Have you ever read a research-based report and thought, "I don't recognise this person, are you sure you wrote about the right person?"

This was the premise of a session I attended at the American Occupational Therapy (AOTA) conference in April titled: Strengths-Based Coaching: Learn how to Implement this Evidence Based Practice. I have to declare my reason for attending the session – one of the presenters is an author I have had the honor of working with, someone who has inspired and taught me so much over the years – Dr. Winnie Dunn (Professor and Chair of the Department of Occupational Therapy Education, University of Kansas), along with her co-presenter Dr. Ellen Pope (Clinical Assistant Professor, Department of Occupational Therapy Education, University of Kansas). As an Occupational Therapist and mother of a child in receipt of many services over the years, the takeaway messages from the session struck both a professional and personal note.

For the purposes of this piece I’ll refer to my child as “A*”…Perhaps subconsciously I am saying my child is “A star”!

Countless times my husband and I have met with a professional to be told:

• “A* can’t do this”
• “A* has not reached this milestone”
• “A* exhibits this negative behaviour”

Countless times, we have turned it around to ask:

• “What is A* good at?” 
• “What are A*’s strengths?” 
• “How can we use these strengths to support A*?” 

By knowing the answers to these questions, we, as parents, feel more engaged in the process. Instead of being defeated by what our child can’t do, we embrace the positives; we see opportunities instead of challenges; we share A’s* potential with others!

As Drs. Dunn and Pope demonstrated in their workshop, current evidence illustrates that strengths-based coaching leads to significant changes in both participation and self-efficacy; seeing the positives and strengths in a person helps focus on a more functional approach to intervention, it helps people to thrive with greater life satisfaction often in quite challenging situations, and in line with Csikszentmihalyi’s work on the Flow experience, helps people persist at an activity when it presents just the right challenge.

Drs Dunn and Pope challenged the audience to consider practical examples of working with families to implement a strengths-based coaching model, to shift from a deficit based method of assessment and intervention to using positive approaches. As a takeaway, I decided to look at some reports I’d read over the years, and have a go at implementing this approach.  What do you think?

Actual Report Wording	Alternative Strengths Based Positive Wording
A* experiences a great deal of anxiety and requires close support of an assistant to feel safe. She requires high levels of structure throughout the day to reduce anxiety and increase understanding of what is expected.	A* is experiencing much less anxiety in school now that she has experienced assistants who help her to understand school expectations.
A* can become extremely upset and needs lots of comfort and support when things change unexpectedly.	With support such as visual aids or social stories, A* is able to deal with changes in routine and situations.
A* has difficulties with toileting, this presents more difficulties when anxious or distressed.	A* is mostly independent with toileting when she is not anxious or distressed.
A*s initial experience of school was very challenging for all concerned. Her very difficult needs are currently met through a combination of successful strategies. After a difficult start A* has started to show progress and a great willingness to engage in learning.	Using a combination of successful strategies A* is now making good progress in school, and is enjoying learning.

Documentation is one part of the process, aligned with this is the intervention planning piece. Drs. Dunn and Pope illustrated how we might guide a caregiver or teacher to use resources readily available within a child’s environment, resources that might already support the child even in challenging situations. By inviting conversation, asking questions to uncover the child and family’s participation priorities, and supporting caregivers to discuss ways of achieving these priorities we open up a world of possibilities rather than prescribing a set of solutions to try and fix or change performance.

Dr. Dunn and Dr. Pope referred to these phrases throughout their workshop, which are useful to reflect on:

“Will they recognise the person you just described?”

And

“Are you interfering with suggestions, or working with the child, family and school to support participation goals.”

References

Dunn, W., Pope, E. (2015, April). Strengths-Based Coaching: Learn how to Implement this Evidence Based Practice. Workshop presentation at the American Occupational Therapy Association Annual Conference, Nashville, TN.

Csikszentmihalyi, M. (1990). Flow. New York: Harper & Row.

- by Shelley Hughes

About the author

Shelley Hughes is a Senior Product Manager for Pearson Clinical Assessment, responsible for the Occupational Therapy portfolio worldwide. Prior to taking up this position, Shelley was a member of the research and development team with Pearson Clinical Assessment, working as the Lead Research Director on the Sensory Profile 2.

Shelley’s background is primarily as a Children’s Occupational Therapist, working in The U.S. school system, and the UK healthcare system. Shelley is based in the UK.

Follow Shelley on Twitter @ShelleyhughesOT