Occupational Therapy and Coaching: Where is it at now?

This year marks 15 years since I completed my first coach training and started to coach occupational therapists (OTs). It has been a fascinating journey. It is worth reflecting on what coaching is, what it offers OT, how OTs are using coaching in different settings, how coaching helps OTs themselves and how coaching could support OT in the future.

Back in 2005, whilst I was still breastfeeding, I fell in love with coaching. It felt so natural to work this way; much less stressful than my OT work had been and more empowering for both parties. I immediately wanted to coach OTs who seemed stressed, burnt out, bullied, or wanted a change of direction. However, most of the OTs who got in touch wanted to learn to coach, rather than be coached themselves! Part of me was frustrated, but my coaching skills for OTs workshop went down so well that I let go of it and just went with the flow. Fifteen years later, that one-day workshop has been taken by hundreds of UK OTs and hundreds more worldwide, online.

I don’t mind admitting that I fell out of love with OT for a couple of years. I was entranced by the coaching world, its positivity and can-do attitude and was a bit fed up with 'problem lists' and deficit thinking, which seemed to abound in OT practice (well, in the settings I had worked in). I also felt less responsible for the outcomes as a coach, rather than as an OT – it wasn’t all up to me whether something was effective, or there was a good outcome.

As time went on, I started to see how coaching could really enhance OT practice, not merely be an additional tool in our already adequate toolbox. I started to see how putting coaching philosophy at the heart of my OT practice changed me as an OT. In this way, coaching was much more than just asking questions and setting goals.

To date, I have used coaching in various ways: as an occupational coach in a return-to-work service; as a private coach, mostly with OTs but also corporate clients; I have set up the coaching element for a cancer vocational rehab programme; I have specialised in coaching creativity and published the first book of its kind; set up a coaching party programme with full training; taught coaching to undergraduate OTs; and many other things too!

I am in the privileged position of seeing how other OTs use coaching too. Along with the leading work by Fi Graham and others in New Zealand, many OTs who work with children and families now use occupational performance coaching (OPC) in their work. Many OTs are setting up their own wellbeing businesses, combining OT and coaching; the Lifestyle Redesign Programme at USC is at the forefront of using coaching and OT; coaching is now often used within vocational rehabilitation, helping people to overcome internal and external barriers to work. In mental health OTs and many other professionals see the value of coaching in recovery but also in prevention; a coaching approach is used in many other ways, including fatigue management and conditional management programmes.

I could go on, but I think you are starting to get the picture. Coaching within OT has really come a long way.

To me, there are many reasons why coaching has become so popular and why so many OTs are looking to how coaching can strengthen their practice:

• The notion of client choice/person-centred practice is very difficult in services which are so tightly controlled. To me, coaching is a way of ensuring at least some of what we do has the person and their world at the core.
  

• Coaching helps shift the power away from the OT, into the hands of the client/patient. Not only does this grow responsibility and self-efficacy, but it should also help the OT too.
  

• In services where OT contact is limited, coaching can sow seeds, which grow long after the OT intervention has ended.
  

• Coaching helps people see how interconnected their world is, shifting away from 'I' to 'We'.
  

• An OT who coaches effectively helps people make conscious occupational choices and supports positive change.

So why is all this important right now?

There has been a drive, in recent years, to empower people and make them less dependent on healthcare services. Certainly, this has been seen in the UK and the Covid situation has expedited this change; access to GP services has changed and reliance on online support has increased. Covid, lockdown and the subsequent societal changes, have also shed light on how OT is such an important profession for the future.

People are having their occupational lives turned upside down: staying at home more, working from home, less social contact or physical contact, with many hobbies and recreational activities stopped. Now is the time for OT to be seen in broader society and to shine. Coaching can support OTs to work in this way.

Climate change, preventing further climate damage - and managing the impact that is now inevitable - all depend on changing our occupational lives. How we live, work, feed ourselves, socialise, travel, etc; all our occupations must change. Our daily 'doing' has caused climate change, so we need to change our daily doing – our occupations. Coaching helps raise awareness of the broader impact of our actions and behaviours and highlights our personal responsibilities. I am also hoping that those OTs who are interested in working in this arena will support themselves, through coaching.

I know this may sound like coaching as a panacea for all the worlds ills, but if you understand what coaching can do, you will start to see its power and potential. We all need to be listened to, to have our deepest concerns and desires heard. We all need to understand our impact on our immediate and broader environment. We all need to have hope.

That is why I love coaching! 😊

Jen Gash

Occupational Therapist

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