The PATHS Coaching Model

A Coaching Model By Margaret Ferguson, Blended Coach, Health Coach, Team Coach, UNITED STATES

The PATHS Coaching Model for Individual Clients

The P.A.T.H.S. coaching model is designed to strengthen the core of health care, that is, the individuals who touch or indirectly support patients. Although adaptable to a wide range of clients, this model is intended to serve clients who are in any discipline in health care (physicians, registered nurses, advanced practice providers, pharmacists, healthcare trainees, and all allied health staff), as well as non-clinical staff and administrators, especially executive leaders.

The general framework for the P.A.T.H.S. coaching model follows a linear path whose successive elements are foundational for the achievement of the individual’s desired goals:

The General Framework for the PATHS Coaching Model

Partner

The partnership between the coach and client is powerful and unique. Unlike most professional associations, a coach truly partners with the client to advocate and guide. Partnering is a collaborative alliance, designed to work with purpose, as individuals. A coach “… will partner with you (client) to set goals and accountability measures that will move you from where you are now, to where you want to be.” (ICA Learnsite, 2024).

Partnership fundamentals:

• Planning, and goal setting between the parties (individual, stakeholder, sponsor, and coach) is done in full transparency and collaboration
• Client-coach confidentiality is emphasized in the engagement contract
• The establishment of a bond is essential for effective partnership and is enhanced by continuing reassessment of the collaboration (Narciso, 2023)

Assess

This coaching model is dependent upon objective assessment of individual personality type, individual behaviors, values, and cultural competency. Assessment of the organizational culture as well as baseline data collection using state-of-the-art, validated tools, is imperative to success with the P.A.T.H.S. coaching model (Gardiner, 2023). If an organization uses specific Tools those individuals or team data, can be leveraged for this model.

Assessment fundamentals:

• Assessment tools must provide a baseline description of the individual’s behaviors, personality traits, and values.
• The assessment data is confidential unless permission is granted to share beyond the individual-coach dyad

Transform

The heart of the P.A.T.H.S. Coaching model is the focus on the individual’s opportunity to improve and maintain their own well-being. Physicians and healthcare workers (HCWs) provide critical services to patients while working adverse hours, often inflexible schedules, and continually putting patients’ needs before their own. These workplace and lifestyle challenges have resulted in high rates of burnout, reduced well-being, job turnover, and even career abandonment. Physicians and HCWs, whether employed in private practice or as employees of health care systems, can feel overworked, minimally resourced, and unable to provide quality care for their patients (de Vries, 2023). The Cycle of Transformation Power tool (Figure 1) provides a visual guide to the hopeful possibility of an individual moving from aspirational goal(s) to achievable. The center of the circle is the ultimate outcome, well-being. The Cycle of Transformation allows reassessment and the addition of new goals, all of which can move from aspirational (“hope”) to achievable (“Realized”).

Honor the Journey

In this model, especially if the focus is on Physicians and HCWs, it is essential to recognize, respect, and Honor the lived experience of the individual. Analogous to military duty, the path taken by potential clients in the healthcare field has been filled with intense training and unimaginable experiences with humans at their lowest point in life. The model is strengthened by intentional recognition and celebration of the enormity of responsibility assumed by these clients. Failure to consider (by coach or client) the complex background and unique challenges in the work life of the healthcare coaching client will diminish any effective goal setting and achievement.

Sustain

The journey to setting and achieving value-driven goals, in the context of professional coaching, borrows from decades of work in changing behavior. With coaching as a framework, clients will move along the Cycle of Transformation (Figure 1) from hope to reality, (Aspirational to achievable goals). By allowing clients the freedom to dream or aspire, the coach can help guide the path to the achievement of desired goals. Actions often require some behavior change or reframing. The P.A.T.H.S. Coaching model drives focus on the final stage of any goal achievement or action – sustainability (Zimmerman, 2000 – Maintenance and Relapse Prevention stage). Guided by the International Coaching Federation (ICF) competencies (Individual ICF, 2024) and Team (ICF, 2021), sustainability is grounded in the coaching process, culminating in the end-of-session discussion of accountability, next steps, and barriers.

Sustainability fundamentals:

• Establish the client’s plans to maintain the goal/behavior change over time
• As a coach, explore potential pitfalls of sustaining a change process, support, and advocate for the client’s success, recognizing there may be unanticipated barriers that can be addressed with ongoing coaching

Individual module – Sample engagement

Dr. B is a 39-year-old female Family Medicine physician referred to professional coaching by her manager because of the manager’s concerns that she was at substantial risk of leaving medical practice. Dr. B and her manager sponsor were very engaged. Dr. B exhibited all the core characteristics of “coachability” in leaders: “tolerance for discomfort, openness to experimentation, ability to look beyond the rational, willingness to take responsibility, capacity for forgiveness, self-discipline, and the ability to ask for support” (Steinberg, 2020).

Dr. B PATHS Professional Coaching

P – Dr. B had an immediate, strong bond with her coach, deep trust in her manager as a sponsor, and a willingness to commit to multiple sessions. Her immediate goal was to gain clarity about her decision to leave the practice of medicine.

A – Dr. B had previously participated in the MBTI assessment (Myers-Briggs); she expressed a desire to move to a personality-style assessment, and a DISC assessment was performed revealing her style as D-I (Driver-Influencer).

T – Using the Cycle of Transformation as a guide (during coaching), Dr. B revealed her “dream” to combine patient care with quality research (aspirational goal). Using the visual tool, through coaching, she crafted a plan to turn her aspirational goal into reality; by the end of the coaching engagement, she was a finalist for a combined role which would allow her to reach her desired state in medicine

H – An entire coaching session was spent hearing the story of Dr. B – her unusual path to becoming a doctor, the long-lasting effects of the pandemic on her motivation and energy to keep going, and the pride she has in being the first and only doctor in her family and in her community.

S – Dr. B established her overarching goal (find a position in patient care and quality research) by the third coaching session. By the end of the engagement, she had plans to not only pursue longer-term coaching but to use an accountability partner to sustain the positive attitude she had re-established, about medical practice.

References

de Vries, N., Boone, A., Godderis, L., Bouman, J., Szemik, S., Matranga, D., & de Winter, P. (2023). The Race to Retain Healthcare Workers: A Systematic Review on Factors that Impact Retention of Nurses and Physicians in Hospitals. Inquiry: a journal of medical care organization, provision, and financing, 60, 469580231159318. 
Gardiner, K. (2023, September 18). Personality assessments: 10 best inventories, tests, & methods. PositivePsychology.com.
ICA Learnsite. What Is Coaching? (Retrieved April 3, 2024).
ICF – Core Competencies. International Coaching Federation. (2024, March 8).
ICF team coaching competencies. International Coaching Federation. (2022, December 8). 
Narciso, D. E. (2023, July 25). A guide to establishing and nurturing effective partnerships. Debutify.
Steinberg, B. (2020, October 30). Are you ready to be coached? Harvard Business Review.
Zimmerman, G. L., Olsen, C. G., & Bosworth, M. F. (2000, March 1). A “stages of change” approach to helping patients change behavior. American Family Physician.