Dear Collaborative (Winter 2020 Edition)

In the Dear Collaborative column, we answer YOUR questions about TCOM and the TCOM tools (CANS, ANSA-T, ANSA).
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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 .
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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.

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