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!
Blog content is created by the shared effort of the Alameda TCOM Collaborative members. Send feedback through the Contact page.