Date Presented 04/01/2022
This qualitative study found that Level II OT fieldwork students perceived coaching, a novel approach within OT practice, to be a valuable clinical tool. These students noted that learning coaching strategies and becoming proficient coaches required a gradual mindset shift. They also reported on the benefits for clients who participated in OT-led coaching sessions, although they perceived that the approach worked better for some than for others.
Primary Author and Speaker: Marie-Christine Potvin
Additional Authors and Speakers: Erin West, Alexis Morales
INTRODUCTION: This past decade, coaching has emerged as a novel practice within occupational therapy (OT) (Dunn et al., 2012; Graham et al., 2010). Coaching is strengths-based, collaborative, client-led approach in which the coach facilitates clients’ progress toward self-identified goals through skillful conversations (Boney et al., 2019; Harrington et al., 2021). Coaching requires a different skill set from what most OT practitioners learn in academic curricula and use in their day-to-day practice. In fact, experienced clinicians who integrated coaching into their practice reported that it increased their flexibility and listening skills, and resulted in a shift from therapist as the expert to a facilitator of change (Graham et al., 2018; King et al., 2018). Studies have yet to investigate whether OT students, as novice clinicians, identify a difference between traditional OT and coaching approaches. This study endeavored to uncover the perceptions of Level II OT students about the in-depth coaching training received and subsequent implementation completed during their Level II fieldwork. This study explored Level II fieldwork students’ (n = 14) perceptions regarding the value of (1) in-depth coaching training as preparation for future clinical practice; and (2) the impact of coaching on clients.
DESIGN: Qualitative, phenomenological design.
METHOD: Semi-structured interviews were conducted with all OT students who had recently completed Level II fieldwork in a non-traditional setting using OT-led coaching as the primary approach. These interviews were transcribed verbatim, coded, and interpreted to identify themes using a non-linear, narrative inquiry process. Each step was executed independently by two researchers who compared their analyses to identify discrepancies and came to a consensus through discussion and through consultation with a senior researcher as needed.
RESULTS: Four themes emerged from the analysis: (1) Coaching is a mindset shift, (2) Change is a journey, (3) When it Works, it Works, and (4) Time is money or is it? OT students shared that coaching is ‘a different way of thinking’ that provides a shift in perspective about clients’ participation within OT sessions (Theme 1). They noted the skills learned through coaching about building positive therapeutic relationships are transferable across OT practice settings (Theme 1). Students also remarked on their improved understanding of clients’ change processes as particular to coaching and transferable knowledge for future practice (Theme 2). Coaching yielded more positive outcomes for some clients than others, but, in the words of one of the OT students, when it works, “it’s magic” (Theme 3). OT students had to develop comfort with the reality that coaching requires time to learn and execute as a practitioner and as a client (Theme 4). Time was an available resource in this fieldwork setting, which students valued (Theme 4).
CONCLUSION: Level II OT students perceived learning and implementing coaching as a worthwhile endeavor that improved their flexibility, therapeutic use of self, rapport-building, active listening, interviewing, and confidence. Moreover, coaching allowed students the opportunity to empower clients to be experts, explore client context, and develop clinical reasoning and realistic expectations of client change. Students emphasized the long-term positive implications of the confidence, insight, and techniques learned through coaching on their future practice.
IMPACT STATEMENT: Coaching is perceived as an advanced practice skill within occupational therapy, but students clearly found value in learning this approach within fieldwork.
References
Harrington*, E., Santos*, G., & Potvin, M.-C. (2021). Students’ Perceptions of Occupational Therapy-led Coaching in Post- secondary Education. Open Journal of Occupational Therapy, 9(2), 1-13. https://doi.org/10.15453/2168-6408.1790 [*Shared 1st authorship]
Graham, F., Boland, P., Ziviani, J., & Rodger, S. (2018). Occupational therapists’ and physiotherapists’ perceptions of implementing occupational performance coaching. Disability and Rehabilitation, 40(12), 1386-1392. https://doi.org/10.1080/09638288.2017.1295474
King, G., Schwellnus, H., Keenan, S., & Chiarello, L. A. (2018). Youth engagement in pediatric rehabilitation: service providers’ perceptions in a real-time study of solution-focused coaching for participation goals. Physical & Occupational Therapy in Pediatrics, 38(5), 527-547.
Boney, J., Potvin, M.-C., & Chabot, M. (2019). The GOALS2 Program: Expanded supports for students with disabilities in postsecondary education. Journal of Postsecondary Education and Disability, 32(3).
