Baldwin P, King G, Evans J, McDougall S, Tucker MA, Servais M. Solution-focused coaching in pediatric rehabilitation: an integrated model for practice. Phys Occup Ther Pediatr. 2013 Nov;33(4):467-83.
This article describes the conceptual basis and key elements of a transdisciplinary model for solution-focused coaching in pediatric rehabilitation (SFC-peds). The model exemplifies a strengths-based, relational, and goal-oriented approach to clinical practice. It provides a distinct shift from a problem-oriented, therapist-directed approach to a possibilities-oriented approach where client empowerment takes precedence. The model facilitates client change through a method of working with client strengths and resources that involves the use of strategic questions to co-construct therapy intervention. Through client-therapist collaboration, therapy goals and plans are developed that align with client hopes, priorities, and readiness for change. SFC supports client self-determination and capacity for change through customized therapy goals and plans that are meaningful for the child and family. Implications for therapists include the need for relational expertise, practical coaching skills, and expertise in facilitating change. The need for research on the effectiveness of this approach in pediatric rehabilitation is discussed.
King G, Schwellnus H, Servais M, Baldwin P. Solution-Focused Coaching in Pediatric Rehabilitation: Investigating Transformative Experiences and Outcomes for Families. Phys Occup Ther Pediatr. 2019;39(1):16-32
AIMS: A qualitative study was conducted to investigate family experiences and outcomes of Solution-Focused Coaching in pediatric rehabilitation (SFC-peds).
METHODS: Two interviews (5 months apart) were conducted with nine sets of family members who had received SFC-peds, within the past 6 months, from therapists with 3-10 years of experience using the approach. Transcripts were analyzed using thematic analysis and a phenomenological approach.
RESULTS:Participants experienced a goal-oriented collaborative process, high engagement, enhanced capacity and community participation, and empowered mindsets. The therapy process was seen as a collaborative solution-focused conversation, situated in the client's world, and involving individualized and co-created goals and plans. SFC-peds provided families with a supportive, structured, and paced goal-setting process. Reported enhancements to capacity included child/youth skill development, enhanced parent skills, enhanced parent knowledge of their child and options, and changes in parenting. Increased community participation was also reported. Empowered mindsets involved increased confidence, increased self-efficacy and self-determination, and broadened perspectives and expectations.
CONCLUSIONS:The study provides evidence for the utility of SFC-peds and the importance of engaging families in a goal-oriented collaborative process. Implications concern greater understanding of transactional dynamics in therapy and real-world client change, and the need to develop measures of client/family resiliency.
Schwellnus H, Seko Y, King G, Baldwin P, Servais M. Solution-Focused Coaching in Pediatric Rehabilitation: Perceived Therapist Impact. Phys Occup Ther Pediatr. 2019 Oct 28:1-16.
Aims: This qualitative descriptive study explored perceived impacts of solution-focused coaching in pediatric rehabilitation (SFC-peds) from the viewpoint of experienced therapists. Methods: Semi-structured in-depth interviews were conducted with six participants (four occupational therapists and two physical therapists) who had incorporated SFC-peds into their practice for three years or longer. Participants were asked to describe perceived differences SFC-peds has made to their clinical practice, service provision, and relationships with clients and families. Interview transcripts were analyzed using the method of thematic analysis. Results: Three major themes, each with subthemes, were identified: 1) changes in therapists' perception of their roles; 2) increased service effectiveness; and 3) enhanced client capacity. Through long-term engagement with SFC-peds, participants have experienced a role shift from an expert adviser to a collaborative facilitator who assists clients and families with capacity building and self-discovery of solutions for their everyday environments. Conclusions: The findings suggest that SFC-peds can help participants reframe professional expertise and integrate principles of family-centred care into their day-to-day practice. Individual- and system-level support, along with flexibility in service structures and processes, may be needed to further the implementation of SFC-peds in service delivery.
Seko Y, King G, Keenan S, Maxwell J, Oh A, Curran CJ. Impact of Solution-Focused Coaching Training on Pediatric Rehabilitation Specialists: A longitudinal evaluation study. J Interprof Care. 2019 Nov 21:1-12
Fostering successful interprofessional collaboration remains a challenge in pediatric rehabilitation. A coaching approach can enhance client-centered care and provide a transdisciplinary framework for collaboration. The purpose of this longitudinal study was to evaluate the impact of Solution-Focused Coaching in Pediatric Rehabilitation (SFC-peds) training on pediatric rehabilitation practitioners from multiple disciplinary backgrounds. Thirty-seven service providers (SPs) completed surveys at baseline and three follow-ups. Quantitative and qualitative findings both suggested that the training proved an effective way to achieve substantial and sustainable improvements in SFC knowledge, confidence, and use of SFC-peds techniques among participating SPs. The educational intervention also facilitated the integration of a strengths-based, solution-building approach at an individual and team level, providing SPs with a common language and shared framework for client-centered care and optimal collaboration with colleagues. A need for practice opportunities tailored to unique care contexts was identified. Future research should further explore the impacts of a SFC-peds approach on interprofessional teams, as well as on health outcomes of clients.
King G, Williams L, Hahn Goldberg S. Family-oriented services in pediatric rehabilitation: a scoping review and framework to promote parent and family wellness. Child Care Health Dev. 2017 May;43(3):334-347.
Family-oriented services are not as common as one would expect, given the widespread endorsement of family-centred care, the role of parents in supporting optimal child outcomes, and legislation and literature indicating that parent outcomes are important in their own right. There are no published service delivery frameworks describing the scope of services that could be delivered to promote parent and family wellness. A scoping review was conducted to identify types of familyoriented services for parents of children with physical disabilities and/or intellectual impairments. This information was then synthesized into a conceptual framework of services to inform service selection and design. A scoping review of the recent literature was performed to capture descriptions of services targeting parents/families of children with physical disabilities and/or intellectual impairments, published in a six-year period (2009 to 2014). Six databases were searched and 557 retrieved articles were screened using inclusion and exclusion criteria. Thirty six relevant articles were identified. Based on descriptions of services in these articles, along with seminal articles describing the nature of desirable services, we propose a needs-based and capacity-enhancing framework outlining a continuum of family-oriented services for parents of children with disabilities. The framework includes six types of services to meet parent/family needs, organized as a continuum from fundamental information/education services, to those supporting parents to deliver services to meet their childˈs needs, to a variety of services addressing parentsˈ own needs (support groups, psychosocial services and service coordination). The framework provides pediatric rehabilitation service organizations with a way to consider different possible family-oriented services. Implications include the particular importance of providing information resources, support groups and psychosocial services to meet parentsˈ needs, enhance capacity and promote family wellness. There is also an opportunity to provide composite parent–child services to address the needs of both parents and children.