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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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 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!
 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.
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.  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.  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.
 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!
 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.
 We know you’ve got a lot on your plate working in behavioral health and child welfare systems. You don’t need to (and shouldn’t) be completing the CANS tool all alone but it may feel overwhelming to consider completing the CANS collaboratively with others. To help you overcome any reticence you may have, we’ve created a Tip Sheet to help increase your effectiveness and comfort in using the CANS tool within your teams. Whether you have Child and Family Teams (CFTs), Multi-Disciplinary Teams (MDTs), or any other groups working together to support youth and families, the team should be developing and monitoring changes on the CANS together so that everyone is and remains aligned.
 Question 1:
I get confused when youth are in foster care. Which caregivers do I rate when they are not living with their biological parent(s)? The manual instructs us to rate Foster Parents if they are the ones fulfilling the permanency plan, and often we rate those who the youth identifies as their caregivers/family. Luckily, you can individually indicate ratings in the caregiver domain for up to 4 caregivers when multiple people are supporting the youth. Question 2: I was certified as a CANS trainer through Praed [completed the training for trainers (T4T) + homework and received a trainer certificate], but recently I completed my annual CANS recertification and did NOT achieve a score of .80 or higher. Can I still train? In order to maintain trainer status, you must earn a reliability score of 0.80 or higher on your local TCOM tool annually and this cannot lapse for more than 3 months. The good news is that you can retest if you don't achieve that score the first time! Once you achieve the required reliability score of .80 or above, you can connect with TCOM Support & Assistance ([email protected]) to ensure your trainer information is up to date. Question 3: Do I have to have 2s or 3s on my CANS? 2s and 3s on the CANS indicate that there is a need for action in order for the rating to change (and for Needs items, this usually means there is an associated functional impairment related to that item). If there are no areas that need action (no functional impairments), then we should ask ourselves if the client needs our level of services and/or if they may need to be referred to a lower level of care. Any client with a mental health diagnosis must have some sort of functional impairment to meet criteria for that diagnosis so there should at least be one 2 for an item that aligns with their mental health diagnosis.  If you take just 5 minutes to watch our new CANS booster video, it will help you reflect on your collaborative style and give you (and your team) ideas about why the CANS is a collaborative tool. You don't have to (and shouldn't be) doing CANS all alone-it's a team tool, so make sure everyone is doing their share, including your clients, their families, your colleagues, and other stakeholders. You can watch the video in just 5 minutes and find an easy corresponding activity and handouts you can use with a friend, supervisor, or in your team if you'd like. Don't miss out on this quick and easy CANS skill booster! Check it out now?
 Did you know that there are engagement resources and guides on the Alameda TCOM website? Come check them out! Engagement Guides: The Child and Adolescent Needs and Strengths (CANS) assessment tool is intended to be used collaboratively with youth, families, and teams. Effective collaboration relies on clear communication, trust, and a commitment to building consensus among team members. Review these guides and tip sheets to see if there are any gems that you can bring back and use in your practice to increase engagement and elevate youth and family voices in care.
For example, we have:
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AuthorBlog content is created by Alameda TCOM Collaborative members. Send feedback through the Contact page. Archives
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