In preparing to speak to several physical therapists last month, I found a brilliant article in the Osteopathy literature, which I felt held lots of interest for those wanting to integrate a coach approach with OT or use some coaching skills alongside their existing OT practise.
The full title is “Health-coaching strategies to improve patient centred outcomes” by Susan Butterworth, who takes a Motivational Interviewing approach to coaching (Although strictly speaking MI is not coaching, much of MI is using in coaching and vice versa and I am not willing to nit-pick right now).
Before we leap in and start offering solutions, advice and direction to our clients, (as OTs we are really good at that BTW) we really need to know, what they already know. In coaching, exploring what the client already knows and unlocking this wisdom is crucial and we spend a lot of time doing this, but in traditional OT settings, this can be a struggle. In this Elicit-Provide-Elicit technique, the aim to first “Elicit” what the client already knows, then fill in any gaps or misconceptions (Provide) and explore how that fits with the clients life (Elicit).
Elicit: Find out what the client already knows, by asking them directly, being curious, enquiring, clarifying, exploring.
“Mrs Smith, I’m curious to know what you already know about managing your fatigue at work. Do you mind telling me?…and what else…and what else…”
Provide: Using direct communication to give short bursts of information, fill in gaps or to explore any misconceptions. (This bit is a balancing act. Are we providing essential information to our clients or pushing them towards what we think they should do, or what our service is about?)
“I can hear that you are taking regular breaks during the day and structuring your day differently. That’s great – making changes can be tricky. Would it be OK to add some other ideas and thoughts?….”
Elicit: back to the enquiry, in light of the new information/ideas. What meaning does that hold, if any, for the client?
“Out of everything we have talked about, what makes sense for you to do?” or “What will have the biggest impact on you, your work and managing when you get home?” or “What do you make of all that?” or “What could help you with this?”
I think this is good, basic starting point for becoming more “coach like” in existing OT roles. What do you think? Its suits quite brief intervention, but could also be used to frame and develop longer term interventions. If you read the original article, it has lots of other goodies and we might explore those over the next few monthsJ
My inner, purist, non-directive coach, really struggled with the notice of “correcting misconceptions” as people’s perception/view of the world, is very real for them, but part of being a courageous coach is being challenging when it might help and as OTs we often have to give information to clients. Nuff said for now as I am starting to ponder and write far too much:)