NIATx (formerly the Network for Improvement of Addiction Treatment) is a manualized approach to promoting performance improvement and the implementation of evidence-informed innovations in organizations. Throughout all types of coaching work, the importance of being dynamic and able to adjust according to the needs of the coachee cannot be understated, as coaches need to be flexible to best support their clients. Once this relationship is established, coaches are more able to push and challenge coachees to make changes to their practices and develop new competencies, as they have already established a strong, trusting relationship. More generally, many studies have found that much of coaching focuses on the relationship between coach and coachee and a significant portion of the work that occurs is around the building of this relationship. However, one study found that only 1/3 of coaching interactions were coded as this type of interaction. Most coaches aim to facilitate critique of and reflection on current practices, as doing so often provides the best opportunities for growth in organizations. While specific coaching techniques can vary by model, there are many commonalities in how coaches interact with their coachees. Many popular coaching models also use techniques found in cognitive-behavioral therapy to help teams reflect on organizational barriers and explore possible steps to mitigate them. This increases organizational capacity for making and sustaining change, even when coaching is no longer available. A focus on solutions helps people develop self-efficacy and confidence in implementing other solutions. However, more recent coaching models used in evidence-based practice implementation projects are solution-focused rather than problem-focused.
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Some coaching models focus on the problem an organization is facing as a starting point for deciding how to proceed. Numerous models of coaching for organizational change have been developed, drawing on a variety of theories and techniques from clinical psychology, organizational development, and social psychology. Recent research suggests that organizational coaching can foster change effectively by providing support and guidance that organizations require during the process of change. Despite the promise of coaching in other fields, its use to promote the implementation of evidence-based practices, particularly within healthcare organizations, is just emerging and remains poorly understood. The use of coaching is common in many fields, including athletics, business, education, and health promotion.
Future research should focus on which processes and patterns make coaching more likely to promote specific implementation outcomes. Understanding what occurs during a successful coaching intervention will improve the effectiveness of coaching as an implementation strategy. Use of tools for organizational change and implementation remained relatively consistent across all coaching periods. Very little coaching work was dedicated to building sustainability. Most coaching work was devoted to building capacity almost as much work focused on building relationships. The coaching work that occurred during these calls aligned closely with the model of coaching for implementation developed by our team.
Later, forty coaching calls with behavioral health organizations in Ohio, Wisconsin, and Florida were analyzed with directed content analysis using a priori codes based on this model. Interviews with nine experienced coaches were conducted and inductively coded to develop a model of coaching for implementation. In order to open the “black box” of coaching for implementation, we first developed, then tested the rigor and utility of a model of coaching for implementation. Organizational coaching to promote the implementation of evidence-informed interventions is becoming more popular in healthcare organizations.
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