Appendix a: CPRI’s domains framework overview

CPRI developed a framework for organizing, interpreting and communicating the large quantities of data provided by the interRAI child/youth suite assessments into meaningful topic areas.

Safety
The Safety domain addresses the control of hazards and assesses a young person’s risk in key areas. By understanding any dangers present, safety planning can focus on creating safe and secure environments which are important to foster good mental health.
Family Life & Social Integration
The Family Life and Social Integration domain captures valuable information on household composition, strong and positive relationships, and social opportunities. When issues are identified in this area, support can be put in place to help achieve stability within the young person’s familial and social interactions.
Health Promotion
The Health Promotion domain addresses any conditions that have an impact on a young person’s optimal level of health and wellbeing. By addressing these needs, we aim to invest in the young persons’ developmental potential by establishing lifelong health behaviours that promote competency and resilience.
Functional Status
The Functional Status domain highlights the young person’s ability to perform activities, manage routines, and participate in life situations. Addressing needs in this domain is important to help children and youth to reach their full potential in daily functioning.
Services & Supports
The Services and Supports domain identifies areas of need where additional services and supports can be beneficial. Addressing service and support needs early benefits the young person by providing tools for long-term success.

Appendix a: CPRI’s domains framework

interRAI ChYMH and ChYMH-DD components mapped to CPRI’s domains framework

Safety
ChYMH Assessment Sections:
  • F. Behaviour
  • E. Harm to self and others
  • C. Mental health indicators
  • N. Stress and trauma
ChYMH-DD Assessment Sections:
  • F. Behaviour
  • E. Harm to self and others
  • C. Mental health indicators
  • N. Stress and trauma
ChYMH CAPs:
  • Control interventions CAP
  • Criminality prevention CAP
  • Hazardous fire involvement CAP
  • Sexual behaviour CAP
  • Suicidality & purposeful self harm CAP
  • Traumatic life events CAP
ChYMH-DD CAPs:
  • Control interventions CAP
  • Hazardous fire involvement CAP
  • Injurious behaviour CAP
  • Sexual behaviour CAP
  • Suicidality & purposeful self harm CCAP
  • Traumatic life events CAP
ChYMH Scales:
  • Aggressive behaviour scale
  • Anxiety scale
  • Depressive severity index
  • Disruptive/aggressive behaviour scale
  • Externalizing scale
  • Internalizing scale
  • Positive symptoms scale
  • Risk of harm to others scale
  • Severity of self-harm scale
ChYMH-DD Scales:
  • Aggressive behaviour scale
  • Anxiety scale
  • DD-Depressive severity index*
  • Disruptive/aggressive behaviour scale
  • Externalizing scale
  • Internalizing scale
  • DD-Positive symptoms scale*
  • DD-Risk of harm to others scale*
  • DD-Severity of self-harm scale*
  • DD-Safety risk scale*
Family life & social integration
ChYMH Assessment Sections:
  • S. Environmental assessment
  • M. Family and social relations
  • B. Intake and initial history
ChYMH-DD Assessment Sections:
  • T. Environmental assessment
  • M. Family and social relations
  • N. Psychosocial well-being
  • B. Intake and initial history
ChYMH CAPs:
  • Attachment CAP
  • Caregiver distress CAP
  • Interpersonal conflict CAP
  • Parenting CAP
  • Social & peer relationships CAP
ChYMH-DD CAPs:
  • Caregiver distress CAP
  • Parenting CAP
  • Social relations CAP
ChYMH Scales:
  • Social disengagement scale
  • Caregiver distress scale*
  • Family functioning scale*
  • Parenting strengths scale*
  • Peer conflict scale
  • Relational strengths scale*
ChYMH-DD Scales:
  • Caregiver distress scale*
  • Family functioning scale*
  • Parenting strengths scale*
  • Peer conflict scale
  • DD-Social engagement scale*
  • DD-Social inclusion scale*

*CPRI-designed enhancements to standard interRAI ChYMH or ChYMH-DD assessments

Health promotion
ChYMH Assessment Sections:
  • L. Health conditions
  • O. Medications
  • Q. Nutritional status
  • D. Substance use or excessive behaviour
ChYMH-DD Assessment Sections:
  • L. Health conditions
  • O. Medications
  • Q. Nutritional status
  • D. Substance use or excessive behaviour
ChYMH CAPs:
  • Caffeine use CAP
  • Gambling CAP
  • Medication adherence CAP
  • Medication review CAP
  • Physical activity CAP
  • Sleep disturbance CAP
  • Strengths CAP
  • Substance use CAP
  • Tobacco & nicotine use CAP
  • Video gaming CAP
  • Weight management CAP
ChYMH-DD CAPs:
  • Continence
  • Medication adherence CAP
  • Medication review CAP
  • Modified nutrition intake CAP
  • Problematic eating behaviour CAP
  • Sleep management CAP
  • Strengths CAPP
ChYMH Scales:
  • Aggressive behaviour scale
  • Anxiety scale
  • Depressive severity index
  • Disruptive/aggressive behaviour scale
  • Externalizing scale
  • Internalizing scale
  • Positive symptoms scale
  • Risk of harm to others scale
  • Severity of self-harm scale
ChYMH-DD Scales:
  • Aggressive behaviour scale
  • Anxiety scale
  • DD-Depressive severity index*
  • Disruptive/aggressive behaviour scale
  • Externalizing scale
  • Internalizing scale
  • DD-Positive symptoms scale*
  • DD-Risk of harm to others scale*
  • DD-Severity of self-harm scale*
  • DD-Safety risk scale*
Functional status
ChYMH Assessment Sections:
  • H. Cognition and executive functioning
  • J. Communication
  • K. Hearing, vision, and motor
  • I. Independence in daily activities
  • G. Strengths and resilience
ChYMH-DD Assessment Sections:
  • H. Cognition and executive functioning
  • J. Communication
  • K. Hearing, vision, and motor
  • I. Independence in daily activities
  • G. Strengths and resilience
ChYMH CAPs:
  • Communication CAP
  • Life skills CAP
ChYMH-DD CAPs:
  • Accessibility and mobility CAP
  • Communication CAP
  • Life skills CAP
  • Play and leisure CAP/li>
ChYMH Scales:
  • ADL hierarchy scale*
  • Hyperactive/distraction scale
  • Youth IADL capacity scale
  • Youth IADL performance scale
  • Communication scale
  • Deaf blind severity index
  • Sensory processing difficulties*
ChYMH-DD Scales:
  • ADL hierarchy scale*
  • Hyperactive/distraction scale
  • Youth IADL capacity scale
  • Youth IADL performance scale
  • Communication scale
  • Deaf blind severity index
  • Sensory processing difficulties*
  • DD-Repetitive/restricted behaviours flag*

*CPRI-designed enhancements to the standard interRAI ChYMH or ChYMH-DD assessments

Services and supports
ChYMH Assessment Sections:
  • R. Education
  • P. Prevention, service utilization, treatments
ChYMH-DD Assessment Sections:
  • S. Education
  • Q. Prevention, service utilization, treatments
ChYMH CAPs:
  • Education CAP
  • Informal support CAP
  • Readmission CAP
  • Support systems for discharge CAP
  • Transitions CAP
ChYMH-DD CAPs:
  • Education support CAP
  • Support systems for discharge CAP
  • Transitions CAP
ChYMH Scales:
  • Risk of school disruption scale*
ChYMH-DD Scales:
  • Risk of school disruption scale*

*CPRI-designed enhancements to the standard interRAI versions of ChYMH or ChYMH-DD assessments

Appendix b: getting started with selecting the right tools for your organization’s needs

Section 1.1: The interRAI ChYMH suite

gave an overview of key considerations when reviewing the assessments. Now that you have reviewed this section of the toolkit and looked at the ChYMH Suite tools on interRAI.org, it’s time to start thinking about your organization’s needs. Consider…

  • What tool(s) might be the best fit for the entire organization?
  • Are there particular considerations for your intake department?
  • What about any program-specific needs?

“What Does the Research Show”

in the Overview and Background section summarizes some key points about implementation science. How will your organization incorporate this knowledge into your implementation planning? For example, how will you avoid taking an approach that focuses too heavily on setting guidelines and policies? How will you make sure your organization commits to a long-term plan?

Appendix c: guiding questions to support mapping

The following questions will guide your efforts to define your information needs and decisions about when and where to use the tools you have chosen. Engage program managers or direct care staff to determine processes that are realistic and likely to succeed. For each step, gather information, consider examples and other relevant factors and then make notes for your own plan.

Step:Ask:Consider:Plan:
1
  • What kind of information do you need?
  • Where in the service journey do you need it?
  • Are you primarily interested in an overview of current needs and risks at intake?
  • Do you also need outcome information at the end of service? What about during?
 
2
  • What assessment documents, scales, checklists are currently in use?
  • Can any current tools or processes be replaced with the new tools/practices?
  • Does your organization use other standardized tools?
  • What about “homegrown” assessments?
  • Can existing tools, especially forms that collect narrative information, be replaced?
 
3
  • What problems or frustrations exist in the current workflow?
  • Does the ChYMH Suite implementation offer an opportunity to address current issues?
  • Are there bottlenecks, duplications, or service quality issues?
 
4
  • What are your current clinical processes?
  • Map out service processes, noting when and how information is gathered, used, and documented.
 
5
  • How will your information management processes need to change?
  • Where will completed assessments be stored?
  • How will completed assessments be shared externally?
  • Do appropriate sharing and consent mechanisms already exist, or will changes be needed?
 
6
  • What guidelines will be put in place regarding timelines?
  • How often will full assessments be completed? How old can an assessment be before it is considered “out of date”?
  • How frequently will monitoring or subsequent assessments be completed?
  • Will these standards be the same across all programs?
 
7
  • Who will administer the ChYMH Suite assessments?
  • What are the resourcing implications?

Consider what can stay the same and what will need to change.

  • Which disciplines and roles will be ChYMH Suite assessors?
  • Do the staff who currently administer assessments have the clinical experience to administer ChYMH Suite tools, or will this responsibility need to be shifted to more qualified staff?
  • Are adequate supervision practices in place?
  • What additional resources (such as time, technology) will be needed?
 
8
  • Who do you know that has successfully adopted the ChYMH Suite into clinical practice?
  • What can you learn from their mapping experience?
  • Consider partner organizations with similar services or workflow.
 

Appendix d: is your leadership team ready to support staff through ChYMH suite implementation?

Use these prompts to think about your organization’s leadership team and whether it is ready to provide strong, consistent, and united support to staff through the ChYMH Suite implementation process. This is a crucial step – if the answer to any of these considerations is “no”, managers and supervisors will not have the knowledge, tools, skills, or motivation to aid in implementing the change. Using this tool can help you can identify any gaps and create a plan to bridge or eliminate them.

Self-assessment reflection questionResponse (Yes, No, Partially)Plan to bridge or eliminate gaps
Do managers and supervisors understand what is required of them as the organization moves towards implementing the interRAI ChYMH Suite, including the specific actions and behaviours needed from them to support launching the tools (e.g., to introduce and follow through on new procedures)?  
Have managers and supervisors been provided with the skills and tools to be successful at leading their staff though the implementation process (such as change management training)?  
Is there a plan for managers and supervisors to monitor and support clinical staff in ongoing use of the tools (such as review of tool use added to supervision meetings)? If not, what could that look like in your organization?  

Appendix e: leadership activities planning

In this activity, key tasks for leaders identified through implementation science research have been applied to ChYMH Suite implementation. This list is not exhaustive nor required. Add or subtract from the list according to the unique circumstances of your organization.

Administrative Support
TaskPerson(s) ResponsiblePlanned TimelinePlanned Approach
Form ChYMH Suite Implementation Team and ensure Terms of Reference includes communication protocols to provide feedback up to higher levels.  
  • Technical
  • Adaptive
  • Notes
Develop/revise policies and procedures to support the changes being implemented.  
  • Technical
  • Adaptive
  • Notes

Speak about the importance of the initiative to: 
 

  • Staff
  • Other stakeholders
  
  • Technical
  • Adaptive
  • Notes

Solicit and analyze feedback from:
 

  • Staff
  • Other stakeholders
  
  • Technical
  • Adaptive
  • Notes
Use feedback and data to make adjustments and improvements to implementation efforts.  
  • Technical
  • Adaptive
  • Notes
Reduce internal barriers such as duplication between ChYMH Suite assessments and internally developed information gathering tools, time constraints that impede learning, or issues with embedding ChYMH Suite assessment results into clinical decision-making.  
  • Technical
  • Adaptive
  • Notes
System Intervention
TaskPerson(s) ResponsiblePlanned TimelinePlanned Approach
Address system-level issues that affect work within the organization.  
  • Technical
  • Adaptive
  • Notes
Engage with others outside of the organization (such as partner organizations, funders) to nurture champions and supporters.  
  • Technical
  • Adaptive
  • Notes
Data & Decision Support Facilitation
TaskPerson(s) ResponsiblePlanned TimelinePlanned Approach
Create data systems to support organizational decision-making (such as use of ChYMH Suite data to support administrative decision-making, use of metrics to evaluate implementation progress and success).  
  • Technical
  • Adaptive
  • Notes
Create data systems to support clinical decision-making (such as ensuring that ChYMH Suite assessment results are used in treatment planning and evaluation).  
  • Technical
  • Adaptive
  • Notes
Create data systems to support assessor competence and fidelity.  
  • Technical
  • Adaptive
  • Notes
Create communication systems that ensure data is meaningfully and regularly shared with relevant audiences (such as staff, families, other stakeholders).  
  • Technical
  • Adaptive
  • Notes

Appendix f: risk management planning

This tool should be completed during the Planning phase to identify current risks and prepare for potential future risks. It is also useful to revisit this tool regularly throughout the implementation process to monitor the ongoing risks and provide an opportunity to flag new issues as they arise. We have pre-populated the first two rows with examples to show how this tool can be used. Add as many rows as needed for additional risks.

RiskIndicatorsPotential Impact (High, Medium, Low)Current Status (Green, Yellow, Red)OwnerMitigation PlanActions Needed
For example: Internet access not consistent for all staffStaff unable to access online softwareHigh
  • Green
  • Yellow
  • Red
IT leadCreate “hoteling stations” for staff internet access or develop procedures for offline tool useComplete assessments by hand or offline and use software at hoteling locations
For example: Not all staff available for scheduled training datesStaff untrained by “Go Live!” dateLow
  • Green
  • Yellow
  • Red
Training leadHave staff trained as trainersTrain internally when staff are available
       
       

Appendix g: communication plan template

This template follows CPRI’s 3-Step Process for Communication Planning, described in section 2. Use the prompts to prepare a targeted communication plan for each stakeholder and message. Add as many lines as needed. Communication Planning is not a one-time process, so be sure to review and add to this plan regularly.

 
Identify your stakeholdersConsider their unique needsContentLeadPlan for Two-Way CommunicationResources/ Costs InvolvedExpected Outcome of the MessageDate/TimingMonitoring/Evaluation
Consider direct and indirect stakeholders.What is their current context /what do they already know?What is the message?Who will deliver the message? How?How will we get feedback?Do we need to involve other people/processes?What is the purpose?When will this be shared?How will we know it was effective?
         
         

Appendix h: training planning worksheet

Follow these steps to create a training plan that matches your organization’s needs and resources.

A. Determine volume of assessors to be trained

1. Think of the programs that are implementing the ChYMH Suite. How frequently are assessments expected to be completed on clients?

  Estimated monthly frequencyNotes
ChYMH-S:  
ChYMH:  
ChYMH-DD:  

2. Assessors should complete a minimum of 3 assessments per month to maintain skills.

Considering this and the projected volume of assessments above, how many assessors will you need, and who will the assessors be? Do you need to consider turnover for these roles?

  Estimated number of assessorsNotes
ChYMH-S:  
ChYMH:  
ChYMH-DD:  

3. Will any assessors use multiple tools?

  • Yes
  • No
  • If yes, note predicted overlap:

B. Determine training delivery logistics

1. Determine training modality:

  • In-person
  • Web-based

2. Set standards:

(Refer to guidelines and recommendations in Section 2)

In-person training
Class size:Minimum: _____ Maximum: _____
Trainer Ratio:(e.g., 2 trainers unless class has <4 participants)
Length and distribution of training:(e.g., ChYMH Assessor Training will take two days back-to-back plus a one-day “clinical utility” session occurring 2 weeks later; Screener Assessor Training will occur over two back-to-back half-day sessions)
Web-based training
Platform:(e.g., Adobe Connect)
Trainer and Support Ratio:(Note: A minimum of 1 trainer to deliver content and 1 trainer/support person to manage technology is recommended)
Length and distribution of training:(e.g., ChYMH Assessor Training will occur over a single week: 5 half-day webinar sessions)

3. Determine who will deliver Assessor Training:

  • In-house trainers – Requires a) Train-the-Trainer training from outside source, or b) in-house development of new curriculum
  • External trainers – Requires partnership with another organization

C. Add literacy training to your plan

Who else needs to have practical knowledge of the tools and how to use the results? Identify participants for Literacy Training.

 Participants:Estimated number of participants:
Delivery logistics:

In-person

Web-based

Trainer details:

In-house

External

Class size estimate: 
Trainer Ratio: 

D. Determine timelines

1. Using the information documented in Steps A, B and C, determine how many training sessions are needed for each tool by dividing the number of participants needed by the standards for class size (Tip: it can be useful to take the midpoint between the class size minimum and maximum as this will allow you to scale class size up or down depending on how much time you have [see below]).

If any overlap in assessor pool was noted in Step A, consider your options for reducing redundancy. You may wish to incorporate a “top-up training” approach:

  • Assessors who will be using both the ChYMH and Screener can attend a full ChYMH Assessor Training and then a shorter session that focuses only on what is different in the Screener.
  • Assessors who will be using both the ChYMH and ChYMH-DD can do the same with a ChYMH-DD “Top-Up” that focuses on population-specific factors.
 Approximate number of sessions required
ChYMH: 
ChYMH-S: 
ChYMH-DD: 
“Top-Up” sessions:(Include type of session)
Literacy: 

2. Use a training calendar to plot these sessions between the “Go Live!” date and your desired training launch date, and make adjustments as needed. Choose a person who can coordinate training, and update the Training Calendar.

  • Training Coordinator:

Appendix h: training calendar sample

This sample template can be used in conjunction with your training plan. The training calendar secures resources and identifies contacts for each training session. This can be particularly helpful in predicting the resources that you will need and ensuring alignment with other initiatives.

Training Calendar Example
Type of trainingDates for trainingAttendeesClass sizeTrainers booked *lead trainer (organization)Location of trainingTraining contact for registrationTraining contact for materials
ChYMH (winter)January 5th/6th   
February 10th		New hires1-16 maxBecky Red* (Organization A)   
Beth Green (Organization A)		Organization ACathy WhiteJulie Black
ChYMH (spring)April 5th/6th   
May 10th		New hires, supervisors1-16 maxMike Blue* (Organization B)   
Mandy Pink (Organization A)		Organization BCathy WhiteJulie Black
ChYMH (fall)October 5th/6th   
November 10th		New hires1-16 maxMike Blue* (Organization B)   
Mandy Pink (Organization A)		Organization CCathy WhiteJulie Black
ChYMH for day treatmentAugust 28th/29th    
October 17th		Current day treatment team1-16 maxMike Blue* (Organization B)   
Mandy Pink (Organization A)		Organization CCathy WhiteJulie Black
Screener (spring)April 7thNew hires1-16 maxMike Blue* (Organization B)   
Mandy Pink (Organization B)		Organization BCathy WhiteJulie Black
Screener (fall)November 7th 1-16 maxMike Blue* (Organization B)   
Mandy Pink (Organization B)		Organization BCathy WhiteJulie Black
Literacy training (spring)March 25th from 10-12New hires, supervisors5-16 maxBecky Red* (Organization A)   
Beth Green (Organization A)		Organization ACathy WhiteJulie Black
Literacy training (fall)October 25th from 10-12New hires, supervisors5-16 maxBecky Red* (Organization A)   
Beth Green (Organization A)		Organization ACathy WhiteJulie Black

Appendix i: resource for navigating “sticky issues” in assessor training

As with any training, there are some common pitfalls in Assessor Training. Be ready for these by reviewing the following support strategies. Review and use your Communication Plan to ensure that messages are consistent.

Sticky issue #1: Participants may have a mental model of assessments that does not match how the ChYMH Suite tools are constructed.

This might look like:
  • Discomfort with information being collected in a semi-structured interview rather than a questionnaire.
  • Discomfort with the way that information is coded as a summary statement (the “what’s happening”) rather than immediately clinically scored (“how severe is it”). Or, discomfort with information being collected in codes instead of a narrative.
  • Difficulty adapting to results that summarize risk and need rather than results that focus on diagnostic information.
You can be ready to support by:
  • Expecting that people with scripted assessment experience may want to fall back on those trusted skills and will need support to shift to a conversational interviewing approach.
  • Recognizing that mental health workers may be intimidated by summarizing need in ‘one code’ or with ‘one statement’, knowing the complexity of the young people they support.
  • Helping by reminding learners that:
    • multiple aspects of need are coded elsewhere in the tool, creating a fuller picture, and
    • note sections can be used to add context.
  • Emphasizing understanding children/ youth holistically, and discussing how to focus intervention when multiple areas of need are identified.

Sticky issue #2: Participants may make assumptions about changes to roles, programs or processes. If misinformation is not dispelled, this can create a significant barrier to learning.

This might look like:
  • Learners aren’t clear on why they are becoming assessors, and they don’t understand how the results will be used in their role.
  • Tool learning is getting derailed by questions about changes to processes or duties.
You can be ready to support by:
  • Being prepared to discuss how being an assessor will (or will not) change their work. Show how choices were made, and allow time for the message to be understood.
  • Having a plan for managing ‘out of scope’ conversations such as a leadership contact to address any ‘parked’ questions.

Sticky issue #3: Participants may become overly focused on coding rather than clinical applications

This might look like:
  • Participants are overwhelmed by learning the process of coding and conclude the assessments are ‘only for data’.
You can be ready to support by:
  • Reassuring participants that the information they collect will be valued and used to support children, youth, and families.
  • Emphasizing that the assessor learning curve does begin with coding fundamentals but leads to clinically helpful outcomes.

Appendix j: sample logic model for program evaluation using ChYMH

Appendix k: evaluation planning template

The Evaluation Planning Template expands upon the outcomes and indicators identified in your Implementation Logic Model. Use this template to identify how these indicators will be measured. Add as many rows as needed for additional outcomes and evaluation questions.

OutcomeEvaluation questionIndicator(s)Target(s)
Outcome 1   
For example: Enhanced use of data to inform clinical and service decision-making		Are clinical staff using ChYMH data to inform care planning?# of programs with ChYMH assessment components embedded into clinical procedures (e.g. reports, processes)Clinical staff
 Are clinical staff using Screener+ data to inform triage decisions?% of intake staff responding positively to the question, “My team uses Screener+ data to make triage decisions?”Clinical staff (intake department)
Outcome 2   
Outcome 3   
Outcome 4   
Outcome 5   

Appendix l: data collection and management template

Once your Evaluation and Monitoring Plan is complete, use this template to plan how data will be collected, stored, and analyzed. Add as many rows as needed for additional data sources.

Data SourceTimeline/ Frequency of measurementPerson(s) responsibleData management systemTimeline/ Frequency of analysis
Data Source 1   
For example: Staff satisfaction and use survey		Initial survey: 3 months post-Go Live date 
Follow-up survey: 9 months post-Go Live date		Implementation Team Quality Assurance LeadSurvey Monkey/Excel datasetImmediately following each data collection period
Data Source 2    
Data Source 3    
Data Source 4    
Data Source 5    

Appendix m: assessor competency checklist

The Assessor Competency Checklist focuses on competencies related to interviewing clients and their caregivers using ChYMH Suite assessments. This resource may be helpful at several points of learning such as when shadowing a skilled assessor, when meeting with clinical supervisors, or when collaboratively planning to support an assessor who is struggling.

Foundations
The assessor…How this is helpful:How to enhance skill in this area:
Knows the items, sections, and similar groupings in the tool
  • Foundation for fluid interviewing
  • Reduces forgotten items
  • Create a note-taking template of the sections/items/challenging areas
Connects similar items across the tool
  • Reduces the amount of time an interview takes
  • Provides a better experience for the client/caregiver
  • Review the instruments to increase familiarity
Creates a plan for items that are more challenging
  • Demonstrates supportive interviewing
  • Takes the burden of initiating difficult conversations or disclosures off of the client/caregiver
  • Review assessor training materials for interview techniques and tips
Adjusts language in the interview according to the audience
  • Demonstrates supportive interviewing
  • Increase familiarity with assessment content
Issue: The assessor is taking a very long time to complete assessments. 

Gather information to understand how they’re working with the tool(s)

  • Are they reading the assessment as a questionnaire rather than using open-ended questions?
  • Are they adding other elements to the interview (such as starting an intervention, or spending a large amount of time obtaining consent, or discussing “housekeeping” items)?
  • Are they entering information into the electronic tool where they can?
  • Do they need support entering the information into the electronic system?

Possible support approaches

  • Set up shadowing/mentoring to demonstrate the semi-structured interview
  • Review how it takes less time to use open-ended questions than to read each item as a question
  • Use self-made interview templates for collecting information in a manner that suits the assessor’s style and approach
  • Discuss the benefits of completing parts of the assessment in advance
  • Review processes for collecting housekeeping and consent
  • Offer supports with using the electronic tool system
Issue: The assessor is struggling to collect information about all the items in the tool. 

Consider:

  • Are they able to generate useful open-ended questions to capture the information?
  • Do they feel resistant to certain sections of the tool? Do they struggle to see the value of the comprehensive nature of the assessment, or feel uncomfortable asking about anything other than immediate mental health symptoms?

Possible approaches to support:

  • Reassure them that asking if a person needs help can be easier on that person than relying on them to bring the issue forward
  • Connect them to the “Intent” section of the manual to help them understand the clinical relevance of the items
  • Have them generate and use an individualized interview template/list
  • Connect them with other assessors for peer-to-peer support
Issue: The assessor is struggling to manage the interview process, including incorporating multiple sources. 

Consider:

  • Are they preparing the client and caregiver when booking the interviews, including making sure the young person will be with the caregiver during the pre-interview observation period?
  • Are they assuming that they need to ask each interviewee about every item collected?
  • Are they remembering that the assessment is about the young person over one observation period in all settings (versus one assessment for each setting)?
  • Are they uncomfortable with reconciling conflicting information? For example, are they comfortable managing situations where the young person reports one thing but their caregiver says the opposite?

Possible approaches to support:

  • Review assessor training materials for interview techniques and tips (such as asking caregivers to bring medication lists, advising caregivers about the observation period and the broad topics that the interview will cover)
  • Review that much of the assessment does not need to be ‘re-asked’ or confirmed by multiple sources. For example, demographics or information asked directly of the young person.
  • Recall how other assessments may only have one caregiver present but are still relevant and valid
  • Set up shadowing/mentoring to demonstrate how to use and reconcile multiple sources of information

Appendix m: trainer competency checklist

The Trainer Competency Checklist focuses on competencies related to delivering ChYMH Suite training. This resource may be helpful at several points of learning such as when shadowing a skilled trainer, preparing/reflecting on a training, or when collaboratively planning to support a trainer who is struggling.

Foundations - Facilitation
The trainer…How this is helpful:How to enhance skill in this area:
Prepares materials and technology ahead of time
  • Reduces distraction for participants
  • Create checklists or other pre-training job aids
Establishes shared expectations with learners
  • Manages time and participant behaviour
  • Supports staying in scope
  • Use established “group rules” that are common at your organization
Monitors group energy levels and takes breaks or adapts approach as needed 
Adjusts language in the interview according to the audience 
Leads group discussions successfully, drawing on learner experience and promoting balanced participation 
Acknowledges that asking questions may be difficult, but assures safety and support in doing so
  • Creates and affirms a positive and safe environment for learning
  • Uses Adult Education principles
  • Have them review Adult Education principles for techniques and tips
  • Encourage reflection on the value of using humour to lighten the mood
Assesses comprehension formally (such as using evaluation handouts) and informally (such as verbal check-ins, circulating) throughout the training
  • Identifies if participants need review or extra support
  • Evaluates pace and tone of training
  • Encourage planned timing of comprehension checks
  • Ensure that the expectations for trainers’ role in evaluation of curriculum and training feedback are clear
Works collaboratively with co-trainers
  • Reduces distraction for participants
  • Models a safe environment
  • Encourage creating a plan for training in pairs
Foundations – Promoting Clinical Embedment
The trainer…How this is helpful:How to enhance skill in this area:
Prompts assessors to consider ‘what would they do’ with the outputs 
Uses examples that are relatable to the participants 
Brings relevant case examples into the active learning activities 
Incorporates documents that are used at your organization into the training
  • Using Adult Education practices:
    • Using life experiences
    • Relevancy to participants
    • Active learning
    • Engaging participants to picture using the information in the future
  • Connecting what is learned in class to organizational policies and processes
  • Create a bank of resources for use at the organization
  • Create a list of success stories
  • Consider ways to bring your organization’s templates and documents into the classroom
Describes the importance of evidence-informed decision-making (at your organization and in the sector)
  • Highlighting the need for quality data to inform decisions and reporting
    • Positioning the change as something “bigger than just us”
  • Encourage use of the organization’s implementation vision statement (see Section 1 in this toolkit)
Issue: The trainer is not completing training in the recommended time. 

Consider

  • Are they adequately prepared and resourced with materials, time to review curriculum, time to set up classroom in advance?
  • Are they adding other elements to the training such as process review, discussing other initiatives?
  • Are they struggling to manage group discussions?
  • Are they using a training plan to keep to timing targets?
  • Are they using their Training Journal to reflect and identify issues?
  • Have they had enough recent practice to feel confident?
  • Is the class very large, such as 12 or more attendees?

Possible support approaches

  • Have them create a checklist for their specific training room/environment
  • Have them reflect on what is in scope for training, and how to redirect concerns that are out of scope
  • Have them review Adult Education materials, particularly regarding classroom management
  • Have them use a training plan to identify and keep to timing targets
  • Connect them to other trainers for advice and perspective, and suggest using a Training Journal
  • Explore possibilities for hosting smaller sessions or increasing number of trainers
Issue: The trainer is completing training in well under the recommended time. 

Consider:

  • Are they establishing a safe space for questions and discussions?
  • Are they making room for discussion?
  • Do they know how to prompt conversation and discussion with quieter participants?
  • Are they answering all the participant questions themselves, rather than encouraging cross-participation and referring to the manual?
  • Are they rushing through active learning or reflection activities?
  • Are they encouraging note-taking in the workbooks/training materials?
  • Are they using their Training Journal to reflect and identify issues?
  • Have they had enough recent practice to feel confident?
  • Is the class very small, such as only 1 or 2 attendees?

Possible approaches to support:

  • Have them review Adult Education principles and information on establishing a safe environment for learning
  • Have them review the curriculum and highlight spots where questions are posed to the group; encourage committing to leading the class to the intended response rather than providing the responses
  • Have them review Adult Education principles regarding the value of using the knowledge in the room, having participants try to answer each others’ questions, and reflection time for embedding learning
  • Emphasize the importance of taking up activities by asking – not telling – what the answers
  • Connect them to other trainers for advice and perspective, and suggest using a Training Journal
Issue: The trainer is struggling to manage classroom behaviour. 

Consider:

  • Are they establishing shared expectations for both participants and trainers at the beginning of training?
  • Have they had enough recent practice to feel confident?
  • Are the participants disruptive and questioning why they are in the training?
  • Are the participants adequately prepared for training? Have they been provided with context and background information?

Possible approaches to support:

  • Consider starting the training session with an introduction and endorsement from leadership
  • Encourage them to reflect on “group rules” that are common at your organization and that they are comfortable enforcing
  • Review the Communication plan
  • Review the Risk Management Plan and assess competing demands
Issue: The trainer is not able to describe how to apply the results, or struggles to create relevant examples to support activities or questions. 

Consider:

  • Are there gaps in the trainer’s foundational knowledge that need to be addressed?
  • Are there issues with access to necessary resources, such as CAP manuals?
  • Does the trainer use the results as part of their daily work? If not, do they need to be connected to an assessor or clinical staff who does?

Possible approaches to support:

  • Connect them to other trainers for advice and perspective
  • Review procedures, templates, and standards for application of results
  • Compile a list of examples of how different programs and teams are using the results
  • Connect them with assessors or clinical staff to foster an understanding of the day-to-day clinical applications of the ChYMH Suite results

Appendix m: clinical staff competency checklist

The Clinical Staff Competency Checklist focuses on competencies related to understanding and using the ChYMH Suite results. These are core competencies that apply to all clinical staff who work on teams or in programs where the ChYMH Suite is used, including assessors and trainers. 

Foundations – For ChYMH and ChYMH-DD
The individual clinical staff member…How this is helpful:How to enhance skill in this area:
Knows the scales/can identify scales best for shorter-term measurement 
Understands Collaborative Action Plans (CAPs) and how they can be used by clinical staff   
Uses results to back up clinical formulation or referrals 
Sets measurable goals with families using the scales or CAPs  
Uses and refers to scales and CAPs when planning intervention strategies  
Refers to scales and CAPs in documentation and in conversations with families
  • Knowing what the outputs indicate and how to use them in formulation
  • Applying targeted evidence-based strategies
  • Demonstrating commitment to evidence-based decision-making
  • Review training materials about scales and CAPs and how to use them to support decision-making
  • Ensure supervisors and non-assessing clinical staff are also familiar with and supportive of the use of these outputs
  • Review how evidence-based decision-making is important for your organization
  • Create report templates that incorporate scales and CAPs (for example, progress reports, documentation of goal-setting process)
Foundations – For ChYMH-S+
The individual clinical staff member…How this is helpful:How to enhance skill in this area:
Knows the outputs (scales, screening algorithms) and how they map on to the tool 
Refers to scales and screening algorithms in documentation and in conversations with families 
Uses results to back up triage, service determination, and referral decisions 
 
  • Knowing what the outputs indicate and how to use them in formulation
  • Using standardized assessments to prioritize, make service determination decisions, and to flag safety concerns
  • Demonstrating commitment to evidence-based decision-making
  • Review training materials about the scales and screening algorithms and how to use them to support decision-making
  • Ensure supervisors and non-assessing clinical staff are also familiar with and supportive of the use of these outputs
  • Create templates that use Screener results to document referral decisions
Issue: It is not clear if/how the results are incorporated into work with the young person or their family. 

Consider

  • Are the results being used in clinical staff’s formulation, but they are writing the reports the way they always have?
  • Are clinical staff unclear about the expectations for how to incorporate ChYMH Suite results into your organization’s current report templates?
  • Do clinical staff understand how the results are used at your organization for purposes beyond immediate service delivery (such as program evaluation)?

Possible support approaches

  • Review report templates to identify where the formulation can be supported by evidence-based decision making
  • Consider creating new report/documentation templates that better highlight the ChYMH Suite outputs
  • Discuss how the information is used at the organization level to provide context and show how the assessor’s time is valued
Issue: The individual is resistant to using ChYMH Suite results to support clinical decision-making. 

Consider

  • Do they lack confidence in the outputs?

Possible support approaches

  • Discuss how the results are based on accurate collection of information during the interview, and identify barriers/concerns around collection
Issue: The individual struggles with understanding how to use the results to support clinical work. 

Consider

  • Are they familiar with the different types of scales (such as measuring shorter-term versus longer-term presentations)?
  • Do they understand the importance of looking at item-level information to understand the context for scale results?
  • [For ChYMH and ChYMH-DD only] Do they know where to access the CAPs?
  • [For ChYMH and ChYMH-DD only] Are they skipping over the clinical staff CAPs and only using Caregiver CAPs?

Possible support approaches

  • Review training materials and user guides about ChYMH Suite outputs and how to use them in clinical practice
  • [For ChYMH and ChYMH-DD only] Review how the CAP manual is accessed
  • [For ChYMH and ChYMH-DD only] Review audience for CAPs versus Caregiver CAPs