Developing the 7th Edition of the Therapeutic Crisis Intervention Program (TCI): Using Concept Mapping to Identify Threshold Concepts

TCI provides the residential care workforce with the skills, attitudes, and knowledge required to use a trauma-informed approach to the prevention, de-escalation, and management of children’s challenging behavior in residential care settings. TCI was first developed by the Residential Child Care Project (RCCP) in the late 1970’s and has been revised six times. The most recent edition, TCI7, was released in January, 2020. Every revision of TCI has been informed by research, both published research undertaken by others and research conducted by RCCP staff.

To create the 7th edition, Concept Mapping (CM) was used to identify “threshold concepts” in TCI. Threshold concepts are distinguished from core concepts in any given field of study by five key characteristics – transformative, irreversible, integrative, bounded and troublesome. Because a threshold concept enables new ways of thinking and understanding, once grasped, it has a transformative effect on the learner. A threshold concept is irreversible in that (again, once grasped) it is difficult or impossible to forget it. Its integrative nature illuminates relationships between ideas or phenomena, and it contributes to defining disciplinary or subject boundaries (i.e. is bounded). Finally, a threshold concept can be counter-intuitive, difficult to grasp, tacit and/or challenging to pre-existing ways of understanding and therefore troublesome. Troublesomeness is often the most immediately recognizable characteristic of threshold concepts.

CM is a powerful, participatory mixed-method approach that organizes and represents ideas from a defined group. Utilizing the individual and collective knowledge of the group, CM generates an interpretable conceptual framework in the language of the participants. As a participatory mixed-methods approach, concept mapping integrates qualitative individual and group ideas on any topic of interest and uses multivariate analyses to represent these ideas visually through a series of related two-dimensional maps.

The CM process to identify threshold concepts in TCI included the following steps:
1) In a brainstorming process, randomly selected TCI Trainers generated 284 responses to the prompt “To fully incorporate TCI into day to day practice, a key idea that may be difficult for staff members to grasp, but also transforms their practice when they understand it is….” RCCP staff distilled the 284 responses into 78 statements that represented all of the ideas offered.
2) To structure the statements, about 45 of the randomly selected TCI Trainers sorted these statements into piles based on perceived similarity, and rated how difficult and how transformative each statement would be on 7-point scales.
3) To represent the statements, multivariate analyses were conducted to create two-dimensional (x,y) maps that 1) show the individual statements in space with more similar statements located nearer each other, and 2) show how the statements are grouped into clusters that partition the space on the map.
4) TCI Instructors and RCCP staff, divided into six small groups, interpreted the maps by merging the 20 clusters into larger, substantively meaningful sets that represented threshold concepts.

This statistically rigorous and highly participatory process yielded two key threshold concepts that helped guide the production of the 7th edition of TCI – use of self and pain-based behavior.