By Emily Leclerc | Waisman Science Writer
Community Outreach Wisconsin (COW) recently achieved a significant milestone by taking their Managing Threatening Confrontations (MTC) training statewide from 2023 to 2024. This initiative, which reached all 72 Wisconsin counties and nearly 1,000 participants, exemplifies the mission of the Waisman Center’s University Center of Excellence for Developmental Disabilities (UCEDD) by promoting the full inclusion and self-determination of individuals with disabilities. Through proactive and positive strategies, MTC equips caregivers with the tools to support individuals with intellectual and developmental disabilities, addressing complex behavioral challenges with a person-centered approach.
MTC is a training that COW has been offering for a very long time. It focuses on teaching proactive and positive strategies for supporting individuals with disabilities through a broad range of behaviors and escalation levels. It provides attendees with knowledge on how to recognize different stages of escalation and a proactive plan that can be implemented if needed. Individuals with intellectual and developmental disabilities can have complex behavioral challenges and sometimes those challenges are met with restrictive measures that can lead to more harm than good. MTC strives to teach more positive approaches that not only enable caregivers to better support individuals but reduce the use of more restrictive measures.
“We understand that it takes a lot of energy to keep people in a good space. And when people are doing well, that’s the time to be engaging more and working harder,” Josh Lapin, MSSW, director of Community TIES, says. “We really think if we can do things right initially, it will help mitigate negative behaviors in the future. The idea for MTC is engaging people, providing positive praise, and building positive relationships.”
For Lapin and the rest of the COW team, these challenging behaviors are seen as unaddressed needs. They are often a form of communication from the individual, indicating that a need is not being met. MTC not only helps prepare caregivers to handle the behaviors in a more positive way, but also gives them strategies for unearthing what may be behind the behavior as well. “The goal is to not just make those challenging behaviors go away but really to address those unmet needs and create an understanding of what is driving those challenging behaviors,” Axel Junker, MS, outreach program director of Community Outreach Wisconsin, says. “And that requires a person-centered approach that MTC provides.”
Lapin and Junker were approached in late 2021 by the Wisconsin Department of Health Services (DHS) asking if they would be willing to give a series of free trainings that would teach how to use proactive and positive supports to avoid restrictive interventions for children. Lapin, who typically gives the MTC training, and Junker quickly agreed. They adapted the curriculum to fit a virtual format and then in 2022, Lapin gave five training sessions with DHS. “Those sessions were very popular. They filled up pretty quick,” Lapin says. This showed them that there was real interest in this training beyond just Dane County. “That inspired the idea to see if we could reach an even broader audience,” Junker adds. “Could we build on this momentum?”
With the help of other COW team members, Lapin and Junker applied to and received a grant from the American Rescue Plan Act (ARPA) to fund their efforts in expanding the reach of MTC. While much of the training’s content had already been adapted for a virtual format, there was more that Lapin and Junker wanted to do.
They decided to use two videos as a part of the trainings that were from an earlier collaboration with Encore Studio for the Performing Arts. Encore Studio is Wisconsin’s first professional theater company for individuals with disabilities and has been around for 23 years. They have been collaborating with COW for 20 of those years. The videos show dramatic, real-life enactments of threatening confrontations and would serve as enhancements for the training being provided. “If you do a training video about people with disabilities, why not have people with disabilities in the training video,” Junker says. “It was just a perfect fit.”
Then from January 2023 to June of 2024, Lapin taught 15 free MTC sessions over Zoom. The first trainings filled so quickly that they reached their 150-person limit within days of registration opening. It became obvious very quickly that this was information that people were interested in. Each participant was asked to fill out a survey at the end of the session and again three months later. The COW team was able to gather some interesting data from the surveys which was analyzed by Michael Truman, community training director of COW, and Emily Hickey, PhD, scientist in the Lifespan Family Research Lab at the Waisman Center.
The trainings had attendees from all 72 Wisconsin counties with a total of 946 participants. The majority of participants were case managers that work directly with individuals with disabilities and their families. At the three-month follow-up, 97% of respondents said that they had utilized at least one skill that they had learned and 75% said they were much more focused on positive and proactive behavior. 90% of participants said that they would change they way they provided support in response to the MTC training. “The responses we got were incredibly validating,” Junker says. “We’ve had those casual observations but now having actual numbers to back it up is just really nice.”
The feedback the team received was equally as good as the data. “This is the best training I have ever participated in,” Tammy Jernigan, director of talent at the Advocates for Healthy Transitional Living, says in an email. “Josh did a fabulous job. The stories made the whole thing because each one was practical and connected to the concept. Outstanding job and a great return on my investment of time today!” A social worker from Waupaca County Birth to Three Program also reached out to express her appreciation for the training. “Thanks for the wonderful training. I really enjoyed the videos and stories that were included,” Sarah Cogar, CSW, says. “Many times it can be hard to maintain focus and attention on a Zoom training however you exceeded my expectations!”
Lapin says one of their key takeaways is that there is a want for training like MTC and not just in Dane County. Since the virtual trainings finished, Lapin has had several agencies, who had representatives attend the virtual sessions, reach out and ask him to come give the class to their entire staff. Jernigan and Cogar both asked if Lapin could bring the MTC training to their entire organizations, among others. He has traveled to several places throughout the state and given several Zoom trainings to programs in the Milwaukee area. “We were able to branch out a little bit and make contacts with other agencies which was nice,” Lapin says.
Both grants supporting this statewide effort have now ended but Lapin and Junker are excited to look toward the future and potential new ways to expand the training’s reach. In particular, they are deeply interested in diversifying the participant pool. For the 15 sessions, the entire registration process was in Spanish and all documents were translated to Spanish as well. There were also several sessions that offered live Spanish interpretation as part of the program. There are no current plans in place for expanding the MTC trainings but Lapin and Junker know now that there is a real need statewide for this information. They have started thinking about how they can expand the program’s reach in a long-term and sustainable way. They are currently exploring a potential collaboration with UW-Green Bay’s Behavioral Health Training Partnership. For now, Lapin has returned to his regularly scheduled in-person MTC trainings that are open to anyone who feels they could benefit. For the schedule and more information on MTC, check out their event calendar!