The Mandt System David Mandt Associates Revised January

+ The Mandt System® David Mandt & Associates© Revised: January 1, 2006 Presented by Karen Kuplicki and Natalie Wahmhoff University of Utah Department of Educational Psychology School Psychology Program US Office of Education 84. 325 K H 325 K 080308

+ The Mandt System: A Brief Description n The Mandt System is a training program that has 3 major components: Relational, Conceptual, and Technical. n Relational Skills: focuses on teaching relationship, communication, and conflict resolution skills. n Conceptual Skills: focuses on teaching positive behavior supports, liability and legal issues, and medical risks of restraint. n Technical Skills: training in providing physical assistance, separation, evasion, and restraint techniques

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

+ Certification Requirements and Cost n For Trainers n Relational, 2 day: $465 -$625 n Relational/Conceptual, 5 day n n Relational/Conceptual/Technical, 5 day n n $710 -$925 $910 -$1, 2225 Relational/Conceptual/Technical Advanced Level, 5 day n $1, 310 -$1, 8880 n 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: n Attend 100% of the trainings n Score 100% proficiency (or 100% adjusted proficiency) on written tests n Demonstrate all physical techniques with 100% proficiency (or 100% adjusted efficiency) n Recertification must be completed annually and can be done by completely retraining, passing a written exam, or skill verification through demonstration

+ Competencies n 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: n “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® n Improve staff relationships and therapeutic environment n Builds self-efficacy and reduces fear when responding to crisis situations n reduces the frequency of physical restraints and the duration of physical restraints n reduces need for physical interactions overall and reduction in crisis incidents n teaches and trains in skills needed to maintain a safe and respectful workplace n Aligns with Positive Behavior Support

+ Training Outline n n Relational Skills n Building Healthy Relationships (2. 5 -3. 5 hours) n Building Healthy Communication Skills (2. 5 -3. 5 hours) n Building Healthy Conflict Resolution Skills (2. 5 - 3. 5 hours) Conceptual Skills n Trauma Informed Services (2 -3 hours) n Positive Behavior Supports (2. 5 -3. 5 hours) n Liability and Legal Issues (1 -2 hours) n Medical Risks of Restraint (1 -2 hours)

+ Training Outline cont’d n Technical Skills n Assisting and Supporting Skills (2 -3 hours) n Separating Technical Skills (2 -3 hours) n Restraining (standing or sitting) Skills (2 -3 hours)

+ Legal Liabilities and Risks of Restraint n One chapter in the Conceptual Skills section is devoted to Legal Liability and Legal Issues n The last chapter in the Conceptual Skills section is devoted to Medical Risks of Restraints

+ Legal Liabilities n brochure states that the Mandt System ® meets or exceeds major accreditation requirements: n Joint Commission on Accreditation of Healthcare Organizations JCAHO n The Commission on Accreditation of Rehabilitation Facilities CARF n the Council on Accreditation COA n Creating Excellence Together/Striving for Quality CET/SFQ

+ Website www. mandtsystem. com

+ Types of Interventions On a continuum from least to most restrictive: n Understanding stress, the crisis cycle, and working with emotions n Understanding the process of communication and developing nonverbal, and vocal skills, assertive and authentic communication n Conflict resolution techniques n SODAS n Help the person n Identify the Situation (define conflict) n Develop Options (generate solutions) n Discover Advantages and Disadvantages (evaluation options) n Select Solutions

+ Interventions, cont’d n Responses to each stage in the crisis cycle n Stage 1 (trigger): removal of or from stress or stimuli n Stage 2 (escalation): offer options and set limits n Stage 3 (Crisis): use least amount of interaction necessary for safety n Stage 4 (De-escalation and Recovery): Structured cooling off n Stage 5 (Stabilization): Active Listening n Stage 6 (Post-Crisis): Observation and Support n Antecedent-Behavior-Consequences n Briefly and vaguely discuss reinforcement and punishment but do not give specific examples

+ Types of Intervention, cont’d n Body positioning in relation to others (providing or preventing exit, walking and accompanying others, touch prompts) n Physical assisting techniques when someone cannot support themselves n Separating and physical release (finger holds, clothing holds, biting, hair pulling) n Monitoring and observing during a restraint

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

+ Media Components n Certified Trainees receive a CD-ROM that includes a student manual, power points for each section, certificates, resource articles, and email support n There is no video, DVD, or online training available for students or trainers

+ Research n An evaluation of four programs for the management of aggression in psychiatric settings. Archives of Psychiatric Nursing, 17, 146 -155. n 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: n Building Healthy Workplace Environments n Effective Communication n Navigating Conflict for Positive Outcomes n Recruiting and Retaining Quality Personnel n The Dynamics of Leadership n Creating Productive Teams

+ Leadership Program n Coaching, Mentoring, and Supporting Emergent Leaders n Supporting All Stakeholders n Creating and Fostering an Inclusive Learning Organization n Fostering Culture Change n The Profitability of Diversity n Gaining and Keeping Trust n Managing Change n Managing Workplace Stress

+ Leadership Program n Motivating and Engaging People n Bully Proofing Your Workplace n Well-Being and Work: Promoting Emotional, Psychological, and Physical Safety n SWOT Analysis: Strengths, Weaknesses, Opportunities and Threats n Understanding My Mix for Our Team