American Academy of Child and Adolescent Psychiatry Work Group on Systems of Care (AACAP) & American Association of Community Psychiatrists (AACP)

Cost to use

For more information contact - clinical@aacap.org

For more information contact - clinical@aacap.org

No copy available from the Knowledge Institute. Contact author or publisher.

For more information contact - clinical@aacap.org

2001

Primary: General mental health assessment
Secondary: None identified

Level of care needed based on mental health needs, strengths, risks, and environment.

The purpose of this measure is to determine the level of care needed by children and young people, based on their clinical and psychosocial needs. This measure also ensures communication among various clinicians (e.g., psychiatrists, social workers, psychologists) to foster collaborative efforts. 

The measure is used by clinicians to identify the level of services a child or young person needs, and to create a comprehensive treatment plan for children and young people by incorporating information from the child, their parents, and their community. It is also used to monitor the progress of the child’s/young person’s treatment.  

Children and young people between 6-18 years.

The CALOCUS and the CASII instruments were recently merged in 2021. The asynchronous training for the CASII instrument was modified to be compatible with that of the CALOCUS, considering that the CASII measure was initially developed as an expanded training manual for the CALOCUS. Now, both instruments are collectively referred to as the CALOCUS-CASII (Parks et al., 2023). 

Interview by clinicians and case managers 

Parents and child/young person

8 dimensions

Risk of harm 

Functional status 

Comorbidity 

Recovery environment (environmental stress)  

Recovery environment (environmental support) 

Resiliency and/or response to services 

Engagement in services (child or young person) 

Engagement in services (parent or primary caregiver) 

Each dimension is scored along a 5-point scale, with specific criteria defined for each point.  

20 minutes

No qualifications needed

Online training and manuals are available for purchase on the CALOCUS-CASII website. 

Prior to scoring, a comprehensive clinical assessment of the child or young person is done. Scoring is done based on the eight dimensions . Based on an algorithm, responses are translated into one of the six recommended levels of care (level 1 to level 6). 

The CALOCUS measure was developed by a small work group of clinicians that included members of AACAP and AACP based on the adult Levels of Care and Utilization System (LOCUS) measure, followed by a broad consultation of clinicians (Fallon et al., 2006; Sowers et al., 2003). 

The authors reported fair to good inter-rater reliability between psychiatrist and non-psychiatrists ranging from 0.57 to 0.95 with composite scores for non-psychologists 1.9 points higher than psychologists’ scores (Fallon et al., 2006).  

The authors found moderate correlations between the CALOCUS, CAFAS and CGAS ranging from 0.41 to 0.26 for subscales relating to the child’s clinical presentation and correlations near zero for subscales relating to the child’s environment (Fallon et al., 2006).  

Cost to use

For more information contact - clinical@aacap.org

For more information contact - clinical@aacap.org

CALOCUS-CASII 

Fallon, T., Pumariega, A., Sowers, W., Klaehn, R., Huffine, C., Vaughan, T., Winters, N., Chenven, M., Marx, L., Zachik, A., Heffron, W., & Grimes, K. (2006). A level of care instrument for children’s systems of care: Construction, reliability and validity. Journal of Child and Family Studies, 15(2), 143–155.  

Parks, J., Sowers, W., Minkoff, K., Metz, P., Goldman, M., & Flaum, M. (2003). Toward a national standard for service intensity assessment and planning for mental health care: The level of care utilization system (LOCUS) family of tools. American Academy of Child & Adolescent Psychiatry and American Association for Community Psychiatry. 

Sowers, W., Pumariega, A., Huffine, C., & Fallen, T. (2003). Level of care decision making in behavioral health services: The LOCUS and the CALOCUS. Psychiatric Services, 54(11), 1461–1463.