Alameda County Behavioral Health will implement the "One CANS per Youth" initiative later this summer. This effort will ensure that each client will only have one CANS assessment at a time. This approach reduces the burden for clients, families and caregivers who may have to be interviewed for the CANS questions more than one time because there is more than one mental health provider working with the same client.
This will be a shift in the way providers complete CANS assessments and how they follow our CANS timelines when there is more than one provider involved with a client. One CANS per Youth will promote efforts in care collaboration and teaming and will eliminate inefficiencies that occur when multiple providers produce an assessment on the same client. CANS is an assessment tool designed to help clients, families/caregivers and providers understand what the needs and strengths are for the client and caregivers and to help care team members focus on these items collaboratively.
Alameda County Behavioral Health will be coming out with a One CANS per Youth grid as time gets closer to provide direction to our mental health providers and partners in understanding which role would be the primary staff responsible for completing the CANS assessment with the collaboration of the other providers involved.
Please stay tuned!
In the Dear Collaborative column, we answer YOUR questions about TCOM and the TCOM tools, CANS and ANSA.
Have questions and want answers? Submit your questions through the Contact page. Submissions are confidential.
Q1: I did the certification training, but I’m just not comfortable asking the families I work with all these questions. Why do I have to ask so many questions?
A1: We know it can be hard, especially if you’re new to the field, to get good at how to do all the things required including using the CANS! We’re sure you got into the field to support people to have better lives and to heal their pain. This is what the TCOM tools are about; they just take some practice to get used to using them! Don’t think of the CANS/ANSA as a questionnaire but as a framework to fit information you gather and know about your client and their family into. This is so everyone on your care team has a shared understanding of what the client and their family want to work on and change.
First, make sure you are transparent with the families and clients you work with that you want to help them with the things they need help with and want to change, AND that to understand their needs you use this tool called the CANS to map out strengths and needs that you will identify together with them when you talk the first few times. Each of the domains in the CANS or ANSA has a core question that you can use to open up a conversation with new clients and their parents. For example the core question for the “Life Functioning” domain is “How is the individual functioning in individual, family, peer, school, and community realms?” You can put this in your own words and ask some questions like this: “How are things going for Andrew at home with the rest of the family”; “Can you tell me what’s been happening at school for Andrew in the last couple weeks”; “How does Andrew get along with other kids in the neighborhood and at school”. Then you’ll take the info you gather and organize it using the CANS.
We know building rapport can be a challenge. Ask your supervisor for support or to role play, or reach out to experienced team members to learn how they succeed at client engagement using the CANS. The TCOM tools are here to help you do great work with clients, supporting them to transform their lives in the areas THEY want to, so practice, practice, practice your engagement skills and it WILL get easier!
Q2: Is it OK to just do the CANS by myself after I meet with the client and their family? I just don’t think they’d understand or be interested in seeing a clinical tool like this.
A2: You might remember from certification training that the TCOM tools are meant to be collaborative tools. This means that the more people work together, the better the data you input will be and the better your treatment with the client will be. We want the client and family voice to be center stage in our work otherwise we’re working on our agenda and that’s not collaborative or client centered and, in the end, it won’t be as effective as it could be. So, the goal in all cases is to involve the clients and their families in understanding the tools exist and working collaboratively to come up with item ratings together. One method of many could be to introduce the tool in the first meeting, ask the general domain questions to gather the information, organize it into ratings, verify each section’s rating with the client or their caregivers, and adjust as needed based on their feedback. This process looks different for every client, but the more collaboration you have, the better the work will be!
Q3: How can the TCOM tools really help me and why do we need them when we have so much paperwork to do already?
A3: The CANS/ANSA are tools that help you with your treatment roadmap. When you get ready to see a client each week, how do you prep? How do you know what you’re working on with the client? How do you know if what you’re doing makes a difference or if the client is making progress? Check your CANS/ANSA frequently throughout treatment to make sure you know what to focus on and to assess progress. Use the tool to guide your treatment plan and check it frequently to identify focus areas for your sessions. Use the data to identify and celebrate successes with your client and your supervisor. Watch those ratings change as you do good work and support your clients with quality care!
Question 1 (Q1): Should I take the practice exam?
Answer 1 (A1): This is entirely up to you. You are given 2 hours to test and if you pass the practice exam, it will not count towards your certification so this will likely double the amount of testing time which is why many people opt to move directly to the real exam. No one gets penalized for taking the test more than once and there is no limit on the number of times that you can take the test. One benefit to taking the practice exam is that it will show you which answers that were incorrect so that you can figure out where to adjust your thinking or seek consultation to help support your efforts to pass the certification test.
Q2: What do I do if I work in 2 Counties?
A2: Email firstname.lastname@example.org and ask for help registering your account under both Counties.
Q3: Do I have to take multiple certification exams if I serve multiple age groups of people?
A3: No, if you pass the certification exam for any age group (CANS or ANSA), you are certified to complete any of the CANS/ANSA versions.
Q4: How do I know what caregiver to rate in the exam when there are multiple referenced in the test vignette?
A4: The name of the caregiver that you should rate during the test is listed at the top of each vignette but make sure you ONLY rate the caregiver within the caregiver needs domain. The rest of the ratings in the CANS/ANSA should be based on the strengths and needs of the youth/young adult/adult who is officially the identified client/patient.
Well it is your lucky day! We have created a version of the new and improved CANS 0-24, with all the changes embedded and highlighted through different symbols including new items, name changes, and description changes. The changes were based on the following:
In the new virtual environment, we’ve all had new challenges added to our already sometimes difficult jobs. Some of these challenges are as simple as technical barriers. Alameda County CANS/ANSA users are issued a variety of devices to use for their work. You could be on a phone, laptop, desktop, Chromebook, or iPad and all of these have large or small screens that make work easier or harder depending on what you’re doing. We also often don’t have printers available at home the way we might have at the office to print big documents like the CANS or ANSA manuals. This can negatively impact some people’s learning as well. Your goal when testing on CANS/ANSA is to pass the test and we want to support you with some suggestions:
The Alameda County Behavioral Health CANS/ANSA Collaborative is currently offering the following live online trainings on an ongoing basis:
The following are the dates for forthcoming offerings of these trainings:
To enroll in one of these trainings, click on the link below to go to the Transformational Collaborative Outcomes Management (TCOM) Website and follow the additional steps described below.
If have any issues with this process, try using the guide below or email email@example.com.
Are you interested in learning how to utilize the CANS or ANSA in the Treatment Planning Process? Did you know that if you conduct the CANS or ANSA collaboratively that the treatment plan essentially writes itself? The "Treatment Planning with CANS/ANSA" training explores how to effectively use CANS and ANSA tools and TCOM (Transformative Collaborative Outcomes Management) principles in the service planning process. Participants will learn about developing a shared vision with clients and explore how to translate this into CANS/ANSA scores that support and guide ongoing collaborative treatment planning activities and documentation. Participants will learn how to prioritize and address CANS/ANSA items in service planning activities. The training includes group activities, vignette work, and service planning examples that align with Alameda County Quality Assurance guidelines. The next training will be November 18th from 1-3pm.
Get ready for the Launch of the Alameda County Child Adolescent Needs and Strengths (CANS) for Ages Birth to 24
The new CANS (Birth to 24) will be tentatively launching in the summer of 2020. This will be the third edition of the Alameda County CANS and it will integrate the Early Childhood (Birth to 5), Child and Youth (6-17) and the Transitional Age Youth (18-24) versions into one document.
Our current versions of CANS do not allow for continuity of questions or long-term CANS data analysis and did not include all of the state mandated questions.
The new CANS (Birth to 24) will have 10 Domains and within each domain, there will be sub-sections by age group, as some questions only pertain to specific age groups:
There will be 7 modules. Modules are more specific questions that will need to be answered based on a CANS response of a 1, 2, or 3 on certain questions. There are 7 questions that will trigger a module. The modules are:
Hopefully, further details can be shared with all agencies in May 2020 including the CANS (Birth to 24) Manual and Scoresheet, which are being tested and finalized now.
Facts about the transition to CANS (Birth to 24):
Please contact Christine Mukai if you have any questions related to CANS (Birth to 24) at: Christine.Mukai@acgov.org or 510-567-8238.
Like most of the Bay Area, many service providers have begun exploring the intricacies of working from home. At times this has meant connecting with kids, teens, families, and young adult clients remotely through phone, video, or other tele-health modalities, and often in the context of new evolving demands from families and our communities.
With the call to action to many providers to maintain the continuity of care, we find the need to re-balance ourselves and move beyond the technology challenges and general uncertainties to fully ground ourselves in values underlying the CANS--collaboration and client care.
Our clients thrive when they feel safe, seen, heard and helped. This calls on us to be there--not to fix, but to provide the containment to hold all the new needs and strengths that are arising with these changing circumstances. The ability to maintain a transformational relationship in the context of a pandemic is founded on the ability to provide clients a steady, authentic presence in a sea of unknowns, and to commit to their care, understanding that in times like this, your services are needed more than ever.
Social distancing does not need to mean social isolation. But it does mean that we have to be intentional about connecting. While we may not be able to provide quick fixes or cures to the pandemic, our presence holds healing and transformative power. Remember, there is value in maintaining and tending to those relationships, innoculating against fear with accurate information, and reminding families that we are still committed to their transformational change and intend to still see them face-to-face when this is all over.
By Cinthya Chin Herrera on Behalf of the Alameda County TCOM Collaborative
Resources to Support TCOM amidst COVID-19 Challenges:
Blog content is created by the shared effort of the Alameda TCOM Collaborative members. Send feedback through the Contact page.