ALAMEDA TCOM COLLABORATIVE
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Integrating Lotería and the CANS: A Creative Approach to Understanding Strengths and Needs

3/25/2025

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​As we step into spring, a season of growth and renewal, we are excited to introduce a new series for the Alameda TCOM Collaborative that combines cultural creativity with practical tools: Lotería and the CANS. Through this series, we’ll explore how Lotería, the beloved Mexican game of chance, can serve as a metaphorical and visual framework to deepen our understanding of CANS items and enhance our practice.

Lotería, often compared to bingo, features a deck of beautifully illustrated cards, each symbolizing unique objects, people, or themes. These cards tell a story, inviting reflection and connection. In this series, we’ll use Lotería cards as jumping-off points to explore specific CANS items or domains, focusing on strengths, needs, and the ways we can support children, youth, and families.
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For this first post, we chose El Árbol (The Tree) to represent family strengths, an essential item in the CANS. Just as a tree thrives with strong roots, families often serve as the foundation for growth and resilience. The CANS assessment invites us to look at family strengths through a strength-based lens, highlighting areas of connection, support, and nurturing.

Using El Árbol (The Tree) as a Tool

El Árbol (The Tree) provides a vivid and versatiles metaphor for discussing family strengths in collaborative meetings. Imagine starting a session by sharing an image of the card and asking: 
  • Who are the people in your life that make up your family?
  • Who do family members consider to be a support?
  • What are the relationships between family members?
  • What helps your family grow and remain healthy? 
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These questions can spark rich dialogue, connecting the visual symbolism of El Árbol (The Tree) with the practical application of identifying and building on family strengths during the CANS assessment process. 

Applying the Concept in Practice

In a CANS session, El Árbol (The Tree) can also help individuals shift their focus toward identifying hidden strengths within families. For example, a family may appear to be struggling with communication, but deeper observation may reveal “roots” of resilience – strong traditions, cultural values, or a shared desire to improve relationships. Acknowledging these strengths allows us to cultivate them further, much like nurturing a tree.

Looking Ahead

​The series will explore more Lotería cards and their connection to CANS items. Whether it’s La Campana (The Bell) and its connection to school-related items or El Sol (The Sun) and its focus on individual strengths, these posts will provide creative ways to approach the CANS while honoring the cultural richness of Lotería.
Stay tuned for our next post, where we’ll continue to blend culture, creativity, and practical application. In the meantime, consider how you might use Lotería or other culturally meaningful frameworks in your work with families. We would love to hear from you about your experiences and other games that can be beneficial to include in our work with the CANS.

Let’s grow together this spring – one card and one strength at a time!
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What’s New with the CANS Across the Bay?

3/25/2025

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Check out the SF BHS CYF T.I.P.s CANS page for tons of CANS resources out of San Francisco!

San Francisco rolled out One CANS per Youth, which is a shared CANS concept. See their CANS Practice Guidelines and Use in Epic resource for  more information.
Their site includes CANS tools, engagement resources, CalAIM-informed care planning strategies, and data reflection guides. They also link to other helpful sites including our very own https://www.alamedatcom.org
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SF CANS RESOURCES HERE!
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Dear Collaborative: Frequently Asked Questions (FAQs)

3/25/2025

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Question 1:
I work with kids, and it's really hard to get many of my clients' parents to spend time with me and answer all these CANS questions; I'm not sure how to get the CANS done. Any advice? 

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​We totally understand that the CANS can be intimidating, especially if you feel like you need to ask about every item. Luckily, CANS isn't meant to be a questionnaire but a framework to organize the information you get from organic conversations with clients, parents, teachers, case managers and others who interact with and know the client. So go ahead and use your engagement skills to have conversations about how life is going, what concerns them, what's going well and where they think they need help or want change. Keep the CANS items in mind while you're talking, and then use the CANS framework to organize what you learned. It's OK if you don't know about every item at first; you'll likely know more when you come back to do an updated CANS after you get to know people better.

Question 2:
I work in more than one county and don't understand why the CANS has different versions-why?

​CANS is a flexible tool that allows jurisdictions to choose the items they feel are most relevant to the folks who live in that area. California has a core set of items used across the state and each county can choose additional items to create a version that fits them best. This customization prevents everyone from having to use extra items that might not be prevalent in some areas but are really important in other regions while also allowing the State to gather data sets on the core items statewide. This can help with funding and service decisions in a really important way!

Question 3:
I don't like rating people-it feels bad; why does CANS force us to rate people?

​Oh no, we definitely don't want to rate people, but we do want to use CANS to rate where we need to act to support clients with needs and help them build strengths. We want to identify action plans so clients get what they need and so we rate for action. This way, we create a road map for ourselves to implement interventions and for clients to be the architects of their own change by collaboratively identifying their strengths and needs. 
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How Can We Make the Newsflash Better for You?

3/25/2025

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FEEDBACK HERE!

When you win (through meaningful use of the CANS), we all win (with increased transparency, collaboration, and transformational change)!

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​Part of our mission as the Alameda TCOM Collaborative is to bring CANS information, resources, and training to the Alameda provider community. We’d love to hear more about what YOU want so we can meet your needs and prioritize information that’s meaningful to you and your practice. Our hope is that the CANS can be a useful tool for you and the youth, families, and teams that you partner with to reach consensus around action, work toward common goals, and celebrate progress. 

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Thank you in advance for sharing your feedback with us!
​We appreciate it. 
FEEDBACK HERE!
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Dear Collaborative: Frequently Asked Questions (FAQs)

12/31/2024

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Question 1:
I remember learning about "the masking principle" in training but I don't remember what it was-can you help?

When we use the TCOM tools we want to rate the needs and strengths based on the person, NOT the person in care. Treatment interventions that are already in place can "mask" or cover up symptoms that would indicate a need for action if they were not already being addressed. It is important to rate the items on the CANS or ANSA for the person in their natural environment to ensure that the tool highlights all actionable areas. E.g., If a client is prescribed medication for ADHD that "masks" their hyperactivity, you will rate the impulsivity/hyperactivity item as if they did not have that intervention in place. This will ensure that staying on medication/other interventions are part of your planning in that area.

Question 2:
Do I have to take all the CANS tests listed on the testing page to work with all those ages?

No! You just need to test once. The testing website gives you the ability to choose what age you'd like your testing vignette client to be so that you can test with a person who is similar to the ages you work with most. You only have to test and pass once and you will then be certified to use the CANS or the ANSA with any age client for one year!

Question 3:
Why are there "trigger items" that make me rate more items? 
Trigger items are items that allow you to dig deeper and better describe aspects of a particular need item. E.g., If your client has a ratable need for the "school behavior" item, you will want to know if the need is related to tardiness or bullying or discipline or something else. The extra items allow you to drill down and better identify the actionable need in a more focused way so you know what to create an action plan for.

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Free CANS Trainings Scheduled for Your Organization

12/16/2024

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Did you know that we offer free, live, virtual CANS trainings for Alameda County providers on your schedule? If you find our monthly certification trainings hard to send staff to due to scheduling conflicts but have a group of staff to train, we can schedule a CANS Certification "roadshow" just for you! Contact us and we will work out a date and time that works best for you and your staff. Beyond CANS Certification trainings, we offer CANS roadshow trainings on other topics as well including, but not limited to: CANS and Supervision; Teaming with CANS; CANS Engagement; & CANS Data/Reporting. We're here to help address your CANS Agency-specific needs!

Click here to Email US & SCHEDULE A CANS Training For Your Organization
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20th Annual TCOM Conference—Climbing the Hill of System Change

12/12/2024

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The first day of the conference, held at Hotel Nikko in San Francisco this year, had powerful sessions that challenged our systems to reflect deeply on change. 

One of those sessions was an inspiring presentation by Dr. Jennifer Roland, Director of Public Policy and Government Affairs at the Illinois Collaboration on Youth, discussed Critical Race Theory and the long history of racism in our child welfare and legal systems.  Recently adopted Resolution 606 
brings needed change by urging governments, courts and practitioners to recognize implicit and explicit bias; acknowledge collective responsibility for challenging laws, policies, and practices that devalue Black families; ensure all legal decisions, policies, and practices respect and value the racial, cultural, and ethnic identities of Black children; and consult, listen to, and be led by Black parents, children, and kin with lived experience in child welfare to learn how to constructively end the legacy of Black family separation.  The presentation ended by reminding us that many of these principles align with the TCOM philosophy that invites us to adopt a child- & family-centered approach to collaboration.


Other highlights from the conference included a gathering of Spanish-speaking providers.
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Those using the CANS in Spanish were able to build community, share un cafecito, discuss barriers, and share resources for using the TCOM tools with Spanish-language communities.  Cristal Alvarado, from East Bay Agency for Children and the newest member to the Alameda County CANS Collaborative, shared about using Lotería (a Mexican game similar to BINGO), as a tool to guide conversations about the CANS. 
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Alameda County was also represented at the CANS Conference. Cinthya Chin Herrera & Crystal Moore provided a thought-provoking presentation that invited participants to consider cultural biases and the clinical value of several items in the CANS Violence Module. Participants were challenged to take a holistic view, challenge assumptions, and ensure that we use the CANS as a tool to partner with youth and families and to interrupt systemic oppression.

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CANS & TCOM Coaching

12/12/2024

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Do you or someone at your organization have questions about the CANS or perhaps would a CANS/ANSA refresher be helpful? We’re here to offer you coaching and consultation.
Click here to Email us to set up a consultation
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New CANS Collaborative Member!

12/3/2024

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In November 2024, Cristal Alvarado officially joined the Alameda County (AC) TCOM Collaborative and she has already become actively involved including being the moderator for our most recently provided live CANS Certification training! Cristal is the Program Director of Learning and Education for the East Bay Agency for Children (EBAC). She comes to the TCOM Collaborative as a bilingual Licensed Marriage and Family Therapist (LMFT), a Registered Play Therapist™ (RPT™), and a Certified Child and Adolescent Trauma Professional (CATP). Cristal has also worked with non-profits in the Bay Area that serve system-impacted youth and families. All of this experience coupled with the attainment of Certification as a Child and Adolescent Needs & Strengths (CANS) Trainer makes Cristal well equipped to work within the TCOM Collaborative to help address CANS and TCOM related needs of Alameda County agencies and staff. We are excited to have her as a new member of the team!

Click here to learn more about Cristal & Other COLLABORATIVE MEMBERS
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Integrating TCOM Principles within Alameda County Behavioral Health Child Family Team (CFT) Practices

12/3/2024

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Transformational Collaborative Outcomes Management (TCOM) is a conceptual framework for managing services and outcomes within complex systems.  Within this framework there is a philosophy, a strategy, and a set of tactics all designed to facilitate an effective and integrated approach to addressing needs and building strengths with people. We have integrated this person-centered, collaborative approach within our Alameda County Behavioral Health Department Child Family Team meetings.  To start with, we have redesigned the Intensive Care Coordination/Intensive Home Based Services (ICC/IHBS) Child and Family Team (CFT) Client Care Plan and meeting notes document by integrating client/family strengths and needs as discussion points which can be weaved in, as necessary, throughout the meeting. This change follows the Integrated Core Practice Model framework as we continue to focus on youth, young adult and/or family strengths and needs and support alignment of all members of the team so that these teams can collaboratively creation immediate and longer term action plans. These updates help ensure that the Child and Adolescent Needs and Strengths (CANS) tool is integral in the teaming process. 
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  • About
    • About TCOM & CANS
    • Collaborative Members
    • Contact
  • Tools
    • Manuals & Scoresheets
    • Engagement Guides
    • Assessment Tools
    • Trauma Assessment
    • Care Planning
    • One CANS Per Youth
    • Objective Arts (OA) Resources
  • Clinical Management
    • Supervision
  • Training
    • Training Calendar
    • Certification
  • Consulting
    • Office Hours
  • News
  • TCOM Conversations
  • The TCOM Channel