+The Mandt System®David Mandt & Associates©Revised: January 1, 2006

Presented by Karen Kuplicki and Natalie WahmhoffUniversity of Utah

Department of Educational PsychologySchool Psychology Program

US Office of Education 84.325KH325K080308

+ The Mandt System: A Brief Description

The Mandt System is a training program that has 3 major components: Relational, Conceptual, and Technical.

Relational Skills: focuses on teaching relationship, communication, and conflict resolution skills.

Conceptual Skills: focuses on teaching positive behavior supports, liability and legal issues, and medical risks of restraint.

Technical Skills: training in providing physical assistance, separation, evasion, and restraint techniques

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The focus of the Mandt system is learning how to reduce or eliminate violence in the workplace by “supporting people, not just their behaviors”.

The Mandt system revolves around building the positive relationships of people in an organization in order to create an overall healthy environment.

One main goal is to teach people how to effectively manage a situation by regulating their emotions, response, and behaviors to positively interact with others.

Philosophy of the Mandt System“Excellence, Efficiency, and Effectiveness”

+Certification Requirements and Cost

For Trainers Relational, 2 day: $465-$625 Relational/Conceptual, 5 day

$710-$925 Relational/Conceptual/Technical, 5 day

$910-$1,2225 Relational/Conceptual/Technical Advanced Level, 5 day

$1,310-$1,8880

For Students, the cost varies and length depends on which components are taught. They can last from 1/2 day to 3 day workshops.

+ Competencies

To become certified in Mandt procedures students must:

Attend 100% of the trainings

Score 100% proficiency (or 100% adjusted proficiency) on written tests

Demonstrate all physical techniques with 100% proficiency (or 100% adjusted efficiency)

Recertification must be completed annually and can be done by completely retraining, passing a written exam, or skill verification through demonstration

+Competencies The competencies selected by The Mandt System, Inc. are

derived from Public Law 106-310, Section 595, Parts H and I, commonly known as “The Children’s Health Act of 2000. A set of standards are presented in the law requiring training in “the prevention and use of restraint” in the following areas:

“the needs and behaviors of the population served, relationship building, alternatives to restraint and seclusion, de-escalation methods, avoiding power struggles, thresholds for restraints and seclusion, the physiological and psychological impact of restraint and seclusion, monitoring physical signs of distress and obtaining medical assistance, legal issues, position asphyxia, escape and evasion techniques, time limits, the process for obtaining approval for continued restraints, procedures to address problematic restraints, documentation, processing with children, and follow-up with staff, and investigation of injuries and complaints Satisfactory completion of training is based on achievement of all specified competencies.” (6)

+Some of the proposed benefits of using the Mandt System® Improve staff relationships and therapeutic environment

Builds self-efficacy and reduces fear when responding to crisis situations

reduces the frequency of physical restraints and the duration of physical restraints

reduces need for physical interactions overall and reduction in crisis incidents

teaches and trains in skills needed to maintain a safe and respectful workplace

Aligns with Positive Behavior Support

+Training Outline

Relational Skills Building Healthy Relationships (2.5-3.5 hours) Building Healthy Communication Skills (2.5-3.5 hours) Building Healthy Conflict Resolution Skills (2.5- 3.5 hours)

Conceptual Skills Trauma Informed Services (2-3 hours) Positive Behavior Supports (2.5-3.5 hours) Liability and Legal Issues (1-2 hours) Medical Risks of Restraint (1-2 hours)

+Training Outline cont’d

Technical Skills Assisting and Supporting Skills (2-3 hours) Separating Technical Skills (2-3 hours) Restraining (standing or sitting) Skills (2-3 hours)

+Legal Liabilities and Risks of Restraint

One chapter in the Conceptual Skills section is devoted to Legal Liability and Legal Issues

The last chapter in the Conceptual Skills section is devoted to Medical Risks of Restraints

+Legal Liabilities

brochure states that the Mandt System ® meets or exceeds major accreditation requirements: Joint Commission on Accreditation of Healthcare

Organizations

JCAHO The Commission on Accreditation of Rehabilitation Facilities

CARF the Council on Accreditation

COA Creating Excellence Together/Striving for Quality

CET/SFQ

+Website

www.mandtsystem.com

+Types of Interventions

On a continuum from least to most restrictive:

Understanding stress, the crisis cycle, and working with emotions

Understanding the process of communication and developing nonverbal, verbal, and vocal skills, assertive and authentic communication

Conflict resolution techniques SODAS

Help the person Identify the Situation (define conflict) Develop Options (generate solutions) Discover Advantages and Disadvantages (evaluation options) Select Solutions

+Interventions, cont’d

Responses to each stage in the crisis cycle Stage 1 (trigger): removal of or from stress or stimuli Stage 2 (escalation): offer options and set limits Stage 3 (Crisis): use least amount of interaction necessary for

safety Stage 4 (De-escalation and Recovery): Structured cooling off Stage 5 (Stabilization): Active Listening Stage 6 (Post-Crisis): Observation and Support

Antecedent-Behavior-Consequences

Briefly and vaguely discuss reinforcement and punishment but do not give specific examples

+Types of Intervention, cont’d

Body positioning in relation to others (providing or preventing exit, walking and accompanying others, touch prompts)

Physical assisting techniques when someone cannot support themselves

Separating and physical release (finger holds, clothing holds, biting, hair pulling)

Monitoring and observing during a restraint

+Types of Intervention, cont’d

Specific Restraints One person standing side body Two person standing side body Hug restraint One person, one arm restraint One person, two arm restraint 2 person, one arm and side body hug Moving restraint with one or two people Child restraint One person kneeling child restraint Restraint of a person of short stature

+Media Components

Certified Trainees receive a CD-ROM that includes a student manual, power points for each section, certificates, resource articles, and email support

There is no video, DVD, or online training available for students or trainers

+Research

An evaluation of four programs for the management of aggression in psychiatric settings. Archives of Psychiatric Nursing, 17, 146-155.

Helmuth, R. (1994). Nursing staff educational preparation and patient inflicted injuries in a 160 bed psychiatric hospital, Alaska Medicine, 36, 189-192.

+ Leadership Program

The Mandt System also provides one day leadership events in the following subject areas:

Building Healthy Workplace Environments

Effective Communication

Navigating Conflict for Positive Outcomes

Recruiting and Retaining Quality Personnel

The Dynamics of Leadership

Creating Productive Teams

+Leadership Program

Coaching, Mentoring, and Supporting Emergent Leaders

Supporting All Stakeholders

Creating and Fostering an Inclusive Learning Organization

Fostering Culture Change

The Profitability of Diversity

Gaining and Keeping Trust

Managing Change

Managing Workplace Stress

+Leadership Program

Motivating and Engaging People

Bully Proofing Your Workplace

Well-Being and Work: Promoting Emotional, Psychological, and Physical Safety

SWOT Analysis: Strengths, Weaknesses, Opportunities and Threats

Understanding My Mix for Our Team