• Fresh Views

    Flipping the Paradigm: Applying a Solution-Focused Approach to Healthy Eating

    Problem talk creates problems, Solution talk creates solutions. – Steve de Shazer

    Tasty, healthy grilled mussels in garlic and lemon

    We are excited to launch into a 7-week series on applying a solution-focused approach to the AADE7 Self-Care Behaviors for managing diabetes. As you probably know, the AADE7 is a framework for organizing diabetes self-management education and support and for identifying key areas that may require behavioral changes to manage diabetes.  The 7 categories are:

    For those of you that follow our blog, you know that we are passionate about flipping the conversation from a “problem focused” (traditional medical) approach to a solution-focused conversation. We are advocates for the use of person-first, empowering language when speaking with and in reference to people with diabetes. #LanguageMatters in diabetes care and education; problem centered talk can make speaking about and managing diabetes more challenging.

    Each of the next seven weeks, we will focus on one of the above self-care behaviors and provide 3 practical illustrations of how to flip the conversation around it to solution-focused talk.

    AADE7 Self Care Behavior #1: Healthy Eating 

    “What can I eat?” is the #1 question asked by people with diabetes when they are diagnosed. Without a doubt it can be a confusing, challenging, and sensitive ongoing area of diabetes management. 

    Often the healthy eating discussion focuses on foods to avoid and “what went wrong” when blood glucose was out of range. The conversation continues with discussion on how to prevent that from happening again. This approach to eating can be painful and result in feelings of blame and shame. A solution-focused approach changes the dynamics of the conversation.  It helps flip the focus to what is working well and building upon existing strengths.

    Instead of focusing on what is not working well or what is “wrong”, here are 3 illustrations of how to flip the conversation:

    Try this: I noticed that you are drinking sweet tea or soda only three times a week now instead of every day. How have you been able to do that? 

    Instead of this: Are you still drinking sweet tea and soda? 

    Try this: I hear you saying that you’d like to lose 20 more pounds. I’m noticing you are down 5 pounds since we last met. I’m really proud of you. What do you think helped you lose those 5 pounds? 

    Instead of this: I hear you saying that you’d like to 20 more pounds. I see you’ve only lost 5 pounds. What have you been eating?

    Try this: We’ve been talking about trying to work in more non starchy vegetables at dinner to help fill you up without raising your blood glucose. How many days a week do you think it’s reasonable to start with? On a scale of 0-10, where 0 is not all and 10 is I can definitely do this, where would you rate yourself? 

    Instead of this: We’ve talked about trying to work in more non starchy vegetables to help fill you up. I want you to eat one at lunch and dinner every day. 

    Be a think partner

    During a solution focused conversation, the diabetes care and education specialist acts as the “think partner” in developing solutions by asking questions and helping the person with diabetes to use their own personal strengths to create solutions that work for them. 

    When you meet again, here are 3 follow-up questions to try:

    • What’s been better since our last session?
    • What skills did you draw upon to make changes?
    • What do you know about yourself that lets you know you can achieve what you want?

    We’ll challenge you each week to try incorporating some flips into your conversations and let us know what impact they have.

    Join us next week as we discuss a solution focused-approach to Being Active!

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou

  • Fresh Views

    Seeing with new eyes: Perceptions of life with diabetes

    The real voyage of discovery consists not in seeking new landscapes, but in having new eyes. – Marcel Proust 

    A view of La Sagrada Familia through an arch on the roof of Casa Mila in Barcelona, Spain

    #EASD2019 is a wrap! Hi this is Deb this week. I represented @AFreshPOVforYou at the 55th Annual Meeting of the European Association for the Study of Diabetes (EASD) conference in Barcelona where I was excited to share the results of our study (more about that below). I learned much at the meeting, connected with friends and colleagues, and met Twitter followers in person for the first time! I also had time to do a little sightseeing and take in the food and culture of Barcelona!

    Front entry of the EASD 2019 meeting, Barcelona

    Our abstract, Perceptions of life with diabetes revealed through a solution focused brief therapy exercise via Twitter, was presented on the final day of the conference in a very large room. Often many people leave for home the last day of the conference so I feared the room would be empty, but it was not! Given that this was the only session addressing the psychology of diabetes, there was a great crowd. The presentation focused on the use of the Miracle Question, a solution-focused tool, to help people overcome challenges by using “solution talk” rather than “problem talk.” We wrote about it in our blog post about our AADE presentation here and here describing our World Diabetes Day 2018 #DSMA Twitter chat.

    I try to start all of my presentations with a slide reminding the audience (or sometimes educating them for the first time) that #LanguageMatters when speaking with or about people with diabetes. You can read our past blog posts related to this here and here.

    #LanguageMatters slide

    I asked for a show of hands to see how many in the room were familiar with the Miracle Question approach. I only saw one hand raised. Since this was a 15-minute research presentation, it was hard to cover a lot of the background, so the focus was on the study outcomes. It was exciting to see lots of Tweets about the presentation and that the concept of a solution-focused approach was being spread across the Twitterverse. You can read the full abstract here

    We have submitted the complete data to be published (fingers crossed that happens soon!). However, in brief, when we employed the Miracle Question approach during a Twitter chat there were five themes that evolved.  That means that these were the most common threads, thoughts, comments that were expressed by those who participated in the chat. The themes were: more of living life; laughter and humor; self-compassion; resilience; and support.  

    Deb at the podium presentation

    There were several questions at the end of the session and many people came up to talk about the approach. In fact, several researchers shared with me about their research and how they could see incorporating a solution-focused approach into their research study.  It was very exciting to see the interest in this tool.

    Most of the comments and questions were positive. Interestingly, one questioned the value of having people “think less” about their diabetes, and worried that diabetes management would be hurt. I responded by saying that Dana Lewis (creator of Open APS) might disagree. When I heard her speak earlier in the conference she indicated that with her Open APS system, she thinks less about diabetes, including not having to bolus when she eats carbs.The theme of “more of living life” meant different things for different people.  The Grumpy Pumper (Chris Aldred) commented, “For me, the issue isn’t how often I think about my diabetes, it’s the type of thoughts. Looping hasn’t made me think less, but my thoughts are more positive because I’m seeing the results I want.”  This was a great perspective. The overarching message was that they wanted to focus on the positive aspects of life.

    It’s important to acknowledge that people engaged in a diabetes Twitter chat are likely very engaged in their diabetes management. There was a question if the process would still be successful in others. We agree that we have the same questions and hope to conduct additional research in this area in the future.  

    We also had a Diabetes Online Community (DOC) advocate @Blue_sugar_cube reach out and ask how she and the DOC could get involved with our work. That was exciting! As well as seeing a few new subscribers to our blog!

    And lastly, a big thanks to @WeRateTalks on Twitter who gave our talk an 11/10!  Wow! We were honored!

    We’ll be seeing some of these diabetes friends in Busan, South Korea for the International Diabetes Federation Congress where Deb will be speaking on two panels, one on #LanguageMatters and one on digital health. 

    Kellie, Karen, Grumpy, Renza, Deb and Donna at the end of our presentation

    By sharing a solution-focused approach to diabetes management with a worldwide audience we hoped to inspire people to think differently and consider incorporating a solution- focused approach in their practice.

    We began this post with the quote, The real voyage of discovery consists not in seeking new landscapes, but in having new eyes by Marcel Proust . We’d like to encourage health care professionals to “have new eyes” when they think about diabetes management, and be open to new tools and solutions. 

    If you’re a researcher and would like us to consult on a future research grant, please reach out – we’d love to chat!

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou

    Disclaimer: A Fresh POV for You is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com. 

  • Fresh Views

    Fresh Start in the Fall

    All endings are also beginnings. We just don’t know it at the time. – Mitch Albom

    Autumn on the Saint Lawrence river in Quebec

    Monday September 23rd heralded in the official start to Fall! For many, Fall signals an ending…the end of carefree summer break for kids, and depending on where you live, the end of warm weather, the end of long sunny days, and the end of leisurely weekend afternoons on the lake or by the pool. 

    But with that “ending” comes striking new “beginnings”. The air takes on a crispness. The trees magnificently change colors and leaves begin to fall. And we enter a season of waiting. All necessary to make way for the new. 

    With the start of Fall, today we share 3 solution-focused fresh starts for Fall: 

    1 – Spend time in reflection. Fall is a great opportunity to take a look back at the past months and summarize your accomplishments in all aspects of life. And to remind yourself what’s gone well. This can help bring fresh perspectives, set priorities and inspire you to consider new possibilities. Life in general brings constant challenges, not even to mention life with diabetes. We encourage you to focus on what has worked. How can you make that happen more often?

    2 – Practice gratitude. Fall is a time of gratitude with Thanksgiving around the corner. Reflect on what you are grateful for and what brings  you joy, especially if life is seeming challenging and burdensome. Feeling thankful for the experiences and emotions they brought you. Read our gratitude blog to get some ideas on some gratitude practices

    3 – Sum up the results and start something new. Building on fresh starts 1 and 2, that “something new” may be self-improvement activities, setting new goals, or devoting more time to the things in life that bring you joy and contentment. Read our past blog on finding joy in life and diabetes education services.  Many programs, workshops and events start in September and October, so it’s the perfect time to enroll. Or it maybe time to take up reading a new book to nourish your soul and help you know yourself better. If you live with diabetes and have not read Adam Brown’s book, Bright Spots and Land Mines, we encourage you to put this on your reading list. The bright spots discussed in his book are very similar to “exceptions” in a solution focused approach. You can read our interview with Adam here.

    Rather than think of Fall as ending, think of it as a beginning of something fresh and new.

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, we invite you to subscribe to our blog, and we will send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Subscribe to our blog and we’ll email you when a new post is published!

    Follow us on Twitter and Instagram @AFreshPOVforYou

    Disclaimer: A Fresh POV for You is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com. 

  • Fresh Views

    Relatable Individualized Solution-focused Education: A Sneak Peek from the @AFreshPOVforYou Retreat

    Relax. Refresh. Renew. Play. Sing. Laugh. Enjoy. Forgive. Dance. Love. Hug. Share. Kiss. Create. Explore. Hope. Listen. Dare. Trust. Dream. Learn. TODAY! ― Steve Maraboli, Unapologetically You: Reflections on Life and the Human Experience


    A view of the gardens at the West Baden Springs Resort in French Lick, Indiana

    We posted this blog back in April during our Fresh POV for You retreat. There continues to be much interest in our work! Since we are traveling this week to present some of our research at the European Association for the Study for Diabetes (EASD) conference in Barcelona, Spain, we thought it timely to revisit this post with a few updates!

    In the spirit of travel, this week’s blog is a re-post from French Lick Indiana, home of Larry Bird of Celtics fame, and also the French Lick and West Baden Springs resorts. Working together, but on opposite ends of the country, (Tami in Kentucky and Deb in California) means we have to be creative finding opportunities for in-person meetings. Luckily, things came together……. a spouse work meeting in Ohio, and a visit with a son the Maurer School of Law at Indiana University, created the opportunity for our first formal @AFreshPOVforYou board meeting.

    Over the past several months we have been exploring ideas around creating innovative diabetes education programs and services that are co-designed by people living with diabetes or prediabetes. Basically that means, we are attempting to actively involve people with or at risk for diabetes in the design process to ensure the end result meets their needs.

    If you’ve been reading our blog, then you know that we love “fresh views” and spending time together enjoying beautiful scenery and experiences.  We feel energized and are more creative thinkers when we take a break, are relaxed, seeing things from a new perspective, laughing together, and often with a nice glass of wine!


    Enjoying a horse and carriage ride through the Indiana countryside

    Over the past year we’ve been planning, thinking, strategizing, writing and sharing our ideas with others in the diabetes community to make sure we are on the right track. Incorporating our practice of using solutions focused coaching, we’ve been asking ourselves, “What’s working well for us and what do we want to do more of?”  On a personal note, a few of those replies include the following:

    • Do hard work in the morning when our minds are most creative
    • Take activity breaks
    • Embrace humor
    • Incorporate things that make us happy and that we find joy in
    • Express gratitude for what we see and experience
    • Plan for future retreats to keep us on track and advancing our vision

    We’ve taken a set of possibilities and turned them into opportunities and are excited to see our vision for the future starting to become a reality! Our March 20, 2019 blog shared learnings from a Twitter chat that we co-hosted with the diabetes online community focused around what would bring joy when engaging in diabetes education services. We had some insightful and amazing feedback. We decided that we really needed to dig deeper, and find more opportunities for people living with or at risk for diabetes to guide us as we design programs and services. So following the Twitter chat we released a survey and had a fantastic response. We followed up the survey with some focus groups.

    We have learned that many are not happy with the diabetes education services they have received in the past and there’s great opportunity to innovate and evolve. We had similar responses from both the Twitter chat, survey and focus groups.  People are interested in community and learning from others living with diabetes; they want individualized education and not a “canned program”; and they want to be an equal team member whose experience and knowledge is valued and appreciated.

    For our focus groups, we employed MDR Consulting, a national business research firm to conduct and summarize the data for us so we can learn more and identify how we might design programs and services that will provide relatable, individualized, solution-focused education (and actually bring people joy)! Our goal is that the voice of the person living with diabetes will be clear and lead the way.

    As a thank you for our focus group participants, we’ve been engaging in complimentary solution-focused coaching sessions with them. These interactions have truly brought to light the value and benefits of a solution-focused coaching approach (rather than focusing on trying to “fix problems”).

    We are excited for the future and our next steps! We’ve been writing and have submitted papers to a couple of journals that we are hopeful will be published soon. We’re excited to be presenting some of our research Friday at the EASD conference. And, we’re in the planning stages to conduct a research study incorporating solution-focused coaching. Exciting times!

    Thanks for being on this journey with us. We look forward to sharing our goals and dreams with you and are eager for your feedback.

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, we invite you to subscribe to our blog, and we will send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Subscribe to our blog and we’ll email you when a new post is published!

    Follow us on Twitter and Instagram @AFreshPOVforYou.

  • Fresh Views

    Barcelona Bound: Look ahead to EASD 2019

    Basílica de la Sagrada Família, Barcelona, Spain

    A Fresh POV for You is excited to head out to Barcelona, Spain, one of our most favorite cities in the world! We are honored to be presenting an oral podium presentation at the 55th Annual Meeting of the European Association for the Study of Diabetes (EASD)

    Tami was last in Barcelona at this same conference six years ago, and not only learned a lot about diabetes prevention and management, but fell in love with the one-of-a-kind work of genius Spanish architect Antoni Gaudi throughout the city! You see one of the Gaudi houses above that Tami snapped. And below is his main work, the towering Basílica de la Sagrada Família, still under construction more than 135 years after the laying of the cornerstone. This  picture was from six years ago. This trip, Deb will be taking a walking tour of La Sagrada Familia with Take Walks,  a great way to get some physical activity in while doing some sightseeing. Looking forward to seeing the progress as construction continues. It is expected to be completed in 2026. 

    This annual Meeting of EASD is held in a different European city each year. It draws more than 15,000 delegates from over 130 countries and includes around 1,200 talks and presentations on the latest results in diabetes research by leading experts in the field. This meeting is highly scientific, and a majority of the oral sessions and posters focus on new diabetes treatments, understanding diabetes complications, and the physiology of diabetes care and prevention.

    A Fresh POV for You presents

    This year 2,003 abstracts were submitted – ours was one of the 1195 accepted for inclusion. Of all those sessions, there is only one oral symposium addressing the psychological side of living with and managing diabetes. That happens to be our session! Friday, 11:00-12:00 PM, in Ochoa Hall,  Integrating psychology into diabetes care. There are four research sessions in this symposium.If you plan to attend this conference, we invite you to join our presentation.

    We will be sharing findings from our research on “Perceptions of life with diabetes revealed through a solution-focused brief therapy exercise via Twitter”. Many of our readers participated in this Twitter Chat and provided important and insightful perspectives that led to the fascinating findings we will present. 

    Five sessions of interest

    A new diabetes questionnaire to add patients’ perspectives to diabetes care: a nationwide cross-sectional study among adults with type 1 and type 2 diabetes M. Svedbo Engström, J. Leksell, U.-B. Johansson, S. Borg, B. Palaszewski, S. Franzén, S. Gudbjörnsdottir, K. Eeg-Olofsson, Sweden 

    This presentation will discuss the research completed to validate a new self-rated diabetes questionnaire (NDR-PROM).  Their data confirms that these questions add patients’ perspectives of living with diabetes and support experienced from diabetes care.

    Association of personality traits with continuous glucose measurement parameters in type 1 diabetes adults treated with personal insulin pumps T. Klupa, B. Matejko, M. Flakus, S. Mrozińska, Ł. Tota, M. Morawska, B. Kieć-Wilk, M. Malecki, Poland 

    This session sounds very interesting. The authors looked at the relationship between the Big Five personality traits and treatment outcomes in adults with type 1 diabetes (T1DM). Ultimately, these traits can help tailor diabetes management to individuals.  At A Fresh POV for you we are all about tailoring treatment and focusing on the unique strengths of the individual.

    Perceptions of life with diabetes revealed through a solution focused brief therapy exercise via Twitter D.A. Greenwood, T. Ross, E. Reifsnider, USA 

    During our session we will share the findings from our Twitter study.  We implemented the Miracle Question (MQ) approach, one tool in the Solution Focused Therapy tool-kit, to enhance resilience and confidence to manage diabetes.  We will expand upon the five themes that emerged from the data in response to the MQ and the desired future state including: more of living life; laughter and humor; self-compassion; resilience; and support. 

    Ketoacidosis hospitalisations among people with type 1 diabetes are associated with increased risks of rehospitalisation for suicide attempt J. Petit, K. Goueslard, J.-C. Chauvet-Gelinier, B. Bouillet, B. Vergès, C. Quantin, France  

    This presentation will share results from a study that identified that people with a past history of being hospitalized for ketoacidosis or hyperglycemic coma have a higher risk of being re-hospitalized for suicide attempt within 7 years. The risk increases with more hospitalizations. This is new information for us, and seems incredibly important to share.

    The EASD/ADA Symposium: Digital apps for diabetes treatment and prevention: opportunities and challenges  If you follow us, you know that we are very interested in the use of technology to improve diabetes care. We look forward to attending this session on Wednesday evening at 5:30 pm and hope it will address using a strengths-based, empowering approach to reviewing diabetes data. 

    A poster session of interest 

    D-PS 064 Psychological aspects of diabetes With posters that range from addressing anxiety and depression in diabetes, to eating disorders and fear of hypoglycemia, 

    Our goal

    Our goal, as we present at conferences this coming year, is to bring attention to the concepts of solution-focused brief therapy and coaching. To focus on “exceptions” (those times the problem could have happened but some how did not) or situations that are going well, instead of always focusing on the problems that need to be fixed. If we spend our time using a strengths based approach we can envision possibilities and opportunities to help people move forward towards their unique vision of their future. 

    After the conference we’ll be sharing more learnings with you!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, we invite you to subscribe to our blog, and we will send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Subscribe to our blog and we’ll email you when a new post is published!

    Follow us on Twitter and Instagram @AFreshPOVforYou

    Disclaimer: A Fresh POV for You is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com.

  • Fresh Views

    AADE’s Project Vision: Positive Change is Coming!

    Every positive change in your life begins with a clear, unequivocal decision that you are either going to do something or stop doing something. – Anonymous

    Are you familiar with the American Association of Diabetes Educators (AADE) and their Project Vision? Whether you are a diabetes care and education specialist or someone living with diabetes, AADE’s Project Vision may positively impact you! 

    Who is AADE?

    If you’re not familiar with AADE, it is an interdisciplinary professional membership organization dedicated to improving prediabetes, diabetes and cardiometabolic care through innovative education, management, and support. AADE has a vast network of more than 14,000 practitioners working with people who have, are affected by, or are at risk for diabetes. AADE is a key influencer and resource in the diabetes space.

    AADE’s Project Vision: What you need to know

    AADE has recently launched a multi-year, transformational initiative known as PROJECT VISION. The goal is to position diabetes educators for success within a dynamically changing environment, elevating their role as integrators for clinical management, education, prevention and support.

    6 key strategies of Project Vision

    Project Vision encompasses 6 key strategies with a framework to guide the diabetes care and education specialty to evolve by enhancing the skills and education, and re-directng resources:

    1. Drive Integration. This strategy focuses on integrating the clinical and self-management aspects of care so that care is holistic and seamless.
    2. Include Related Conditions: Strategy 2 acknowledges that diabetes isn’t an isolated health condition. Diabetes educators will demonstrate expertise in the full range of cardiometabolic conditions including diabetes, obesity, hypertension and cardiac disorders.
    3. Focus on Behavioral Health: Foundational focus is on supporting the emotional well-being of the whole person with diabetes.(The AADE Project Vision web page has a great blog post by Dr. Nicole Bereolos about behavioral health that is well worth the read!)
    4. Leverage Technology: Diabetes educators will be technology experts and data interpreters, trainers, and consultants driving care. 
    5. Promote Person-Centered Care: AADE will continue to advocate that every individual with diabetes and cardiometabolic conditions has access to a diabetes educator.
    6. Achieve Quadruple Aim: The quadruple aim in healthcare focuses on better outcomes, improved patient experience, lower costs, and improved clinician experience. 

    Positive change is coming!

    What this means is that positive change is coming! This excites us here at A Fresh POV for You! Our work aligns with several of these strategies:

    • Promote Person-Centered Care. Read about how we use co-design here.
    • Leverage Technology. Read about our review of sessions at #AADE19 here
    • Focus on Behavioral Health. Our guess is that you already realize this is a big focus for us. Our #AADE19 presentation was in the behavioral health track titled The Miracle Question Applied to Diabetes. Of note, our session was standing room only, which we think indicates an interest, need, and willingness of diabetes clinicians to learn more behavioral techniques and approaches to add to their tool box.

    Diabetes Care and Education Specialists

    At the AADE business meeting at #AADE19 in Houston last month, AADE President Karen Kemmis unveiled the new name for the specialty, evolving from Diabetes Educator to Diabetes Care and Education Specialist! Through a recent AADE survey, most current educators respond that their work involves much more than education, including clinical management components.  The survey data overwhelmingly demonstrated that diabetes educators felt a name change would not only more accurately reflect the work being done but also would raise the level of respect for the specialty. Ideally, resulting in more referrals, increased access to services and more opportunities for all. 

    Our hope

    Our hope is that as Project Vision continues to reframe and reshape the practice and the specialty, that more diabetes care and education specialists will embrace a solution-focused approach to care, and incorporate the techniques such as those we share via our blog and through presentations and papers (be on the lookout for an article in AADE in Practice journal next spring!).

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, we invite you to subscribe to our blog, and we will send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Subscribe to our blog and we’ll email you when a new post is published!

    Follow us on Twitter and Instagram @AFreshPOVforYou


  • Fresh Views

    5 Solution-focused Strategies for Labor Day Gatherings

    Marblehead Harbor, Marblehead, MA

    Labor Day is just a few days away! This first Monday in September celebration often is heralded in with gatherings amongst family and friends. Sometimes it can be challenging to maintain healthy lifestyle habits around holiday gatherings, especially if everyone is not on the same page. It’s helpful to have strategies that work at the ready. Today we want to share with you 5 solution-focused strategies for navigating Labor Day gatherings so you feel satisfied and won’t feel that you missed out on a thing.

    5 Solution-focused Strategies for Labor Day Gatherings

    #1 – Bring something to share that incorporates seasonal produce. Many of the food traditions associated with Labor Day are filled with the best summer has to offer. Not only is flavor at its peak, seasonal produce is packed with nutrients (and lower in cost). Below you see a variety of beautiful tomatoes. 

    An easy, colorful, flavorful salad with Tami’s crew is simply chilled diced tomatoes and cucumbers tossed with light Italian dressing. The flavor intensifies if the salad is chilled 30-60 minutes before serving. (Stir it up and pop in the cooler. It will be good to go by the time you arrive at the gathering).

    Seasonal tomatoes and fresh berries

    Another well-loved side dish is roasted carrots. They’re low in carbohydrate, high in flavor, and won’t keep you hanging out in the kitchen. Toss sliced or diced carrots with some olive oil, kosher salt, and black pepper. Roast at 425 degrees in an even layer on a sheet pan until fork tender (about 20-25 minutes). 

    Roasted carrots

    #2 – Make a swap or two. Consider the foods that are often at Labor Day gatherings and determine where you can make a swap or two for health. One of our favorites is swapping lean turkey burgers in place of hamburgers. Maybe everyone doesn’t want a turkey burger, but having a few on the grill is a tasty option for those trying to be health conscious.

    Turkey burgers and zucchini

    Another delicious swap is spiralized zucchini salad in place of traditional macaroni or pasta salad. Raw fresh zucchini is crisp and delicious with little carbohydrate. A spiralizer  is a handy, inexpensive kitchen tool.  Here’s a simple way to make a zucchini salad with a Mediterranean flair (you can find more Mediterranean swaps and ideas in our July 17, 2019 blog here.) 

    #3 – Portion your plate by the healthy plate for diabetes. As we shared in our July 3, 2019 post, when you are ready to sample the celebration spread, if there’s a choice on plate size, go with a smaller plate (maybe the ones that are out for salads or desserts). Then fill half the plate with non-starchy vegetables (such as veggie salads, green beans, or sliced tomatoes), one fourth of the plate with lean protein foods (such as a grilled turkey burger or grilled chicken), and one fourth with carbohydrate foods (this is where potato salad, corn on the cob, or a sweet treat may fit). Partitioned paper plates can do the portioning for you. Not sure partitioned paper plates still exist? Here you go, just a click away.  When asked how high one can “pile the plate”…try to keep it no higher than a deck of cards is thick. This simple strategy has brought success for many when navigating picnics and celebrations. 

    Lobster salad with a light dressing, vegetables, healthy fat and 1/4 portion of potatoes

    #4- Go on a walk early in the day. We are believers in making a commitment to move even more when we know there is a weekend or vacation ahead filled with a few indulgences. Taking a walk early in the day (as you’ll see us doing with our husbands on a holiday escape to Chicago), makes sure that movement doesn’t get pushed out by other holiday activities. And if you find blood glucose out of range 1-2 hours after you eat, take another walk to help lower blood glucose.

    Mike, Tami, Deb & Mark, Walking along Lake Michigan, Chicago, IL

    #5 – Focus on fellowship and laughter. We believe that laughter is the best medicine, and we try very hard to practice what we preach. Scientists have shown that laughter is a great stress reliever and causes mental relaxation. Laughter can even improve blood pressure, pain, and immunity. Most importantly it strengthens human connections when we laugh together. There is now actually “laughter therapy” defined by the National Cancer Institute as therapy that uses humor to help people cope with medical conditions by relieving pain, stress and improving well-being. 

    Tami and Deb enjoying some “laughter therapy”

    You’ll find 4 more of our tried and true solution-focused strategies for picnics and celebrations in our July 3, 2019 post. 

    As you prepare for Labor Day gatherings, we challenge you to consider the following:

    • What strategies have worked well for you in the past to navigate picnics and gatherings? 
    • Which of the strategies that we’ve shared might help you? 
    • Choose at least one of those to put into practice on Monday

    We’d love to hear from you on strategies that worked for you! Happy Labor Day!

    Tami and Deb, Highland Beach, FL

    Subscribe to our blog and we’ll email you when a new post is published!

    Follow us on Twitter and Instagram @AFreshPOVforYou.

    Disclaimer: A Fresh POV for You is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com. 

  • Fresh Views

    The Miracle Question Applied to Diabetes at #AADE19

    You had the power all along, my dear – Glinda the Good Witch from the Wizard of Oz

    River pool at the Marriott shaped like the state of Texas!

    #AADE19 is a wrap! And what an exciting (and scorching) week we had in Houston, TX! The over 100 degree temperatures kept us from venturing outside much, but we enjoyed the view of the Texas shaped lazy river just outside our hotel window.

    Change is here!

    It’s difficult to describe the thrill of being immersed in learning through cutting edge, high quality sessions with more than 3000 other people passionate about supporting individuals affected by diabetes to live long and happy lives. And to learn that our specialty (formerly Diabetes Educator) has a new name: Diabetes Care and Education Specialist! This repositioning and new title fully acknowledges us as trusted experts of the integrated care team that provide collaborative, comprehensive, and person-centered care and education to people with and at risk for diabetes. Woohoo! More to come!

    Taking a solution-focused approach to managing diabetes

    A description of our presentation “Applying the Miracle Question in Diabetes” at #AADE19 can be found in the online conference planner. We were honored to be one of the over 130 sessions attendees could choose from. Can you see the joy in our faces below at the crowd filling the room (late on a Friday afternoon nonetheless) to learn about taking a solution focused approach to managing diabetes rather than a “traditional problem-focused” approach? 

    Tami and Deb getting ready to present at #AADE19

    In quick illustration, here’s a comparison from one of our slides showing how a solution-focused approach differs from a traditional counseling approach. The traditional counseling approach tends to focus on what’s “wrong” and identifying how to “fix” it, whereas a solution focused approach focuses on those times when things are going well, and leveraging those past successes to do more of what’s going well. 

    What is the Miracle Question?

    The Miracle Question applied to diabetes is one tool or technique, if you will, that can be implemented as part of a solution-focused approach to help clients envision a future that is more problem-free. You can learn more about the Miracle Question applied to diabetes in a previous blog post here. The Miracle Question has powerful impact. It is creative, bold, healing, a bit mysterious sounding (and has a cool name!). It allows a person to step out of their current problem story to a time when the problem occurs less. It helps people identify “exceptions” or times when the problem doesn’t occur, but could have.  We think of exceptions as similar to “Bright Spots” (From Adam Brown’s Bright Spots and Landmines) or times and choices that work well for people. The Miracle Question challenges a person to look past their obstacles and feelings of hopelessness to focus on possibilities, opportunities and a vision for the future. (Hmmm sounds like the Mission of @AFreshPOVforYou!). The goal is to help one identify what they’ve actually known all along, and that they have the power to make choices and changes that can move them forward. 

    We value the voice of those that live with diabetes every day and listen intently to inform our work. We have some intriguing findings from a study we conducted that will be presented in September at an international diabetes conference, the European Association for the Study of Diabetes, in Barcelona, Spain. And other insightful learnings to guide our work from focus groups, surveys, and interviews we’ve conducted. Many have asked if we’ll share that information. Stay tuned!  We will soon reveal more through three peer-reviewed publications – one of those being an international publication.  

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, we invite you to subscribe to our blog, and we will send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

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    Disclaimer: A Fresh POV for You is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com.

  • Fresh Views

    Doing things differently: Using solution focused questions to build a therapeutic alliance

    Tami’s photos from the Chihuly glass sculptures exhibit at the Biltmore Estate in Asheville, NC. She did things differently by not only viewing the exhibit in the daylight, but also after dark, and got an entirely different perspective.

    Doing things differently leads to something exceptional. – Anonymous

    We’re just returning home from the fantastic #AADE19 Annual Meeting and look forward to sharing some new information next week. Today enjoy an encore post from this past march where we discussed the concept of a Therapeutic Alliance!

    The strength in a therapeutic alliance

    As you may know, we strongly believe in the concept of a “therapeutic alliance” (which you may also know as the “helping alliance” or the “working alliance”). This alliance refers to the relationship between a healthcare professional and the person with diabetes by which they engage with each other to bring about beneficial change for that person with diabetes. This relationship is a most important component.

    The power of language

    It’s near to impossible to create those connections and build that alliance without focusing on language. Language and word choice is one of the most powerful choices we have. Words can demonstrate respect, empowerment and support or words can shame and blame. Respecting the expertise and experience of the person living with diabetes is essential to develop a strong therapeutic alliance.

    Focusing on solutions, not problems

    You also probably know that we are using solutions focused brief therapy (SFBT) and coaching in our work. SFBT is a questioning approach with conversation focusing on the client’s vision and how he/she identifies potential solutions. The questions asked during the interaction focus on a desired future state, and on what is already working well for that individual in the present. We acknowledge that the client has all the skills necessary to achieve their goals. As we mentioned last week, our goal, through incorporating principles of SFBT and coaching in diabetes care and education, is to change the conversation, the interaction and the experience of the diabetes community to improve health.

    10 questions practitioners can use to build a therapeutic alliance

    If you are a healthcare practitioner, we want to share 10 questions that you might find useful when engaging in discussions with patients or clients to acknowledge and build the therapeutic alliance. These questions reinforce the human side of both parties. They demonstrate that you care about the person sitting with you and that the relationship between you is important. Moreso, the word choices and body language during the interaction can go a long way towards creating a relationship of mutual respect.

    1. Thank you for coming in. Tell me what’s been going on. What can I help you with today?
    2. What do you wish to achieve or learn by the end of this session so that you can say you’re glad that you were here?
    3. What is the best way for me to work with you? (For example, do you prefer talking on the phone or text messages?)
    4. So that I can learn more about you, what do you consider your assets and strengths?
    5. Is there anything else you’d like to share that I should know?
    6. When you are at your best, what does that look like? How is that different from the way things are now?
    7. How can you do more of what is making things go well?
    8. If we created a plan, what would you consider a start to your being on the right track? And what else?
    9. What can you take from this session that can help you in the coming weeks?
    10. What will you be doing differently after the visit?

    Here are 3 additional questions that can be used to glean insight and feedback on the interaction:

    1. What feedback would you like to give me about today’s session?
    2. On a scale of 0-10, to what extent did you feel heard, understood, and respected during this session? 0 being you did not feel heard, understood or respected at all.
    3. On a scale of 0-10, to what extent did we talk about and work on the things that are important to you during this session? 0 being not at all.

    If you try incorporating some of these questions, we’d love to hear from you about your experiences and if you felt differently during your client visits. We leave you with 3 things to consider:  

    • Do you feel more present and “conscious” during the visit?
    • Do you feel like a “human” first and a practitioner second?
    • Do you notice that your clients are achieving their goals, and most importantly, are they feeling more confident in their ability to live well while managing diabetes?

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    Disclaimer: A Fresh POV for You is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com.

  • Fresh Views

    #AADE19 Sessions (Part 2)

    More Behavioral Health, Language, Peer Support, Tech & Social Media 

    The long awaited #AADE19 Annual Meeting in Houston August 9-12 is here! Tomorrow we’ll be on a plane headed to Houston to join more than 3700 diabetes educators and other healthcare professionals at the American Association of Diabetes Educators (AADE) Annual Conference. It is the premier educational and networking event for diabetes educators. Can you tell we’re excited??

    Tami and Deb at AADE a couple years back, with now AADE President Karen Kemmis

    Last week we shared the sessions that peaked our interest to catch on Friday. And today we’re sharing a look at the sessions we’ve highlighted in our online planner for Saturday-Monday.  As you will see, many overlap. So much great content, so little time to catch it all!. So, if you’re joining us in Houston and haven’t had a chance to look at sessions yet, here’s a glance at the top twelve we’re excited about and which again focus on behavioral health, how to impact behavior change, and the use of peer support. To keep it simple, we pulled out the session descriptions for you and reviewed uploaded slides when available. You can find all of this information in the Online Planner.  

    Saturday August 10, 2019

    S03 – 9:15-10:15 am AADE’s Practical Approach to Mental Health for the Diabetes Specialist by Shannon Eaves, Jasmine Gonzalvo, Jay Hamm, & Cynthia E. Muñoz

    Description:

    The AADE practice paper A Practical Approach to Mental Health for the Diabetes Educator describes common psychosocial considerations in people with diabetes (e.g. depression, anxiety, diabetes distress, disordered eating, etc.), the pharmacological impact of relevant medications, appropriate assessment and referral strategies, and effective communication practices. During this presentation, the authors of the paper will review the content of the paper and expand on specific aspects, including clinical scenarios to highlight real world implementation of the assessment and referral recommendations.

    Our take away:

    The dynamic duo of Jasmine Gonzalvo and Jay Hamm are two of the speakers on this panel who will review the practice paper findings and discuss medication therapy. We predict this session will be well attended. 

    S16A – 1:00pm-1:30pm Online and In-Person Peer Support for Underserved Populations by Michelle Litchman, Cherise Shockley and Heather Walker

    Description:

    Support for individuals with diabetes is recommended per the 2017 DSMES National Standards; however, it is not always easy to identify support resources, especially for underserved populations. In this session, online and in-person support specific to those with different ethnic, language, abilities and diabetes type will be discussed. This session will provide diabetes specialists with tools for identifying, creating, and referring to support resources.

    Our take away:

    This team is well known in the diabetes support space and we look forward to learning from them.

    S16B – 1:30-2:00 pm Create Lasting Behavioral Change in African Americans with Diabetes by Sharon Evette

    Description:

    African Americans have one of the highest rates of diabetes in the US. Diabetes specialists play a significant role in addressing cultural barriers which enable diabetes self-care. The Change Model addresses the person’s level of growth by helping them identify goals and develop strategies for long term self-care behavior change.

    Our take away:

    We’re interested in learning about their process. In the 7-step process of change they describe, step 2 is establishing a “vision” which is in alignment with what we are trying to do here @AFreshPOVforYou , and aligns with the Miracle Question exercise we’ll present on Friday.  If you’d like to read more about the Miracle Question, we are fans of this book

    S21A – 3:15-3:45 pm Making Space for Lurkers in Peer Support: A Community-Supported Approach to Engagement by Anna Norton and Heather Walker

    Description:

    Peer support in diabetes has been shown to positively impact the health of those who actively participate; however, only one recent study points to the power of a lurker. In this session, the role of the lurker will be introduced and highlighted in the context of diverse populations. The session will conclude with strategies to include underserved and low-income adults generally not reached through traditional peer support programs.

    Our take away:

    These powerhouse women are strong advocates of peer support and are fantastic speakers. We love the concept of lurkers as being truly a part of the community, learning and engaging in a way that works for them. Not everyone has the same needs, desires and abilities. We support all.

    S28-4:30-5:30 Beyond Coping: Raise Your Spirits, Not Your Blood Sugar, by Maggie Hunts

    Description:

    This interactive and musical presentation incorporates key methodologies to improving diabetes care for the specialists and the person with diabetes. Be uplifted by musical parodies about living with diabetes, as you learn key ways to reach individuals.

    Our take away:

    While this presentation seems like it will be a lot of fun, we were attracted to the solution focused approach described in the slide deck. She emphasizes starting with “wins” to build on what’s working and to teach seeing “victories” no matter how small. Love this! Tami will catch this one since Deb will be presenting another session at the same time.

    S25 – 4:30-5:30 pm Use of Social Media and Peer Support in Diabetes Care: A Panel from AADE Project Leaders by Deborah Greenwood, Ashley Ng, Michelle Litchman and Hope Warshaw

    Description:

    This panel presentation will share findings, tools, tips and practice pearls from publications in a special edition of the Journal of Diabetes Science and Technology focusing on social media and peer support in diabetes. Three projects, which will be highlighted, had support from AADE. These include the online peer support community scoping review, the peer support communities initiative and iDOCr council. Join us to learn how to incorporate a variety of peer support and social media components to improve outcomes.

    Our take away:

    Deb was a special section editor for these journal issues and will share with other authors on the panel some learnings about the benefits of social media in diabetes care and education.

    Sunday August 11, 2019

    D01 – 9:15-10:15 am Tic-Tac-Tech: An Expert Panel on the Game of Integrating Technology into Practice by Crystal Broj, Kelly Close, Jasmine Gonzalvo and Deborah Greenwood

    Description:

    The panel discussion will focus on technology and its evolution in diabetes care. Real world case studies will demonstrate how educators can integrate new technologies into practice and work flow to ultimately produce improved outcomes.

    Our take away:

    Deb will be speaking on a panel with other tech savvy individuals in the diabetes space. The team hopes to generate a lot of discussion and conversation with the audience. So please join us if you would like to talk tech!

    D11 – 10:30-11:30 am No One Understands Me!; Helping People Live Well with Diabetes by Ann Constance and Cecelia Sauter

    Description:

    Only 32% of people with diabetes reported recently being asked about their emotional well-being by a member of their health care team.This interactive session will discuss new evidence about the negative effects of diabetes-related distress. It will explore effective and practical strategies diabetes specialists can incorporate into care delivery models to address emotional well being.

    Our take away:

    The Empowerment model will be employed in this presentation, helping people use their “own innate ability to gain mastery over their chronic disease.” Their slides describe very solution focused approaches to practice including focusing on goals and NOT solving problems for the individual, but listening to them and supporting them in their efforts.

    Next is a description of a two-session series on diabetes distress in the afternoon.

    D15A – 1:30-2pm Interventions to Help Overcome the Impact of Diabetes Distress by Eliot LeBow

    Description:

    Diabetes distress can impact a person’s life and diabetes self-management.This presentation orients educators to the underlying causes of diabetes distress, the symptoms, and the impact on peoples’ lives. Validated resources will be provided to help attendees understand and decipher the differences between diabetes distress and clinical depression. Interventions to help overcome the impact of diabetes distress will be reviewed.

    Our take away:

    We’re interested in the concept of “micro-trauma” as a factor in diabetes distress and look forward to learning more.

    D15B – 2:00-2:30 pm Diabetes Distress and Burnout: Helping Youth and Families Live Well with Diabetes by Rebecca Butler, Katherine Gallagher and Amber Smith

    Description:

    Most people with diabetes will experience diabetes distress at some points during their life. The emotional side of diabetes is often the area where providers spend the least amount of time, but it is one of the most important things to address to help people succeed. The goal of this presentation is to help diabetes specialists learn to recognize when people may be exhibiting diabetes distress and to provide tools to empower them to provide emotional support.

    Our take away:

    There are some great solution focused approaches to practice in this slide deck, including providing 3 behavior praises for every one correction and for parents and providers to notice what the kids did WELL!  Also, there’s great inclusion of using empowering language.

    D22 – 2:45-3:45 pm Mind, Body, History: Listening, Eliciting, Responding to the Whole Story of the Person with Diabetes by Marina Tsaplina

    Description:

    Behind the complexities of diabetes management, is a human being with a lived history that shapes their diabetes story. Narrative medicine understands that illness unfolds in stories and that a competent diabetes specialist must be trained in the physiology of the body and appropriate treatments, but also in narrative competence, humility and mind-body practice to serve people with diabetes across cultural, racial, and economic inequities. We invite you to participate in a workshop that incorporates theater, narrative medicine, and mindfulness to strengthen your practice of delivering compassionate, whole-person diabetes care.

    Our take away:

    While there were no slides to review, this interactive session by Marina Tsaplina will discuss building a therapeutic relationship with clients, an important concept to us, and in any solution focused approach.  

    Monday August 12, 2019

    M12 – 10:45-11:45 AM Not the Word Police: What the Language Movement is Really About by Jane K. Dickinson

    Description:

    The 2019 Diabetes Educator of the Year will present a deeper dive into the language movement in diabetes. Why are we trying to change the language around diabetes, why does it matter, and how can we do it effectively? We will discuss what the language movement is not, and have some hands on practice with replacing unhelpful messages.

    Our take away:

    Dr. Jane K. Dickinson will work through some examples of how to change practice and use person first, empowering language that does not stigmatize, shame and blame. Hooray! 

    So many fabulous speakers, topics, panels and presentations are ahead of us! Not to mention all of the great posters that will be presented as well. Join us in tweeting using the #AADE19 hashtag – share what you are learning along with others in your network. While we love the learning, we are also excited to connect with dear friends and colleagues, laugh a little (or maybe a lot), enjoy an adult beverage (or two) and dance at Sunday night’s classic celebration!  

    Please find us and say hello at the meeting! We love meeting our “online friends” when we are at in-person at conferences! We plan to share our highlights in a future blog, so stay tuned!  Hope to see you in Houston! 

    2019 AADE President, Karen Kemmis and Past President Donna Ryan at last year’s AADE Celebration!

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    Disclaimer: A Fresh POV for You is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com.

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