OPINION
Deloris Gene Powell appeals her capital murder convictions of Emmanuel Gillens, 78, as well as his wife Nellie Gillens, 73. In three issues, she challenges the legal and factual sufficiency of the evidence and the admission of alleged hearsay evidence from the child Frederick, made to his therapist. We will affirm.
*796 I.
The bodies of the Gillens were found by police on a Wednesday. A neighbor saw lights on and heard a banging noise from the Gillens’ home, early Tuesday morning. Mr. Gillens’ body had been stabbed three times plus he had some twenty incised wounds, likely defensive wounds. Mrs. Gillens suffered seven stab wounds and some defensive wounds. Thursday the body of six-year-old Corinthian, the couple’s great-grandson was found wrapped in a damp bathrobe, hidden in a closet of the home. Missing from the couple’s home was another great-grandson Frederick, age 3, cash from Mr. Gillens, and his truck. Police found a cigarette, which was left burning on the television of the couple’s home, in a bedroom where one of the bodies was found. Mrs. Gillens did not allow smoking in the house and forensic testing showed DNA from the cigarette matched appellant’s profile. On the same Tuesday as the murders, Rockwall County Sheriffs Department stopped appellant for impeding traffic, doing thirty miles per hour in a sixty five mile per hour zone. She was driving the deceased’s truck and had Frederick with her. A search produced two crack pipes, cigarettes, $3,082 in various U.S. currency, and 5.1 grams of rock cocaine. Further facts will be developed as necessary in our sufficiency review.
II.
When we review the legal sufficiency of the evidence, we review the proof in the light most favorable to the prosecution to determine whether any rational trier of fact could have found the essential elements of the offense beyond a reasonable doubt.
Jackson v. Virginia,
In determining the factual sufficiency of the elements of an offense, the reviewing court “views the evidence in a neutral light, and sets aside the verdict only if it is so contrary to the overwhelming weight of the evidence as to be clearly wrong and unjust.”
Johnson v. State,
A conviction was authorized under the evidence if the jury found: (1) appellant stabbed Mr. Gillens with the intent of killing him in the course of robbing him; (2) appellant intentionally caused the death of both Mr. and Mrs. Gillens during the same criminal transaction; or (3) appellant *797 stabbed Mrs. Gillens with the intention of killing her in the course of robbing Mr. Gillens. Tex. Penal Code Ann. § 19.03(a) and § 29.02(a) (Vernon 1994).
III.
The appellant argues only a cigarette butt found on the television in the Gillens’ home linked appellant to the scene. No witnesses placed appellant at the home on the Monday night or Tuesday morning in question. Appellant had previously been a renter of the Gillens and, according to the argument, could have left the unauthorized cigarette on an earlier occasion. Although appellant was arrested driving Mr. Gillens’ truck, appellant again argues there is no evidence that she did not have permission. Likewise there was no evidence that Mrs. Gillens did not give permission for appellant to give three-year-old Frederick a ride in the truck. Other physical evidence at the scene did not link appellant. The knife had only the Gillens’ blood. Some evidence at the scene excluded appellant and the DNA testing showed “unknown contributors.” A T-shirt and gloves contained “unknown” DNA. Latex gloves at the scene likely contained skin cells of appellant, not blood. Appellant argues the gloves could have been used earlier when she helped Mrs. Gillens.
An alternate theory of the cash found on appellant showed she had received a $2,800 tax refund, albeit the check was cashed in February, two months before the murders. Finally, appellant argues the State failed to prove that the murders were committed while appellant committed or attempted to commit robbery. Proof of a robbery committed as an afterthought and unrelated to a murder will not support a capital murder conviction.
See Moody v. State,
The State argues that it is indeed entitled to prove its case with circumstantial evidence.
See Wilson v. State,
A Mend of the Gillens testified he saw the couple late Monday afternoon and witnessed a customer paying Mr. Gillens cash for landscape work. Mr. Gillens commonly kept cash at the house. The police investigation turned up no money, Mr. Gil-lens’ truck was missing, and Frederick was gone. Appellant did not show up for work on Tuesday, the day of the murders. Appellant was stopped that day by Rockwall Sheriffs Department for impeding traffic. Appellant first identified herself as Barbara Jackson, then later as Barbara Kelly. She claimed Frederick was her six-year-old son, then changed her story twice to identify Frederick as her grandson then her nephew. A consent search produced the drugs we already noted plus over $3,000 in cash. Although much of the forensic pathology was inconclusive, several items in the Gillens’ truck appellant was driving were positive for blood: white latex gloves, a jacket, garbage bags, washcloth, and a belt. The T-shirt worn by appellant had visible bloodstains, which were not pathologically connected, but the *798 back of the T-shirt had DNA markers of Mrs. Gillens.
Finally, the child Frederick’s statements given through the therapist Karen Karr, further implicated appellant. When asked if someone hurt Frederick’s great-grandparents, he referred to appellant’s nick name “Honey.” Frederick also demonstrated an action by appellant and stated: “She went gr-r-r-r and my grandpa fell down.”
We may agree with appellant, that a cigarette on a television set where appellant had prior access, standing alone, might not be legally sufficient under other circumstances. Here, however, the sum total of the surrounding additional facts and incriminating circumstances warrant the jury’s conclusion of guilt.
Beardsley v. State,
IV.
In her final issue, appellant argues the trial court erred by admitting hearsay statements of the boy Frederick, through the witness Karen Karr. Karr is a child therapist working at the Dallas Children’s Advocacy Center. Karr has no medical degree but rather has a master’s in counseling from Dallas Baptist University. She is a licensed professional counselor in Texas for six years and had ten years prior experience in the same field. Child Protective Services referred the three-year-old Frederick to her for therapy. Over a timely hearsay objection by the defense, the trial court allowed Karr to testify that when she questioned Frederick about his grandmother and grandfather, he stated that they were dead and the person that hurt them was “Honey.” Karr also testified, that the child, again in response to her questioning of what appellant did, demonstrated, “She went gr-r-r-r and my grandpa fell down.” She further related Frederick wanted to “kick her [appellant’s] ass,” and he demonstrated aggressive signs. When he saw the color red, he was drawn to it and said, “Oooh blood” and looked afraid, according to Karr.
Appellant cites only to Tex.R. Evid. 803(4). She presents no case authority on the complex question of whether the three-year-old’s account, particularly in response to questioning by Karr, were statements for the purpose of medical diagnosis or treatment. The State argues for the application of
Gohring v. State,
The State also cites
Puderbaugh v. State,
Brouwer acknowledged that in the course of treatment in counseling C.P., it had been conveyed to C.P. that the reason for seeing him was to help her with her emotional problems. Brouwer and C.P. discussed the importance of telling the truth to him, and C.P. understood the difference between telling the truth and telling a lie. Thus, the State established both the medical care component of Brouwer’s sessions with C.P. and C.P.’s awareness of the purpose of the treatment.
Id. In Puderbaugh, a case of sexual assault, we only know that C.P. was under the age of foürteen. But we also know that there was at least proof that C.P. knew she was seeing the social worker for treatment, the treatment was in a medical office, referred by a physician 1 and the therapist saw C.P. over 30 times. Id. 2
To be admissible under Rule 803(4), the statement must be reasonably pertinent to diagnosis or treatment. For example, statements as to fault would not ordinarily qualify.
Fleming v. State,
We hold there is an abuse of discretion to admit the out-of-court hearsay statements of this three-year-old, where there is no evidence Frederick understood he was seeing Karr for the purpose of medical treatment and that his statements were for the purposes of treatment of his “trauma.”
Gohring,
Next we turn to the harm analysis. Error in the admission of evidence is subject to a harm analysis under Rule 44.2(b) of the Rules of Appellate Procedure.
Johnson v. State,
Frederick’s hearsay statement via Karr about his association of red paint and blood, could hardly be surprising for a three-year-old. Likewise, the “gr-r-r-r” statement, in light of his predilection toward Batman and Superman, seem hardly persuasive. However, his statement, via Karr, that “Honey” hurt his grandfather and grandmother, is powerful, if only emotionally. The prosecution did argue briefly Frederick’s hearsay, but mainly relied upon the many circumstances that connected appellant to the murders. Given the defense did not even bother to cross-examine the very brief testimony of Karr, they certainly seemed to view it as not that effective. Karr had little expertise, and only mentioned play therapy as her means of ascertaining the cause of Frederick’s trauma. Rockwall police had already testified that when appellant was arrested the day of the murders, the child was incoherent. The strong circumstantial evidence of appellant’s access to the home, her proximity, her drug use, her cigarette in one of the murder rooms, and being arrested the day of the murders with the victim’s truck, his money, and his grandson, would, we believe, be much more reliable and weighty to most juries than the hearsay of a three-year-old. Nor do we believe the State would likely repeat this error, which is hopefully limited to this unique case. In light of the totality of the record, we hold the error to be harmless under the non-constitutional standard. Id. Appellant’s third issue is overruled.
The judgment of the trial court is affirmed.
Notes
. We should note that Texas law has significant restraints against the unauthorized practice of medicine. "A person may not practice medicine in this state unless the person holds a license issued under this subtitle.” Tex Occ.Code Ann. § 155.001 (Vernon Supp.2002). " ‘Practicing medicine’ means the diagnosis, treatment, or offer to treat a mental or physical disease or disorder or a physical deformity or injury by any system or method, or the attempt to effect cures of those conditions....” Id. at§ 151.002(a)(13).
.
See also Moyer v. State,
.When appellant was stopped by Rockwall deputies and arrested, the boy was said to be incoherent.
. Appellant made no objection under the confrontation clause. Hearsay statements used against a defendant over his objection could violate the confrontation clause if they were not admitted under a well-recognized exception to the hearsay rule or the court failed to make a finding that the statements were otherwise reliable.
See Idaho v. Wright,
