TCOM Italia, the organization supporting TCOM in Italy, held its 7th Conference, bringing together the global TCOM Collaborative to exchange ideas and experiences among researchers, practitioners and others united by a shared aspiration to create systems that care. From May 12th -13th over 250 attendees and 20 presenters came together in Milan, Italy. The conference theme was “TCOM tools as an operational strategy addressing the intersection of neurodevelopmental disorders and complex social needs within the challenges of health and social care integration during childhood and adolescence.” This article discusses the history of TCOM in Italy as well as introduces some impactful research and projects that were presented at the Conference.
Evolution of TCOM In Italy
What happens when, instead of a government agency mandating service providers use TCOM tools, those providers convince the government to adopt them? Unlike in the United States, where service providers typically adopt TCOM tools due to a government mandate, in Italy practitioners were the ones to adopt the tools first. Their success with TCOM tools eventually led to the tools being adopted by the government. More specifically, a team of researchers at the Policlinico di Milano, a hospital, were searching for a way to evaluate the efficacy of public health interventions and found in TCOM exactly what they were looking for. Since then, over 2,800 practitioners and 200 human care agencies have adopted one or more of the TCOM tools across Italy. The CANS tools played a key role in the 2021-2023 National Plan for Intervention and Social Services to prevent unnecessary hospitalization of youth and adolescents.
Highlighted Research and Projects as Part of the Conference Program
Screentime and the CANS – Presented by Michele Marangi
Is the effect of one hour of screen time the same for everyone? Or could it be time on electronic devices changes depending on the person and the way the device is being used? Michele Marangi presented his work, “Domesticating Screens: Digital Domestication as a Framework for Assessing Developmental Needs” at TCOM Italia’s Conference. He makes the case screen time is an imperfect measure of the effects of digital exposure on children and adolescents and the CANS can be used to better capture this effect. He maps out the effect of this process across the different domains of the CANS, showing how it can easily be adapted to evaluate the effect of exposure to digital media on the well-being of children and adolescents.
Meeting the Needs of Unaccompanied Migrant Minors: The Fr-Agile Project – Presented by Nicoletta Stefanelli
How do we meet the multi-dimensional needs of migrant children who arrive in a foreign country alone? The Fr-Agile project set out to address this issue after a large wave of unaccompanied minors arrived in Italy, with the goal of meeting this group’s unique needs with transparency, equity and appropriate care. It also set out to overcome system vulnerabilities through experimental mechanisms and cross-agency cooperation made possible by the systems-wide adoption of the CANS. From a strength-based approach, the project guides youth on paths towards integration into Italian society with targeted interventions built upon each individual’s personal strengths and capacity. They also built a Day Center for adolescents who need exposure to peers where they could learn independent living skills while receiving specialized, intensive education.
Strengthening Local Networks for High Complexity Youth: the Percival Project – Presented by Sara Panunzi
The Percival Project set out to improve treatment for the highest complexity youth in Milan’s healthcare system through two TCOM tools: the CANS and the CAT. They specifically targeted adolescents with complex diagnoses and elevated risk to self or others as measured by the CAT. The goal was to identify emerging population needs and adapt the network of services to meet them. As a result of the study, local service networks were strengthened while low-intensity treatment options such as trekking and museum visits were launched. Project leaders credited the CAT for improving clinical decision-making, fostering active engagement of the patient and their family, and facilitating the adaptation of services to meet emerging needs in the local population.
Conclusion
These projects and presentations, in their own way, embody the principles of the TCOM approach. All sought to address failings in current systems or shortcomings in the way care is delivered, adopting a person-centred perspective to improve the way mental health is addressed. TCOM Italia showcases the adaptability and diverse applications of the TCOM framework and tools across a global context through highlighting different cases, applications and adaptability for intervention and action-planning.
Written by Trevor Lyons, Ph.D.
To learn more about TCOM Italia, visit their website (in Italian) https://www.tcomitalia.com/home