Recommendations:
Whilst specialist knowledge and facilitation skills are required by those delivering a resilience-based coaching programme like this, its potential as a cost-effective and scalable intervention is great given the size of the healthcare workforce who could benefit. Scalability is possible without losing intervention fidelity, using controlled ‘manualisation’ of the intervention and a ‘train the trainer’ model. This approach could enable specialist up-skilling of mental health professionals and other experienced facilitators with transferable psychological care skills and specialist Cognitive Behavioural Therapy training to provide a critical mass of appropriately trained and supported facilitators to enable widespread availability of the intervention.
The wider applications of resilience-based coaching interventions such as the one explored here also offer great potential as a relatively low-cost, scalable means of supporting the general well-being, psychological resilience and coping mechanisms of health professionals dealing with the inherent, non-error related challenges of their everyday work.
Health systems and organisations seeking to garner the gains of resilience-based programmes must first address negative connotations associated with such interventions by distinguishing the role of resilience in the context of system inadequacies. Despite evidence of resilience-based interventions working to support health professionals in managing clinical work, the reluctance of some staff to engage with resilience training due to its misapplication in many healthcare contexts, prohibits effective implementation. Future resilience-based interventions should therefore take account of previous critiques regarding individual versus system change and focus on the prophylactic application of practical, evidence based self-management and support strategies of relevance to specific aspects of clinical working, which are highly valued by staff, if they are to maximise staff engagement and impact in practice. Most importantly, to be truly effective, developing staff capability around resilience requires more than just delivering training, but must also involve system change. Examples should include changes to the current predominantly individual focus of resilience-based intervention design and incident investigation that are largely outside the control of individual health professionals.