THE CHILD AND ADOLESCENT NEEDS AND STRENGTHS (CANS)
WHAT IS CANS?
The CANS is an open domain tool that is free for anyone to use. There is a community of people who use the various versions of the CANS and share experiences and additional items and supplementary tools.
0 – No evidence
1 – Watchful waiting/prevention
2 – Action
3 – Immediate/Intensive Action
0 – Centerpiece strength
1 – Strength that you can use in planning
2 – Identified-strength-must be built
3 – No strength identified
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. Versions of the CANS are currently used in 50 states in child welfare, mental health, juvenile justice, and early intervention applications.
A comprehensive, multi-system version exists as well. The CANS was developed from a communication perspective so as to facilitate the linkage between the assessment process and the design of individualized service plans including the application of evidence-based practices. The CANS is easy to learn and is well liked by parents, providers and other partners in the services system because it is easy to understand and does not necessarily require scoring in order to be meaningful to an individual child and family. The way the CANS works is that each item suggests different pathways for service planning.
There are four levels of each item with anchored definitions; however, these definitions are designed to translate into the following action levels (separate for needs and strengths)
SIX KEY COMPONENTS OF A COMMUNIMETRIC TOOL
- Items are selected based on relevance to planning.
- Action levels for all items
- Consider culture and development before establishing the action level
- Agnostic as to etiology—descriptive, no cause and effect
- About the child, not about the service. Rate needs when masked by interventions.
- Specific ratings window (e.g. 30 days) can be over-ridden based on action levels
Decision support applications include the development of specific algorithms for levels of care including treatment foster care, residential treatment, intensive community services, and traditional outpatient care. Algorithms can be localized for sensitivity to varying service delivery systems and cultures. The applications of CANS-based decision algorithms have documented dramatic impacts on service system. In Illinois, use of a simple decision model for residential treatment resulted in savings of approximately $80 million per year in residential treatment in the late 1990’s. In Philadelphia, their use of a decision model for Treatment Foster Care reduced lengths of stay dramatically and saved the city $11 million in the first year of use.