Cans assessment answers

Cans assessment answers DEFAULT

Magellan CANS assessment

Lawrence lives with his mother and older sister in an apartment.   Lawrence's mother works two jobs and is often not home.  Lawrence’s sister has a 14-month old daughter and he helps out with his niece when his sister is at work.   His mother reports that Lawrence is kind to the baby and he has a good relationship with his mother and his sister.   However, he does frequently miss his curfew as he likes to hang out with his friends as long as possible.   She worries that as he gets older she won’t be able to manage his behaviors and feels overwhelmed by that.   They have a large extended family with whom they are very close and who are supportive even though they do not live nearby.  

Lawrence makes friends easily.  He has a group of friends with whom he hangs out. They often play basketball at the nearby park; however, they sometimes get into trouble, as they play basketball when the park is closed.  Lawrence says he and his friends like the thrill of possibly getting in trouble for using the park after hours and he believes that there are no real consequences.   His mother blames the influence of these youth for most of Lawrence’s trouble with the police.  She states that they are a bad group and she believes some might even be gang members.   Lawrence denies gang involvement but says that he knows some guys who are part of a gang.   Lawrence admits to drinking with his friends but says everyone does it and he never ‘passes out’ like other friends do.  He has also admitted to drinking before going to school and had been the day he was suspended for verbally assaulting his teacher.

In the past six weeks, mother reports that Lawrence has become increasingly irritable, withdrawn and angers very quickly. He has become very sensitive to criticism and reacts with verbal aggression to even minor perceived slights.   She noted that he is sleeping later and is harder to get out of bed to go to school.  This has resulted in several tardy and a number of missed days.   Prior to being suspended, he had been going to school about 4 out of 5 days. 

Behavioral/Emotional Needs Domain

Put rating (number) next to each.

0. No evidence of need

1. History or Suspicion

2. Action Needed, Need interferes with Functioning

3. Immediate Action Needed, Need is dangerous or disabling

Top of Form


1. Psychosis

2. Impulsivity/Hyperactivity

3. Depression

4. Anxiety

5. Oppositional

6. Conduct

7. Anger Control

8. Substance Use

9. Adjustment to Trauma

Caregiver Needs & Resources

0. No evidence of need

1. History or Suspicion

2. Action Needed, Need interferes with Functioning

3. Immediate Action Needed, Need is dangerous or disabling

Top of Form


1. Supervision

2. Involvement with Care

3. Knowledge

4. Safety

5. Residential Stability

6. Organization

7. Social Resources

8. Mental Health/Substance Use

9. Medical/Physical/Developmental

Cultural Factors Domain

0. No evidence of need

1. History or Suspicion

2. Action Needed, Need interferes with Functioning

3. Immediate Action Needed, Need is dangerous or disabling

Top of Form


1. Language

2. Traditions and Rituals

3. Cultural Stress

Life Functioning Domain

0. No evidence of need

1. History or Suspicion

2. Action Needed, Need interferes with Functioning

3. Immediate Action Needed, Need is dangerous or disabling

Top of Form


1. Family Functioning

2. Living Situation

3. School Achievement

4. School Attendance

5. School Behavior

6. Social Functioning

7. Developmental/Intellectual

8. Decision-Making

9. Medical/Physical

10. Sexual Development

11. Sleep

Risk Behaviors Domain

0. No evidence of need

1. History or Suspicion

2. Action Needed, Need interferes with Functioning

3. Immediate Action Needed, Need is dangerous or disabling

Top of Form


1. Suicide Risk

2. Non-Suicidal Self-Injurious Behavior

3. Other Self-Harm

4. Danger to Others

5. Sexually Problematic Behavior

6. Delinquent Behavior

7. Runaway

Strengths Domain

0. Centerpiece Strength

1. Useful Strength

2. Identified Strength

3. No Evidence

Top of Form


1. Family Strengths

2. Interpersonal

3. Educational Settings

4. Talents and Interests

5. Spiritual/Religious

6. Cultural Identity

7. Community Life

8. Natural Supports

9. Optimism

10. Resilience

11. Resourcefulness

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Completing the CANS Certification

CANS Tool Training.

If you want training hours for completing the CANS Tool Training documented in your PDS Online account, you can access the CANS Tool training using the link below.

Access the CANS Tool Training in PDS Online.

If you’re not interested in having training hours documented in your PDS Online account, complete the modules that are posted on this webpage below.

CANS Certification Exam

The exam begins by reading a short vignette about a child and family. Then, you’ll be asked to complete a CANS for the family.

Access the CANS Exam in PDS Online

If you were previously certified and need to re-certify, click here:

Caseworkers who rate the CANS and have passed the initial exam are required to become re-certified annually.

Re-Certification Information

The exam is accessed and scored through PDS Online. Everyone in need of certification must have a PDS Online Account. If you have questions about creating a PDS Online account or logging into your account, please click here.

You can access and complete the CANS Exam once you have finished the CANS Tool training that can be accessed in PDS Online at the red button earlier on this page. For any questions about the training and certification process, please contact our office at [email protected]

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The Child and Adolescent Needs and Strengths assessment is a comprehensive trauma-informed behavioral health evaluation and communication tool. It is intended to prevent duplicate assessments by multiple parties, decrease unnecessary psychological testing, aid in identifying placement and treatment needs, and inform case planning decisions. CANS assessments help decision-making, drive service planning, facilitate quality improvement, and allow for outcomes monitoring.


The required use of an internationally recognized assessment instrument, provides a comprehensive multi-purpose tool developed for mental health services to support decision making, including selection of the level of care, recovery or treatment planning, quality improvement initiatives, and monitoring of service outcomes. The assessment tool is used to communicate the shared vision throughout the system, elevating the individual and family voice along the continuum of care. The uniform assessment serves as the psychosocial assessment, as well as a trauma screening and suicide screening tool, for all people entering community mental health services in Texas. In addition, the uniform assessment is used to determine authorization for community mental health services and the appropriate level of care recommended under Texas Resiliency and Recovery services. An array of evidence-based practices and promising practices can be personalized in each level of care to meet the individual and family needs and build upon the unique strengths of each person. Services and supports provided via the TRR model are expected to result in improved behavioral and emotional functioning.

Six Key Principles of the CANS/Communimetrics Tool

  1. The CANS rating items were chosen because they are each relevant to service planning. An item exists because it might lead down a unique pathway regarding decision-making.
  2. Each item uses a four-level rating system. These levels are designed to translate immediately into action levels. Different action levels exist for needs and strengths. For a description of these action levels, see below.
  3. Rating should describe the youth, not the youth in services. The assessment should identify what is important to the person, and what is important for the person. If the youth receives treatment, the provider should factor the needs of the youth and not how the youth behaves or responds to treatment.
  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 chronological age depending on the item. In other words, delinquency is not relevant for a young child, but would be for an older youth. Alternatively, school achievement should be considered within the framework of expectations based on the youth's developmental age.
  5. The ratings are generally collaborative. This descriptive tool is completed in a collaborative relationship by incorporating input from the youth and parent or guardian. It's about the 'what' and not the 'why.' It doesn't explain why there might be an underlying cause or reasons.
  6. Specific ratings window (for example, 30 days) can be overridden based on action levels. A 30-day window is used for ratings to ensure assessments stay "fresh" and relevant to the youth's present circumstances. However, if there is good reason, the action levels can be used to override the 30-day rating period. During the initial assessment, the rating is based on the presenting needs that can be outside of the 30-day rating period. Additionally, if the presenting problem or the behavior happened before 30 days and is still a focus of treatment, this behavior would be rated outside of the 30-day window.

Why the CANS?

The assessment is easy to learn and is well liked by recipients, family members, providers, and other partners in the services system because it is easy to understand and is a collaborative tool. The way the CANS works is that each item suggests different pathways for recovery treatment. There are four levels of each item with anchored definitions, however, these definitions are designed to translate into the following action levels and be scored accordingly (separate for needs and strengths).

For needs:

0 = No evidence
1 = Watchful waiting/prevention
2 = Action
3 = Immediate/Intensive Action

For strengths:

0 = Centerpiece strength
1 = Strength that you can use in planning
2 = Identified strength must be built
3 = No strength identified

Certification is required to perform the CANS. See the links below for information on the training certification.




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Answers cans assessment


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