Transformational Collaborative Outcomes Management (TCOM) and TCOM Tools have been incorporated throughout the United States, and beyond, within children’s behavioral health systems for several decades. However, many agencies, organizations, state-run programs have yet to fully unlock the power of TCOM, more specifically CANS Assessment.
The Child and Adolescent Needs and Strengths (CANS) Assessment
The Child and Adolescent Needs and Strengths (CANS) assessment is a powerful tool for healthcare clinicians, mental health workers, behavioral health staff, healthcare providers, and doctors – everyone providing support/services to children, youth, and families. This multi-purpose system can support decision-making by providing the level of care information as well as service planning data. CANS supports a ‘team’ approach in making informed decisions in service delivery, progress tracking, and outcomes management.
Learn how to use, implement, and interpret results from the CANS Assessment. Opeeka’s P-CIS provides insights into the CANS and other assessments to support practitioners’ work more efficiently/effectively to achieve transformational outcomes. In this blog post, we’ll explore how to use the CANS for decision-making; implement it in your practice; interpret results from it; and to access available resources in learning more about the TCOM Worldwide Collaborative. Read on to discover all you need to know about the CANS!
Overview of the CANS Assessment
What is the CANS Tool?
The Child and Adolescent Needs and Strengths assessment or CANS is a tool used by healthcare clinicians, mental health workers, behavioral health staff, healthcare providers, and doctors to evaluate the needs of children and adolescents. It helps professionals gain an understanding of a child’s strengths as well as areas in which they may need assistance or support. The CANS consists of items connected to areas of needs, connected with life domains (home, school & community) as well as strengths (person, environment & familial). The scoring or rating is based upon communimetrics and uses a 4-point scale from 0 (no identified need/centerpiece strength) to 3 (severe or intense need/no identified strength).

Benefits of the CANS Assessment
The CANS Assessment provides valuable information for decision-making about treatment plans for children/youth and their families from birth to age 21. It can help identify potential issues such as depression or anxiety before they become more complex. Additionally, it allows clinicians and the treatment team to track progress over time by comparing scores from one assessment to another over time in care. This data can be used to determine whether interventions are adequate or if additional services should be considered.
How Opeeka's P-CIS Transforms the CANS Assessment
Opeeka’s Person-Center Intelligence Solution (P-CIS) offers an innovative way to use the CANS assessments, in real-time, in every stage of its automated scoring system. With our person-centered technology, clinicians can quickly access patient data, including demographics, medical history, medications prescribed, assessments completed, diagnoses made, etc., all within seconds. This makes it easier for practitioners to make informed decisions about their patient’s care without manually inputting each item into a spreadsheet or other software program. Furthermore, P-CIS also provides detailed reports that allow users to quickly analyze trends over time to better understand how their interventions impact outcomes for individual patients or groups of patients.
The CANS Assessment is a powerful tool for understanding the needs of those we serve, increasing collaborations in creating comprehensive treatment (care) plans. By leveraging Opeeka’s P-CIS, clinicians can streamline the assessment process and quickly access actionable data to inform decision-making. Let’s take a closer look at how to use the CANS Assessment for decision-making.
Using the CANS Assessment for Decision-Making
The CANS is a valuable tool for providers of care to make informed-collaborative decisions regarding both level of care and service planning. It provides treatment teams comprehensive information about the child/youth/family’s functioning in multiple domains, including physical health, mental health, behavior, and social environment. This data can identify strengths and needs and guide treatment (care) plans.

Level of Care and Service Planning
The CANS assessment effectively assists with determining the appropriate level of care for everyone in care based on their current behavioral and functional levels of needs and strengths. Appropriate decision-making should consider factors such as:
- Medical history
- Diagnosis
- Symptom(s) severity
- Risk factors for relapse or deterioration in condition
- Available resources (e.g., family support)
- Other relevant criteria when making this decision
The results from the CANS assessment provide an objective measure that can inform treatment/intervention decisions by providing a ‘snapshot’ of how someone is currently behaving or functioning across various life domains.
Gathering Information to Make Decisions
To accurately assess a person’s current functional status using the CANS, it is important that accurate information is gathered from multiple sources (e.g., family members/caregivers, teachers). This includes gathering detailed information about past medical history; past traumatic experiences; current symptoms; medication use; lifestyle habits; psychosocial issues; educational background; housing situation, and legal involvement/history. All this information should be gathered before administering the CANS assessment so that it can be accurately scored according to established criteria ensuring both validity and reliability.

Utilizing Results to Guide Treatment Plans
The CANS Assessment is a powerful assessment tool which can help treatment teams make informed decisions about both the level of care and intensity of services needed to support and meet the needs of those within care. In the next section, we will discuss specific ways to successfully implement the use of the CANS assessment into every aspect of the work. It should be noted that the TCOM Tools, including the CANS, are used in every state throughout the United States and around the world including:
- Canada
- China
- England/Europe
- Guam
- Italy
- Singapore
- Russia
Implementing the CANS Assessment in Practice
When implementing the CANS in practice, those who administer the tool must be adequately trained to ensure validity/reliability of use. There must be a clear understanding of communimetrics, including the purpose of the assessment, its components, and how to interpret scores and ratings. Before administering the assessment, they should also understand the child/youth and family’s history and current condition. Training on all TCOM Tools, including the CANS, is done through the Praed Foundation, which provides comprehensive instruction on proper administration techniques and an overview of scoring criteria.
Preparing the treatment team for the CANS and for the assessment process is also important for obtaining reliable results. It is important for the entire treatment team, especially the child/youth and family, to fully understand what will be asked so they can provide honest answers which accurately reflect their current situation. It is also vital that those incorporating the CANS into the work explain why they are conducting this evaluation, what information it will provide, and how it will be used to guide treatment plans going forward.

Collecting data from the CANS Assessment requires careful attention to detail by both professional helpers and those within care alike. All questions must be answered entirely with accuracy for results to be meaningful when interpreted throughout the time in care. All responses must be carefully recorded while ensuring that any additional comments or observations which are noted subsequently are appropriately throughout each section of the evaluation form or in accompanying notes if necessary.
Once collected, data from the CANS Assessment needs to be understood thoroughly before making decisions about care or service planning based on findings from this evaluation tool alone or combined with other assessments used concurrently if applicable. Scores and ratings should be compared against established standards within each domain area being assessed, such as physical health status versus mental health functioning capabilities, depending upon individual circumstances. This comparison allows healthcare providers to identify strengths and areas needing improvement, which can inform treatment recommendations, accordingly, moving forward into future care planning phases.
The CANS Assessment is a powerful tool for clinicians, care-managers, residential providers, peer advocates, and others to use in assessing those they serve. With proper training and preparation, the assessment can be used to accurately identify the strengths and needs of individuals, allowing providers-of-care to make informed decisions on treatment (care) plans. Now that we have discussed implementing the CANS Assessment within practice let’s look at how results from the assessment are interpreted.
Interpreting Results from the CANS Assessment
Interpreting Results from the CANS Assessment is an important part of decision-making for healthcare professionals, mental/behavioral health clinicians, peer advocates, and other care team members, including those in care. Understanding individual ratings and overall scores from the assessment can help identify individuals’ strengths and needs which can then be used to make recommendations for treatment plans.

Understanding Scores and Ratings
The CANS assessment uses a numerical scoring system to rate different areas of functioning, such as physical health, social/emotional well-being, educational performance, etc. These scores are then compared against established norms to determine if an individual is meeting expectations or if any areas of concern need further exploration and intervention. For example, a score of two (2) regarding physical health may indicate that the individual has an underlying medical condition or other challenge related to their overall well-being, which should be included in the treatment/care plan.
Identifying Strengths and Needs
Once scores have been gathered, it is important to look at the needs and strengths within each area assessed by the CANS tool. This allows care coordinators to understand better how the individual functions in different aspects of their life. This can then inform decisions about treatment(care) plans or referrals for additional evaluation/interventions as needed. For instance, identifying high levels of resilience or problem-solving skills could provide insight into potential coping strategies while also recognizing areas of communication skills needs, which might suggest interventions like therapy or coaching sessions focused on further developing these skills and abilities.
Make Recommendations
After gathering information from the CANS assessment, it is time for clinicians to make recommendations based on what they have found during the evaluation process. These recommendations should consider strengths and weaknesses identified through analysis so that appropriate resources can be provided accordingly, with consideration given to individual preferences whenever possible. Additionally, follow-up assessments should be scheduled periodically to monitor progress over time and make changes when necessary, depending on results seen after each review period concludes successfully.
Interpreting the results from a CANS assessment can help clinicians better understand their patient’s needs and strengths, allowing them to make more informed recommendations. The following section will explore available resources for further information on the CANS assessment.
Resources for Further Information on the CANS Assessment
To ensure that this TCOM (communimetric) tool is used correctly and effectively within treatment practice, it is essential to have access to resources that can guide the use of the CANS assessment.
Agencies/Organizations Providing Guidance on the Use of CANS
Agencies, organizations, county/state systems such as Child-Welfare, Juvenile Justice, and Mental/Behavioral health must provide information about best practices when using the CANS assessment. These groups have access to support from both the Praed Foundation and the training team at the University of Kentucky’s Innovation in Population Health (IPH) Center. Supports are provided beyond the starting point of certification, including guidelines for implementing and interpreting results from the various TCOM Tools, including the Child Adolescent Needs & Strengths (CANS) Assessment.

Online Training and Resources Explaining Implementation Strategies
Several online courses cover topics related to implementation strategies for using the CANS assessment in clinical settings. These courses typically include lectures by experts in child welfare or mental health services who discuss best practices for administering and interpreting results from the CANS assessments. Additionally, webinars hosted by various organizations often feature discussions about implementing effective strategies with clients or patients using this tool.
Research studies examining the effectiveness of the CANS Assessment are regularly conducted by universities or research institutions worldwide. These studies often focus on specific populations such as children with autism spectrum disorder or adults living with chronic illness and examine how well these individuals respond to interventions based upon results from their CANS Assessments. Results from these studies can be found through scholarly databases, including PubMed Central or Google Scholar. Anyone interested in learning more about this topic can go John Praed Foundation or TCOMConversations.
Conclusion
By understanding the purpose of the Child Adolescent Needs & Strengths or CANS Assessment and how the communimetric tool can be implemented, care coordinators are better equipped to make informed decisions that will ultimately benefit those they serve. With Opeeka’s P-CIS transforming the CANS into real-time insights for decision-making, care providers have access to even more comprehensive data when making important decisions about the people and populations they serve. The resources provided here should help those looking to learn more about TCOM/CANS and gain a deeper understanding of their capabilities and the impact of health equity for all.