Peer Group 23 Sep 2016: Dr Fi Graham

Dr Fiona Graham is a Senior Lecturer with the University of Otago, Wellington. Working from Christchurch, Fiona teaches distance-based postgraduate coursework in rehabilitation. Her research interest is enabling children’s participation through more effective ways of working with their caregivers.

Abstract: Physiotherapist and occupational therapist experiences of adopting coaching methods when working with caregivers of children with disabilities
Authors: Fiona Graham, Pauline Boland, Sylvia Rodger, Jenny Ziviani
Themes: Multi-agency, multidisciplinary collaboration to think, learn and do participation

Background: Occupational Performance Coaching (OPC; Graham et al., 2009) has been suggested as an intervention for working with caregivers toward achievement of participation-oriented goals for their children. Preliminary studies indicate its’ effectiveness (Graham et al., 2013) however it is unclear how therapists trained in this approach experience implementing it in clinical settings.
Aim: This study explored physio- and occupational-therapists’ experiences of implementing Occupational Performance Coaching.
Method: Data from interviews (n = 10) and a focus group (n=3) with therapists working in child development services were analysed using thematic analysis (Braun and Clark, 2013).
Results: Four major themes in therapists’ experiences were identified: (1) Sharing power, (2) Reprioritising processes, and (3) Liberating but challenging. An overarching theme, ‘Listening better’ was evident across all themes. Implementing Occupational Performance Coaching drew on familiar skills for therapists and fitted with existing values in working with families. However, techniques that focused on building rapport with caregivers and eliciting caregivers’ knowledge were valued most highly. These techniques appeared to augment the therapeutic relationship and the process of therapy in ways that were energising but at times, challenging for therapists.
Conclusions: From therapists’ perspective, Occupational Performance Coaching can be implemented in a range of paediatric service environments by physio- and occupational-therapists. Occupational Performance Coaching appears to assist implementation of family-centred practice ideals and deepen therapists’ commitment to its philosophy.

BRAUN, V. & CLARK, V. 2013. Successful Qualitative Research Los Angeles, CA, Sage.
GRAHAM, F., RODGER, S. & ZIVIANI, J. 2009. Coaching parents to enable children’s participation: An approach for working with parents and their children. Australian Occupational Therapy Journal 56 16-23.
GRAHAM, F., RODGER, S. & ZIVIANI, J. 2013. Effectiveness of Occupational Performance Coaching in Improving Children’s and Mothers’ Performance and Mothers’ Self-Competence. American Journal of Occupational Therapy, 67, 10-18.