This book presents a definitive guide to understanding, applying, and teaching Occupational Performance Coaching (OPC). Grounded in principles of occupational therapy, person-centredness, and interprofessional frameworks of health and disability, this book will be of interest across health and rehabilitation professions.
Supporting people affected by disability to do well and live the life they want is the ultimate outcome of all rehabilitation professionals, no matter where on the lifespan our clients sit. Coaching is increasingly recognised as highly effective in achieving this aim. This accessible manual provides case examples related to diverse health conditions alongside practitioner reflections. Uniquely, this manual presents coaching methods designed specifically for the rehabilitation environment.
This book is a manual for practitioners, researchers, students, and lecturers interested in gaining a robust understanding of OPC methods, theoretical basis, and implementation.
An e-Resource linked to the book provides access to video demonstrations, a podcast from Dr Graham, and downloadable materials including a self-assessment of OPC skills (OPC Fidelity Measure), templates for clinical work, and teaching presentation material.
Fiona Graham is Senior Lecturer in interprofessional rehabilitation at the University of Otago, New Zealand. Fiona has over 25 years' experience working with children and families in public, private, health, and education sectors. She travels internationally, speaking and teaching on the use of coaching in rehabilitation settings. Dr Graham developed Occupational Performance Coaching as part of her doctoral studies with Vale Professor Sylvia Rodger and Professor Jenny Ziviani at The University of Queensland. Her research continues to examine the use of OPC in diverse settings, knowledge translation, and interprofessional practice.
Ann Kennedy-Behr is Senior Lecturer in occupational therapy at the University of South Australia. An experienced clinician, she is passionate about supporting parents and caregivers of children with disabilities and making healthcare as accessible as possible, particularly for people living in rural and remote areas.
Jenny Ziviani is Professor of Occupational Therapy at The University of Queensland with extensive experience in family-centred multi-disciplinary research for children with developmental challenges and their families. Her specific interest is in strategies that harness motivation and support self-competence as children and their families navigate their way to achieving personally meaningful life goals.
Table of Contents
Chapter One: Introduction
Chapter Two: Theoretical and Conceptual Foundations
Occupational Performance Coaching, in a nutshell
OPC targets participation outcomes
The concept of occupational performance
Person- and family-centred care
Alignment of OPC with person- and family-centered care
Person-centred care explained
Family-centred care explained
Coaching single and multiple clients: merging person- and family-centred practices
Building family capacity through coaching
Self Determination Theory
What is SDT?
Alignment of OPC to adult learning theory
Transformational learning theories
Contrasting OPC with other coaching interventions
Distinguishing aspects of OPC from other coaching interventions
Occupational Performance Coaching logic model
Chapter Three: Implementation Procedures
Overview of the OPC domains: Connect, Structure and Share
The first domain: Connect
The challenge of listening
Empathy and self-care of practitioner
Why is partnering challenging?
Have we got time to partner?
How can we cultivate partnership?
The second domain: Structure
Structure: Establish valued participatory goals
Why do goals need to be 'valued?
Why do goals need to be 'participatory'?
How do we describe degree of change or the scale of OPC goals?
How can we measure goal progress?
Whose goals are targeted in OPC?
What does OPC with multiple clients look like?
Structure: Collaborative Performance Analysis
Collaborative Performance Analysis: Envision
Collaborative Performance Analysis: Explore
Exploring the 'Person'
Exploring the 'Task'
Exploring the 'Environment'
Collaborative Performance Analysis: Engage
Act: Doing it
The third domain: Share
Share: Expect resourcefulness
Share: Ask first
Share: Prompt reflections
Share: Teach principles
Chapter Four: Fidelity Processes
A fidelity framework
What practitioner background training is needed?
Are there pre-requisite practitioner competencies for OPC?
How is OPC training delivered?
Minimising implementation drift
Tailoring of training
Training of trainers in OPC
What dosage of OPC is required to effect change?
What delivery formats are suitable for OPC?
How is fidelity to OPC measured?
OPC Fidelity Measure
How have client perspectives of fidelity been gathered?
How is OPC fidelity monitored?
External observer monitoring
Self-monitoring of fidelity
How can OPC be tailored?
Are outcome measures considered an adaptation to OPC?
Can I grade language and visual supports without tailoring OPC?
How is cultural diversity accommodated within OPC delivery?
What therapeutic strategies are beyond tailoring of OPC?
Chapter Five: Threshold Concepts
Threshold Concept #1: High trust partnerships are critical to coaching and are intentionally developed.
What are high trust partnerships?
The power of high trust partnerships
High trust partnerships in action
Threshold Concept #2: Meaningful goals are when dreams come true, rather than problems minimised.
What are meaningful goals?
The power of motivating goals
Motivating goals in action
Threshold Concept #3: Impairments rarely inform solutions. Enabling strategies can arise from anywhere.
What are enabling strategies for occupational performance/ participatory goals?
The power of a systems view for identifying strategies
A systems view of enablement in action
Threshold Concept #4: Clients, rather than practitioners, are the agents of change in coaching.
What is client agency within coaching?
The power of client agency
Client agency in action
Threshold Concept #5: Expertise in coaching lies in how we engage with people rather than what we know about them.
What does it mean to be expert at engaging with clients?
The power of expertise in engaging with people
Expert engagement in action
Chapter Six: Research Findings
OPC with primary caregivers
Client strategies which effect change arising from OPC
Lived experience of engaging in OPC
OPC with teachers
Research using adapted versions of OPC
OPC after stroke
Chapter Seven: Practice in Diverse Service Delivery Contexts
Service delivery implications
How does OPC fit with service values?
How does OPC impact on practitioner time use?
How can OPC principles inform first contact and triage?
How might OPC affect team structures?
Does OPC affect the overall amount of therapy clients receive?
How can the principles of OPC inform service delivery beyond researched populations and formats?
OPC with at-risk infants and their parents
OPC in single session contacts
Adaptive equipment assessment
Can OPC work through interpreters?
Does OPC translate across diverse cultures?
When is OPC not the right fit?
How should I evaluate outcomes of OPC in my clinical work?
As a service leader, how can I support application of OPC?
Support practice change at all levels
Mentor new staff
What does written communication informed by OPC look like?
Communicating OPC to colleagues and partner agencies
Electronic Resources Reference Page
Chapter One: Podcast
Chapter Five: Video demonstration series
Introductory Teaching Resources
Appendix A: Occupational Performance Coaching Fidelity Measure (OPC-FM)
Scale Descriptors and Rating Guide
Appendix B: Occupational Performance Coaching Process
Appendix C: Occupational Performance Coaching: Goal Examples
Child related goal examples
Adult related goal examples
Appendix D: Occupational Performance Coaching: Goal Development Example and Template
Appendix E: Suggested Wording for Occupational Performance Coaching (OPC) Template for Intervention Description and Replication (TIDieR)
Appendix F: Occupational Performance Coaching: Session Schedule
Appendix G: Occupational Performance Coaching: Casenote Audit Tool
Appendix H: Occupational Performance Coaching: Casenote Template
Appendix I: Occupational Performance Coaching: Discharge Report Template