​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:

• A student struggling academically may still have strong relationships with peers that serve as a foundation for engagement.
• A child with frequent absences might benefit from identifying what “rings true” for them about school–whether it’s a specific teacher, activity, or subject–and finding a way to amplify that connection.
• A family experiencing conflict may need guidance in communicating with school staff, fostering stronger collaboration between home and school.

 
Some questions clinicians can ask clients and families to better understand these experiences are:

• What comes up for you when you think about a typical day at school?
• What are the things about school that you like? Dislike?
• What are the things about school that you do well?
• Where do you need more support in school? What would make your school experience easier?
• What comes up for you when you think about a school bell ringing? School year starting? Ending?

 
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:

• What does the sound of a bell symbolize for your client? Anticipation? Stress? Celebration? What have they shared about their school experience?
• Does your client experience school as a place of growth? Or as a place of struggle?
• What role can caregivers, teachers, and providers play in “tuning” the bell to make school a supportive and empowering space?

 
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!!

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.

​Did you know that you need to recertify your CANS certificate every year? 
​The process is simple. Take a look!

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?
​
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?
​

• 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.

As the days grow longer and the sun shines brighter, summer invites us to pause, reflect and recharge. In our previous post on Lotería and the CANS series we focused on how El Árbol (The Tree) was used as a tool to discuss family strengths. In this installment, we’ll explore El Sol (The Sun) and how it can inspire us to approach strengths in the CANS. Just as the sun provides light and energy, strengths are the bright spots that illuminate a child’s potential and guide our collaborative work with families.

Applying the Concept in Practice 
Some questions clinicians can ask their clients and their families are:

• Walk me through what a typical day in your life looks like.
• What are the things that help you cope during stressful times?
• Who are the people that are most important/influential in your life?
• What are the things that you need to get through the day?
• What are the things that you look forward to each and every morning?

By helping families see their strengths as a source of light and growth, we empower them to build on those strengths and move toward meaningful change. When working with children and families, El Sol reminds us to seek out and amplify the positive elements in their lives.

For example:

• A child struggling with anxiety may still display kindness and empathy toward others–a strength that can serve as a foundation for coping strategies.
• A family experiencing financial stress might have a strong cultural identity or shared traditions that provide resilience and connection.
• A teen navigating difficult relationships might show incredible perseverance and commitment to personal goals, even when faced with obstacles.

 
Part of our work is to help families see their own strengths and make those connections as seen in the examples. Questions like, “Walk me through what a typical day looks like for you” and “What are the things that help you cope during stressful times” are open-ended questions that help us see the bigger picture from a client’s perspective. We might not hear how a family has a strong cultural identity or how a client has empathy towards others with simple yes or no questions. Using the Lotería cards and the open questions can really help us get a better understanding of a client’s perspective on their strengths and needs. It is in those moments where the strength-based language and collaboration can really shine. As providers we can say, “It sounds like your culture and family are really important coping mechanisms during stressful times.” That invites our clients to add more information or clarify. Either way, it is a win win for us.

Using El Sol (The Sun) as a Supervision Tool 
The CANS is also a tool that can be brought into supervision to not only further deepen a clinician’s understanding of CANS items/ domains but overall their implementation of the CANS. El Sol (The Sun) is a powerful symbol of warmth, hope, and growth–qualities that align beautifully with the strengths-based philosophy of the CANS.
 
In a CANS assessment session, El Sol can be used as a metaphor to spark reflection on how we, as providers, identify and build upon the strengths of children, youth, and families. The same can be true in supervision.
​

​​Consider these prompts with a supervisee:

• What are the areas where you see your client “shine?” How does this inform your CANS ratings for the Strengths domain?
• Does your client know the areas in which they “shine?”
• What role do supportive adults/family members/teachers play in helping strengths “shine” for our clients? What supportive adults would you say see how or what areas your client shines?
• What helps them cope?
• What is a typical day like for this client? Where do you see this reflected in their CANS?

 
These questions encourage individuals to think creatively and collaboratively about the importance of centering strengths in assessment and planning. Additionally, it helps all the items in the CANS align. When a supervisor hears a provider describe crucial support from a "neighbor" or "community member," but the Natural Supports rating is a "3" (no evidence of a strength), it's an opportunity to discuss that difference further.

Looking Ahead 
As we soak up the summer sun, let’s commit to shining a light on the strengths of the children, youth, and families we work with. Whether it’s celebrating small victories or uncovering hidden resilience, we have the privilege of being part of their journey toward growth and healing. We would love to hear your experiences and/or questions about using Lotería cards during your CANS assessments. Feel free to contact us. 

In future posts, we’ll continue to explore Lotería cards and their connections to CANS, blending cultural creativity with practical tools. Until then, let’s embrace the warmth and energy of El Sol as a guiding force in our work this summer.
 
Here’s to brighter days and a renewed focus on strengths that help children and families thrive.

What are your best practices for completing a CANS collaboratively with a client/family? 
When meeting with a client/family it can be helpful to start by clarifying our role, the purpose of CANS and the goals of the assessment. Review the limits of confidentiality and informed consent. This is their assessment and should be treated as such. Meet the client where they are at, use their words, and allow them to drive the conversation. Be flexible and creative in your methods of gathering information throughout the process. Highlight their strengths and guide identification of goals. Encourage self advocacy. Be open to feedback and suggestions. We are there to assist in connecting to resources or placing referrals. Our role is to support the client/family, listen and learn.

What are your best practices for attending a CFT meeting with a client/family? 
It's important to set the tone at the very start of a Child and Family Team Meeting. As clinicians we ensure that the entire team is aware of the purpose of SSA CANS service. We make it clear that SSA CANS is not a mental health service but is focused on strengths, empowering clients and families, recognizing challenges and setting goals. We also acknowledge the efforts of clients and caregivers in completing the SSA CANS as this process is time consuming particularly for families facing complex systems. Acknowledging this effort helps to build rapport and shows appreciation for their participation in the process. We encourage the family and others to share strengths, needs, and any challenges they may be facing so that we can better advocate for their needs.

If you’re certified in CANS, you recall the process of going to tcomtraining.com to get certified each year. There are several common questions or needs that can be addressed by the TCOM support team by emailing [email protected]. Here are some things they can help with:
 
If you change jobs and can’t log in because you no longer have access to your old work email, email [email protected], and they can change your email and association to your new agency to allow you access to your account. You can still use an active CANS certification if you’re still in the same county or request that they add a new county, if possible, to your account. Asking for support helps many people avoid taking unnecessary additional CANS certification tests when they move to a new job.
 
If you work in multiple counties and need your tcomtraining.com account and CANS certification associated with multiple counties, this is often possible without taking extra exams. If you certify in one county (e.g., Alameda), you can email [email protected] to request that your certification be linked to additional counties you work in (e.g. Contra Costa or San Francisco). There is no limit on the number of counties that can be associated with one user. Not every county accepts the certification from another county, but many do, so it’s worth checking before you take multiple certification exams.
 
The folks at [email protected] are always available to help you with website access or navigation issues, so feel free to reach out and ask!

Do you feel like you could be a more effective CANS user or better understand the TCOM philosophy? If so, the Praed Foundation (makers of the CANS) has just the thing for you - The TCOM YouTube Channel.
 
If you’ve got five extra minutes or a free hour, check out a wide variety of videos from short, 5-minute tutorials like the TCOM Heuristics (approach to problem solving) Series to full, topic-specific presentations from TCOM conferences or trainers.
 
Check out the site by trying out this 3-minute video on Building Strengths from John Lyons, the father of TCOM and the CANS:
 
The more we know, the better we get!

​Yes! In time. Alameda County is currently working toward a One CANS per Youth model, although it has been delayed due to technical challenges. One CANS per Youth means that one provider is responsible for holding authorship of the CANS, incorporating youth/family/team feedback (including feedback from providers across programs), and sharing w/ relevant parties. The goal is for all providers to operate off the one shared CANS for coordinated care and continuity. Alameda County Behavioral Health will alert Alameda providers once technical challenges have been resolved, and a clear workflow has been established. In the meantime, continue to complete individual CANS collaboratively. 

​Great question. In general, a Release of Information is not required to share CANS ratings w/ the following providers on the team, as applicable: Juvenile Probation, Child Welfare, other mental health providers. That said, if the CANS indicates current or historical substance use needs, an ROI specifically addressing substance use is required. To release the CANS prior to receiving an ROI, the substance use rating for client and/or caregiver (and related extension module if applicable) should be redacted. 

Question 3:
I’ve been hearing about a version of the CANS called the CA IP-CANS. What is it and do I need to use it? 

The CA Department of Social Services (CDSS) adopted the CA Integrated Practice (IP) CANS as the functional assessment tool to be completed collaboratively through the Child & Family Team (CFT) processes to guide case planning. Beginning July 1, 2025, all placing agencies* are required to ensure the collaborative completion of the IP-CANS for all children, youth, and nonminor dependents. The IP-CANS includes the CA core 50 items, a module on Potentially Traumatic/Adverse Childhood Experiences (yes/no), and a module for Early Childhood (birth-five). The Alameda CANS (birth-24) includes the CA IP-CANS items (plus a few more). 
 
For ACBHD providers and partners, there is no change. Please continue to use the Alameda CANS (birth-24) version.
​​

• IP-CANS Manual/ Reference Guide
• The IP-CANS Rating Sheet- English | Spanish (pdf)
• CDSS IP-CANS Resources | ​CANS and ​Tiered Rate Structure

​*Placing agency: According to Welfare and Institutions Code (WIC) Section 16560 (b)(4), placing agency means a county child welfare agency, a county probation department, or an Indian tribe that has entered into an agreement pursuant to WIC Section 10553.1.