Tips from the most recent 4-day intensive programme “Coaching, Consultation and Leadership Skills for Pharmacists and Pharmacy Leaders”

Top 10: Ways to Shift from ‘The Expert Approach’ to ‘The Coach Approach’

by Rachel Dungan

 

Ultimately it is all about results.  And results are generated through people.  ‘The Expert Approach’ achieves the desired results for many clients.  They take the advice provided.  They follow through.  However, it is also true that in many cases ‘The Expert Approach’ does not achieve the results desired by either the expert or the client.  Take the example of Medication Adherence.  Numerous studies have shown that approximately 50% of patients taking medication to manage a long-term condition take their medication as prescribed.  However, for the remaining 50%, ‘The Expert Approach’ has not achieved this result.  In a previous article I wrote about leadership, the number 1 tip was “Take responsibility”.  Blaming clients for failing to follow our well-intended advice costs us credibility, erodes trust, creates defensiveness, reduces motivation, and ultimately sabotages progress.  ‘The Coach Approach’ offers an alternative way to engage with these clients to help them to achieve the results they want to achieve.  The goal of coaching is to encourage personal responsibility, reflective thinking, self-discovery and self-efficacy; for the client to become a proactive decision-maker.

Just as an expert holds beliefs about themselves and their client, so too does the coach choose certain beliefs to support him/her to transition into the coaching mind-set. 

If you were to adopt ‘The Coach Approach’ in your practice, here are 10 beliefs you would choose to believe about yourself, the client and the coaching process.  Notice how they differ from the traditional ‘Expert Approach’. 

  1. The client is naturally creative, resourceful and whole.Your client is not broken and in need of being fixed.  Instead, you believe your client either has the internal and external resources to achieve their goal, or s/he has the ability to develop them. 
  2. Elicit the client’s agenda.  Your client is in charge of the agenda, chooses what to talk about, what his/her priorities are, what results s/he wants.  Your role is to facilitate the coaching process to build self-efficacy and client autonomy.
  3. Reach a shared understanding of how you will work together and get clear on what the client’s desired outcome is up-front. Do not make assumptions.  Explicitly agree with your client your boundaries (e.g. the time each of you can dedicate to your meeting, right now), your role, your client’s role.  You may need to teach your client how to be a client.  After all, s/he has been a patient all his/her life.
  4. Address your client’s whole life . Multiple areas of your client’s life are intrinsically intertwined and a specialist approach which focuses on one area to the exclusion of others, often has limited impact.  Most clients need assistance to integrate information from multiple experts to decide what actions to take and how to prioritise them, within the context of their whole life.  You can use the coaching process to assist them to process this.
  5. Be an advocate, an ally, a collaborator, a champion, a sounding board, a partner, an unconditional support, a facilitator of change. Choose to be steadfast, compassionate and non-judgemental.  Choose to hold the client in unconditional positive regard.  Choose to believe that s/he is doing the best s/he can with the resources s/he has at this moment. Choose to believe that his/her best will get better as s/he develops better resources, more empowering beliefs, more references for success. 
  6. Choose to view the conversation as a “meeting of experts”.  This is NOT an expert/patient relationship.  This is a meeting of equals.  The client is an expert in his/her life, in his/her experience of his/her life, his/her medication/treatment/condition.  You are an expert in facilitating the coaching process and in your professional discipline.
  7. Seek first to understand, THEN be understood.  As the coach, it is your responsibility to enter your client’s world (not your client’s job to fit into YOURS!).  That is what client-centred care means.  Your role is to ASK questions and LISTEN FOR the client’s ideas, concerns, expectations, beliefs, values, successes, challenges.  You’ll receive valuable insights and set a tone that encourages healthy dialogue.
  8. Provide advice only if asked or after your client has granted explicit permission to receive it.   Even if your client asks for advice, do so AFTER s/he has already identified options of his/her own.  Unsolicited advice - even when both parties know it is offered with the best of intentions - rarely has the desired effect. 
  9. Focus on your client’s strengths, opportunities and possibilities (rather than problems). Build on what IS working.  Celebrate successes (no matter how small).  This builds confidence in his/her ability to make the changes they want to make.
  10. Own your impact on the quality of the relationship between you and your client. Research in fields such as neuroscience, emotional intelligence & positive psychology demonstrates that how you show up, is more important than what you know.  Be grounded.  Be present.  Trust in your client.  Trust in yourself.  Trust in the coaching process. 

 Just like your client’s journey to master a more health promoting lifestyle, your path to mastery of ‘The Coach Approach’ will not be an instantaneous event.  It too will be a process.  Remember, like your clients, who have many years of practice to be experts in living their lives, you have many years of practice mastering ‘The Expert Approach’. 

Transformational changes can and did occur in our recent 4-day immersive Coach Training.   Mastery of coaching skills requires consistent practice, feedback, reflection, mentoring, supervision, and continued practice.  

As one graduate commented "You could do the L.E.A.D. Programme every year and deepen your learning every time".  

To find out more about ‘The Coach Approach’ in a pharmacy or healthcare setting, contact Rachel at Rachel@racheldungan.com  


Rachel Dungan
4Front Pharmacy Solutions Ltd