Coaching Into Well-being : A realist synthesis of a cognitive behavioural coaching intervention in an Egyptian technology organisation

Abdelfatah, Ola and Giga, Sabir and Simpson, Jane and Harding, Andrew (2025) Coaching Into Well-being : A realist synthesis of a cognitive behavioural coaching intervention in an Egyptian technology organisation. PhD thesis, Lancaster Medical School.

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Abstract

Cognitive Behavioural Coaching (CBC) is “an integrative approach which combines the use of cognitive, behavioural, imaginal, and problem-solving techniques and strategies within a cognitive behavioural framework to enable clients to achieve their realistic goals” (Palmer & Szymanska, 2008, p. 86). Although CBC has been the most cited approach towards evidence-based coaching, its utility in conventional, more purely outcome-driven reviews has not been universally supported (Minzlaff, 2019). This PhD proposes further research using a form of evidence synthesis from a different theoretical and methodological perspective to address some evidence shortcomings and thus better inform practice. The proposed methodology, referred to as realist methodology, aims to uncover more about the context and mechanisms by which an intervention generates intended and, at times, unintended outcomes. This study adopts a realist methodology to evaluate an organisational ‘CBC trial run’ to gather evidence about the programme’s mechanisms and effectiveness in generating employee well-being related outcomes (Graf & Dionne, 2021). The research question investigated is: Regarding workplace CBC interventions, what works, or does not work? For whom? In what context and how? The research is operationalised in two phases. First is a realist review phase, which is a form of literature review that aims to understand deep generative mechanisms (Pawson et al., 2005). In accordance with realist methodology, the review method, and findings (Chapter 3) are presented in terms of initial programme theories, i.e. hypothesised ideas on how, when, and why the programme works or does not work. The second is a realist synthesis phase. The realist synthesis attempts to test out these provisional theories regarding the CBC programme and understand “what works for whom in what circumstances” empirically, through collecting and analysing primary data (Greenhalgh et al., 2017b, p. 1). This empirical part of the methodology proceeded with evaluating and refining initial programme theories (produced by the literature review) via realist interviews. Eight stakeholders were interviewed including one coach, one HR representative and six coachees. Data from the review were analysed using NVivo, while interview data were examined through NVivo's coding structure from the review, alongside a theory refinement template, adopted from Gilmore et al. (2019). Seven programme theories regarding CBC effectiveness were initially identified through the realist review, with substantial theory refinements made through the realist synthesis. Four novel theories regarding the programme implementation process were added during the synthesis. This study is the first realist synthesis to explore CBC well-being interventions in organisational contexts. Thus, it contributes to organisational intervention research as well as coaching theory. It also includes other practical recommendations for policymakers, coaches and coachees.