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 of 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 T4T facilitated by Praed and they must complete and pass a certification exam at .80 or higher. Annual training (and in some cases additional training) and certification is required for providers who administer the CANS as well as 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 that focus on CANS overview, case planning, and supervisor training.
- Overview and Case Planning (Module A) is a one-day training workshop for child welfare social workers, mental health plan clinicians, juvenile probation staff, Child and Family Team facilitators, and supervisors who will be using the CANS and do not need to be certified in the tool. This module includes instruction and practice in the use of the CANS in practice, including case/treatment planning. This module does not include explicit instructions on completing the tool and does not provide CANS certification preparation. Pre-requisite: None
- The CANS: Overview, Case Planning and Preparation for Certification (Module B) is a two-day training workshop for child welfare social workers, mental health plan clinicians who will be completing and using the CANS, and for child welfare supervisors who oversee case planning. This module includes instruction and practice on completing the CANS, and using it in case or treatment planning. Preparation for the CANS certification test process is provided. This is the only module that prepares individuals for CANS certification. Prerequisite: None
- The CANS and Supervision (Module C) is a one-day training module for supervisors to support child welfare social workers, mental health plan clinicians, juvenile probation staff, and CFT facilitators in their use of the CANS in child welfare and mental health practice. Prerequisite: Module A or Module B.
- The CANS: Review and Case Planning (Module D) is a one-day training workshop for child welfare social workers, mental health plan clinicians, juvenile probation staff and supervisors with previous CANS training or certification and need a refresher on core concepts as well as specific instruction and practice on the use of the CANS in case or treatment planning. Prerequisite: Previous CANS training; CANS certification recommended.
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.
CANS Convenings
Documents related to the May 7, 2020 Convening held virtually can be found below.
CANS Convening Notes 05/07/2020
Documents related to the February 7, 2020 Convening held in San Diego can be found below.
CANS Convening Notes 02/07/2020
CFT/CANS Videos
Documents related to the November 19, 2019 Convening held in Orange County can be found below.
CANS Convening Notes 11/19/2019
Orange County CFT Consent Form
Continuum of Care Reform (CCR) Resources
Continuum of Care Reform Microlearning
Orange and Imperial County Implementation Planning Presentation Slides
Southern Region CCR Webinar Convening – February 27, 2018