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This chapter opens with a summary of advice on interviewing people with intellectual disabilities. Then the need rating algorithm is provided, as it applies to CANDID-S and Section 1 of CANDID-R. Need ratings of met (M), unmet (U) and no need (N) represent a change from the numerical ratings of CANDID 1st edition. Furthermore, a set of frequently asked questions and comprehensive answers is provided. The questions are applicable to both CANDID-S and CANDID-R.
A comprehensive training programme for completing the CANDID is described. It covers both versions of CANDID and provides all training slides and notes for the trainer. Learning points covered are the background to the CAN approach, the policy background to needs assessment in intellectual disabilities services, the concept of need, research using CANDID thus far, CANDID domains, need rating (no need, met need, unmet need), CANDID rating algorithm, structure of the CANDID (including trigger questions, anchor points, perceptions of help of interventions, and the differences between staff, service user and informal carers assessment of needs. Two case vignettes are provided along with expected ratings. A role play is suggested in order to give participants the opportunity to learn, practice or consolidate needs assessment using CANDID. A discussion focusses on the rationale behind each rating,
The development and psychometric evaluation of the CANDID is reported. It was developed by modification of the Camberwell Assessment of Need (CAN). The four principles that informed the development of the CAN and the CANDID are 1. people with intellectual disabilities and mental health problems have basic needs like everybody else along with specific needs associated with their conditions
2. the primary aim is to identify rather than describe in detail each need; once a need is identified more specialist assessment can be conducted in those domains
3. needs assessment should be possible to be conducted by a wide range of people, so that it can be applied in routine clinical practice
4. there may be differences of opinion about the existence of need amongst people involved and therefore different points of view should be recorded separately.
The reliability and validity of CAN have been investigated and found to be acceptable. Research studies using CANDID are summarised here.
The policy background is provided that underpins the assessment of needs in intellectual disabilities mental health services. Developments since the publication of the 1st edition of the CANDID are provided along with an updated list of measures and instruments used to assess needs in this population.
Step by step description of using the CANDID-R as a needs assessment tool is provided. This includes suggestions on what CANDID-S can be used for (as an audit and research tool, as well as as an aid for a CANDID-S user to familiarise themselves with the approach) and who can use CANDID-R (no formal training is required and can be used by any person with experience in working with adults with intellectual disabilities and mental health problems). Then, the question of who should be interviewed is addressed, whilst highlighting the importance of assessing needs of the person from three perspectives: that of the person being assessed, their informal carer and the staff involved in their care. A description is provided as to how the instrument is used by way of a semi-structured interview using trigger questions in each domain, to initiate discussion. As with CANDID-S, a timeframe of 4 weeks is used. In addition, the rating of informal and formal help and satisfaction with the latter is described. Thus, the interview with each respondent takes typically 20–30 minutes. Finally, the approach to recording the need ratings and summary scores is descibed: one recording sheet for each interview or record ratings on CANDID-R.
The Camberwell Assessment of Need for Adults with Developmental and Intellectual Disabilities (CANDID) is introduced. It was developed at the Institute of Psychiatry, Psychology and Neuroscience, King’s College London in 1999, and published in book form in 2003. It was developed by modification of the Camberwell Assessment of Need (CAN), the most widely used needs assessment approach for people with severe mental health problems. In addition to CANDID, a number of other variants of CAN have been developed including needs assessment for forensic patients, for mothers and pregnant women, for older adults and for people in disaster and relief situations. In this 2nd edition, the need rating for the presence or absence of need and met or unmet needs is discussed. In addition, a need rating algorithm has been introduced. Both changes are in line with changes in the 2nd edition CAN. Moreover, the terminology in this 2nd edition has changed to reflect terminology used in contemporary intellectual disabilities services.