A Comparison of Two Coaching Approaches to Enhance Implementation of a Recovery-Oriented Service Model

@article{deane2014a,
  author = {Deane, Frank P. and Andresen, Retta and Crowe, Trevor P. and Oades, Lindsay G. and Ciarrochi, Joseph and Williams, Virginia},
  title = {A Comparison of Two Coaching Approaches to Enhance Implementation of a Recovery-Oriented Service Model},
  year = {2014},
  journal = {Administration and Policy in Mental Health and Mental Health Services Research},
  volume = {41},
  number = {5},
  pages = {660-667},
  publisher = {Springer Science and Business Media LLC},
  doi = {10.1007/s10488-013-0514-4}
}

In plain language

Mental health services worldwide are moving toward "recovery-oriented" care, where planning centers on the client's own values, life vision, and personally meaningful goals rather than goals dictated by professionals. The problem is that training staff in a new way of working often fails to change what actually happens in practice — one earlier study found only 37 percent of practitioners had implemented any aspect of this model a year after training. This study asked whether follow-up coaching could help the training stick, and whether the style of coaching mattered.

Staff from four community-managed mental health organisations across 13 Australian sites (188 practitioners) were trained in the Collaborative Recovery Model and then assigned, by team, to 12 months of either skills-based coaching (focused on techniques and problem-solving barriers) or transformational coaching (which explored the practitioners' own values and used the same life-vision and goal-planning tools with staff that staff use with clients). The quality of care planning was measured by auditing 298 randomly selected client files from before training, 0-6 months after, and 6-12 months after.

Training followed by coaching was associated with significant, sustained improvements in the quality of recovery-oriented goal and action planning over the 12 months. The two coaching styles did not differ significantly overall, but follow-up analyses showed that only the transformational coaching group improved significantly from before training to the 6-12 month mark — suggesting that values-based, experiential coaching deserves further study. The practical message for services: committing to ongoing coaching after training helps new practice models take hold.

Key findings

• Training in the Collaborative Recovery Model followed by 12 months of coaching produced significant improvements in the quality of documented care planning (significant main effects for both time and coaching condition).
• No significant interaction was found between the two coaching approaches, but post hoc analyses showed a significant improvement from baseline to 6-12 months only in the transformational coaching condition.
• Care-planning quality was assessed by auditing 298 client files with the GAP-IQ instrument, which showed high inter-rater reliability (total-score correlation of .92 between raters).
• Practitioners received coaching only about once every two months on average, rather than the monthly sessions the protocol prescribed — more regular coaching might yield larger gains.
• Even after improvement, care-planning quality scores remained relatively low, indicating substantial room for further growth in recovery-oriented practice.
• The study spanned 188 trained practitioners in four organisations, with coaching condition randomised by team (20 teams) and blocked by organisation.

Related work

• All publications by Joseph Ciarrochi (searchable, with free PDFs)
• Process-Based Therapy & Idionomic Analysis

Author: Joseph Ciarrochi (ORCID 0000-0003-0471-8100). Free copy hosted with permission for scholarly use. Please cite the published version via the DOI above.