce eding is not a person’s m ental health but whether he is predisposed to sexually violent conduct. And i n deciding that issue, as this c ase makes clea r, the kind of evalua tion done by a psy cholog ist may be
at least as important as a medical diag nosis. The usefulness of the expert’s opinion in assisting the trier- of-f act rests not on the ty

pe of license the expert holds but on the expert’s knowledg e, training ,

G a m m i l l , 9 7 2 S

. W

. 2 d a t 7 2 7 ( q u o t i n g G e n . E l e c . C o . v . J o i n e r , 5 2 2 U

. S

. 1 3 6 , 1 4 6 ( 1 9 9 7 ) )

. 44
S

. V

. v . R

. V

. , 9 3 3 S

. W

. 2 d 1 , 4 2 ( T e x . 1 9 9 6 ) ( C o r n y n , J

. , c o n c u r r i n g )

. 45
T r a n s c o n . I

n s . C o . v . C r u m p , 3 3 0 S

. W

. 3 d 2 1 1 , 2 1 7 ( T e x . 2 0 1 0 )

. 46 

### 1 5

## and experience in dealing with sexual offe nders. A person’s training and experience in clinical

intervi ews and actua

rial tests is no less helpful mere ly beca use the person is not licensed as a psy cholog ist. We see no basis for limit ing the experts who can testify in SVP commitment proce eding s to phy sicians and psy cholog ists. The purpose of the Act i s to reduc e the risk of those who are behavior ally predisposed to sexually violent conduct. An expert thoroug hly acqua inted with sexual offe nders’ behavior

may be qualified to assess the risk a person poses t o others. Acc ording ly , we hold that a person is not disqualified from testify ing as an expert in an SVP commitment proce eding

mere ly beca use the pe rson is not licensed as a phy sician or psy cholog ist. 4 7 

## IV We turn finally

to whether

the exclusion of Shursen’s testimony was ha rmful er ror. Thoug h Shursen lacks medical or psy cholog ical training , she has broad experience in dealing with sexual offe nders. She is licensed by the S tate to provide treatmen t fo r s exual offe nders, and while that license may

not in its elf qua lify her as an ex pert on SVPs, she has also spent more than 1,000 hours in that work to obtain her license and continues to see more than a 100 patients a wee k. She t es t i fi ed t h at she rec eives continuing instruction, some of which is g ear ed to apply ing and interpre ting actua

rial tests and to commitment assessments. She is qualified to apply such tests and has testified re peate dly

in commitment procee dings.

W e n e e d n o t e x c l u d e a l l p o s s i b i l i t y t h a t a m e d i c a l d i a g n o s i s m i g h t b e i m p o r t a n t i n m a k i n g a r i s k a s s e s s m e n t 47 i n a p a r t i c u l a r c a s e b e c a u s e t h e S t a t e d i d n o t o b j e c t t o B o h a n n a n ’ s e v i d e n c e o n t h a t b a s i s . 

### 1 6

## The State arg ues that Shursen is qualified to assess the risk that a p er s o n will eng ag e in

sexuall y v i o l en t co n duct only for the purpose of providing trea tment, and not for the purpose of commitment proce eding s. The State notes that by statute, experts on incompetenc y and insanity in criminal proc eeding s must be licensed phy sicians or psy cholog ists. But the absence of any such 4 8



## s t atut ory require ment in SVP commitment proce eding s tends to contra dict the State’s arg ument. Whil e the L eg islature h a s d is c retion to set require ments for expert testimony on specific issues, when the L eg islature has not done so, the State’s attempted distinction betwee n betwee n risk assessments for pur poses of tre atment and those f or purpose s of civil commitment is unfounded. Risk asse ssments a

re to a deg ree subjective, a

nd in evaluating an expert’s qualifica tions to make them, it is important to know what training and experienc e an e x pert ha s in mini miz ing tha t subjectivity

. Her e, S hursen use d the same well-re cog nized actua rial t ests that Price used and was
prepa red to defe nd her scoring , based on Boha nnan’s reco rd s an d h er interview with him. Fur thermore , Ara mbula testified that the risk assessments he uses in SVP proce eding s are the same as those he use s in treating sex offender s. The trial court’s discretion in deter mining whether an expert is qualified to testify on a matter is broad but not unbounded. A trial court abuses its discretion when it excludes rele vant and

4 9 

## reliable evide n ce . Most SVP commitment proce eding s are conducte d in a single district court 5 0 

## befor e a few judge s, and appea ls are almost alway s hear d by one court of appea ls. Fr om the rec ord

T E X
. C O D E C R IM
. P R O C
. a r t s . 4 6 B

. 0 2 2 , 4 6 C

. 1 0 2

. 48
B r o d e r s v . H e i s e , 9 2 4 S

. W

. 2 d 1 4 8 , 1 5 1 ( T e x . 1 9 9 6 )

. 49
S t a t e v . C e n t

. E x

p r e s s w a y S i g n A s s o c s . , 3 0 2 S

. W

. 3 d 8 6 6 , 8 7 0 ( T e x . 2 0 0 9 )

. 50 

### 1 7

## befor e us, the trial court appea rs to have deter

mined that Shursen is unqualified t o testify , not for

rea sons peculiar to her experience and training , but beca use she is not a phy sician or psy cholog ist. I n this contex t, we think a more car eful re view of the trial court’ s ruling is wa rra nted. We conclude that the trial court abused its discretion in excluding Shursen’s testimony

. The State does not challeng e the court of appea ls’ holding that the exclusion was harmful, and there fore we do not conside r the issue. * * * For the re asons g iven, the judg ment of the c ourt of appe als is Affirmed

.

Nathan L . Hec ht J ustice Opinion delivere d: Aug ust 31, 2012

1 8