CANS/FAST use in Singapore
Thank you to our partners at the Rehabilitation and Protection Group in Singapore for joining our conversation:
In 2010, the Rehabilitation and Protection Group in Singapore was in need of a way to communicate the needs and outcomes for children in care. After reviewing the different frameworks in the literature, we decided that the Child and Adolescent Needs and Strengths (CANS) captured what we needed. Having an outcome management framework (TCOM) so elegantly designed to support person-centered planning at all levels of the system through the use of a collaborative focus on personal change was exactly what we needed.
Since then, we have worked with Fostering Services, Residential Care and Child Protection Services in the implementation of TCOM. Training and coaching on the CANS is ongoing to ensure that users accurately capture the needs of the child so that their needs can drive treatment planning, program management and system and policy design. This year, promising results have indicated that the level of needs of child welfare clients, classified by an algorithm, demonstrated statistical significance when predicting critical incidents and placement stability.
In 2013, a need for a common assessment framework for families in need was identified. As the CANS was already being used as the strategy to determine and address needs of children in care, it just made sense to now use the FAST (Family Advocacy and Support Tool). After all, it is an outcome management strategy that we wanted to be able to support planning at all levels of the system. While the CANS focused on the child in care, the FAST was used to determine the highest needs of the family by rating the family member with the highest needs for each item. There were many lessons gleaned from the implementation of the CANS and there are many more learning lessons as we go through the stages of FAST implementation.
1. Involving all partners who have a vested interest in the use of TCOM to be part of the customization of CANS/FAST items. People own what they help create.
2. Having believers who are able to collaborate with others and articulate TCOM and communimetrics.
3. Staying focused on the vision of creating safe, happy, healthy children and families who are able to pursue their dreams.
4. Using implementation science to guide implementation.
5. Putting procedures and protocols in place to help both the implementation consulting team and the FAST implementers to have better clarity about their roles in the implementation process. An implementation guide for the FAST was developed.
6. Centralizing the training of the CANS and the FAST at the Social Service Training Institute and setting standards for trainers.
7. Providing ongoing on-site technical assistance with appointed competent coaches and frequent check-ins on “out-of-ordinary” cases using the FAST.
Moving on, our future goals are:
1. Building self-sustaining implementation sites
2. Integrating the CANS and the FAST into existing national online systems
3. Working with the Praed Foundation to enable an online recertification process for all users
4. Developing an item bank and tracking these items across different populations and systems
As we have more and more interest in the use of the FAST in our community, we have had requests for different versions and different combinations of items to meet the needs of the specific population of clients that they work with. We are curious to know if other states have this dilemma of what would work best and what they are currently doing.
We are also curious to know if anyone has used the Service Process Adherence to Needs and Strengths in conjunction with the FAST and whether anyone has presented the results of the use of Service Process Adherence to Needs and Strengths in conjunction with the CANS.
-Karen SIK MSF, Karen_SIK@msf.gov.sg