There are several more modern methods out there that you can do by machine. One general method is that you place a piece of batting under the motif you want to trapunto, stitch around the motif, cut the excess batting, then sandwich the whole piece as you would usually do. this gives you a double batt in the desired areas. Another way is to double batt, with a fluffier batting on the top, then quilt the heck out of the areas surrounding your tapunto. This depresses those areas making your trapunto stand out.