30 Sep What is Evidence ?based Coaching? What are its Strengths and Limitations?
Evidence based coaching is a concept that emerged early in the first decade of this century as an attempt to maintain ? or possibly establish ? credibility for coaching as a practice. However, as ?the way ahead? for coaching evidence based coaching is problematical: Whilst one may find the phrase ?Evidenced Based Coaching? instinctively appealing, as the saying goes, ?The devil is in the detail?: Legitimate questions the detail devil may ask include: What is evidence? Who decides what is evidence? What is the evidence to be used for? ?To understand how ?evidence based coaching? (EBC) emerged as a proposed approach to coaching and I appraise its value to the coaching fraternity an examination of a number of factors is important: Firstly, what factors underpinned the drive to advocate EBC by various coaching professionals. Secondly, and quite possibly linked to the first, how was (and is) EBC influenced by the emergence and adoption of? ?evidence based medicine? (EBM) and evidence based practice (EBP) in the last part of the previous decade? Thirdly, the application to coaching of EBP as practised by other disciplines deserves examination, as do the underlying assumptions in the phrase EBC. Finally the various strengths and limitations of EBC as a coaching approach should be appraised. Whilst EBC would initially seem a relatively simple concept, the application of EBC as a coaching industry approach is far from easy. Currently EBP remains an aspirational statement of intention with the challenge for the industry being to develop a common understanding of what it actually means before it can hope to develop a common understanding of its application.
Why did evidence based coaching emerge? ?What is different about evidence based coaching compared to other forms of coaching? EBC arose primarily because of concerns regarding the credibility of coaching as a nascent discipline and its future. Following the ?explosion? of coaching in the late 1990s and early 2000s there was no clear definition of what coaching was and who could and should do it. Further, there was confusion as to whether ?coaching? was a distinct discipline or whether, for example, it was psychology in another form or a simply a renaming of the self-improvement movement that preceded it. There was inferred evidence for the validity of some aspects of coaching from related disciplines, psychology in particular, but there was a dearth of evidence specific to coaching. In addition to this there was (and still is) a plethora of companies selling coaching based on models subject to minimal scrutiny and unwilling to subject them to scrutiny for primarily percunary reasons (Grant, 2005). In response to the prevailing situation the Coaching Psychology Unit at the University of Sydney coined the phrase evidence based coaching to ??describe executive, personal and life coaching that goes beyond adaptations of the popular self-help or personal development genre, is purposefully grounded in the behavioural and social sciences and is unequivocally based on up-to-date scientific knowledge? (Grant, 2005). The emergence of EBC was as much a political invention as anything else (Spence, 2007), (Clutterbuck, 2007), (Sheldon, 2007) driven by the need to develop an approach differentiated by establishing a validity and credibility for coaching thereby separating it from the faddism and the hyperbole of some parts of the industry lest there be guilt by association.? The choice of the phrase ?evidenced based coaching? was no accident but very much in alignment with the prevailing ?mood of the times? in the behavioural and social sciences from which coaching draws. EBC was derived from evidence based practice (EBP) which was itself derived from evidence based medicine (EBM)
Evidence based medicine as a concept had a relatively long gestational period. Medical interventions using controlled trials had been established as early as the 1940s (Council., 1948), (Patulin Clinical Trials Committee, 2004). However what later came to be known as evidence based medicine did not emerge until 1972 with Professor Archie Cochrane?s book ?Effectiveness and Efficiency; Random Reflections on Health Services? (Cochrane, 1999) and was not ?crystallised? until 1999 when Sackett and his colleagues proposed that EBM involved making decisions about patient care based on the integration of the physician?s clinical expertise with the appropriate external clinical research. These decisions should be individualised to the specific patient (Sackett, Rosenberg, Gray, Haynes, & Richardson, 1996). Greenhalgh argues that EBM challenges the healthcare professional to ask questions and seek answers about scientific evidence in systematic way and adjust their practices accordingly (Greenhalgh, 1997). Interestingly, the title of Greenhalgh?s book ? ?How to Read a Paper: The Basics of Evidence Based Medicine? is strongly indicative of the way in which the medical community as a whole has chosen to interpret EBM ? a very strong focus on external evidence in the form of published papers in peer reviewed journals. Well constructed double blind randomised placebo controlled trials along with meta analyses are considered the ?gold standard? is determining what constitutes good quality evidence (Rycroft-Malone et al., 2004). This has lead to a focus on getting research evidence produced and disseminated and the subsequent development of treatment algorithms and guidelines designed to reflect EBM (Parati et al., 2010), (Hsu, Lam, & Browne, 2010), (Gupta et al., 2009), (Ozcan, 1998). However, it should be remembered that EBM as defined by Sackett and his colleagues also emphasised that clinical expertise and the specific needs of individual were also integral parts of EBM: Concerns have been raised that a slavish adherence to an empirical model of EBM does not automatically equate to best practice (Tonelli, 2001). In particular concerns regarding devaluation of the individuality of the patient and the shift in focus away from the care of individuals to the care of populations ahs been expressed. Also there are those who feel an over reliance on empirical data does not take into account the complexities of sound clinical judgment (Tonelli, 2001), (Tonelli, 1998), (Naylor, 1995), (Ferlie, Wood, & Fitzgerald, 1999) and a concern that simply disseminating research evidence to practitioners is unlikely ? as a stand alone approach ? to improve or guide its use in practice (Rycroft-Malone, et al., 2004). Despite these concerns EBM has been virtually universally accepted by the medical community as the cornerstone of best practice as evidenced by the pre-eminent status accorded to Cochrane Evidenced Based reviews (Greenhalgh, 1997)
Unsurprisingly the tenets of EBM were adopted by other health related fields and also by the social sciences ? for example Social Science (McDonald, 2003), Speech Pathology (Dodd, 2007) and Psychology (Allen, Oseni, & Allen, 2011) - ?in the form of evidence based practice (EBP). EBP draws its central tenets from EBM and like EBM much of the application of EBP in related fields like psychology and social work has focused on development of empirically based research to drive ?best practice?. However, how directly transferable these tenets are to other disciplines? There are significant difficulties in matching the double blind randomised placebo-controlled trial ?gold standard? of EBM. The default position of EBP in the human and social science fields has been the use of randomised controlled trials. However, apart from the difficulties in constructing the interventions necessary to produce the empirical data critical to EBP, scepticism exits as to the real value of empirical evidence when applied in actual practice. The concerns are the same as those expressed by some in the medical profession regarding EBM noted above. It should be noted that many of these arguments are not questioning the value of evidence as a guide to best practice but rather how well the current focus on empirical evidence gained via randomised trials delivers the evidence required to deliver best practice. This position is in the context of a perceived over emphasis of empirical evidence in relation to other evidence such as evidence gained from the experience and skill of the of the practitioner (Rycroft-Malone, et al., 2004), (Green, 2008) and a fear that the current interpretation and application of EBP may lead to only certain forms of action or practice as being legitimate (Webb, 2001). What we see in EBP applied to the human and social sciences field is an amplification of the concerns expressed by some in the medical field regarding EBM.
So from EBM ? which had general but not universal acceptance in the medical fraternity? - to EBP in the allied health, behavioural and social sciences - where the universal acceptance and application of EBP principles appears more problematic ? to EBC. Again we see an amplification of the concerns expressed by practitioners regarding EBM and EBP. As the word ?evidence? moves from a relatively narrow field i.e. medicine to the broader fields of the human and social sciences, the contextual difficulties of a narrow interpretation of the word have become apparent. This is even more so in the field of coaching.
Coaching draws from a number of other disciplines including psychology, counselling, education, philosophy and religion (Grant, 2005). Each of these disciplines has a different raison d?etre and consequently different evidential needs from coaching. Within this multidisciplinary coaching community practitioners have needs for evidence on how to best practice and clients, be they organisations or individuals need evidence in the form of the results they are seeking. One of the limitations of the empirical evidence that EBC strives for that is there will always be a gap between the research and practice ? as indeed there is in EBM upon which EBC is ultimately based (Tonelli, 2001), (Naylor, 1995).
To further confound things, some have challenged the commonly accepted of the use of the word evidence: Drake contends that coaching has always been based on evidence of some kind and that what constitutes ?evidence? is determined by context and cultural norms. He further contends that evidence is the coaching context is more a verb than a noun (Drake, 2009). Drake also echoes the concerns of practitioners regarding EBP that any evidence needs to be translatable into practice. The coaching fraternity currently lacks consensus on a working definition of ?evidence? and until this is addressed EBC will remain an ambiguous phrase. In fact we are already seeing the phrase EBC being utilised by proprietary coaching organisations (Skiffington, 2011) ? the very thing the development of EBC was trying to avoid. Interestingly, the International Coach Federation, the current leader in the promotion and regulation of professional coaches does not have in its 11 core coaching competencies any mention of an EBP approach to coaching (Griffiths & Campbell, 2008)
Notwithstanding the above limitations EBC as an aspiration has much to commend it as a positioning statement on how to move forward from the current ambiguity and has already resulted in a move to collect more rigorous empirical data specific to coaching. This should be viewed as a positive: Notwithstanding valid differences of opinion as to the transferability of empirical data there was, and is, a lack of empirical specific to coaching. The emergence of EBP can be seen as a key driver in the increased activity in this area (Grant & Cavanagh, 2007). Further, EBC has also underpinned a number of studies that have direct application to the practice of coaching (de Haan, Culpin, & Curd, 2011), (Ladegard, 2011) Indeed, the initial proponents of EBC as a concept acknowledge it?s origins in EBM but stress an avoidance of? ?the prescriptive linear approach too often associated with the medical model? and a movement ?toward contextually relevant coaching methodologies that incorporate both rigor and the lived experience of the practitioners and clients? (Stober & Grant, 2006). This approach, if adopted by the coaching community, should address the concerns espoused by Drake and others concerned about losing the ?art? of coaching.
In conclusion, EBC emerged as a poitical necessity as a different approach designed to distinguish it from the perceived faddism of the market driven coaching which had developed form the self help industry. It emerged as an approach at the same time that EBM and EBP in the medical and human and social sciences were emerging and logically followed their paths. It is not without the ambiguity experienced by EBM and EBP and indeed may indeed suffer from amplification of ambiguities. However, as an aspirational starting position it has much to commend it and has already contributed significantly to coaching?s knowledge base. However, until consensus is gained in the coaching fraternity as to how flexible the definition of evidence can be, the hoped for ?comprehensive, flexible, and strong model of coaching? (Stober & Grant, 2006) may yet be some way off.
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