1. Fundamentally communimetric tools like the CANS, ANSA and FAST are checklists of the various things that get done in human services.When a communimetric tool is filled out fully, you know that a thorough assessment has been done, and the disposition and treatment planning are now a direct act of bringing interventions to the identified needs and strengths. The communimetric tool has thus transformed something we always do in our field (assess and plan) into a mathematical formulation, and this allows a lot of power in analyzing what is happening, planning next steps, and monitoring outcomes.
2. But they are super fancy checklists: Communimetrics takes checklists to a whole new level, by adding more options than just the traditional done/not done distinction. On TCOM tools in particular (e.g. CANS, ANSA, FAST), there are always four positions: nothing needs to be done (0), watch it (1), do something about it (2), do something immediately and/or intensely about it (3). This expands the mathematical possibilities significantly of the tool, and makes it possible to capture most of the essential details of the formal interviews, without getting swamped in the long narratives and vagaries of written assessments.
3. Since the communimetric tool is a formalized universal assessment, the same tool can be used across an entire agency or system of care. Instead of every program having its own measure for its unique program, communimetric tools make programs universally comparable to each other. This increases their usefulness for treatment matching (certain profiles on the tool should go to certain programs, regardless of where the client entered your system), and for program comparison. Consider this graph below (you may need to zoom in), which shows you the Incoming and Outcome scores for all of the programs in an agency, so we can see that the right kids are going to right level.
4. TCOM tools are built for real world care in the community, not abstract change in the lab. When one thinks about tools like the CBCL, BASC, etc., we must understand that they were originally built as research tools. As such, they are dependent on controlled environments to produce meaningful information. Outside of the lab, these tools lose a lot of their efficacy. This is why so many organizations have implemented these tools only to find the initiatives flounder after 3 or so years … at that point, the needs of the lab have outstripped the usefulness of the tool, and everyone just finds the whole thing a hassle. This is not so with communimetric tools. Communimetrics measure a person in the contexts that matter for real-world care: symptomatology, risk, functioning, caregiver measures and strengths. By noting the needs and changes on these domains we see the real change for a client, not the change as measured in an abstract environment.
5. Communimetric tools are appreciated by clinicians. When a frontline clinician uses a communimetric tool, they are getting structure and decision support for their work, and it is helpful. This is especially true for program levels where workers cycle in and out often – the communimetric tool gives direction for assessing, conceptualizing, referring and treating. All within the context of their actual work environment – clinicians do not give up this tool quickly once it is introduced.
6. Communimetric tools can be individualized for your local needs. Because communimetric tools are checklists of what needs to be done, if your system has new unique things that get done, you can modify the tool for these unique action trajectories. For instance, if you are working with a lot of people with developmental disabilities, it would probably help for you to add items relevant to the action planning of developmental disabilities. Questions that link to occupational therapy, speech therapy, and so on, these are not on all of the traditional “TCOM tools” (CANS, ANSA, FAST) but are very relevant in some jurisdictions. They can be easily added, and now the clients and system are better understood within the context of those possible directions of care.
7. Communimetric tools allow the development of locally relevant decision support algorithms for treatment referral and planning. Communimetric tools have the unique ability to turn not only assessments into formal mathematical models, but also program descriptions, level of care regulations, and managed care contracts can also be made quantifiable by communimetric means. How is this done? Well, every program has a list of things that it does, and those should match what’s on the tool you use. As such, communimetrics offers a powerful means to make decision support algorithms based on your local realities, and not abstract ideas. If you try to use psychometric tools for decision support, you invariably get very generic recommendations, that are also often wrong because of their inability to account for the context that matters: your actual care system. In contrast, communimetrics has the ability to make a mathematical model of each person and fit it into the mathematical model of each program. Please take a look at this diagram below from an old PowerPoint I used to use that explained why systems should switch to a communimetric tool:
Here we see a client, who is assessed with the CANS, and as such his needs are transformed into numbers. Then, there are three programs in this system of care, and each has its own target population as described in their service description. Once both the person and the program are transformed into their respective communimetric profiles, the process of linking a child to the right program becomes efficient and mathematical. Psychometric tools simply cannot do this.
8. And beyond the scientific reasons, communimetrics has been institutionalized into the TCOM community, which is one of the most vibrant and resourceful communities in human services. It is important to note that most tools out there are proprietary, with their use tightly controlled by organizations which charge for access and use. In contrast, John Lyons has established the edifice around communimetrics in an open source model. Instead of Microsoft, think Linux. Instead of dollars, think bitcoin. TCOM is a world of people like you, working to measure their system and change it for the better. When you start working with communimetric tools, help is always a quick email away – and it’s not necessarily to a company who is serving you, but to other professionals working with you to advance the science and the cause.
So, I hope this summary is succinct enough. I’m such a fan, I can really go on forever … but once again, the proof is in the pudding.
Contact us today at firstname.lastname@example.org if you want to see what systems are doing with their TCOM implementations, and I’m sure you’ll instantly see the difference.