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Comprehensive, Culturally Approriate, and Competency-Based Workforce Development.

Child and Adolescent Needs and Strengths (CANS)

The Child and Adolescent Needs and Strengths (CANS) in the California Integrated Core Practice Model

CANS in the California Integrated Core Practice Model, is the result of the invaluable work and guidance from many people throughout California’s Child Welfare system in conjunction with the Praed Foundation. The CANS is a multi-purpose tool developed to support care planning and level of care decision-making, to facilitate quality improvement initiatives, and to allow for the monitoring of outcomes of services. The Praed Foundation convened experts throughout California to adapt their curriculum to reflect statewide practice in California. This devoted group of professionals included members from the California Department of Social Services (CDSS), all four Regional Training Academies (RTAs), the University Consortium for Children and Families (UCCF), Los Angeles County Department of Children and Families Training Division, the Resource Center for Family-Focused Practice (RCFFP) and the California Social Work Education Center (CalSWEC). As a result of their efforts, this curriculum is grounded in the framework of the Integrated Core Practice Model, and reflects the connection of the CANS to the CFT process, which supports the values of engagement, teaming, child and family voice and choice, and shared decision-making.

Effective January 1, 2017, county child welfare and juvenile probation agencies are required to provide a CFT to all children, youth, and nonminor dependents (NMDs) in foster care. A team-based approach is the pathway to consistent uniform service planning and provides a standard approach to Engagement. Effective authentic engagement is the single best predictor of treatment success, regardless of the service sector. Each family member is supported and encouraged to voice their strengths, preferences, and needs. The key professional behaviors are to listen and to suspend judgement.

The CANS is an information integration, functional assessment tool, chosen by CDSS and DHCS for use with children and youth that is used to identify the needs and strengths of children/youth and their families. Its underlying philosophy and approach is person-centered: by gathering information on youths and parents/caregivers’ needs and strengths. Strengths are the child/youth’s assets: areas life where he or she is doing well or has an interest or ability. Needs are areas where a child/youth requires help or intervention. The CANS helps care providers decide which of a child/youth’s needs are the most important to address in a treatment or service planning. The CANS also helps identify strengths, which can be the basis of a treatment or service plan. By working with the child/youth and family during the assessment process and talking together about the CANS, care providers can develop a treatment or service plan that addresses a child/youth’s strengths and needs while building strong engagement. The CANS is made of domains that focus on various areas in a child/youth’s life, and each domain is made up of a group of specific items. There are domains that address how the child/youth functions in everyday life, on specific emotional or behavioral concerns, on risk behaviors, on strengths and on skills needed to grow and develop.

The CANS is made of domains that focus on various areas in a child/youth’s life, and each domain is made up of a group of specific items.

The CFT and CANS is an organic process, California’s child welfare system greatly benefits from this collaborative partnership, which helps the workforce improve practice and meet the needs of the state’s children and families.

The Praed Foundation created an approach from which change can grow which is referred to as TCOM:

  • Transformational: The work is focused on personal change.
  • Collaborative: The team must develop a shared understanding and vision.
  • Outcomes: What is measured impacts the decisions made about the strategies and interventions we use.
  • Management: Information gathered is used in all aspects of managing the system from planning for individuals and families, to supervision, and program/system operations.

Users of the CANS must complete and pass the CANS certification exam at .70 or higher. To train CANS, the super user/trainer must attend a 4-day TFT facliltated by Praed, complete and pass a certification exam at .80 or higher. Annual training and certification is required for providers who administer the CANS and their supervisors.

For more information about Praed: http://praedfoundation.org. Visit the TCOM page to view the list of all TCOM Tools used in your jurisdiction.
For more information about CANS certification: https://tcomconversations.org/TCOMtraining-faq/

For more helpful information and/or the latest version of the curriculum, please visit the California Social Work Education Center (CalSWEC) website: https://calswec.berkeley.edu

Questions regarding the CANS can be sent to the CANS Lead, Mechelle Robinson at mrobinson2@sdsu.edu.

CANS Training

There are three module/training types for CANS to focus on overview of CANS, case planning, and supervisor.

Overview and Case Planning Curriculum/Training: Overview and Case Planning curriculum is combined into one training with two different modules offered.

The Overview gives participants an understanding of how California will use the Child and Adolescent Needs and Strengths (CANS) as a strategy to meet the Integrated Core Practice Model (ICPM) vision for creating behavioral objectives with families and teams. The ICPM articulates the shared values, core components, and standards of practice reflecting findings of current research that demonstrate how collaborative and integrated family services work best in meeting the complex needs of children, youth, non-minor dependents, and families involved with multiple, government funded organizations.

The Case Planning focuses on collaborative case planning with the Integrated Core Practice Model and CANS. CANS Case Planning will help to develop a roadmap for change. Using the CANS Case Planning will define the priority needs – what is the root cause. Define an activity/service/support/referral to address the priority need. Case Planning will support the CFT by defining the desired goal/outcomes, the background needs/strengths – how can the activity/service/support be tailored around the child/youth/family’s needs and/or strengths.

Module A is a 1-day training module for those counties who are relying on partners in behavioral health to complete the CANS. It does not include explicit instruction on completing the tools.
Module B is a 2-day training module for those counties who are asking the child welfare social worker or CFT facilitator to complete the CANS. This module includes instruction and practice completing the CANS tool. This module is longer to allow time for additional instruction and skill practice. Supervisor Curriculum/Training: For supervisors to better support users of the CANS and the CFT.

Module C is a 1-day training module for supervisors to support child welfare social workers, mental health plan clinicians, and CFT facilitators in their use of the CANS in child welfare practice. For supervisors, there is a sequence in that they will take either Module A or Module B with their staff and will follow that with Module C, which focuses on supervision.

For child welfare social workers, mental health plan clinicians, and CFT facilitators these modules are not intended to be a sequence; participants take only one, depending on whether or not they will complete the CANS. The curriculum was developed with public funds and is intended for public use.

Six Key Principles of the CANS

1. Items were selected because they are each relevant to service/treatment planning. An item exists because it might lead you down a different pathway in terms of planning actions.
2. Each item uses a 4-level rating system that translates into action. Different action levels exist for needs and strengths. For a description of these action levels please see below.
3. Rating should describe the youth, not the youth in services. If an intervention is present that is masking a need but must stay in place, this should be factored into the rating consideration and would result in a rating of an “actionable” need (i.e. ‘2’ or ‘3’).
4. Culture and development should be considered prior to establishing the action levels. Cultural sensitivity involves considering whether cultural factors are influencing the expression of needs and strengths. Ratings should be completed considering the youth’s developmental and/or chronological age depending on the item. In other words, anger control is not relevant for a very young youth but would be for an older youth or youth regardless of developmental age. Alternatively, school achievement should be considered within the framework of expectations based on the youth/youth’s developmental age.
5. The ratings are generally “agnostic as to etiology”. In other words this is a descriptive tool; it is about the “what” not the “why”. Only one item, Adjustment to Trauma, has any cause-effect judgments.
6. A 30-day window is used for ratings in order to make sure assessments stay relevant to the child/youth’s present circumstances. However, the action levels can be used to over-ride the 30-day rating period.

CANS-50/IP-CANS Core Domains:

Life Domain Functioning
Behavioral/Emotional Needs
Risk Behaviors
Cultural Factors
Strengths
Caregiver Resources and Needs*
Potentially Traumatic/Adverse Childhood Experiences
Early Childhood Module
*A caregiver is the family member or paid helper who provides support for an individual who is unable to fully care for themselves. If the child/youth is in foster care, the caregiver is the person(s) who is part of the permanency goal. The IP-CANS is not meant to be a diagnostic tool. It can, however, support or validate a diagnosis.

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