 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.
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 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:
 May 22 and 29, 2020
April D. Fernando, PhD Center for Innovation in Population Health University of Kentucky Time: 9:00am – 1:00pm This course will be conducted via video-conference and attendance at both sessions is required. Course Description: The Alameda County Adult Needs and Strengths Assessment (ANSA) and Child and Adolescent Needs and Strengths (CANS) are a collaboratively completed measure of either individual adult or child and family strengths and needs. These evidence-based, standardized assessments were developed to support decision-making, including level of care and action planning, to facilitate quality improvement initiatives, and to allow for the monitoring of clinical and functional outcomes. As a communication tool, it facilitates the linkage between the assessment process and the design of individualized service plans. The ANSA/CANS Certified Trainer Training workshop is designed for individuals who have completed the ANSA/CANS Orientation and TCOM Overview and are interested in coaching and/or training their staff on the ANSA or CANS. Key concepts and skills will be practiced through small group discussions, exercises and activities. In addition to participating in this 2-session video-conference workshop, ANSA/CANS Certified Trainer credentialing includes: • Achieving a ANSA/CANS certification reliability of .80 or above; • Developing examples of the Six Key Principles of a communimetric tool; •Developing ANSA/CANS domain level mini-vignettes to help in identification of specific domain items and determine action levels; •Developing and submitting one original vignettes with recommended action levels and rationale using the ANSA/CANS; •Developing a case plan using the corresponding action levels from the trainer developed vignette; and •Articulating an introduction to TCOM and the ANSA/CANS to be delivered to clients and their families. At the end of the 2-session workshop and once all credentialing steps and materials noted above are met, trainers will be provided access to ANSA/CANS training curriculum and materials on TCOMtraining.com. CANS Certified Trainers are to re-certify annually on TCOMtraining.com to maintain their trainer status. Certified Trainer re-certification requires annual re-certification ANSA or CANS reliability of .80 or above. Attendance at the annual TCOM Conference once every 2-3 years is highly recommended.  Michael Kessler, LPCC, CRC is a Licensed Professional Clinical Counselor and a Certified Rehabilitation Counselor. He began his work in mental health settings in 1994 as a Registered Music Therapist (RMT). In 2011 Michael began his work at Alameda County Behavioral Health Care Services, and currently he is the Clinical Program Specialist for the Older Adult Division. In that capacity, he ensures that the needs of Alameda County’s older adult mental health consumers are being addressed and that services for that population are available and implemented. Previously, Michael spent 15 years as the Director of Therapeutic Activities at the San Francisco Mental Health Rehabilitation Center (SFMHRC), where he was responsible for the development, implementation and supervision of the Psychiatric Rehabilitation Inpatient Program. During his tenure at SFMHRC he was also a Lecturer at the Department of Counseling at San Francisco State University, where he taught Advanced Counseling Process and supervised students in advanced practicum and internships. Throughout his career he has been an advocate for the use of expressive arts therapies, primarily music therapy, in the design and development of psychiatric rehabilitation programs.
 Trainings to look forward to in 2020 include:
CANS & ANSA Overview & Certification:
Training for Trainers—Coming this spring – date TBD Agency-specific trainings available in:
The TCOM tools (CANS and ANSA) are planning tools that express what areas to focus on in treatment with measurable metrics. It shows the level of urgency needed to take action, to provide clinical interventions for specific needs, and what strengths to build on in treatment with clients. The tools are also used for tracking case progress, acting as a roadmap throughout the time we work with clients. The CANS/ANSA help us to identify needs & strengths and treatment plans in an organized and communication-oriented manner that keeps us focused on the uniqueness of each client and what they present.
When you think about clinical supervision, supervisees and their supervisors are surely discussing all of these themes in the room each week. You are bringing client needs and strengths into the supervision hour, discussing assessment and interventions, and sharing progress and changes in the lives of the clients. What would it be like to do this using the CANS/ANSA in the clinical supervision space? Could the tool help you focus and organize the complex information and make the case easier to discuss with purpose and attention to what needs to be addressed? Try it out. Make a commitment. The tools have more impact the more we commit to using them in the way they are intended: to bring multiple voices into the conversation, keep the client front and center, and help us be the best clinicians we can be. Supervisors and supervisees, see what can come from using the tools in your time together! The Alameda TCOM Collaborative has an entire section of Supervision Resources for supervisors and clinicians, including:
 In the Dear Collaborative column, we answer YOUR questions about TCOM and the TCOM tools (CANS, ANSA-T, ANSA).
Have questions and want answers? Submit your questions through the Contact page. Submissions are confidential. Q1: What do I do as a clinician if there are A LOT of action items or needs identified on the CANS and I can’t address all of them in treatment at this time? A1: This is one example of when the collaborative nature of the CANS can be a helpful tool in determining where the highest needs are and who can address them. If you are addressing one set of needs and another provider is addressing another, you can work in collaboration and provide this context in your clinical documentation (e.g., clinical formulation and treatment plan). Additionally, it can be helpful to categorize needs as either background needs (typically more static, underlying needs that may be driving current behaviors, such as “Living Situation”) and target needs (identified with a "2" or "3" and intended to be addressed in treatment, such as “Self-Harm”). For target needs that are believed to share the same root cause, you can cluster them together and select interventions that address the whole cluster. By addressing target needs, you may also impact background needs. Similarly, you can categorize strengths into useful strengths and strengths to build. This is helpful when incorporating strengths into the treatment planning process. The process of clustering needs and strengths in order to focus treatment can not only help you as a clinician, but also the client, family, and treatment team to reach consensus and work toward common goals. Q2: When completing the ANSA, who is considered the caregiver when assessing caregiver needs? A2: For adult services, the “caregiver” is generally any person the recipient identifies as their caregiver. This could be a friend, a family member, or a spouse. When completing the CANS/ANSA certification exam, it will be made explicit who the caregiver is, both in the vignette and at the top where it reads “rate [name] as caregiver.” Q3: There’s a lot to remember regarding the CANS and ANSA tools. Is there a one-pager with key points? A3: Yes! Praed Foundation created the Child and Adolescent Needs and Strengths (CANS) User Tip Sheet and the Adult Needs and Strengths Assessment (ANSA) User Tip Sheet. Both tip sheets include a description of the tool, guiding principles, questions to consider and a quick action rating guide. Both serve as a great snapshot. If you’re interested in digging deeper, check out our Manuals & Scoresheets and Engagement & Planning Tools resources . Each newsletter features top questions submitted to the Alameda TCOM Collaborative. If you have an urgent or critical CANS-related question, you can contact your agency's CANS/TCOM Coordinator or one of the Collaborative Members at any time.  Why do we require that Alameda County providers do their initial CANS/ANSA Certification Training in person rather than simply having folks log in and do it themselves online? It’s a fair question to ask, given that it would seemingly be more efficient to have everyone do it on their own.
We do initial certification training in person because such an environment allows for deeper and broader understanding of these tools, connection-building with other providers, the opportunity for active conversation and questions, and the chance for individualized support from our experienced trainers. It is an all-day training, designed to allow you to briefly set aside your many obligations, immerse yourself in the experience, and not feel rushed. What’s more, most folks pass their certification test on their first try after these trainings, making this in-person setup, well, quite efficient, too. Think about the trainings you have been to throughout your career. Which ones were more effective? Which ones answered your specific questions? From which kind did you retain more information? Here’s to more fantastic training and CANS-certified providers in 2020! Be sure to check out the Alameda TCOM Collaborative Training Calendar for all upcoming in-person training sessions. Our CANS data says YES!  As providers, we know the importance of being strengths-based in our clinical work. This means being aware of our clients' strengths and emerging strengths, and identifying them in our CANS. Data from across Alameda County shows that clients receiving services are building their strengths during their time in treatment. The 14 items in the Strengths Domain show consistent increases in the number of centerpiece and existing strengths (ratings 0 and 1) from midway through treatment to discharge.
The largest gains were seen in the following CANS items:
The data set included almost 16,000 children and youth served by Alameda County providers from July of 2017 to July 2019. The outcome data clearly shows the importance of treatment and how we are making positive differences in the lives of children and youth. Keep up the good work! |
