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Key Principle 5: Rate the "WHAT" not the "WHY"

  • Updated

Key Principle 5: Rate the “What”, not the “Why”

TCOM tools organize the stories we learn about adults, children/youth, and the families we serve. When we see evidence of a need or strength, we assign an action rating. Focusing on the “what” provides an opportunity to build consensus with adults, children/youth, and families, without bringing shame or blame into the process. While important, the underlying reasons for needs and strengths do not factor into the tool’s rating. We avoid making assumptions about needs being present because of other needs, and we do not explain away needs because we know the reasons for them. Later on, when we are building a plan, the “why” becomes important. During the assessment, we focus on the “what.”

The “WHAT” is descriptive and actionable.

The “WHY” is addressed in the plan, which connects children/youth, and, families to appropriate resources.

The tool helps us communicate about and identify needed action around the needs and strengths of adults, children/youth, and families who are receiving care management.

We ask: What needs have been identified? What are the strengths of the individual, child/youth, and/or family? What action is needed to address needs and build upon or build strengths? Focusing on the “what” helps us identify the presence of needs that we see evidence for. It keeps our assumptions from obscuring what we see.


Select Notes and Examples

(See below for examples of focusing on the “why” in a few of the items.

Remember, this principle applies to all of the items.)


Exception: Some items consider the why because they ask us to consider history.

  • Intentional Misbehavior. Why the child/youth is misbehaving is the reason for this item. If they're intentionally getting in trouble in school or at home, and looking for consequences.
  • Non-Suicidal Self-Injurious Behavior. If the purpose or goal of this behavior is self-soothing.
  • Adjustment to Trauma. Items related to trauma ask us to think about cause and effect. We rate these items as actionable when we know that the trauma experience has led to adjustment problems. There is no way to describe trauma without a cause-and-effect relationship. The cause describes “why it happened” and the effect describes “what happens.”