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This past October, I (Cristal Alvarado, EBAC/ Alameda TCOM Collaborative Member), had the privilege of presenting at the 2025 TCOM Conference held in Chicago. This year’s theme was grounded in “Standing on the Shoulders of Those Who Came Before.” As someone who lives at the intersection of Play Therapy and CANS practice, the theme resonated deeply. Our work is always built on foundations laid long before us, by early play therapy pioneers, by youth and families who’ve trusted us with their stories, and by the evolving framework of TCOM and the CANS itself.
One participant even shared that they played this game for many years as a child, and didn’t realize just “how deep” families could get with the game. It was a moment of inspiration and motivation.
Participants loved the hands-on approach of the session. Many noted how deeply these questions reach, how much we ask young people to reflect on, and how easy it is to forget the emotional lift required. Playing through the experience allowed everyone to feel the depth, not just think about it.
Why Play Matters in CANS Work One of the biggest takeaways (for the participants) was this: if we ask clients to do something, we should try it ourselves. Play-based methods make the experience more accessible, relational, authentic, AND more ethical (meeting the developmental needs of children and youth when assessing and gathering information). When we feel what it’s like to answer difficult questions in a “game,” we become more attuned to how we ask, pace ourselves, and support youth through the process. Standing on the Shoulders…and Reimagining Moving Forward Both sessions felt like a natural blending of my two worlds: Play Therapy and CANS. I left the conference feeling energized by the feedback. People felt motivated to integrate games into their work. They appreciated the blend of clinical depth and cultural responsiveness. And many said it helped them reconnect with the humanity at the heart of assessment. That’s the legacy we stand on: innovation rooted in relationship, safety, culture, and care. Want This Training At Your Agency? If you’re interested in bringing CANS + Games (Jenga, Uno, Lotería, or other playful tools) to your staff or program, we’d love to come teach. Contact us here. Let’s bring play, culture, and connection into your CANS practice. Thank you for growing in this work with us. Here’s to standing strong on shoulders….and building new ones!
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In a stressed system, it can be difficult to connect to other providers, parents, teachers, social workers, and other key stakeholders who play a vital role in the life of a client. Despite the challenges, it is vital to work with others when completing or updating a CANS to ensure an accurate and wholistic picture is created through the communimetric ratings. With CANS deadlines a part of our reality, try to plan ahead and reach out to others early and often so you can integrate the observations and concerns of as many people as possible. Emphasize to stakeholders that their input is vital to supporting your client’s success. Dedicate time each week for outreach to ensure it remains a priority. Stay consistent and patient when connecting with others who also have demanding schedules, and remember that collaboration ultimately serves the client’s best interests.  The CANS identifies the needs and strengths that guide our work and treatment, so the better the assessment, the better the plan to support. This is the roadmap for our work. Rather than a reactive approach to whatever comes up that day, a robust and accurate CANS grounds us in where the client is now and where they want to go, allowing the treatment team to identify areas of focus, plan interventions, and all travel down the same, coordinated path to wellness with our clients.
 Clint Pulver with his drums This short video (3.12) shares the story of a teacher who alters the life trajectory of a 10-year-old boy who is getting into trouble regularly at school. It is heartwarming and touches our aspirations as mental health practitioners, but more importantly, it embodies a strength-based approach in the following ways: 1. By reframing a problematic behavior as an asset that has the potential to become a talent. In CANS terms, it takes a “2” rated strength and builds into a “0” rated strength. 2. By reinforcing the belief that every behavior has meaning and serves a purpose – it just may have been difficult to uncover until now. 3. By centering connection as a significant agent of change. The innate transformational impact of seeing each youth as more than their struggles is enormous. 4. By reminding us of our crucial function as holders of hope that things can be different. We don’t know if every child will become a rock star, however, it is imperative to approach each child with the belief that their future has limitless possibilities.
 This year at the TCOM Conference in Chicago, one of the most moving and energizing talks was delivered by Dr. David Fakunle in a powerful presentation titled: “Reaffirming Humanity: How Storytelling Uplifts Contexts, Healing, and Truth.” His message was clear, bold, and deeply worded in ancestral wisdom: storytelling is healing … and it always has been.
The Ancestral Legacy of Storytelling One of the themes that stood out the most was Dr. Fakunle’s reminder that BIPOC communities have used storytelling, ritual, art, rhythm, and cultural practices as healing tools for centuries. These practices were foundational. What’s happening now is not the discovery of something new; it’s simply that modern data is finally catching up to what so many communities have always known. This affirms the importance of integrating cultural practices into assessment, engagement, and healing, not as add-ons, but as the roots of the work. Storytelling and the CANS: Seeing the Whole Person While Dr. Fakunle didn’t talk about the CANS directly, the connections were immediately apparent and powerful. He emphasized that storytelling allows us to see the whole person, understand their world, honor their truth, and uplift the context around their experience. That is exactly what the CANS is meant to do. The CANS is more than an assessment tool: it is a framework for hearing a person’s story fully, respectfully, and with nuance. Every time we ask a question, every time a youth checks in with us, every time a caregiver shares a detail from their day, they are already storytelling. Our role is not just to listen, but to receive the story with care. Dr. Fakunle said something that was particularly powerful: “For good storytelling, there must be good story receiving.” And that is the heart of the CANS practice. It’s not just about documenting needs, it’s about being present enough, attuned enough, and culturally responsive enough to receive someone’s narrative as they offer it. The Stories That Heal Us Dr. Fakunle shared several stories throughout his keynote, but the one about “the story of the precious stone” was really aligned with the theme of integrating stories with CANS practice. An old woman finds a valuable stone. A man sees it and asks for it, and without hesitation, she gives it to him. The man returns to ask for the inner quality that allowed her to give it so freely. The message was profound: it’s never about “the thing.” It is about the person, the essence, the lived experience behind it. In the same way, CANS ratings are not about the numbers. They are about the human being behind every item, and their courage and context. “Until the Lion Tells Their Side of the Story …” Dr. Fakunle ended with one of the most important quotes of the day: “Until the lion tells their side of the story, the tale of the hunt will always glorify the hunter.” The CANS must be a tool that centers the voices of our clients, a tool that helps youth and families reclaim authorship of their experiences, a tool that ensures their version of the story is not only heard, but honored. Bringing It Back To Practice This keynote reaffirmed why the CANS matters and why story-based, culturally grounded approaches are essential. Whether through games, play, conversation, or reflection, our goal is to invite their story, receive their story, and help youth and caregivers make meaning from it. Contribution by Alameda TCOM member and conference presenter/attendee C.A.  Q1: If my agency transitions from using the Alameda County CANS 0-24 to the California Integrated Practice (IP) CANS, do I need to certify in the CA IP-CANS right away? A1a: No. In this scenario, your Alameda County CANS 0-24 certification is sufficient. Plan to certify in the CA IP-CANS after your current certification expires. A1b: For best practice, you should certify in the CANS version your agency is currently using. If your agency continues to use the Alameda County CANS 0-24, you should certify in the Alameda County CANS 0-24. [See previous Newsflash for more info on this.] Q2: If I get certified in the CA IP-CANS, will my certification automatically sync to Objective Arts (OA)? A2a: Yes! It will automatically transfer to OA. A2b: If your certificate does not automatically sync, please check that your staff ID/ SmartCare ID number is entered correctly on OA and Schoox/TCOM Training. If not, please correct the information. A2c: Every user can manually transfer their certification to OA following the steps below:
Q3: For all Alameda providers, will Schoox/TCOM Training be adding a course for the CA IP-CANS, including supporting materials/manual? A3: Yes. Training materials are available on Schoox/TCOM Training under the California, Behavioral Health-Alameda bundle. You’ll see three courses to choose from (see screenshot below).
 Q4: If using Objective Arts for CANS data entry, how will I know which questions are required (CA IP-CANS items)? A4: All CA IP-CANS questions are required for submission and will have an asterisk* next to the category/question. If the question does not have an asterisk*, it is optional. Q5: Will the CSV upload format change, and will Objective Arts still accept all CANS scores? A5: The CSV format will not change. OA will accept all CANS scores, including optional ones (additional Alameda County CANS 0-24 items). Q6: What are the client age ranges for the CA IP-CANS? A6: 0-5 (Early Childhood Module), 6-20. Alameda providers are required to complete CANS for children/youth ages 0 up to 21.
 To: ACBHD All Providers From: Laphonsa Gibbs, Director, ACBHD Child and Young Adult System of Care Memo Highlights: Effective October 6, 2025, under your contract, the Child and Adolescent Needs and Strengths (CANS) requirements will change. Only the IP-CANS questions will be required as part of the transition toward implementing a “One CANS per youth” model for ages 6-21 years. The CANS must be completed by the mental health provider at intake, every 6 months, at discharge, and annually. ... ... ACBHD will require completion of the IP-CANS. At the same time, we recognize that individual agencies may choose the approach that best fits their practice. Agencies may continue encouraging staff to complete the full Alameda Birth-24 CANS version, or they may decide to focus on completing only the IP-CANS items. Our goal is to provide flexibility while ensuring consistency on required elements. ... See memo for more details including Data Entry of CANS and PSC-35- CHANGES TO OA. Please contact Jessica Vigil if you have any questions related to CANS or Objective Arts navigation support at [email protected]. Attachments • IP-CANS Rating Sheet- English | Spanish (pdf) (other threshold languages will be coming soon) • IP-CANS Manual English (other threshold languages will be coming soon)  >>> Specific to the Alameda Birth-24 CANS (not included in the IP-CANS):
All Extension Modules:
 As the school year begins, it’s the perfect time to reflect on how we can best support children and youth in their academic journeys. In this installment of the Lotería and the CANS series, we’ll explore La Campana (The Bell) and its connection to the school-related items in the CANS. Just as the bell signals the start to the school day, it also represents opportunities for growth, connection, learning, and perhaps even triggers–both for students and for those working alongside them. For more information on using Lotería cards with other CANS items, such as strengths and family, visit our previous posts and newsletters for further details. The CANS includes several school-related items, such as school behavior, achievement, and attendance. These areas are critical to shaping a child’s overall well-being, and La Campana offers a creative way to explore them during assessments.  Applying the Concept in Practice When assessing school-related needs, La Campana can serve as a visual reminder to listen for the unique “ring” of each child’s experience. For example:
Some questions clinicians can ask clients and families to better understand these experiences are:
The responses to these questions can then lead to collaborative conversations around CANS needs ratings. By focusing on both strengths and challenges from their responses and ratings, we can help children and families navigate the complexities of the school environment with greater resilience and success. Using La Campana (The Bell) as a Supervision Tool La Campana (The Bell) can evoke many interpretations–some positive, such as excitement for learning, and some more challenging, like the stress of high expectations or other triggers. The CANS is an amazing tool that can be brought into supervision to further deepen discussions. La Campana can be used as a metaphor to spark reflection on how school environments impact a child’s strengths and needs. Consider posing the following questions to a supervisee:
These prompts can lead to rich discussions about school-related CANS items and how we approach them in a collaborative, strengths-based way. Looking Ahead As the school year progresses, La Campana reminds us to celebrate even the small victories: a child’s improved attendance, a parent-teacher partnership, or a student feeling more confident in their abilities. These moments resonate far beyond the classroom, creating a ripple effect of growth and empowerment. We would love to hear your experiences and/or questions about using Lotería cards during your CANS assessments and using them in schools. Feel free to contact us here: In future posts, we’ll continue to explore Lotería cards and their connections to CANS, weaving cultural creativity into meaningful conversations about strengths, needs, and collaboration. Until then, let’s keep listening for the bells that signal progress in our work with children, youth, and families. Here’s to a school year filled with opportunity, resilience, and connection–one ring at a time!!  If you’ve come to live online CANS certification training, you might remember that a foundational characteristic of the CANS is that culture should be considered throughout every domain and item. There are, however, specific items related to culture and these items are found both in strengths and needs domains.  In the strengths domain, we have the cultural identity and spiritual/religious items to rate. These items can capture the powerful positive impact that belonging to a specific cultural group or having a specific religious identity/spiritual belief or community can have on a child, youth, or family. The cultural identity strengths item is inclusive of factors such as race, religion, ethnicity, geography, and sexual orientation or gender identity and expression. It is imperative that we understand how clients and their families self-identify, and if their identity creates a sense of inclusion and/or pride for them that might indicate a centerpiece strength or if we have something to build on. On the needs side, our Alameda County CANS has the Cultural Factors needs domain with four items to capture any needs related to language, traditions and rituals, cultural stress, and cultural differences within the family. This domain highlights our county’s acknowledgement of the very real negative impacts systemic racism and oppression can have on our children, youth and families. The more we understand our clients and their lived experiences, the more we can support them to build resilience and connect to resources to strengthen their cultural identities and connections and reduce culturally-related needs.  Alameda Birth-24 CANS  CA IP-CANS Did you know that you need to recertify your CANS certificate every year? The process is simple. Take a look! 
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