If a CANS screening has been recommended for your child, you may be wondering what to expect, what questions you’ll be asked, and what the results could mean for your family.
Will your child be tested? Are there right or wrong answers? Does a CANS screening mean your child automatically qualifies for WISe?
For families who are already trying to manage behavioral health concerns, school challenges, crises, or involvement with several systems at once, another assessment can sound overwhelming.
The CANS screening is intended to help determine whether a young person’s needs appear to rise to the level of care offered through Atención integral con servicios intensivos, commonly called WISe. Washington’s Health Care Authority describes the WISe screen as a 26-question CANS screening tool that may be completed over the phone or in person.[1]
Knowing what to expect can make the process feel more manageable.
What Is CANS?
CANS stands for Child and Adolescent Needs and Strengths.
It is a structured tool used to organize information about a young person’s needs and strengths. In Washington’s WISe system, the CANS is used during the initial screening process to help determine whether a child or youth may benefit from the intensive, coordinated level of behavioral health care WISe provides.[1]
That distinction matters.
A CANS screening is not simply a list of everything that is going wrong. Needs are part of the conversation, but strengths matter too. The broader CANS approach is designed to support planning around both needs and strengths rather than focusing only on symptoms or diagnoses.[2]
For a parent, that may mean talking not only about difficult behaviors or recent crises, but also about the people, routines, interests, relationships, and abilities that help your child function.
The Screening Is About the Bigger Picture
Behavioral health needs rarely exist in only one part of a child’s life.
A young person may be struggling emotionally at home, missing school, having conflict with family members, receiving services from several agencies, or facing the possibility of a higher level of care.
The purpose of the WISe screening is to gather enough information to understand that bigger picture and determine whether WISe may be an appropriate level of support.
Washington guidance for professionals describes WISe referrals as appropriate to consider when a young person has serious behavioral health needs, needs a higher-than-average level of behavioral health support, has significant family conflict related to mental health needs, is involved with multiple systems, or may be at risk of out-of-home placement or hospitalization.[3]
A family does not need to decide which category their child fits into before asking about WISe. The screening process is there to help organize the information.
What Might You Be Asked About?
Every family’s situation is different, but expect the person completing the screening to gather information about your child’s current needs and circumstances.
The CANS looks at six main areas, or domains. The names may sound clinical, but they are simply different parts of the bigger picture:
- Family Functioning — what daily life, relationships, routines, and challenges look like at home
- Behavioral/Emotional Needs — concerns such as anxiety, mood, behavior, or emotional regulation
- Risk Behaviors — safety concerns or behaviors that may put your child or others at risk
- Child Strengths — relationships, interests, abilities, and supports your child can build on
- Caregiver Resources and Needs — the supports, stressors, and resources affecting the adults caring for your child
- Cultural Factors — cultural identity, values, beliefs, or experiences that may be important to understanding your child and family
Washington’s WISe referral guidance specifically notes information such as diagnoses, psychiatric medications, insurance, and indicators of intensive behavioral health need as relevant to the referral and screening process.[3]
You may not know every answer. That is okay. The goal is to give the screener the clearest picture you can of what life currently looks like for your child and family. The better you can paint that picture, the better Three Rivers Therapy can understand whether WISe may be the right fit. When less information is available, it can be harder to make an accurate determination.
You Do Not Need to Make Things Sound Better — or Worse
Parents sometimes become used to explaining their child’s needs to schools, providers, relatives, insurance plans, and other systems.
That can create pressure to find exactly the right words.
For a CANS screening, try to describe what is actually happening.
If mornings regularly end in conflict, say that. If your child has stopped participating in activities they once enjoyed, mention it. If school attendance has become difficult, explain what that looks like. If your family has found strategies that are working, share those too.
Concrete examples can be more useful than broad descriptions.
Instead of saying, “School is terrible,” you might explain that your child has missed several days because anxiety makes it difficult to enter the building.
Instead of saying, “They are doing better,” you might explain that your child has gone two weeks without a crisis call and has started spending time with friends again.
The purpose is not to prove that your child is struggling enough. It is to help the person completing the screen understand your child’s needs and strengths as accurately as possible.
Can a CANS Screening Be Done by Phone?
Yes.
Washington’s Health Care Authority states that the 26-question WISe CANS screening can be completed either over the phone or in person.[1]
That means families may not necessarily need to attend a traditional office appointment simply to complete the initial screen.
At Three Rivers Therapy, the CANS screening typically takes approximately 30–45 minutes. If you are unsure how your child’s screening will take place, ask the screening provider what to expect, whether your child should participate, and whether there is information you should have available beforehand.
What Happens After a CANS Screening?
At Three Rivers Therapy, the CANS screening helps determine what happens next. After a referral is received, the CANS screen helps us understand whether WISe may be the right level of support for your child and family.
If WISe may be a fit: Referral → CANS Screen → Intake → Start Services
If WISe may not be a fit: Referral → CANS Screen → Recommended Next Step
If WISe may be the right fit, the next step is intake and further evaluation before services begin. If another level of care may be more appropriate, Three Rivers will help identify the recommended next step.
According to Washington’s Health Care Authority, if the screening indicates that a young person may be eligible for WISe, the family is connected with a WISe provider agency. If the screening does not indicate WISe eligibility, the family should be referred to other mental health services that fit the young person’s needs.[1]
Washington’s family WISe materials further explain that when the screening indicates WISe could potentially benefit a child, the child is referred to a WISe agency for an intake evaluation. The provider then determines whether WISe is medically necessary.[4]
In other words, the initial CANS screen and enrollment in WISe are not exactly the same step.
A screen can indicate that WISe may be appropriate, but additional intake and clinical evaluation occur before services are established.
If Your Child Moves Forward With WISe
If WISe is determined to be medically necessary, the WISe provider agency assigns a team and coordinates care through that team.[4]
WISe is designed around a team-based approach. At Three Rivers Therapy, that team can include a care coordinator, counselor, peer support, the child or youth, caregivers, and other supportive people involved in the family’s care. Washington guidance requires WISe providers to use the Wraparound model, identify a care coordinator, include peer support on teams, and provide access to 24/7 crisis services for WISe participants.[5]
The CANS also does not disappear after the initial screening.
Washington WISe guidance indicates that a full CANS is completed early in services and is repeated during care and at discharge. This allows the team to revisit needs and strengths over time rather than treating the first assessment as a permanent description of the young person.[5]
That is important because children change. Families change. What requires the most attention at the beginning of care may not be what requires the most attention several months later.
What If My Child Does Not Qualify for WISe?
A result indicating that WISe is not the appropriate level of care does not mean your child’s concerns are unimportant.
WISe is one specific level and model of behavioral health care.
Washington’s Health Care Authority states that when a young person is not eligible for WISe based on the screening process, they should be referred to other mental health services that better fit their needs.[1]
Ask what the recommended next step is.
That might mean outpatient behavioral health treatment or another service appropriate to your child’s circumstances. The exact recommendation will depend on the young person and the resources available.
The important question becomes: If WISe is not the right fit, what support is?
Cómo pueden prepararse los padres
You do not need to prepare a formal report before a CANS screening.
It may help, however, to think through a few areas before the conversation:
- What concerns led you or someone else to request the screening?
- What has changed recently?
- What does a particularly hard day look like?
- How are the concerns affecting home, school, relationships, or daily routines?
- Have there been crises, hospitalizations, suspensions, or other significant events?
- What services has your child already tried?
- What seems to help?
- Who are the supportive people in your child’s life?
- What does your child do well?
- What would you most like to see become different?
If you have medication information, provider names, or other relevant records readily available, they may also help you answer questions accurately.
But you do not need to arrive with every detail perfectly organized. Your knowledge of your child and your family’s day-to-day experience is valuable information.
Your Child Is More Than a Screening Result
A CANS screening can help organize complicated information, but it cannot capture everything about a young person.
A score does not tell the whole story of your child’s personality, potential, relationships, humor, interests, or future.
Think of the screening as one tool for answering a practical question: What level and type of behavioral health support may be appropriate right now?
If WISe appears to be the right level of care, the next steps allow the provider and family to learn more and begin building a plan around the young person’s needs and strengths.
If another service is more appropriate, the screening can help point the family toward that next step.
Three Rivers Therapy provides WISe and other behavioral health services for children, youth, and families in Washington.
If WISe has been recommended for your child or you are wondering whether your family may benefit from this level of support, contact Three Rivers Therapy to learn more about the screening process and available services.
Fuentes
- Washington State Health Care Authority. Wraparound with Intensive Services (WISe). https://www.hca.wa.gov/free-or-low-cost-health-care/i-need-behavioral-health-support/wraparound-intensive-services-wise
- Washington State Department of Children, Youth, and Families. Child Welfare Assessments: Child and Adolescent Needs and Strengths-Family (CANS-F 2.1). https://www.dcyf.wa.gov/practice/practice-improvement/aog/child-welfare-assessments
- Washington State Health Care Authority. WISe: Individuals Providing Behavioral Health Services to Children and Youth. https://www.hca.wa.gov/assets/billers-and-providers/82-0149-wise-individual-mental-health.pdf
- Washington State Health Care Authority. WISe: Information for Families. https://www.hca.wa.gov/assets/free-or-low-cost/82-0154-522-wise-family-fact-sheet.pdf
- Washington State Health Care Authority. WISe Guidance / WISe Program Requirements. https://www.hca.wa.gov/assets/program/wise_guidance_document_october.pdf
