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 Camberwell Assessment
of Need for Adults with
Developmental and
Intellectual Disabilities
Second Edition

Downloaded from [Link] , on 28 Feb 2022 at [Link], subject to the Cambridge Core terms of use, available at
[Link] [Link]
Downloaded from [Link] , on 28 Feb 2022 at [Link], subject to the Cambridge Core terms of use, available at
[Link] [Link]
 Camberwell Assessment of Need
for Adults with Developmental
and Intellectual Disabilities
CANDID
Second Edition
Kiriakos Xenitidis
South London and Maudsley NHS Foundation Trust

Mike Slade
University of Nottingham

Graham Thornicroft
King’s College London

Nick Bouras
King’s College London

Downloaded from [Link] , on 28 Feb 2022 at [Link], subject to the Cambridge Core terms of use, available at
[Link] [Link]
 University Printing House, Cambridge CB2 8BS, United Kingdom
One Liberty Plaza, 20th Floor, New York, NY 10006, USA
477 Williamstown Road, Port Melbourne, VIC 3207, Australia
314–321, 3rd Floor, Plot 3, Splendor Forum, Jasola District Centre,
New Delhi – 110025, India
79 Anson Road, #06–04/06, Singapore 079906

Cambridge University Press is part of the University of Cambridge.

It furthers the University’s mission by disseminating knowledge in the pursuit of
education, learning, and research at the highest international levels of excellence.

[Link]
Information on this title: [Link]/9781911623489
DOI:10.1017/ 9781108963541
Kiriakos Xenitidis, Mike Slade, Graham Thornicroft and Nick Bouras © 2003, 2021
This publication is in copyright. Subject to statutory exception
and to the provisions of relevant collective licensing agreements,
no reproduction of any part may take place without the written
permission of Cambridge University Press.
First published 2003
Second edition 2021
Printed in the United Kingdom by TJ Books Limited, Padstow Cornwall
A catalogue record for this publication is available from the British Library.
Library of Congress Cataloging-in-Publication Data
Names: Xenitidis, Kiriakos, author. | Slade, Mike, author. | Thornicroft, Graham, author. | Bouras, Nick, author.
Title: Camberwell assessment of need for adults with developmental and intellectual disabilities : CANDID / Kiriakos Xenitidis,
Mike Slade, Graham Thornicroft, Nick Bouras.
Other titles: CANDID
Description: Second edition. | Cambridge, United Kingdom ; New York, NY : Cambridge University Press, 2021. |
Includes bibliographical references and index.
Identifiers: LCCN 2020036491 | ISBN 9781911623489 (paperback)
Subjects: MESH: Intellectual Disability | Adult | Mentally Disabled Persons | Mental Health Services |
Needs Assessment | United Kingdom
Classification: LCC RC570 | NLM WM 300 | DDC 362.3–dc23
LC record available at [Link]
ISBN 978-1-911-62348-9 Paperback
Cambridge University Press has no responsibility for the persistence or accuracy of
URLs for external or third-party internet websites referred to in this publication
and does not guarantee that any content on such websites is, or will remain,
accurate or appropriate.
Every effort has been made in preparing this book to provide accurate and up-to-date information that is in accord
with accepted standards and practice at the time of publication. Although case histories are drawn from actual cases, every effort has
been made to disguise the identities of the individuals involved. Nevertheless, the authors, editors, and publishers can make no
warranties that the information contained herein is totally free from error, not least because clinical standards are constantly
changing through research and regulation. The authors, editors, and publishers therefore disclaim all liability for direct or
consequential damages resulting from the use of material contained in this book. Readers are strongly advised to pay careful
attention to information provided by the manufacturer of any drugs or equipment that they plan to use.

Downloaded from [Link] , on 28 Feb 2022 at [Link], subject to the Cambridge Core terms of use, available at
[Link] [Link]
 Camberwell Assessment
of Need for Adults with
Developmental and
Intellectual Disabilities
Second Edition

Downloaded from [Link] , on 28 Feb 2022 at [Link], subject to the Cambridge Core terms of use, available at
[Link] [Link]
Downloaded from [Link] , on 28 Feb 2022 at [Link], subject to the Cambridge Core terms of use, available at
[Link] [Link]
 Camberwell Assessment of Need
for Adults with Developmental
and Intellectual Disabilities
CANDID
Second Edition
Kiriakos Xenitidis
South London and Maudsley NHS Foundation Trust

Mike Slade
University of Nottingham

Graham Thornicroft
King’s College London

Nick Bouras
King’s College London

Downloaded from [Link] , on 28 Feb 2022 at [Link], subject to the Cambridge Core terms of use, available at
[Link] [Link]
 University Printing House, Cambridge CB2 8BS, United Kingdom
One Liberty Plaza, 20th Floor, New York, NY 10006, USA
477 Williamstown Road, Port Melbourne, VIC 3207, Australia
314–321, 3rd Floor, Plot 3, Splendor Forum, Jasola District Centre,
New Delhi – 110025, India
79 Anson Road, #06–04/06, Singapore 079906

Cambridge University Press is part of the University of Cambridge.

It furthers the University’s mission by disseminating knowledge in the pursuit of
education, learning, and research at the highest international levels of excellence.

[Link]
Information on this title: [Link]/9781911623489
DOI:10.1017/ 9781108963541
Kiriakos Xenitidis, Mike Slade, Graham Thornicroft and Nick Bouras © 2003, 2021
This publication is in copyright. Subject to statutory exception
and to the provisions of relevant collective licensing agreements,
no reproduction of any part may take place without the written
permission of Cambridge University Press.
First published 2003
Second edition 2021
Printed in the United Kingdom by TJ Books Limited, Padstow Cornwall
A catalogue record for this publication is available from the British Library.
Library of Congress Cataloging-in-Publication Data
Names: Xenitidis, Kiriakos, author. | Slade, Mike, author. | Thornicroft, Graham, author. | Bouras, Nick, author.
Title: Camberwell assessment of need for adults with developmental and intellectual disabilities : CANDID / Kiriakos Xenitidis,
Mike Slade, Graham Thornicroft, Nick Bouras.
Other titles: CANDID
Description: Second edition. | Cambridge, United Kingdom ; New York, NY : Cambridge University Press, 2021. |
Includes bibliographical references and index.
Identifiers: LCCN 2020036491 | ISBN 9781911623489 (paperback)
Subjects: MESH: Intellectual Disability | Adult | Mentally Disabled Persons | Mental Health Services |
Needs Assessment | United Kingdom
Classification: LCC RC570 | NLM WM 300 | DDC 362.3–dc23
LC record available at [Link]
ISBN 978-1-911-62348-9 Paperback
Cambridge University Press has no responsibility for the persistence or accuracy of
URLs for external or third-party internet websites referred to in this publication
and does not guarantee that any content on such websites is, or will remain,
accurate or appropriate.
Every effort has been made in preparing this book to provide accurate and up-to-date information that is in accord
with accepted standards and practice at the time of publication. Although case histories are drawn from actual cases, every effort has
been made to disguise the identities of the individuals involved. Nevertheless, the authors, editors, and publishers can make no
warranties that the information contained herein is totally free from error, not least because clinical standards are constantly
changing through research and regulation. The authors, editors, and publishers therefore disclaim all liability for direct or
consequential damages resulting from the use of material contained in this book. Readers are strongly advised to pay careful
attention to information provided by the manufacturer of any drugs or equipment that they plan to use.

Downloaded from [Link] , on 28 Feb 2022 at [Link], subject to the Cambridge Core terms of use, available at
[Link] [Link]
 Camberwell Assessment
of Need for Adults with
Developmental and
Intellectual Disabilities
Second Edition

Downloaded from [Link] , on 28 Feb 2022 at [Link], subject to the Cambridge Core terms of use, available at
[Link] [Link]
Downloaded from [Link] , on 28 Feb 2022 at [Link], subject to the Cambridge Core terms of use, available at
[Link] [Link]
 Camberwell Assessment of Need
for Adults with Developmental
and Intellectual Disabilities
CANDID
Second Edition
Kiriakos Xenitidis
South London and Maudsley NHS Foundation Trust

Mike Slade
University of Nottingham

Graham Thornicroft
King’s College London

Nick Bouras
King’s College London

Downloaded from [Link] , on 28 Feb 2022 at [Link], subject to the Cambridge Core terms of use, available at
[Link] [Link]
 University Printing House, Cambridge CB2 8BS, United Kingdom
One Liberty Plaza, 20th Floor, New York, NY 10006, USA
477 Williamstown Road, Port Melbourne, VIC 3207, Australia
314–321, 3rd Floor, Plot 3, Splendor Forum, Jasola District Centre,
New Delhi – 110025, India
79 Anson Road, #06–04/06, Singapore 079906

Cambridge University Press is part of the University of Cambridge.

It furthers the University’s mission by disseminating knowledge in the pursuit of
education, learning, and research at the highest international levels of excellence.

[Link]
Information on this title: [Link]/9781911623489
DOI:10.1017/ 9781108963541
Kiriakos Xenitidis, Mike Slade, Graham Thornicroft and Nick Bouras © 2003, 2021
This publication is in copyright. Subject to statutory exception
and to the provisions of relevant collective licensing agreements,
no reproduction of any part may take place without the written
permission of Cambridge University Press.
First published 2003
Second edition 2021
Printed in the United Kingdom by TJ Books Limited, Padstow Cornwall
A catalogue record for this publication is available from the British Library.
Library of Congress Cataloging-in-Publication Data
Names: Xenitidis, Kiriakos, author. | Slade, Mike, author. | Thornicroft, Graham, author. | Bouras, Nick, author.
Title: Camberwell assessment of need for adults with developmental and intellectual disabilities : CANDID / Kiriakos Xenitidis,
Mike Slade, Graham Thornicroft, Nick Bouras.
Other titles: CANDID
Description: Second edition. | Cambridge, United Kingdom ; New York, NY : Cambridge University Press, 2021. |
Includes bibliographical references and index.
Identifiers: LCCN 2020036491 | ISBN 9781911623489 (paperback)
Subjects: MESH: Intellectual Disability | Adult | Mentally Disabled Persons | Mental Health Services |
Needs Assessment | United Kingdom
Classification: LCC RC570 | NLM WM 300 | DDC 362.3–dc23
LC record available at [Link]
ISBN 978-1-911-62348-9 Paperback
Cambridge University Press has no responsibility for the persistence or accuracy of
URLs for external or third-party internet websites referred to in this publication
and does not guarantee that any content on such websites is, or will remain,
accurate or appropriate.
Every effort has been made in preparing this book to provide accurate and up-to-date information that is in accord
with accepted standards and practice at the time of publication. Although case histories are drawn from actual cases, every effort has
been made to disguise the identities of the individuals involved. Nevertheless, the authors, editors, and publishers can make no
warranties that the information contained herein is totally free from error, not least because clinical standards are constantly
changing through research and regulation. The authors, editors, and publishers therefore disclaim all liability for direct or
consequential damages resulting from the use of material contained in this book. Readers are strongly advised to pay careful
attention to information provided by the manufacturer of any drugs or equipment that they plan to use.

Downloaded from [Link] , on 28 Feb 2022 at [Link], subject to the Cambridge Core terms of use, available at
[Link] [Link]
 Contents
Acknowledgements for the First Edition vi
Acknowledgements for the Second Edition vii
List of Abbreviations viii

1 Introduction 1 Appendix 1 CANDID-S 27

2 Needs Assessment in Intellectual Disabilities Appendix 2 CANDID-R 30
Mental Health Services 3 Appendix 3 Rating Sheets for CANDID-R 59
3 Development and Use of CANDID 7 Appendix 4 Training Slides 64
4 Using CANDID-S 11 Appendix 5 Training Vignettes 74
5 Using CANDID-R 14 Appendix 6 CANDID Reliability and
6 Training for CANDID 18 Validity 81
7 Guidance on Rating 22 Appendices also available for download at:
[Link]/can
References 90
Index 93

Downloaded from [Link] , on 28 Feb 2022 at [Link], subject to the Cambridge Core terms of use, available at v
[Link] [Link]
 Acknowledgements for the First Edition

Interviews to evaluate the CANDID were undertaken expert administrative support. The invaluable statis-
by Helen Philp, Jane Sayer, Elizabeth Harris and tical advice from Morven Leese is also acknowledged.
Donna McGee. Maria Fotiadou and Declan Murphy The authors would like to thank all the service
contributed at various stages in the development of users, carers and staff members who took part in the
the CANDID. validity and reliability study. Without their contribu-
The authors are grateful to Karen Langridge (at tion the CANDID development project would not
PRiSM) and Chris Laming (at ESTIA) who provided have been possible.

Downloaded from [Link] , on 28 Feb 2022 at [Link], subject to the Cambridge Core terms of use, available at
vi
[Link] [Link]
 Acknowledgements for the Second Edition

The authors would like, in addition to the people literature. Finally, the authors would like to thank
acknowledged in the first edition of the CANDID clinical, academic and management colleagues
book, to thank colleagues who used CANDID for including Dene Robertson, Quinton Deeley and Jill
clinical and research purposes since its publication. Lockett, of South London and Maudsley NHS
Special thanks to those who, by publishing their Foundation Trust for their support with the dissem-
work, contributed to the growing CANDID ination of CANDID.

Downloaded from [Link] , on 28 Feb 2022 at [Link], subject to the Cambridge Core terms of use, available at vii
[Link] [Link]
 Chapter
Introduction

1
The Camberwell Assessment of Need for Adults a full assessment by a physiotherapist may be
with Developmental and Intellectual Disabilities required. Both versions of CANDID are administered
(CANDID) is a needs assessment scale specifically by a semi-structured interview inquiring about need
designed for people with intellectual disabilities (pre- in 25 life domains. Both versions use trigger (prompt-
viously known as learning disabilities, mental retard- ing) questions to open discussion in order to inform
ation, mental handicap or mental impairment) and the rating in each domain. A time frame of four weeks
mental health problems. CANDID was developed at prior to the interview is used. CANDID-S is a brief
what was then known as the Institute of Psychiatry, (one page) schedule that aims to establish for each
London (now the Institute of Psychiatry, Psychology domain: (i) whether a need is present; and (ii), where
and Neuroscience). It was developed by modification a need exists, whether it is currently met or unmet.
of the Camberwell Assessment of Need (CAN), an CANDID-R addresses, in addition, the issues of help
established needs assessment scale for people with received for each need from both professional and
severe and enduring mental illness (Slade 1999). The informal carers, how much help is needed, and
validity and reliability of the CAN and CANDID have whether the respondent is satisfied with the help the
been investigated by Phelan et al. (1995) and Xenitidis person is currently receiving.
et al. (2000), respectively, and were found to be CANDID covers a wide range of physical and
acceptable. The first edition of the CANDID book mental health needs as well as social needs. It records
was published in 2003 by Gaskell, the imprint of the the views of the service users and their carers in
Royal College of Psychiatrists. addition to those of staff. CANDID can be used by
In addition to CANDID, a number of other vari- (i) people who are involved in the care of adults with
ants of the CAN have been published for use in intellectual disabilities (both professionally and infor-
a range of populations, including older adults – mally); and (ii) people interested in evaluating intel-
Camberwell Assessment of Need for the Elderly lectual disabilities services (e.g. researchers,
(CANE) (Reynolds et al., 2000; Orrell & Hancock, managers).
2004); forensic patients – Camberwell Assessment of This book provides a brief introduction to the
Need – Forensic (CANFOR) (Thomas et al., 2003; subject of needs assessment in intellectual disabilities
Thomas et al., 2008); mothers and pregnant women services (Chapter 2), a description of the process of
with mental health problems – Camberwell development of CANDID and an overview of the
Assessment of Need – Mothers CAN-M) (Howard literature using CANDID since its publication
et al., 2007); and people in disaster relief situations – (Chapter 3), detailed instructions for using the two
Humanitarian Emergency Settings Perceived Needs versions of the instrument (Chapters 4 & 5), and
(HESPER) scale (Semrau et al., 2012). guidance for rating either version, including answers
Two versions of CANDID have been developed: to some frequently asked questions (Chapter 7).
a research version (CANDID-R) and a short version Chapter 6 contains guidance for training interviewers
(CANDID-S) for both research and clinical use. in the use of CANDID. The full instruments can be
CANDID, in both its versions, is a screening instru- found in Appendices 1 and 2 and can be photocopied
ment that aims to identify areas of need, which may or scanned for clinical or research use. Also included
then be explored further by the appropriate person or for photocopying/scanning are the rating sheets for
team using more detailed instruments as necessary. If, CANDID-R (Appendix 3) and material to facilitate
for example, an unmet mobility need is identified, training in the use of CANDID (Appendices 4 & 5).

Downloaded from [Link] , on 28 Feb 2022 at [Link], subject to the Cambridge Core terms of use, available at 1
[Link] [Link]
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