A Journey Begins with First Step
Too often those who are in care often must re-tell their ‘story’ or historical traumatic experiences. What is the message given when this happens? Are we really hearing what is being told to us? Or are we just completing paperwork, which will remain secure in an electronic health record? The reality is that it doesn’t make a difference to those who must repeat this information over to treatment providers. This should not and cannot be the case if we really want to be ‘trauma-informed’ and person-centered. Instead, information must follow those receiving care from the beginning until transitioning out of care.
The communimetric approach captures this very approach. Dr. John Lyons in his book aptly titled, “Communimetrics: A Communication Theory of Measurement in Human Service Settings” discusses the main purpose of ‘measurement in human services’ simply put it means how well the effort serves our clients. Another way of saying this is the data should not exist in a vacuum and must be communicated in a clear way to everyone on a treatment team, especially with those being served.
The Transformational Collaborative Outcomes Management (TCOM) Tools serve as the common language to support care between families, providers and across various systems. If those in care are children and young people, then the Child Adolescent Needs & Strengths or CANS is used to capture the ‘story’ of that individual child/youth and family. CANS provides an organization of information obtained directly from the family or referring source. However, if the person in care is an adult, then the ANSA (Adult Needs & Strengths Assessment) is used.
Building Trust, Builds Information for Collaboration
Another question becomes, do we get the complete story or what is happening or what has happened from the initial assessment or CANS? Most often the answer is no, we will get information for intake and initial care planning. If someone is experiencing a crisis, then the planning is more focused towards immediate concerns for safety. If this initial information gathering is not the complete story, then what does it take to move treatment planning further. We as professional helpers know that building a rapport or foundational trust is essential in gaining a deeper understanding and background information.
It is with the development of a ‘therapeutic relationship’ that treatment moves forward and begin to gain a more complete picture of that person or family’s life story. The great thing about the communimetric approach is that we can continually add to the information gathered. In fact, over time we can gain multiple perspectives of the ‘what’ is going on and update the CANS. Did you know that the CANS or communimetric approach only gathers information of ‘what’ is going on in the lives of those we serve? It is up to the treatment team to come up with theories as to the ‘why’ these are occurring. The final step then becomes the ‘how’ the treatment team will plan to meet the challenges or needs, using functional strengths, which have been identified over time.
Life Domains Offer Unique Insight of Context
What are the life domains for a child/adolescent? There are three main life domains which include home, school, and community. We often can gain a richer or more complete understanding of an individual when there is a context of how they are behaving and interacting with others. It is when we gather information from others, such as their parents/caregivers, teachers, and peers, that we can see the ‘whole-person’ and how they overall are doing in everyday life. It may be that the challenges are only at school and the child is doing well at home and in their community. There may be others who are doing well at home and in their community but having challenges in school. And there may be others who are having daily struggles in all their life domains.
This gathering of more information from different various individuals often provides a more comprehensive understanding of the individual and the challenges they are experiencing. It will get the treatment team closer to the ‘why’ these challenges are present and ‘how’ treatment planning can be more successful. The CANS which follow those in care will shift the needs towards behaviors and not ‘blame and shame’ the child/adolescent and parents/caregivers. The ONE CANS will lead the treatment team towards tracking progress and outcomes planning throughout the time in care.
In addition to context of understanding for the child and family, the CANS and life domains strengthen the roles and expectations of the system partners. For example, what if child welfare became involved with the family due to school refusal. It is learned that the child is having difficulties at school because of a learning disability, which is now being adequately addressed. School attendance is no longer a challenge and child welfare can transition out of the treatment team. The team then expands to include community supports, after school tutoring, and counseling to strengthen communication among family members.
ONE CANS for Transformation Care Planning
One CANS to follow that individual and family in care will assist in ensuring that the treatment team is working cohesively to ensure complete collaboration in care planning. Dr. Lyons has expanded the communimetric approach in his writings and lectures around TCOM or Transformational Collaborative Outcomes Management. The use of TCOM Tools ensures that our work is redefined as a collaborative partnership with those we serve, using the data in care planning towards transformational goals.
Transformational Care-Planning is completely aligned with Transformational Collaborative Outcomes Management or TCOM. Transformational Care-Planning is the collaborative process of engaging those being served, developing goals of life through conversations and relationship building. These goals are to assist with getting them back on track to effectively manage life challenges. Transformational Care-Planning actively coordinates those connected to the individual within care. This ‘team’ approach using the One-CANS throughout treatment serves to support the individual (person-centered care) and the individual within each life domain (whole person).
Opeeka’s Person-Centered Intelligence Solution (P-CIS| pronounced pieces) has led the charge to support Transformational Care-Planning for All! P-CIS provides access to real-time data sharing so that once the question of ‘what’ is going on begins to become clearer, then the next piece to effective care planning is the ‘why’ connected to the challenges.
Opeeka Partnering with Ventura County to Implement ‘One Child One CANS’
Earlier this month Opeeka announced that it will be actively supporting Ventura County, California in their implementing a One Child One CANS (Child and Adolescent Strengths and Needs assessment) approach across Behavioral Health and Child Welfare. This partnership will move California’s Statewide Children and Youth System of Care (AB2083) forward where agencies will be able to securely share information through a coordinated effort to provide holistic care for all families and children.
This is where assessments and building a trust (rapport) assists as a conduit for increasing understanding, including breakthroughs leading to insights and moving those closer to healing, growth and change. However, this ‘big-picture’ or whole-person picture is needed to ultimately be successful at achieving sustainable health & saving lives. These pieces using P-CIS can be put together with interoperability or sharing of essential health information.
Use of One CANS and the sharing of data is essential for effective outcomes, keeping everyone (primary care, mental health, community supports) on the same page. One CANS supports the increased sharing of information, eliminating redundancy (preventing someone from having to tell their story over again & again), streamlining treatment protocols, encouraging best practices, as well as ultimately improving the lives of those we serve!