By: Barbara Ann Dunn, ACSW, LCSW, Director, Program Innovation and Outcomes, Magellan Healthcare Transitions Using Child and Adolescent Needs and Strengths (CANS) algorithms for access and transition decision support is particularly helpful when celebrating successes. It’s not always appropriate to use the algorithms to screen people for discharge from programs. Screening divides those who get certain services and those who don’t; however, it may not be appropriate for use in the same way for discharging. The CANS needs items get a youth into a program, while strength-building creates lasting progress. It is… Read More
Appropriate and Effective: How does managed care use the Child and Adolescent Needs and Strengths (CANS) tool?
By: Barbara Ann Dunn, ACSW, LCSW, Director, Program Innovation and Outcomes, Magellan Healthcare Appropriateness and Effectiveness An appropriate service should be effective. These two Key Decisions are inextricably linked and are often the basis of medical necessity. Evidence-based practices assign a defined appropriate population and a set of measures demonstrating effectiveness and provide a good example of how the community at large and managed care can agree. More work may be required, however, to come to agreement on how the Child and Adolescent Needs and Strengths (CANS) is used to identify the… Read More
From Access to Engagement: How does managed care use the Child and Adolescent Needs and Strengths tool?
By Barbara Ann Dunn, ACSW, LCSW, Director, Program Innovation and Outcomes, Magellan Healthcare Engagement In my last post we looked at Key Decision 1 (Access) and how managed care uses the Child and Adolescent Needs and Strengths (CANS) to enable access to services. Key Decision 2, Engagement, is about bringing people from access — opening the door — to becoming equal partners in the helping system. Engagement is built on respect and understanding that youth and family are experts in their own lives and need to captain their own ships. Engagement uses… Read More
By: Barbara Ann Dunn, ACSW, LCSW, Director, Program Innovation and Outcomes, Magellan Healthcare The Child and Adolescent Needs and Strengths (CANS) is a multi-purpose tool developed for children’s services to support decision making, including level of care and service planning, to facilitate quality improvement initiatives, and to allow for the monitoring of outcomes of services. I am often asked “How does managed care use the CANS?” Those of you who ascribe to Transformational Collaborative Outcomes Management (TCOM) likely recognize that managed care plays an increasing role in using clinical decision support tools… Read More
By Kenneth McGill, Senior Training and Consultation Specialist from Rutgers University On June 30th New Jersey Children’s System of Care held a 2-hour Town Hall style webinar with Dr. John Lyons, developer of TCOM, who provided answers to questions from system partners on the CANS Tools (i.e., SNA, CAT, & FANS). In addition, Dr. Lyons shared the work being done at the University of Kentucky as Director of The Center for Innovation in Population Health. Click here for webinar (password: yJTJfTX7)
Post-COVID 19 Planning Strategy-As we SIFT through the impact of this worldwide traumatic event-We must support school-age children/youth towards HOPE.
By: Kenneth McGill, EdS LMFT Kenneth initially wrote this blog in early June. We find his words ring just as true today, as America continues to respond to the pandemic and the racial inequities laid bare and necessitating both a shared vision and transformation. Like many it only took me a few weeks to recognize the immense impact spreading across my local community, the state, country and throughout the world. Now, as a mental health professional, I began viewing things through a trauma lens as it became clearer that individuals, families, schools, organizations …basically… Read More
By: Cinthya Chin Herrera, PsyD Across the country, most states have joined the the remainder of the world in moving nearly every aspect of our society into digital spheres. In the Bay Area, many service providers have begun exploring the intricacies of working from home. At times this has meant connecting with kids, teens, families, and adult clients remotely through phone, video, or other telehealth modalities, and often in the context of new evolving demands from families and our communities. With the call to action for many providers to maintain the continuity… Read More
Drs. John Lyons and April Fernando recently recorded a webinar on the use of the CANS and ANSA in non-face-to-face modalities (e.g., telephone). Texas was kind enough to let us share it. Download the webinar for free at the link below: Stay safe and well. — TCOM Team
by Michael Cull, PhD, Associate Director for Safe Systems, University of Kentucky’s Center for Innovation in Population Health No doubt our resilience as a nation is being tested by current events. We’re facing significant uncertainty at home and at work. How will we accomplish home visits? How do we ensure child safety? How can we use technology to help those we serve? How will we address our own and our family’s needs? In the face of growing personal and professional stress, there may be no better time to re-visit how we think… Read More
By Kate Cordell, PhD, MPH, Managing Director at Mental Health Data Alliance, LLC What if we could utilize the CANS and ANSA to identify which items, if resolved, were associated with success in our program? What if we could look at that by race/ethnicity, gender and age? If we could, we could get a lot closer to identifying what works for whom. The CANS and ANSA are ideally suited for determining what works for whom. These assessments help build a comprehensive picture of a person’s story as it relates to well-being. I… Read More
Avoid this Fundamental Mistake in TCOM Tool Scoring: confusing anchor definitions, for concrete details
By Dan Warner, Executive Director-Community Data Roundtable I have seen many hard-working, diligent people fail TCOM certification because they over-focus on anchor definitions, and do not properly understand the item they are rating. They think that by focusing on the anchor definitions they are being “detail oriented,” but instead they are “missing the forest for the trees.” The anchor definitions are not the “concrete” part of a TCOM tool. It is the items themselves that are concrete. After all, this is the first rule of a communimetric tool: It is an item… Read More
Presented and written by Lynda Killoran (Centerstone), Lynn Steiner (Chapin Hall at the University of Chicago), and Deborah Thomas (Centerstone) In our work as trainer, supervisor or clinician, we often hear a variation on THIS theme from assessors who were recently trained on a version of the CANS: “It’s SOOOO long and there are too many questions for me to ask. I have no idea how to use this during the assessment process (or, I already know how to do an assessment, so I don’t need anyone to tell me how to… Read More
RISEmploy Each TCOM tool is a combination of items inside of a domain meant to reflect the emerging needs and strengths of its population of use. It is adaptable. One of these adaptations is the “Readiness Inventory for Successful Employment (RISEmploy), also known as the Strengths at Work (SAW), can be implemented as its own tool or included as a module in the Adult Needs and Strengths Assessment (ANSA). This tool focuses on skills and strengths that can ensure success in obtaining and maintaining a job.
Of the TCOM suite of tools, the most widely used tool is the Child and Adolescent Needs and Strengths Assessment (CANS). The CANS is a communimetric measurement tool that utilizes direct feedback from the youth, family & other team members to identify the actionable needs & strengths of the youth & family in developing and informing the treatment plan. While the tool is proven to be successful and helpful to many people, we always want to make sure that clinicians, case workers, and children find the CANS to be engaging and accessible. This desire is what led Lisa,… Read More
Meet one of your #TCOM2018 Presenters! Featured in this post: Vida Khavar Vida Khavar is a Licensed Marriage and Family Therapist who has 25 years’ experience in child welfare. Vida began her career as a clinician in various agencies throughout Los Angeles. She developed expertise in all areas of child welfare while striving to bring Permanency to center stage. Vida became a consultant in 2012 and since then, has assisted a multitude of organizations in developing new or enhancing existing child welfare programs. One of Vida’s priority is to transform the platform on which… Read More
Thanks to recent technological growth, children are receiving cochlear implants earlier than ever before. This advance in technology offers a great benefit to support earlier development of language skills. While these advancements are exciting, they, of course, create some new challenges for the young patients, their auditory-verbal therapists, and their families. Because of their young age—less than 18 months—it’s hard to track the impact of the implants. And it is more also challenging for therapists to communicate with, and counsel, parents who want to understand how their child is responding to the… Read More
Over the last 10 years, behavioral health systems and organizations have increasingly adopted the Adult Needs and Strengths Assessment (ANSA) to support planning, to monitor progress, and for quality improvement initiatives. However, research related to the ANSA remained scarce. This gap was recently been addressed through a publication by Betty Walton, PhD, and Hea-Won Kim, PhD, from the Indiana University School of Social Work. “Validating a Behavioral Health Instrument for Adults: Exploratory Factor Analysis”, published online in the Journal of Social Service Research in March 2018, examined the psychometric properties of the… Read More
Examining the Effectiveness of Integrated Behavioral and Primary Healthcare Treatment-A Brief Summary
Using subscales of the Adult Needs and Strengths Assessment (ANSA) and an author created Crisis Event measure, holistic client functioning was assessed for persons diagnosed with comorbid serious mental illness (SMI) and primary healthcare diseases. An ex post facto, quasi-experimental, pre- and post-test design was selected to compare the effectiveness of an integrated behavioral and primary healthcare (IBPH) treatment approach to a treatment-as-usual (TAU) approach, across a 12-month treatment period.
by: Ella Jackson, MA, LMFT Clinical Specialist, Sonoma County Behavioral Health Continued from Part 1 posted April 5, 2018 — I worked with Anna for 4 years. She was the first client I moved out of a state hospital. She transferred to a local locked treatment program, and as I carefully tracked her progress and setbacks, I learned the value of using the language of the ANSA to talk to my program managers and to Anna herself about decisions regarding her care. As I grew in my work with her, I discovered ways to… Read More
by: Ella Jackson, MA, LMFT Clinical Specialist, Sonoma County Behavioral Health I have heard people say that a person receiving care in the adult system for years, a person with Schizophrenia and a history of substance abuse, will not get better. It’s a story I have heard told over and over about many of the adults in our system of care. In my first years working in public mental health, a woman (who we will refer to as Anna for this post) was assigned to my caseload who was in a state hospital. … Read More
Safe Systems Improvement Tool Tennessee’s Communimetric Assessment for Understanding Critical Incidents The 1st annual Safety Culture Summit gave attendees and their larger audience a glimpse of the work being done around safety culture. Along with the tools shared during the poster session at the summit, Michael Cull, Policy Fellow at Chapin Hall at the University of Chicago, and Tiffany Goodpasture, Director of Organizational Culture and Workforce Safety at TN Department of Children’s Services, had the opportunity to locally share the Safe Systems Improvement Tool (SSIT).
This is the last key principle in this series. Return to our home page to view all key principles!
Communimetrics Key Principle #5
Communimetrics Key Principle #4
Communimetrics Key Principle #3
Communimetrics Key Principle #1
Facilitated Collaborative Inquiry: From Stories to Hypothesis Part 3/4 by Stephen Shimshock, PhD Director of Systems-Data and Reporting, Casey Family Programs — This post is part three of a four-part series on Facilitated Collaborative Inquiry (FCI). In the previous post (Using Data to Show Differences in Outcomes) we examined ways to identify subgroups of youth that may not be having the same outcomes as others. The example given in the previous post was somewhat simplistic (youth with five or more actionable items in the behavioral, life functioning and risk domains as identified using the… Read More
Facilitated Collaborative Inquiry: Using Data to Show Differences in Outcomes Part 2/4 by Stephen Shimshock, PhD Director of Systems-Data and Reporting, Casey Family Programs — This post is part 2 of a 4 part series on Facilitated Collaborative Inquiry (FCI). This post builds on the foundational material presented in the previous post . In this post we will explore the first phase of FCI: Identify the Opportunity/Gap. In general, child welfare agencies aim to improve outcomes for the youth and families they serve. While it is easy to intuitively agree with that statement, it… Read More
Thank you to Tracey Merachli for sharing her vision of the CANS in this poem. Planting a Seed of Wisdom, December 2015 by: Tracey Merachli, firstname.lastname@example.org Resource Consultant-Children First Well let me tell you about my vision for the CANS. It starts with listening to families and understanding their unique life and plans. The life and plans that they experience each and every day The struggles, challenges and especially STRENGTHS they see for their child, come into play. We learn together by rating whether there is a need. By encompassing a reflection… Read More
Resiliency, as defined by the TCOM tools, is an individual’s capacity to identify and use their internal strengths to manage their lives in times of need and support their own development. Resiliency acknowledges an individual’s ability to “bounce back” from psychosocial consequences resulting from traumatic experiences. These experiences can range from traumatic life events such as sexual or physical abuse, witness to violence, or natural disasters to the divorce of parents or a change in schools. Any one of these events (and many others) can cause children to have strong feelings and… Read More
By: Nathaniel Israel, PhD EPISODES: STRUCTURE, FUNCTION, MANAGEMENT *Episode—a container or set of parameters which define when a series of actions are expected to take place and when interventions have ceased A building block of understanding a person’s care is being able to assign an Episode of Care to a person. Nearly all reports are based on expectations for, and the execution of, specific treatment-related activities with the hope that they lead to particular transformational outcomes. However, not all data systems create or manage episodes in a clear and consistent manner. Following our… Read More
*September 2017 Post Update: Additional information added to the TCOM Report Suite. Click here to view the amended version. The work we do across all levels and systems of care is a knowledge-based community connected to a variety of service settings including clinics, hospitals, state and local agencies. Ultimately, the goal is to improve the quality of care offered to the children and family we serve. Our success depends heavily on the ability to take all of the data, interpret it, evaluate it, and share it in ways that are most useful and… Read More
By Jesh Harbaugh, Assistant Director of Business Intelligence Development, Evaluation, and Strategic Initiatives (DESI) SENECA FAMILY OF AGENCIES This is the last post of a 3 part series In the previous posts of this series, Data is Only Useful When it’s Used and Increasing the Value of Your Data With Interactive Reports, I’ve discussed the importance of setting up your data systems in a way that facilitates engagement and demonstrated how interactive reports can guide users to a deeper exploration and understanding of a topic. Today, I’m going to share some key… Read More
By Jesh Harbaugh, Assistant Director of Business Intelligence Development, Evaluation, and Strategic Initiatives (DESI) SENECA FAMILY OF AGENCIES
This post is Part 2 of 3! Stay tuned next week for more from Jesh and Seneca Family of Agencies
By Jesh Harbaugh, Assistant Director of Business Intelligence Development, Evaluation, and Strategic Initiatives (DESI) SENECA FAMILY OF AGENCIES This is the first post of a 3 part series In the helping professions, few words elicit such strong and varied reactions as “data.” In our culture of evidence-informed treatment, having strong outcome data to support your organization’s claims is essential, and there is immense value in having high-quality information to guide your decision-making. But let’s be honest—there’s another perspective on the data revolution which is more focused on the drawbacks of “big data”… Read More
by: Mario Cappelli, PhD and Paula Cloutier, MA Affiliations: 1Children’s Hospital of Eastern Ontario (CHEO), 2CHEO Research Institute, 3University of Ottawa What is the HEADS-ED? The HEADS-ED is a brief mental health screening tool that helps physicians to obtain a psychosocial history to aid in making decisions regarding patient disposition (e.g., admission, discharge, or requesting specialized mental health consultation). The tool was designed by a multidisciplinary clinical and research team to match the existing psychosocial “HEADS” interview 5 as closely as possible by adapting it for emergency department (ED) use and adding… Read More
Happy Valentine’s Day! What does Valentine’s Day mean to you? Is it a celebration of love, a hallmark holiday, or both? As a child, this holiday can take the form of a classroom activity where you put Valentine’s Day grams with chocolates and hand them out to each child in the class. As we get older we can celebrate this holiday with friends (Pal-entine’s/Gal-entine’s day), family, and/or a significant other by sharing gifts or other displays of affection. Harvard University conducted a study on how our social connections have the power to… Read More
The TCOM Team met in Chicago in January to kick off the New Year and review the work being done across the collaborative. As a result of this meeting we’ve produced our very first TCOM newsletter that highlights these efforts! *Keep an eye out for the release of our newsletter next week!* One important discussion at our team meeting was the use of the TCOM Tools and the targeted audience. While all derived from Communimetrics, there are clear distinctions in the focus of our tools as noted in their titles: Child and Adolescent… Read More
A caregiver is a family member or paid helper who provides physical, emotional, and/or developmental support for an individual who is unable to fully care for themselves. When an individual is in care or receiving services, it is often important to look at multiple aspects of their life – strengths, risk behaviors, functioning, and school/work. Nearly always with children, and sometimes with adults, it can be just as vital to consider the resources and needs of those entrusted to care for the individual. If you interact with the various TCOM tools, you… Read More
There is a growing awareness that the sex industry sometimes victimizes children. The Federal Trafficking Victims Protection Act (TVPA) of 2000, along with reauthorizations in 2003, 2005, and 2008 describes a victim of human trafficking as a person induced to perform labor or a commercial sex act through force, fraud, or coercion. Any person under the age of 18 who performs a commercial sex act, is considered a victim of trafficking regardless of whether force, fraud or coercion was present. The term used to describe these particularly vulnerable young people is Commercial… Read More
December 14, 2016 Written by Paul Berger, Managing Director at SAAVSUS Inc Funded by a series of grants from the National Institute of Mental Health, the Adolescent Coping with Depression Course (CWD-A) is an evidence-based, cognitive-behavioral therapy (CBT) for adolescent depression. The course materials, Leaders Manual and Student Workbook, are available as a free download at: http://www.saavsus.com/adolescent-coping-with-depression-course The CWD-A is designed for use with groups of four to eight adolescents, or it can be modified for use on an individual basis. The treatment sessions are conducted as a class in which a… Read More
By: Dr. Thomas S. Lyons, PhD Michigan State University R.I.S.E. -Readiness Inventory for Successful Entrepreneurship In the business world, it has been known for some time that companies that want to be successful in the highly competitive global economy must be constantly reinventing themselves through innovation. This requires that they develop a culture of creativity, continuous learning, openness to new opportunities to add value for their customers, and risk tolerance through effective risk management. This is the only way these companies can sustain themselves and grow in the challenging economic environment… Read More
This is the first post of a multi-part series on Collaborative CQI (Continuous Quality Improvement) Part 1: Creating Trust and Positive Impact by Nathaniel Israel Health and human service systems are composed of people. People make important decisions which shift the likelihood that children and families will meet their health and wellness goals. Having a common framework for understanding and improving decision-making is critical to system adaptation and child and family success. Responsibility and empowerment to make decisions cannot be left up to people at only one level of the system. Multiple… Read More
Mark was in Phoenix, Arizona, conducting a two day CANS Integration training for supervisors and staff from Casey Family Program’s Tucson and Phoenix field offices. He was joined by Neil Mallon from the University of Maryland. The training focused on integrating the CANS into Multidisciplinary Team Meetings, Developing Strength Based Action Plans based on the completed CANS assessment, and enhancing supervision around assessment and planning using the CANS. Staff worked in teams to develop skills around quick and accurate completion of the tool, engagement of the child and family team, developing effective… Read More
Thanks to Stephanie Romney, in collaboration with Carolyn Webster-Stratton and John Lyons, we have a great guide to the integration of the Incredible Years and the CANS 0-5. What is The Incredible Years (IY)? The Incredible Years is a training program that occurs as a series of complementary evidence-based programs that promote child social, emotional, and academic competence and reduce child behavior problems. Integrating the IY and the CANS 0-5 Dr. Webster-Stratton and Dr. Lyons contributed their breadth and depth of experience to help integrate the use of the CANS 0-5 into the parent training programs for caregivers… Read More
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… Read More
John continues his trip on the west coast with two stops in California. This past Friday, John was at the West San Gabriel SELPA in Alhambra and today he is at the Southwest SELPA in Rondo Beach, California. He is training on the new version of the CANS specifically designed for use in schools! This version was developed in collaboration with Rebecca Cole and the school psychologists from both SELPA locations under a grant from the California Board of Education. The CANS-EI focuses on 5 core domains to best reflect the strengths and needs of… Read More
April rounds off her Washington whirlwind adventure with one last stop in Kent, WA (just an hour or so away from Seattle). Here she is working with a supervisor group focusing on how to provide culturally responsive care and work from a culturally humble approach. In our combined efforts to do so, the CANS Core has shifted items and domains to align with SOGIE (Sexual Orientation, Gender Identity, and Expression). Items in the Strengths and Cultural Factors Domain, specifically, aim to be inclusive and relevant of all cultural/personal experiences and needs. A… Read More
Mark was in Towson, MD today as part of the implementation of Maryland’s family version of the CANS, the CANS-F. Frontline staff and supervisors from the county child welfare agency met to discuss their existing implementation, review their CANS-F data from the past quarter, and work on strategies to simplify the re-certification process. (As it turns out, people’s anxiety about testing is often the biggest barrier. Several people stayed after the meeting to take the re-certification exam on their laptops; 100% pass rate!) The supervisors in attendance are interested in continuing to… Read More
From Yakima to Spokane to Arlington, April continues her Washington adventure with another stop in Arlington, WA. April is conducting treatment planning and supervisor trainings to another great group at the WA State Department of Social and Health Services. The team here is using the CANS to support families and children involved in the child welfare system in WA. The purpose of becoming a trainer/SuperUser is to be able to train their staff and others on all of the TCOM tools. After you have completed your own training, you are now the… Read More
Complete a test, Do your research, Collect the data… There is no doubt that we live in a world with a wealth of information about the people, place, and entire environment around us. Aside from the thrilling celebrity gossip and election 2016 madness, what are we doing with all of this information? With great RESEARCH come great RESPONSIBILITY. The TCOM Tools help users obtain great information about the child and family. But, what is the distinction between collecting/reporting data (outcomes measurement) and using it at ALL levels of a system (outcomes management)… Read More
From Yakima, April headed straight for Spokane. Washington State is ok, not bad, pretty, GORGEOUS in the fall! Now we know where April is, but why is she there??? One of more widely known tools of TCOM is the CANS. The Child and Adolescent Strengths and Needs. It (like the other tools) focuses on identifying actionalbe needs and useful strengths. There are 6 essential Domains of the CANS called the CANS CORE. In these domains, there are various items that are completed together. It identifies your current strengths and needs. The scoring system… Read More
ANSA – Adult Needs and Strengths Assessment The ANSA is another TCOM Tool that was developed for adult’s behavioral health services to support decision making, including level of care and service planning, to facilitate quality improvement initiatives, and to allow for the monitoring of outcomes of services. The ANSA is currently used in a number of states and Canada in applications hospitals, emergency departments, psychosocial rehabilitation programs, and ACT programs. BUT, today Dr. John Lyons is out in San Leandro, California working with ANSA Trainers. We have great partners in Alameda County…. Read More
Holding onto the remnants of summer 2016, John is in the historical town of Buford, Georgia, attending the Behavioral Health Symposium hosted by the Department of Behavioral Health and Developmental Disabilities (DBHDD). This is a two day conference aimed at informing professionals of best practices in delivering services and supports. Missed the conference??? The team at Community Friendship Incorporated has shared a snip of their presentation with us! mh-symposium_ansa-presentation_10-7-16
Anyone who is certified in the CANS, ANSA, FAST, or any of the Communimetric tools has taken the time to become certified. Those of you who certify online at TCOMTraining.com have probably received an email from one of us stating something along the lines of… “Unfortunately you have not yet received sufficient reliability. Your most recent exam has been reviewed and I noticed you are struggling in the _____ Domain.” Well, the CANS is a multiple choice test, assessment, TOOL to help identify a child and family’s strengths and needs across all the… Read More
***11/18/2016 UPDATE*** Currently at Closing Plenary in Princeton, NJ for the 2016 TCOM Conference. Below you will see our updated CANS Core Items available. If you have any additional questions on how to implement the CORE items to your own agency/jurisdiction/state, contact April Fernando at email@example.com cans-6-17-core-50-2016 Every agency, jurisdiction, and, most importantly, child, is unique. This is why the CANS is adapted to meet the needs of your region. With that being said, the Communimetric approach to measurement is modular and contextual. All items are developed based on their usefulness and… Read More
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