Abstract Coaching has become a popular method to develop senior executives, yet its effectiveness is open to debate. First, coaching is often conducted without addressing the environment in which the executive operates, making gains derived from coaching difficult to sustain. Second, executives often resist being coached, inhibiting them from learning or acting differently. This article demonstrates executive coaching to be an effective management and organizational development tool, particularly when coaches become more aware of their own resistance to coaching. This article demonstrates executive coaching to be an effective management and organizational development tool, particularly when coaches become more aware of their own resistance to coaching. I wasnt surprised to receive a phone call from Ilene, but I was surprised by what she wanted to discuss. Ilene was an HR executive I knew from another company where I had helped implement a large-scale organization change initiative. She was well acquainted with my bias toward a more systemic rather than an individual approach to change, so I was puzzled that she wanted to discuss a one-on-one executive coaching assignment. She knew my opinion that an outside coach was often brought in as a surrogate for an individuals manager who didnt have the courage to provide feedback. I said that the individuals boss should be coached, not the individual. She was also aware of my low opinion of companies that tolerated the flaws of high-flying executives until they stopped “bringing in the bacon,” at which point they thought a coach might “fix” their problem.
Many nurses may be familiar with life coaching or executive coaching. Coaching is a partnership between coach and client. The coaching process is designed to support clients as they work toward fulfilling personal and professional goals. While life and executive coaching may be the most well-known forms of coaching, the approach and methods of coaching have been extrapolated into other areas or niches. One of these is AD/HD coaching. “A designed partnership that combines coaching skills with knowledge of attention deficit disorder, a neurobiological condition. The coaching process enhances quality of life, improves performance, and supports growth and change. The purpose of AD/HD coaching is to provide support, structure, and accountability. Coach and client collaboratively explore strengths, talents, tools, and new learning to increase self-awareness and personal empowerment. Together they design strategies and actions and monitor progress by creating accountability in line with goals and aspirations” (IAAC, 2007). AD/HD coaching was brought into the spotlight as an intervention for the treatment of adult AD/HD by Hallowell and Ratey (1994) in their seminal book, Driven to Distraction. At that time, professionals focused mainly on educational accommodations and therapy for children and teens with AD/HD. Little had been written about coaching for youth with AD/HD, and the focus on youth coaching was centered on academics. Academic and educational coaches were available to students needing support, with a strong recommendation of academic coaching for struggling students with AD/HD and learning disabilities. Help4ADD@HighSchool (Nadeau, 1998) was one of the first books to discuss AD/HD coaching on a larger scale, reaching beyond simply academic coaching. In her book, Dr. Nadeau states, “Coaching is one of the best ways to deal with your ADD. A coach provides external structure and support, and teaches [you] how to develop your own internal structure” (p. 62). Coaching helps children and teens with AD/HD with several key challenges they face. First, coaching helps a child/teen learn techniques for maintaining focus, stay on task, and improve time management and organizational skills. The development of these skills can contribute to smoother family life and improved school performance. These skills are also the building blocks for future success. Second, by initiating the coaching process with school-aged children, coaches are able to help students with AD/HD avoid frustration and keep motivated, as well as help them build self-confidence and self-awareness during the formative years. Third, most children benefit from daily routines and structures, and building structure and predictability through routines is an effective tool for parents of challenging children with AD/HD (Heininger Weiss, 2001). Yet, routines can be difficult for the child with AD/HD to maintain, and a busy parent can easily be thrown off a routine when a child has AD/HD. Additionally, many parents of children and teens with AD/HD have attentional issues themselves and find it difficult to keep up with a plan on a daily basis. With the support of a well-trained AD/HD coach (IAAC, 2007), effective structure and routines can be developed and sustained, facilitating the consistency that allows children with AD/HD and related behavioral issues to thrive. This can be done with support, care, and humor to protect and build the self-esteem of everyone involved.
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07.03.09 
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. Subsequently, some investigators showed that monophasic defibrillation thresholds can increase over time with transvenous lead systems (9, 10). In selected patient, this increase required reoperation. Improvements in ICD technology permitted the routine active pectoral implantation of devices. Such active pectoral pulse generators, in combination with biphasic waveforms, result in marked reductions in DFTs and more stable thresholds long term (9, 11). The Low Energy Safety Study (LESS) examined whether the 10-J safety margin still was necessary using pectoral defibrillators with active can, biphasic shock waveforms (12). The main results of the study showed that a 4 to 6 J of safety margin above the DFT ++ is adequate for safe implantation of modern ICD systems.