Career Adaptation Coaching in a Rural Clinic: a Case Study

Thesis Abstract

Career Adaptation Coaching in a Rural Clinic a Case Study The study investigates how career adaptation coaching interventions influence client employability, career resilience, and psychological well-being within a rural clinical context where access to dedicated career services is limited and stigma surrounding psychological support persists. Despite increasing emphasis on workforce reintegration and life-design approaches, there is a paucity of rigorous empirical work examining the implementation and outcomes of career coaching in primary care or rural settings, where logistical constraints and cultural factors shape engagement and effectiveness. This gap potentially limits the scalability and fidelity of coaching models when transferred from urban, specialist environments to rural clinics serving diverse socio-economic groups. Aims and objectives The primary aim is to evaluate the effectiveness and mechanisms of career adaptation coaching delivered in a rural clinic. Specific objectives include (1) assessing changes in employability skills, career clarity, and adaptive career self-efficacy among clients; (2) examining variations in psychological distress and well-being pre- and post-intervention; (3) exploring clients’ perceived barriers and enablers to sustained career adaptation; (4) identifying core processes and practitioner capabilities that mediate intervention outcomes; and (5) developing a context-informed framework for integrating career coaching within rural primary care services. The study is anchored in Career Construction Theory (Savickas) and the Self-Determination Theory to interpret motivational dynamics and autonomous goal setting. Methodology A mixed-methods, embedded design will be employed over 12 months in a rural district clinic serving agricultural and peri-urban populations. The population comprises adults (aged 18–55) seeking employment support or career guidance (n ? 220). A purposive sample of 60 clients will receive a standardized eight-session career adaptation coaching programme over twelve weeks; a matched comparison cohort (n ? 60) will receive usual care, enabling quasi-experimental analysis. Data collection instruments include (i) the Career Adapt-Abilities Scale (CAAS) to measure concern, control, curiosity, and confidence; (ii) the Career Satisfaction and Employability Questionnaire (CSEQ) adapted for rural contexts; (iii) the General Health Questionnaire-12 (GHQ-12) for psychological well-being; (iv) a barrier-enabler interview protocol and (v) coaching fidelity checklists. Validity and reliability will be established through pilot testing (n=15) and Cronbach’s alpha assessments (>0.80 for key scales). Data analysis will incorporate (a) hierarchical linear modeling to evaluate pre-post changes and between-group differences while controlling for covariates such as age, education, and prior work history; (b) thematic analysis of qualitative interviews to elucidate mechanisms and contextual factors; (c) mediation analysis to examine whether improvements in self-efficacy and autonomy mediate employability outcomes; and (d) process evaluation using regression discontinuity-inspired checks for fidelity. Theoretical integration will triangulate Savickas’ career construction processes with Deci and Ryan’s Self-Determination Theory to interpret motivational and identity-related shifts. Expected findings It is anticipated that participants receiving career adaptation coaching will show statistically significant improvements in CAAS scores, CSEQ employability metrics, and GHQ-12 well-being indicators compared with the control group at immediate post-intervention and at a three-month follow-up. Qualitative data are expected to reveal enhanced career adaptability through narrative meaning-making, goal alignment with local job opportunities, and increased autonomous motivation. Mediation analyses are expected to demonstrate that gains in career self-efficacy and intrinsic motivation partially account for improvements in employability and well-being. The study also aims to identify rural-specific barriers, such as transportation, seasonal work patterns, and stigma around seeking psychological support, and to uncover facilitator factors such as integration with primary care, local employer engagement, and culturally sensitive coaching practices. Contribution to knowledge The research will provide empirical evidence on the feasibility, effectiveness, and mechanisms of career adaptation coaching in a rural clinic, contributing to the literature on applied career development within primary care settings. It will offer a context-sensitive framework for implementing coaching interventions in resource-limited environments, including fidelity indicators and a theory-informed interpretation of outcomes. The findings will inform policy and practice by outlining scalable training requirements for clinicians, adaptation of coaching protocols to rural labor markets, and guidelines for integrating career adaptation services with general health care. Conclusion and recommendations The study is expected to conclude that structured career adaptation coaching delivered within rural clinic settings enhances employability, self-efficacy, and well-being, with effects mediated by autonomous motivation and narrative self-formation. Recommendations include adopting blended delivery models to accommodate transportation constraints, leveraging tele-coaching for remote access, forming partnerships with local employers, and embedding career conversations into routine primary care workflows. Further research should examine long-term sustainability, cost-effectiveness, and cross-cultural applicability across diverse rural contexts.