Dear Collaborative: Frequently Asked Questions (FAQs)

Q1: My agency uses Objective Arts (OA) for direct CANS entry. What are some helpful reports to look at client progress and needs over time? 

A1: Several reports can be accessed using OA, such as Tickler with Episodes, Impact Report, TCOM Caseload Progress, and others. To make the most of the reports based on your caseload, the most informative one for you would be the Items Impact Report. This report, which your agency can extract directly from OA, provides a comprehensive overview from intake to present. From this report, you can see actionable items for a caseload as well as the percentage of resolved items. In this report, your agency can also identify items where programs are making the biggest impact on client needs, as well as areas of improvement for providers.  If you or someone at your agency would like additional information on pulling reports and OA data, you can learn more through the Objective Arts Key Reports Manual found HERE. You can also access the PowerPoint slides that highlight report use and parameters.

Q2: I need support grounding myself in the ratings. Sometimes the ratings feel like they are flipped in my mind when going from NEEDS to STRENGTHS and back again.

A2: When rating a NEED, 0 indicates no need. When rating a STRENGTH, 3 indicates no strength. This may feel flipped or like opposites for many users of the CANS/ANSA. A different way to reorient yourself to the ratings is to tie them to your potential action level as a provider, as this does not change regardless of whether the item is a need or a strength.

When looking at the Needs, 0 means zero action is needed. A 1 rating is an item to keep an eye on while you gather more information or determine if it’s something that could benefit from an intervention. A 2 rating requires you to intervene, but you have time to develop and provide interventions. A 3 rating represents a worst-case scenario, and an immediate need for you to do safety planning, going over and above the baseline intervention.

When looking at STRENGTHS, a 0 rating means no action is required, as this is something the client has a handle on and can use independently. A1 rating indicates a strength that is there, and it can be useful for you to know it exists.  The 2 and 3 identify an actionable item IF the client WANTED to further develop this strength. A 2 rating for strengths is something that could benefit from an intervention to build it (if the client wanted). A rating of 3 in strengths means that extensive support would be needed, as you would be starting from scratch (if the client wanted to work to develop that strength).

We also like to use this iceberg visual to help solidify actionable ratings regarding both needs and strengths domain items: 

You can also find additional tips and tricks on our Alameda TCOM Collaborative website such as a CANS Rating Windowpane-Scoring Guide, 

Q3: I need help with really understanding and grounding myself on how to separate a rating of 2 from a rating of 3 in looking at NEEDS.

A3: You have identified an actionable needs item for your client. How do you determine the amount of support to provide? There are a few ways to identify the level of support necessary to aid in healthy development.

One way is to go back to your CANS/ANSA manual and look at the anchor text for the item. Which of these descriptions—a 2 or a 3— best fits the level of negative impact the client is experiencing?
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If you're still unsure, you can ask, "Does the client have time for the provider to provide an intervention over time?" If so, a rating of 2 may be appropriate. If time is critical, a 3 may be most fitting, as this item may indicate a severe, dangerous, or disabling level of functioning. Think about the worst-case scenario.

​It's also important to consider the principle of masking: Is there an intervention (short or long term) that is helping this need appear less severe? Interventions might include medications supporting symptom stabilization or a residential facility that limits access to potentially dangerous situations. If these interventions were removed, would the client’s level of risk increase? And to what degree?
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• Enough to impact day-to-day functioning, but with time to put in an intervention? - Rating of 2.
• Enough to be exposed to a higher risk, such as loss of life or a debilitating level of functioning? - Rating of 3.

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