Bridging Transitions for Success: CANS to ANSA, an Emerging Practice
By: Kenneth McGill, EdS LMFT
A Solution-Focused Care Senior Scientist at Opeeka in Folsom, California
Developmental Transformational Care
The TCOM Tool, the Child Adolescent Needs and Strengths Assessment or CANS, has been developed to serve children within systems of care. Most children serving systems (child welfare, juvenile justice, and early intervention services) throughout the United States use a version of the CANS. These systems have incorporated CANS to support children’s services, especially in decision-making processes such as level of care, service planning, quality improvements, and for monitoring of outcomes.
However, there are some emerging adults who have long-term needs/challenges which continue to require formal systems support. These can include those with mental health, medical, intellectual/developmental and/or substance misuse needs. Most child-serving systems will end services and supports when the individual turns 21 years of age. This transition must take place prior to aging out and often requires several years of preparation for a smooth continuum.
Similar But Different in Focus
The scope of children/youth serving systems is to support the three (3) life domains: home, school, and community. The specific items on the CANS have been included to engage the young person while planning for their future. Systems partners collaborate to meet the needs of children/youth in care, while also empowering their primary support system or family.
However, there is a misconception relating to outcomes while in systems of care. Too often, it is the mindset that after transitioning out of care all needs will be met. This misnomer does not fit with TCOM, especially while using the CANS. We all know that needs will continue throughout a person’s lifespan. That is why the tools include strengths. It is not the CAN (Child Adolescent Needs Tool), but CANS (Child Adolescent Needs and Strengths Tool).
The scope of children/youth serving systems is to support the three (3) life domains: home, school, and community. The specific items on the CANS have been included to engage the young person while planning for their future. Systems partners collaborate to meet the needs of children/youth in care, while also empowering their primary support system or family.
However, there is a misconception relating to outcomes while in systems of care. Too often, it is the mindset that after transitioning out of care all needs will be met. This misnomer does not fit with TCOM, especially while using the CANS. We all know that needs will continue throughout a person’s lifespan. That is why the tools include strengths. It is not the CAN (Child Adolescent Needs Tool), but CANS (Child Adolescent Needs and Strengths Tool).
Building strengths is just as important as working on meeting needs. An example of an important strength to build is resilience. There has been much written on and about ‘resilience’ and how we can build resiliency in children, youth, and emerging adults. The research of Michael Ungar, at the Resilience Research Centre in Canada supports:
innovative research that explores pathways to resilience across cultures. That work focuses on explaining how children, youth and adults thrive in family, school, workplace and community settings under stress. The Centre also provides resilience measurement tools and training in the form of workshops and conferences. Through its partnerships with researchers, policymakers and clinicians around the globe, the Centre has built a world-renowned resource hub of resilience expertise and tools to support individuals and communities on their path to psychological, social, cultural and physical well-being.
TCOM Supports Continuum of Care
All too often there is an unfulfilled need for the transitional planning that occurs when a youth ages out of one system into other system. For example, when an emerging adult turns twenty-one, they are no longer eligible to receive children/youth services. They are now adults and must be served within the adult system. However, what happens when the steps required for someone to become eligible for adult services have not been completed?
The answer is a gap in services results and that adults are left without care. The age group most impacted by the lack of preparation for transition are those ages 21- to 26. Often the result of systemic delineation is simply one system not coordinating or planning with the other. However, since TCOM Tools have been created from a communimetric perspective, they can serve as the conduit for systems collaboration. In fact, the state of Illinois has embedded both CANS and ANSA in support of a continuum of care.
Illinois Department of Healthcare and Family Services serves as a model for other states when it comes to applying the emerging practice of integrating CANS & ANSA. For many young adults it is essential that adequate transition planning occur before moving over to adult systems, which include divisions that support those with developmental/intellectual, mental health, substance misuse and labor/workforce development needs.
Did You Know? The array of TCOM Tools supports the developmental continuum of care, beginning with the Child Adolescent Needs & Strengths ages 0-4 ears, Child Adolescent Needs & Strengths ages 5 to 21, and the Adult Needs & Strengths Assessment or ANSA 21 and older. We know that sometimes there are individuals who need long-term or lifetime support and care. For example, those who may have intense needs connected with intellectual/developmental challenges who age into the adult system-Division of Developmental Disabilities. Often complete information does not follow them and there may be gaps in care and/or service delivery. Are there any other states, besides Illinois, that use both CANS and ANSA, as an emerging practice, to assist with transitional care planning?
Kenneth McGill, EdS LMFT- Ken spent the last two decades serving New Jersey Children’s System of Care (CSOC) in several key administrative roles, including the last 12 years at Rutgers University-Behavioral Research Training Institute (BRTI). While at BRTI he was the lead curriculum developer, trainer and provider of technical assistance on Wraparound/Child Family Team and all of the TCOM Tools (CANS, CAT, FANS). Ken was the 2013 recipient of the Praed Foundation’s Outcomes Champion (CANS) Award for his work in children’s systems of care and outcomes management. He has more than 20 years of experience in marriage & family therapy, education & research and was the longest serving President of the New Jersey Association for Marriage and Family Therapy (NJAMFT). Ken received his Bachelor of Arts in Psychology from William Paterson University. He is currently a Solution-Focused Care Senior Scientist at Opeeka in Folsom, California, where he continues to support Transformational Care in every human service sector throughout the United States and beyond.