The Process of Empowerment in Coaching

Elizabeth Ahmann, ScD, RN, PCC

We all understand from experience working with clients that coaching is an empowerment process. But what does that actually mean?

According to Shearer and Reed (2004), empowerment can be defined as purposefully participating in the process of changing one’s own behaviors and environment, and engaging inner resources toward well-being.

The assumptions of empowerment theory (Shearer & Reed, 2004) include that empowerment is:
1)    internal, not external to the individual, and cannot be given or forced upon a person
2)    a mutual, interactive relationship between the individual and his/her environment
3)    a continuous process, not a static outcome
4)    a process that can be facilitated by supportive others. (Shearer and Reed formulated their theory specifically for the nursing field, but empowerment theory is utilized in other fields as well.)

But, what is the link between empowerment theory and coaching?

To reconfigure the definition of empowerment proposed by Shearer and Reed (2004), as coaches, we want to support our clients in engaging their inner resources to purposefully participate in changing their behaviors and environment to better meet their needs, and support goal-attainment and success, as defined by each client.

Empowerment intrinsically relates to the development of self-efficacy (See Conger & Kanugo, 1988, for a discussion of this relationship.) In the coaching literature, links are also drawn between empowerment and self-determination theories (Tuttle, Ahmann, & Wright, 2016).

One study of ADHD coaching for young people explicitly used an empowerment framework to examine the impact of coaching (Garcia-Ron, Serrano-Grasso, Blanco lago, Huete Hernani, & Pérez Martinez, 2015).  This study used the empowerment framework identified by Anderson and Funnell (2005).

Several other studies of ADHD coaching have used a self-determination framework (Maitland, Richman, Parker, & Rademacher, 2010; Parker & Boutelle, 2009; Richman, Rademacher, & Maitland, 2014; Swartz, Prevatt, & Procto, 2005).

So what is it that we do in coaching to support empowerment?

An interesting study examined how the process of empowerment actually happens in coaching. Caldwell, Grey, and Wolever (2013) examined the structure and process demonstrated in a number of recorded health coaching sessions to explore how empowerment occurs. In this study—a sub-component of a larger study related to the maintenance of weight loss—individuals had participated in 12 weekly 2-hour psychoeducational groups with three subsequent booster sessions. Participants in the larger study also received health coaching every two weeks, beginning the 9th week of the group meetings, and continuing for 6 months. Individual coaching sessions lasted 20–30 minutes.

The coaches in this study had the following credentials: “One had a master’s degree in health psychology, and the other had a master’s in rehabilitation counseling. Both had between 64 and 97 hours of coach-specific training… and at least 6 years of experience coaching lifestyle change” (Caldwell et al., p.  50).

A random sample of 69 recordings was drawn from a total of 156 sessions offered to 12 of the study participants. The recordings were transcribed and then coded for themes regarding session structure and communication strategies, using standard procedures for this type of research.

The structure of the coaching sessions was generally as follows:
1)    Brief check-in
2)    Review of progress toward goals; examination of barriers; strategies to overcome barriers
3)    Goal setting and planning time for next session

Of more interest to practicing coaching may be the communication strategies employed by the coaches in the study, which fell into two broad areas:

1)    Exploring the client’s experience – including use of a casual, friendly tone, a client-directed process, encouragement/affirmation, focusing on progress, a nonjudgmental approach, rapport building, reflections, open-ended questions, and what the authors called “overlapping of speech” (e.g., the use of “uh-huh” as a positive utterance) (Caldwell et al., pp. 51–52).
2)    Active interventions – including reframing, offering tentative suggestions, offering information or a rationale for an approach, and guiding to goal creation (e.g., SMART goals) (pp. 52–54).

The study authors link many of the communication strategies used by the coaches to established approaches in relevant literature from other fields, such as counseling and psychology, cognitive-behavioral therapy, linguistics, patient–provider communication, and social support communication (pp. 51, 52). In this paper, the active interventions, other than reframing, were not supported by other literature.

ADHD coaches will likely recognize a great similarity in approach to that of the health coaches whose sessions were explored in this qualitative research paper.  This study affirms common coaching approaches as elements of an empowerment model.

A study such as this, making elements of the structure and process of coaching explicit to others, can also help support understanding and acceptance of the coaching field.

Why would I read this study?

This research study by Caldwell and colleagues is worth a read, if only for affirming what you already do as an ADHD coach. It is also encouraging to have research affirm that typical coaching communication patterns contribute to client empowerment. Although the study explored here is focused on health coaching, not ADHD coaching, it is a useful resource to share with those who would like to gain an understanding of how coaching works.

The study is available free online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833537

 

References

Anderson, R., & Funnell, M. (2005). The art of empowerment: Stories and strategies for diabetes educators (2nd ed.). Alexandria, VA: American Diabetes Association.

Caldwell, K. L., Grey, J., & Wolever, R. Q. (2013). The process of patient empowerment in integrative health coaching: How does it happen? Global Advances in Health and Medicine, 2(3), 48–57.

Conger, J. A., & Kanungo, R. N. (1988). The empowerment process: Integrating theory and practice. The Academy of Management Review, 13(3), 471–482. Available here.

Garcia Ron, A., Serrano Grasa, R., Blanco Lago, R., Huete Hernani, B., & Pérez Martinez, D. A. (2015). Pilot study of the efficacy of empowering patients through coaching as a complementary therapy in attention deficit hyperactivity disorder. Neurologia [Epub ahead of print]. doi:10.1016/j.nrl.2015.06.017

Maitland, T., Richman, E., Parker, D., & Rademacher, K. (2010). The impact of coaching on academic success: A focus on university students with learning disabilities and attention deficit/hyperactivity disorder. Paper presented at the 2010 Conference of AHEAD: Association on Higher Education and Disability, July 14, Denver, CO.

Parker, D. R., & Boutelle, K. (2009). Executive function coaching for college students with learning disabilities and ADHD: A new approach for fostering self-determination. Learning Disabilities Research & Practice, 24(4), 204–215.

Richman, E. L., Rademacher, K. N., & Maitland, T. L. (2014). Coaching and college success. Journal of Postsecondary Education and Disability, 27(1), 33–52.

Shearer, N., & Reed, P. (2004). Empowerment: Reformation of a non-Rogerian concept. Nursing Science Quarterly, 17(3), 253–259.

Swartz, S. L., Prevatt, F., & Proctor, B. E. (2005). A coaching intervention for college students with attention deficit/hyperactivity disorder. Psychology in the Schools, 42(6), 647–656.

Tuttle, L. J., Ahmann, E., & Wright, S. D. (2016). Emerging evidence for the efficacy of ADHD coaching. Poster presented at the 2016 Annual Meeting of the American Professional Society for ADHD and Related Disorders (APSARD), Washington, DC, January 15–18.

Liz-Ahmann2Elizabeth Ahmann, ScD, RN, PCC
ACO Research Committee