Dear Collaborative… Summer '18 Edition

In the Dear Collaborative column, we’ll answer YOUR questions about TCOM or the TCOM tools (CANS, ANSA-T, ANSA).
 
Have questions and want answers?  Submit your questions through the Contact page and look for the answer in the next edition of Dear Collaborative. Submissions are treated confidentially.


Q1: How do I score someone with a substance abuse history who hasn't used in 30 days?
A1: This depends on the reasons for their 30-day abstinence. If the reason for the abstinence is that the client has engaged in voluntary recovery, then you would rate this item as at least a 1, indicating a recent history of substance abuse.  If you and/or the individual feel that the risk of relapse is significant and that more planning is needed to support recovery plans, then this should override the “30‐day window” rule. If the reason for the abstinence is due to a situation in which the individual has no choice but to abstain (e.g. jail, or a locked detox program), then you would rate the item according to the individual’s Substance Abuse needs just prior to entering the program.
 
Q2: I barely know this client at this early stage, but I need to turn in my assessment. What happens if I find out more about their actual treatment needs after I have completed the ANSA?
A2: At any given time, we have incomplete knowledge about the people we work with. When paperwork is due, we capture only what we know about the client at that time and expect to learn more as we move forward together. As we learn more, we update our understanding of their needs, strengths and treatment planning implications. It is always possible to update your CANS or ANSA ratings and this is recommended if there are significant shifts in the client’s life, particularly if your treatment plan is shifting because of the changes. 
 
Q3: What should I put in the strengths domain if I can't identify any strengths?
A3: In the Strengths domain, if there is no evidence of a particular strength, we rate it a score of 3. When planning treatment with the individual, family, and team, it is helpful to explore possible strengths or how the team can engage in strength building activities that suit the individual’s goals and desires.
 
Each newsletter will feature top questions that are submitted to the Alameda TCOM Collaborative. If you have an urgent or critical CANS/ANSA -related question, you can contact your agency's CANS/TCOM Coordinator or one of the Collaborative Members.

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