Common Misperceptions about Coaching
Misperception 1: Coaching only works with certain families
The most common misperception voiced about using a coaching approach is that it might work with some families, but not families who are challenged by addiction, poverty, mental health issues, low cognition, or the families who do not care or really do want the practitioner to work with their child. These beliefs are held by individuals who have not fully embraced family-centered practices. The characteristics of family-centered practices and effective help-giving include respect for the family member, presumption of competence, and promotion of their strengths and abilities rather than limiting them by their presumed deficits (Dunst & Trivette, 1996). If a practitioner or service coordinator is unable to set aside personal filters that place limited expectations on the family, then coaching cannot be successful. With a negative view of the family, even using a child-focused treatment model will not be effective because we cannot provide enough therapy to make a difference, we are creating dependence, and when we are not present, the situation will return to the way it was before we were involved. Most importantly, research tells us children learn through opportunities to use their skills within the context of real life activities they find interesting and their families find important (Dunst, Hamby, Trivette, Raab, & Bruder, 2000).
Misperception 2: Coaching is only useful for children with mild disabilities
Another misperception regarding the use of coaching is that this approach is limited to use with parents of children who have mild disabilities. Some practitioners believe that children with multiple or severe disabilities require more intensive and more specialized services than coaching can accomplish. The practitioner or service coordinator who holds this perception is operating in a deficits-based, service-based, professionally-centered paradigm. They view their role as teaching skills or engaging the child in decontextualized, passive interventions that they believe the parents are not capable of or do not have time to do. Conversely, when focusing on child participation in meaningful activities as the outcome, parents are very good at knowing what their child likes, wants, and needs to do (Dunst, Hamby, Trivette, Raab, & Bruder, 2000).
Misperception 3: Coaching is a watered-down approach
We often hear another misperception from therapists who believe that coaching is a watered-down approach that does not require a therapist. A multidisciplinary perspective is required to effectively support families in early intervention. Individual coaches must have knowledge, skills, and experiences useful as the content for coaching conversations with families of children with disabilities. How this information is shared, however, is the difference between coaching and a treatment-based approach. The coaching process affords family members and other care providers the opportunity to use and build upon their own ideas prior to jointly exploring other strategies and supports with the coach.
Misperception 4: Coaching doesn't allow the therapist to touch the child
Frequently, therapists also believe that touching the child is not allowed as part of coaching. When using a coaching approach, two reasons exist for the therapist to touch the child (Shelden & Rush, 2001). This includes the assessment process in which the therapist and parent explore what strategies work and do not work. The other reason for touching the child is modeling evidence-based strategies for the parent or care provider to try and reflect on during and between visits. This does not mean that the parent must then become the therapist; rather parents participate in the recognition, development, and use of ideas to help their children learn and grow as a natural part of family and community life.
Misperception 5: I can't bill for coaching
Finally, once practitioners accept that coaching is a viable means of supporting families and other care providers, they express their concern that they will be unable to be fiscally compensated for this type of intervention. We agree that most billing systems are extremely complicated, overburdened, and almost exclusively provide reimbursement for the remediation of deficits through therapy. Coaching is therapy and is a direct intervention with a child and family. In early intervention, billable services are focused on those necessary to achieve outcomes on the Individualized Family Service Plan (IFSP). Coaching conversations are about generating effective strategies for achieving the IFSP outcomes and can be documented as such.
As the field of early intervention moves forward with the use of evidence based practices, we must hold ourselves accountable for our day-to-day interactions with all families and care providers. In doing so, we must use practices that are empirically sound and discontinue our use of non-evidence based practices, although often preferred by practitioners, which are decontextualized and practitioner-dependent. The continued use of practitioner-dependent interventions is generally a reflection of the extent to which one truly believes in family-centered practices. While the knowledge, skills, and experiences of the practitioner are useful and necessary in early intervention, the willingness of the practitioner to acknowledge and promote the capabilities of ALL families and care providers is a fundamental characteristic of effective helpgiving. Coaching is an evidence based, helpgiving approach to promote the competence and confidence of families to support the growth and development of their children.
Dunst, C.J., Hamby, D., Trivette, C.M., Raab, M., & Bruder, M.B. (2000). Everyday family and community life and children's naturally occurring learning opportunities. Journal of Early Intervention, 23(3), 151-164.
Dunst, C.J. & Trivette, C.M. (1996). Empowerment, effective helpgiving practices and family-centered care. Pediatric Nursing, 22, 334-337, 343.
Shelden, M.L. & Rush, D.D. (2001). The ten myths about providing early intervention services in natural environments. Infants and Young Children, 14(1), 1-13.