Youth Engagement in Pediatric Rehabilitation: Service Providers' Perceptions in a Real-Time Study of Solution-Focused Coaching for Participation Goals

ABSTRACT

Aim: Client engagement is assumed to affect therapy outcomes. This study examined service providers' perceptions of youth engagement in solution-focused coaching sessions focusing on participation-oriented goals for youth with cerebral palsy. Method: Service providers completed the Pediatric Rehabilitation Intervention Measure of Engagement—Service Provider version (PRIME-SP) at the end of each session of the brief solution-focused coaching intervention (3–5 sessions) for 10 youth. Results: Youth engagement was high yet fluctuated over the sessions. Service providers noted a range of components of engagement/disengagement (affective, cognitive, and behavioral) and related factors, including client states, components of behavior change (success or nonsuccess between therapy sessions, and pleasure with success), and service provider strategies. Four preliminary patterns involving engagement, client-reported success, and goal difficulty (personally achievable or dependent on others) appeared to be meaningfully related to quantitative measures of youth outcomes. Conclusions: The study provides insights into the highly engaging nature of solution-focused coaching and the relational, co-constructed nature of the therapeutic interaction. The study indicates the utility of the PRIME-SP as a tool for recording observations of components of engagement and related factors that may be useful for clinical decisions about the use of engagement strategies and for general reflections on practice.

KEYWORDS:

• Cerebral palsy
• coaching
• engagement
• motivation
• process research
• realist approach
• SFC-peds
• therapy session

Acknowledgments

We would like to acknowledge the contributions of Patricia Baldwin, Michelle Servais, and our colleagues on the Pediatric Rehabilitation Intervention Measure of Engagement (PRIME) research team (http://primeresearchteam.com).

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

About the Authors

Gillian King is a Senior Scientist (Bloorview Research Institute), Professor in the Department of Occupational Science and Occupational Therapy (University of Toronto), and Canada Research Chair in Optimal Care for Children with Disabilities (Tier 1). Heidi Schwellnus is a Collaborative Practice Leader at Holland Bloorview Kids Rehabilitation Hospital. Sarah Keenan is a Life Skills Coach and Clinical Team Investigator at Holland Bloorview Kids Rehabilitation Hospital. Lisa Chiarello is a Professor and Director of the PhD and DHSc Programs at Drexel University in Philadelphia.

Additional information

Funding

Canadian Institutes of Health Research (950-230077)

Funding

Institute of Coaching (010.77573410000)

We acknowledge funding awarded to Heidi Schwellnus from the Institute of Coaching to conduct the study of solution-focused coaching, and funding awarded to Gillian King from the Canadian Institutes of Health Research, which supported the development of the PRIME-SP measure. Gillian King holds the Canada Research Chair in Optimal Care for Children with Disabilities, funded by the Canadian Institutes of Health Research.