Having Effective Coaching Conversations for a Person Centered Culture Ms. Elaine Fallon Director of Nursing and Midwifery Quality Improvement Division

Person Centered Culture Explores: Personal values Working with colleagues Service users’ experiences of care Hopes: New way of working together – everyone Enabling each one to flourish

Person-centeredness “Person-centeredness is an approach to practice established through the formation and fostering of healthful relationships between all care providers, service users and others significant to them in their lives. It is underpinned by values of respect for persons, individual right to self determination, mutual respect and understanding. It is enabled by cultures of empowerment that foster continuous approaches to practice development”.

Clinicians as Coaches

Benefits of Coaching Opportunity to work with people who are (usually) strongly motivated to grow and change Opportunity to make a difference Huge potential in terms of job satisfaction Enables augmentation of your normal management style Special opportunity to ‘walk with’ someone through difficulty – solidarity with a client (s) is in itself an enriching experience by helping people to grow, reach their potential, and make a difference themselvesto be gained from working with people in a developmental, future-oriented, problem-solving mode with more facilitative and elicitive set of behaviours and attitudes which can transfer to other important relationships too

International Coach Federation definition of coaching Coaching Definition “Partnering with clients in a thought-provoking and creative process that inspires them to maximise their personal and professional potential, which is particularly important in today’s uncertain and complex environment.." International Coach Federation definition of coaching (www.coachfederation.org)

What is Coaching? Coaching incorporates an appreciative approach Begins with personal interview Between sessions coachee asked to complete specific actions Coach may provide additional resources

International Coach Federation - Ireland Eleven core coaching competencies developed The Core Competencies grouped into four clusters

Core Competencies A Setting the Foundation B Co-creating the Relationship C Communicating Effectively  D Facilitating Learning and Results   Setting the foundation: Meeting Ethical Guidelines and Professional Standards Establishing the Coaching Agreement. 3. Establishing Trust and Intimacy with the Client Coaching Presence 5. Active Listening  6. Powerful Questioning 7. Direct Communication 8. Creating Awareness  9. Designing Actions  10. Planning and Goal Setting 11. Managing Progress and Accountability Understanding of coaching ethics and standards and ability to apply them appropriately in all coaching situations Ability to understand what is required in the specific coaching interaction and to come to agreement with the prospective and new client about the coaching process and relationship. Co creating the relationship: Ability to create a safe, supportive environment that produces ongoing mutual respect and trust. Continuously demonstrates personal integrity, honesty and sincerity. Establishes clear agreements and keeps promises. Demonstrates respect for client’s perceptions, learning style, personal being. Provides ongoing support for and champions new behaviors and actions, including those involving risk taking and fear of failure. Asks permission to coach client in sensitive, new areas. Ability to be fully conscious and create spontaneous relationship with the client, employing a style that is open, flexible and confident. Accesses own intuition and trusts one’s inner knowing—”goes with the gut.” Sees many ways to work with the client and chooses in the moment what is most effective. Uses humour effectively to create lightness and energy. Demonstrates confidence in working with strong emotions and can self-manage and not be overpowered or enmeshed by client’s emotions. Communicating effectively: Ability to focus completely on what the client is saying and is not saying, to understand the meaning of what is said in the context of the client’s desires, and to support client self-expression. Summarizes, paraphrases, reiterates, and mirrors back what client has said to ensure clarity and understanding. Encourages, accepts, explores and reinforces the client’s expression of feelings, perceptions, concerns, beliefs, suggestions, etc. Integrates and builds on client’s ideas and suggestions. Ability to ask questions that reveal the information needed for maximum benefit to the coaching relationship and the client. Ability to communicate effectively during coaching sessions, and to use language that has the greatest positive impact on the client. Reframes and articulates to help the client understand from another perspective what he/she wants or is uncertain about. Facilitating Learning and Results: Ability to integrate and accurately evaluate multiple sources of information and to make interpretations that help the client to gain awareness and thereby achieve agreed-upon results. Goes beyond what is said in assessing client’s concerns, not getting hooked by the client’s description. Invokes inquiry for greater understanding, awareness, and clarity. Ability to create with the client opportunities for ongoing learning, during coaching and in work/life situations, and for taking new actions that will most effectively lead to agreed-upon coaching results. Helps the client to focus on and systematically explore specific concerns and opportunities that are central to agreed-upon coaching goals. Engages the client to explore alternative ideas and solutions, to evaluate options, and to make related decisions. Challenges client’s assumptions and perspectives to provoke new ideas and find new possibilities for action. Encourages stretches and challenges but also a comfortable pace of learning. Ability to develop and maintain an effective coaching plan with the client. Creates a plan with results that are attainable, measurable, specific, and have target dates. Ability to hold attention on what is important for the client, and to leave responsibility with the client to take action. Keeps the client on track between sessions by holding attention on the coaching plan and outcomes, agreed-upon courses of action, and topics for future session(s). Focuses on the coaching plan but is also open to adjusting behaviors and actions based on the coaching process and shifts in direction during sessions. Is able to move back and forth between the big picture of where the client is heading, setting a context for what is being discussed and where the client wishes to go. Develops the client’s ability to make decisions, address key concerns, and develop himself/herself (to get feedback, to determine priorities and set the pace of learning, to reflect on and learn from experiences).

Quality Questions: Simple Clear sense of purpose Influence, not controlling Focus from problem to solution Generate movement

Incisive Questioning Well timed, perfectly worded questions turn keys, unlock doors, provoke real insight “What is important to do first?” “If you could change this situation, what would you do?”

Five Levels of Listening 5. Intuitive listening 4. Listening and asking for more 3. Giving advice 2. Giving our own experience 1. Waiting to speak

Getting the Right Balance: Support and Challenge

Ask an open –neutrally worded -question Coaching behaviours Say nothing Ask an open –neutrally worded -question Summarise what you have been hearing Useful to enable someone to pause, reflect or go deeper to what they are saying Suggests calmness from you allows other person to relax Watch for cues that you have overdone the silence –e.g. body language, tone etc To have the least directive style of influence a question should be open and worded as neutrally as possible. Enables you to demonstrate that you’ve understood the key points of what someone has said and so confirms mutual understanding Helps ‘filter out’ less relevant facts by not mentioning them When someone hears what they have been saying, they have additional insight or reach conclusions they may not have found otherwise

Coaching Behaviours Effective coaches make observations Make an observation Effective coaches make observations What we notice happening in real time when we coach Useful if someone is contradicting what they are saying Some observations will be factual some will have your opinion included –you will need to clarify!

Giving Advice Opinions An effective “coach” gives advice sparingly and with caution When someone hears what they have been saying, they have additional insight or reach conclusions may not have found otherwise

Giving instruction If situation warrants, may use directive instruction to help coachee be self directed But, remember……….

Listen like a Coach Think like a Coach Speak like a Coach

Examples of Models in Coaching GROW Model -Goal, Reality, Options, Will (1980s, G. Alexander, A. Fine and Sir J. Whitmore) CLEAR Model -Contract, Listen Explore, Action, Review (1980s, Peter Hawkins)

Clinicians as Coaches

Thank You elaine.fallon@hse.ie