Rolling with the F-words Life Wheel: reflexive thematic analysis of a coaching-based, holistic approach to pediatric occupational therapy

Abstract

Background and purpose: The F-words Life Wheel approaches child development by hybridizing a holistic model in the F-words for Child Development, and a coaching model in Occupational Performance Coaching, along with a life-flow approach in the Kawa model. The effect of the F-words Life Wheel has not been previously studied. The purpose of this paper is to report parents' experiences with the F-words Life Wheel. Methods: This was a qualitative study based on interviews with parents of children with developmental needs and experts in child development. Interviews were conducted in person and transcribed verbatim. The researchers used reflexive thematic analysis within a critical realist paradigm. Results: A total of 13 interviews were conducted, 11 with parents of children with developmental needs and two with child development experts. Interview transcripts totaled 42,763 words from which we developed 45 codes and three themes. The themes were 1) overwhelming, 2) power rebalance, and 3) connectedness. The overwhelming theme addresses how life with developmental needs is challenging, engaging with the health and disability system is difficult, and the focus on deficits can lead to a sense of being overwhelmed. The power rebalance theme addresses the transition from professionals calling the shots to giving agency to the child and family. Holistic goal setting empowers parents and children to direct and prioritize therapy, and helps shift from a deficit-focused to a "can-do" attitude. The connectedness theme addresses the linkages between psychological health, physical health, the extended family, and the planet as a whole. Conclusions: The F-words Life Wheel approach appears to be empowering and motivating for children and families. Further research is needed to explore how holistic models of therapy such as the F-words Life Wheel can promote family-centered care and connectedness on a wider scale.