L2.1 Occupational Performance Coaching

Question 1

what happens to the family when there is a child with a disability?

Answer 1

• impact of caregiver roles on occupations
• stress from increased workloads
• differential effects for each parent or family member
• impact on relationships
• not usual BUT raising and parenting child with health problems may be challenging with respect to physical and mental health and family function

Question 2

what is occupational performance coaching?

Answer 2

• verbal based one on one intervention
• devised to improve children’s participation by working with caregivers to create more enabling environments
• a goal focused reflective conversation between caregiver and therapist (guide discovery and problem solving)
• aim to support children to participate in personal and family activities by building capacity to problem solve in context

Question 3

what are the elements and benefits of coaching?

Answer 3

1. element: client orientation- client centred, strength based, relational; benefits: positive therapeutic alliance, client strengths and resources through all of therapy process
2. element: process orientation- future/possibilities orientation, solution-focused, exploration of needs; benefits: customisation with client needs, ideas, priorities. shift focus to solution –> sense of hope, self-determination
3. element: goal orientation- collaborative approach, mutual expectations, meaningful goals; benefits: client ownership of goals (meaningful, optimal context for development of knowledge and skills)
4. element: ecological orientation- real-world, client-driven, reflective, capacity buidling; benefits- capacity for transfer of learning to other situations, empowerment, improved self-efficacy

Question 4

what are the theoretical basis’?

Answer 4

• enablement perspectives: adult learning theory; learning is not just acquiring knowledge and skills. learning involves understanding context and critically reflecting on one’s assumptions/beliefs
• occupation-centred practice: enabling occupation in everyday contexts, intervention is occupation centred, focus is on child’s performance in home and community contexts (those in which parents have the most influence)
• family or client centred practice: intervention is family centred, goals are parent generated, based on the principle that parents have the most influence over and knowledge about their childs environment

Question 5

when is it suitable and not suitable to use occupational performance coaching?

Answer 5

suitable:
- when the child’s performance is highly dependent on the context in which it occurs
- when the parent wants ways to support their child performance of occupational roles
- when the parents have goals related to their occupational performance
not suitable:
- when children are medically compromised
- when parents have mental health issues or learning difficulties

Question 6

what are the three enabling domains of the OPC process?

Answer 6

1) emotional support: the verbal and non-verbal strategies used by the therapist to proceed from a problem-based view of issues to a more solution-based focus
2) information exchange: identifying the parents’ knowledge of existing circumstances and provision of information by the therapist when only a gap in knowledge becomes apparent
3) structure process: the problem-solving process or format followed during sessions and hopefully independently by the client at other times

Question 7

describe the structure process aspect of the OPC process

Answer 7

solving process:
- set goals
- set sub goals
- context of the performance may be graded from discrete to generalised
explore options:
- therapist may trial strategies/techniques with children as part of an exploration of options- purpose is to identify techniques that work and then discuss implementation with parents
- guided questions: helping parent/caregiver to identify their own strategies/techniques by way of reflection
- plan actions
- carry out plan
- check performance
- generalise

Question 8

describe the information exchange aspect of the OPC process

Answer 8

• a two way process between parents and therapist
  1. OT needs to determine what the parent already knows so that information can be targeted appropriately
  2. information provided by the therapist is limited to what parents need to know in order to formulate a plan to address the issue being addressed
• typical development (discuss with parents)
• health conditions and impairments (about child’s health)
• teaching and learning strategies
• specialised strategies
• community resources and entitlements

Question 9

describe the steps of collaborative performance analysis (CPA) and the therapists’ roles/objective in CPA

Answer 9

a) identify what currently happens
b) identify what the parent would like to happen
c) explore barriers and bridges to enabling performance
d) identify parents’ needs in implementing and enabling change
therapists’ roles/objective in CPA:
- determine where the task is breaking down for the child and the parent
- determine what needs to change for the child to achieve success in the identified task
- determine what needs to be different in order for the parent to facilitate change
- develop the parents’ ability to find solutions for their child’s performance challenges

Question 10

describe the emotional support aspect of the OPC process

Answer 10

• critical to goal achievement (parents need to have the opportunity to express emotions)
• emotional support is an enabling domain (bc it facilitates a shift from an emotional orientation to a solution finding orientation)
• listen (without judgement)
• empathise
• reframe (paraphrasing or gently offering alternative interpretations can assist parents to reframe perceptions about issues)
• guide (seek and provide information while encouraging parents to make choices about changes or actions)
• encourage (specific feedback, complimenting parents’ actions, providing insight and observations)