• Fresh Views

    EXPERTS: Today’s word to jump-start a solution-focused practice

    Today’s word is: EXPERTS

    If you’ve been following our blog, you know that we’re in a series addressing how to move towards a solution-focused practice….one word at a time. This week our word, EXPERTS, applies to both diabetes care and education specialists (DCES) and people with diabetes (PWD). You can read more about STRENGTHS, OPPORTUNITIES, and incorporating the input from experts in their diabetes management here.

    The Association of Diabetes Care and Education Specialists (ADCES) recently published two technology focused papers in The Diabetes Educator journal addressing the role of DCESs in leveraging technology to improve outcomes in people with diabetes. You can find a link to the ADCES landing page here that highlights both papers and includes links to two different podcasts with the primary authors of each paper.

    The Identify, Configure, Collaborate (ICC) Framework

    Deb and co-authors of A Framework for Optimizing Technology-Enabled Diabetes and Cardiometabolic Care and Education document a systematic approach to incorporating technology into the diabetes self-management plan known as The Identify, Configure, Collaborate (ICC) Framework. It is a model to support DCESs to maximize and ensure successful use of technology. We’ll walk you through the 3 components of this framework when incorporating technology into care…

    IDENTIFY: First, identify technology tools that will support self-management and decrease the burden of living with diabetes. It’s important to identify individual bias regarding technology to ensure everyone is offered tools to support them regardless of their age, gender, race and socioeconomic status among others. DCESs are technology champions and can have a big influence regarding technology use. However, we don’t want to be “gatekeepers” denying technology based on our assumptions. 

    CONFIGURE: Once a tool is identified, configuring the settings and plan for use is just as important.  Technology can only improve outcomes if the tools are used to their fullest potential. For example, helping PWD enable alerts and alarms or weekly email notifications when using continuous glucose monitors (CGM)  can help them learn from their own diabetes data in real-time. Mobile apps can be configured to capture patient generated health data (PGHD) that is meaningful to the individual.

    COLLABORATE: Finally, viewing all of the data generated from the technology tools then engaging in collaborative discussions around what the data means and how to make health behavior or medication changes is essential. The DCES is the key team member to support  PWD in the use of technology. DCESs have been focusing on PGHD since the invention of blood glucose monitors and are experts in using data to manage diabetes. And, the use of PGHD can support PWD as experts in their own diabetes as they learn how  food choices, activities, stress, and medication, among other things affect them.

    When incorporating a solution-focused approach into practice, the client is recognized as the expert in their own life and their own diabetes. Clients already have the resources and strengths to move forward to achieve their desired future state. When considering incorporating technology to support diabetes self-management, begin by acknowledging PWD as EXPERTS, prior to identifying and configuring tools, and then collaborating to modify the treatment plan. Create an opportunity to learn from your clients and discuss the value and benefits technology has provided them, as well as the challenges and burdens. This collaborative discussion can help all of your clients as technology evolves.

    Each week we invite readers to participate in a solution-focused challenge. Our solution-focused challenge for this week is to focus on your clients as the experts when incorporating technology and applying the ICC Framework.

    1. Identify and highlight the client’s strengths, positive qualities, resources, and ability to generate solutions prior to suggesting technologies.
    2. Configure technology tools that focus on the details of the solution instead of the problem.
    3. Collaborate to develop action plans that support what is working well for the individual.

    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

    Deb is an employee of Dexcom but view here are her own

  • Fresh Views

    JOURNEY: Today’s word to jump-start solution-focused practice

    A journey of a thousand miles begins with a single step.” – ancient Chinese proverb

    Tami and Deb with our friend Karen Kemmis ready to head off to the Kentucky Derby a few years back


    This Saturday September 5 marks the 146th running of the Kentucky Derby! If you are not familiar with this premier thoroughbred horse racing event, it is held annually in Louisville, KY, typically on the first Saturday in May. Yet, due to the pandemic, this year’s Derby was moved to the first Saturday in September in hopes that this “Fastest Two Minutes in Sports” would have an excited crowd cheering on the three-year-old thoroughbreds as they raced the one and a quarter miles to the finish line. The stands typically would be teeming with spectators from around the world oozing with fashion…ladies sporting beautiful dresses and big hats and men decked out in colorful suits…yet this year the stands will be empty. This race is often called “The Run for the Roses” because a blanket of roses is draped over the winning horse. It is the first leg of the American Triple Crown, followed by the Preakness Stakes and then the Belmont Stakes. A horse must win all three races to win the Triple Crown.

    Our husbands sporting their sharp Derby attire

    Not only is this premier horse racing event near and dear to our hearts since we had the opportunity to experience it a few years back, it causes us to take pause and reflect on the JOURNEY to qualify for the “Run for the Roses”.

    Some horses are born with talent, and are simply stronger and faster than other horses in the race. They are considered the “favorites” to win their races. But yet, the “favorite” doesn’t always win every race. Sometimes the winner is a horse with lesser talent so to speak, but who has a trainer that’s able to help maximize the horse’s potential through customized training based on the horse’s particular strengths and weaknesses, and by leveraging factors such as weather and track conditions, to give the horse the desire and best chance to win.

    As is the path to the Kentucky Derby a JOURNEY, without a doubt living with diabetes is a JOURNEY too.

    Today’s word is JOURNEY

    This journey brings not only glucose ups and downs, but twists and curves based on life’s experiences and challenges. When working with clients facing diabetes challenges, it’s key to focus on where they are in their journey and the complex decisions and choices they make on a daily, hourly, and even minute-by-minute basis. 

    We’ve shared before our fondness of Taxonomy of the Burden of Treatment paper (Tran et al) which helps clarify in a visual way the complexity and work required to manage a complex chronic condition like diabetes. When thinking about where clients are on their journey with diabetes, consider all of the factors that are impacting their decisions, choices, opportunities, and challenges. We can be supportive by helping them focus on their strengths, successes, and resilience. Just identifying one thing that is working well for them or finding an area in their life where their hard work is paying off can be incredibly impactful. 

    How often are people with diabetes recognized for the work they do?

    During one presentation at the Association of Diabetes Care & Education Specialists virtual annual meeting the current ADCES Diabetes Care and Education Specialist of the Year, Dr. Diana Isaacs, made a profound statement that resonates with a solution-focused approach: 

    In her practice’s shared medical appointments where participants wear a continuous glucose monitor (CGM), she starts off by thanking everyone for wearing the CGM for the week and recognizing the achievement in doing so. A thank you…it sounds simple, but is so powerful. How often are people with diabetes  recognized for the work they do? Diana focuses on what worked well for them during their week, and asks permission to discuss their challenges. During the session participants are able to focus on the journey of learning how they can make decisions and changes moving forward, based on their discoveries. No matter how small the changes may be, small steps add up.

    What an impactful way to make education meaningful and individualized, with the DCES stepping alongside as a “think partner” helping them take the next step on their journey. 

    As we shared in this blog around Derby time last year, when a client is faced with a scenario they’re trying to sort out, here are 3 key questions you can ask as their think parter:  

    1. What’s going well?
    2. How did you accomplish that?
    3. How can you do more of that? 

    Each week we invite readers to participate in a solution-focused challenge. This week we encourage you to:

    1. Start each session with a client by acknowledging the hard work they are doing managing their diabetes, even if it’s as simple as a thank-you for attending the session.
    2. Discuss with clients the concept of living with diabetes as being  a journey where there is always opportunity to shift directions.
    3. Offer clients support on their journey by sharing resources on peer support groups, either in person or online. Learning how others are moving forward living with diabetes can be life changing. 

    Try out one or more of the strategies we’ve shared, and reach back to  let us know how you’re doing! We’d love to help you de-stress and focus on a positive mindset.

    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

    Deb is an employee of Dexcom but all comments are her own.

  • Fresh Views

    HUMOR: Today’s word to jump-start solution-focused practice

    Laughter is an instant vacation. – Milton Berle

    Given the stress, anxiety, and chaos that COVID-19 is still raining upon the world, we’ve been looking for opportunities to laugh and find humor in our everyday world. Earlier this week, that came in the form of a virtual happy hour (pictured above) with dear colleagues at the close of the Association of Diabetes Care and Education Specialists (ADCES) virtual meeting. A special shout out to Lorena Drago for being the “hostess with the mostest” and donning a blonde wig and festive party attire for the celebration! 

    You may be super busy these days and have many things on your mind, so we’re hoping today’s blog can help you take a short stress break, identify personal opportunities to laugh, and consider how you can look for moments to incorporate humor in encounters with your clients and diffuse stressful conversations.

    Today’s word is HUMOR: 

    Finding humor and laughter in the everyday world is a key opportunity to reduce stress. Personally, we often feel rejuvenated and ready to face the world again after a good belly laugh or a few silly moments. Suddenly the weight of the world is lifted off our shoulders. 

    Research has shown that not only can humor reduce stress, it can decrease anxiety and fear, and help people cope with challenging situations. Humor can instill a more lighthearted perspective and make challenges seem less threatening. Laughter increases hormones in the body that reduce stress, decrease pain, and can even improve the immune system by supporting T-cell development. Humor can instill a sense of power, especially during times when feeling powerless. In fact, we have documented through our research that humor increases resilience in diabetes management and is a key factor to living well with diabetes. You can read more about the research findings in our recently published research paper, Applying a Solution-Focused Approach to Life With Diabetes: Insights Gleaned via Twitter published in July in The Diabetes Educator journal (). In the study, laughter and humor were described by all participants as essential for overcoming the burden associated with living with a serious chronic condition.Strength and resilience were often equated with a sense of humor when faced with challenging situations

    Here are 5 ways that we have been finding opportunities for humor which we hope may spur some ideas for you and that you can suggest to your clients:

    1 – Get together and laugh with friends: Whether this is via Zoom or in a social-distanced driveway happy hour. Fun virtual backgrounds can add laughter for virtual gatherings.

    2 – Social Media cartoons, memes and videos: We have a couple of friends that also help us start each day with a funny cartoon or meme posted on Facebook. We look forward to that chuckle as we head off to our home office for work. Taking a mid-day break and searching for a good laugh is also good medicine. 

    3 – Binge watch comedy shows: Like Deb, you may have older kids home again with many schools and colleges being virtual. Deb’s found that watching old shows with her daughter has been a great bonding experience and opportunity to laugh. The current binge is Gilmore Girls (now up to Season 3).  Any suggestions for the next show?

    4 – Smile every day,  even when it’s hard: Starting the day off with a smile can help impact your mood.  You’ve heard the old saying “Fake it until you make it.” Well, saying that you’re going to have a good day and find humor in your day can really make a difference.

    5 – Laugh at yourself: If you tend to take everything very serious, especially these days, finding ways to relax a little and laugh at mistakes, misfortunes and circumstances can make life easier. Laughter connects us with others and most people find that laughter is contagious. The picture below candidly caught us sharing contagious laughter a few years back. This photo still makes us smile and is a gratitude reminder everytime we look at it. You can learn more about gratitude reminders in our post here and about Finding Joy in our post here.

    Each week we invite readers to participate in a solution-focused challenge. We encourage you to ask your clients this week what they have been doing in their life to find opportunities to laugh! Discuss with them that finding humor in the everyday world is healthy for them both physically and mentally.  If you are doing telehealth meetings and you see something that makes a person unique in their home, maybe you can ask them to tell you about its significance, maybe there is a light hearted story to tell. 

    Try out one or more of the strategies we shared today, and reach back to  let us know how you’re doing! We’d love to help you de-stress and focus on a positive mindset.

    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

    ADCES 2020 goes virtual: 8 sessions you don’t want to miss!

    Tami & Deb at ADCES 2019

    With the Association of Diabetes Care and Education Specialists Annual meeting (formerly AADE) right around the corner, we’re taking a brief break from our solution-focused word of the week series to highlight some of the sessions that will be presented at the ADCES meeting on psychosocial and behavioral health and technology. They align with our thinking and approach, and we thought might be of interest to you too. 

    This typically in-person meeting is always one of our favorite times of the year! It is such a great opportunity to reconnect with friends and colleagues while being energized about the work we do in diabetes care and education. However, in light of the pandemic, this year’s meeting (like many others) has gone virtual. So it is with mixed emotions that we share this ADCES preview. While we  look forward to learning from colleagues in the comfort of our homes this year, we so wish times were different and we could share coffee or lunch together, catch up on everyone’s lives over a glass of wine, give a lot of hugs, and dance the night away at the annual Sunday night dance party. Especially for the two of us, we have not been together in person since last October. One of our hopes in collaborating on this blog together was that we’d have the opportunity to spend more in-person time together. While we engage via Zoom, it’s just not the same.

    We’re excited to share that  we had an abstract accepted to present as an oral session at the originally scheduled in-person meeting in Atlanta on “Flipping the Paradigm: Applying a Solution-Focused Approach to the AADE7 Self-Care Behaviors”! But due to the condensed nature of the virtual meeting we opted out, with the hope that we can share our full presentation next year (fingers crossed!). In the meantime, we’ve had our first research paper incorporating a solution-focused approach published! You can find it online, Applying a Solution-Focused Approach to Life With Diabetes: Insights Gleaned via Twitter. This paper resulted from our presentation at the European Association for the Study of Diabetes last fall. We report the findings of our online study where we employed the Miracle Question approach during a Twitter chat. 5 themes evolved of a desired future state: more of living life; laughter and humor; self-compassion; resilience; and support.  

    Here are 6 of the sessions of interest that you may want to check out (all times are central time zone): 

    GS02 – Mobilizing for Health Equity (Friday, Aug 14 9:00 AM, 1 hour)

    This session will provide the participant with an understanding of the history and impact of structural racism on health equity. Throughout the presentation, Dr. Blackstone will define structural racism and how it relates to the social determinants of health. The participant will leave the session with key strategies to make individual steps toward interacting with equity.

    F06 – Empowering African Americans With Diabetes Through Positive Thinking (Friday, Aug 14 2:05 PM, 30 minutes)

    African Americans face many challenges associated with diabetes self-management and it is common for them to fall into negative thinking patterns. Researchers suggest that positive thinking can lead to improved diabetes management and empowerment to foster independence, self-management and the ability to question and make informed choices. This presentation offers 6 positive thinking strategies that can be utilized to assist in empowering the African American participant.

    F05 – Integrating Diabetes Technology Into the Clinical Paradigm (Friday, Aug 14 1:00 PM,  (1 hour)

    New and emerging technologies can help people with diabetes optimize glucose levels, reduce diabetes burden, achieve improved quality of life, and reduce the risk of acute and chronic complications. Diabetes care and education specialists and clinical practices are struggling to keep up with the pace of technological change. While essential, expertise in diabetes technology is not enough. There must also be processes in place to streamline paperwork and documentation, optimize clinical flow, educate staff and providers, and obtain reimbursement. This session will provide an overview of how diabetes technology can be effectively integrated into the clinical paradigm and discuss the role of the diabetes care and education specialist as the clinic’s technology expert and champion.

    F12 – COVID-19 Update: Protecting Adults with Diabetes (Friday, Aug 14 3:45 PM, 30 minutes)

    A significant portion of the U.S. population is vulnerable to severe complications, including death, from COVID-19. In addition, social disruptions secondary to the pandemic response are creating new vulnerabilities in the provision of chronic disease care and self-management for non-pandemic illnesses. This presentation will expand foundational knowledge of the impact of COVID-19 on people with diabetes and provide strategies through education and technology to protect adults with diabetes from COVID-19 while reducing gaps in diabetes care and self-management.

    S06 – Diabetes Psychology and Diabetes Services: Similarities and Differences (Saturday, Aug 15 10:40 AM, 30 minutes)

    This presentation will explain how diabetes psychology is used to help people implement new behaviors, navigate social stressors and manage the feelings of anxiety, depression and stress that often accompany diabetes. A discussion of similarities and differences between diabetes psychology and diabetes services will be provided. A model for integrating diabetes psychology with diabetes services will be described with examples of implementation at the San Diego VA hospital.

    D09 – Using Mindfulness in Veterans to Lower Diabetes Distress (Sunday, Aug 16 12:05 PM, 30 minutes)

    Mindfulness benefits veterans with depression and PTSD, but little is known about the impact of mindfulness in those with diabetes. This presentation will share our experiences and participant perspectives of a mindfulness-based diabetes education intervention that utilizes a digital application to support daily mindfulness in everyday life. Additionally, we will examine associations between mindfulness, diabetes distress (DD), stress-related symptoms, and glycemic management (A1C) and show how incorporating a mindfulness intervention into DSMES can target both DD and A1C in at-risk populations.

    Also, check out Deb’s 2 research presentations, one oral and one poster:

    F03C – 12-Month Outcomes for a Behaviorally-Enriched Diabetes Prevention Program for State Employee Commercial Drivers

    Not all participants achieve DPP outcomes. Identifying opportunities to augment, enrich and enhance the traditional program are needed to meet individual needs.  This session will present data from a 12-month observational study that evaluated the effectiveness of an innovative, behaviorally enriched  Diabetes Prevention Program (DPP), on program outcomes of attendance, weight loss and physical activity.  This innovative, coach-led, behaviorally-enriched DPP was designed specifically to engage and motivate a “hard to reach”, mobile population at risk for developing type 2 diabetes using a behavior and social assessment and decision support tool set to facilitate a practical behavior change model (Information, Motivation, Skills) integrated into routine team care delivery and clinical software applications. Note: Sarah Downs and Alyssa Griswold contributed as co-authors on this submission.

    P409 – Diabetes Education Through Peer Support for Hispanic Spanish Speaking People with Type 2 Diabetes

    Diabetes is twice as likely to affect Hispanic people than their Caucasian counterparts. Our previous community-based participatory research demonstrated that technology in addition to social support is necessary to effect diabetes-related behaviour change in Hispanic individuals with type 2 diabetes (T2DM). In this feasibility study, we address gaps in diabetes care for Hispanic people with T2DM by combining technology with an online peer support intervention. The inclusion of Hispanic, Spanish-speaking peer facilitators with diabetes lived experience will enable culturally appropriate discussion, advice and strategies to enhance the use of CGM and improve diabetes outcomes in participants. This poster presentation will describe the study background, methodology and intervention protocol.

    Also, please consider attending the Dexcom Educational Theater on Thursday, August 13, 2020 at 2:45 pm CT, Lighting the Fire: Bringing DSMES to Life with CGM with Dr. Bill Polonsky and Dr. Diana Isaacs. During this session, Dr. Diana Isaacs incorporates solution-focused principles when discussing CGM data with her clients.* This program is open to anyone whether attending the conference or not. You can register here.

    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

    *Note: Deb is employed by Dexcom but anything posted on this blog is her personal opinion.

  • Fresh Views

    SOCIAL WELLNESS : Today’s word to jump-start solution-focused practice

    With the United States slowly reopening, many are longing to physically be in the presence of family and friends, and are fatigued with virtual “gatherings” (ourselves included!). The very thought of even a small physically-distanced in-person gathering brings joy! After all, these summer months typically abound with backyard barbecues, family reunions, and pool parties. 

    Research has shown that these types of interactions are not only fun, but healthy too – helping people stay healthier both mentally and physically. They contribute to what’s known as “social wellness”. Fittingly, July is Social Wellness Month.

    Many people with diabetes, parents and children with diabetes spent last weekend engaged in social wellness by participating in the Virtual Friends for Life conference. Normally in Orlando every July, this meeting is so unique and so important for the many families that attend. At the meeting people wear a green bracelet when they have diabetes and an orange one if they do not. Tami used to serve on the Children with Diabetes board and we’ve both attended the conference several times and guarantee that it is a magical event. Especially when you see young children making “friends for life” with other kids, just like them, sporting their green bracelet, living with diabetes. While a virtual format does not allow for the connections that are made in person, there were many opportunities to have fun, dance, learn and “meet up” in the virtual hallway. People were doing their best to stay connected.

    Today’s words are: SOCIAL WELLNESS

    What is “social wellness”? Social wellness refers to building positive, supportive, healthy relationships that can offer support during challenging times. Support comes in many forms. In this blog we share 5 ways to guide your clients to engage in ongoing diabetes support. In case you’re wondering what exactly are hallmarks of  a “healthy” relationship, here are signs to consider:

    • feeling good about yourself around your friend, family member, or partner
    • feeling safe talking about how you feel, 
    • feeling listened to, and valued, and truly experiencing mutual trust

    Social wellness is now receiving greater focus and emphasis from the medical community. It is a critical aspect of overall health. Through research and focus groups that we’ve conducted with people with diabetes, we’ve heard time after time the critical nature of fostering a genuine connection with others with a lived experience. Strong and healthy social connections and networks are associated with the following:

    • blood pressure and heart rate that respond better to stress 
    • a healthier endocrine system  
    • enhanced immune system’s ability to fight off infection 
    • a more positive outlook on life
    • longevity

    In the quest to help people with diabetes be their healthiest self, here are 2 strategies for improving social wellness that you may want to explore with your clients::

    Strategy 1- Make Connections. Come alongside your clients to identify ways to find new social connections, particularly in these socially distanced days. Here’s a few ideas: 

    • Join an online group focused on an interest or hobby, such as painting, great hiking spots, or an online book club. 
    • Expand horizons by taking virtual music lessons, using a cooking app to learn how to make new recipes, or finding a recipe that you can prepare on zoom simultaneously with a friend.
    • Participate in a neighborhood event, such as a driveway happy hour with neighbors sitting in their own driveways, or walk by “concerts” where musically talented neighbors have mini “concerts” in their front yard or on their balcony.

    Strategy 2 – Build Healthy Relationships. Making connections doesn’t mean one has arrived. Relationships require work and nurturing to build strong bonds. Here are a few areas you can explore with your clients: 

    • Share feelings honestly and respectfully
    • Ask for what you need from others
    • Be caring and empathetic
    • Decide what you are and aren’t willing to do
    • When compromise is needed, try to find a compromise that works for all involved

    THIS WEEK’S SOLUTION-FOCUSED CHALLENGE

    Each week we offer a solution-focused challenge that can help evolve care and education in a solution-focused manner. Here’s this week’s challenge: Consider asking some of the following questions the next time you engage with your clients to help identify their existing resources to move towards social wellness.

    1. What do you do for fun?
    2. Who do you enjoy spending time with? What makes that time enjoyable?
    3. How do you show the people in your life that you care for them?
    4. What would the closest person to you say is their favorite thing about you?
    5. What are you most proud of about yourself?

    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

    OPPORTUNITIES : Today’s word to jump-start solution-focused practice

    Every accomplishment starts with the decision to try ~ Author unknown

    Deb’s new hummingbird feeder creating opportunities to catch an up close view of these beautiful tiny birds

    In this new virtual world, Deb had the opportunity to attend the virtual American Diabetes Association (ADA) Scientific Sessions, from the comfort of her home office! While we @AFreshPOVforYou really enjoy the social aspect of attending in-person conferences, Deb embraced this virtual opportunity and found some interesting presentations.Today we want to focus on and share with you one particularly outstanding session.

    Today’s word is: OPPORTUNITIES

    If you follow our blog, you know that we’re in a series which addresses a client-focused approach to a solution-focused practice word each post. So we want to think about today’s word OPPORTUNITIES in relation to diabetes care and education specialists embracing some learnings from ADA Scientific Sessions.

    One presentation in particular that garnered much attention was the ADA’s 2020 Diabetes Educator of the Year Award Lecture by recipient Dr. Bill Polonsky. His lecture,Tedious, tiresome and dull’: Strategies to improve diabetes self-management education” was thought-provoking and insightful. Dr. Polonsky stressed that diabetes care and education specialists need to make education meaningful to those living with diabetes, and it can’t be focused simply on a checklist of content. We are of like mind as Dr. Polonsky, and believe there are new opportunities to engage with people with diabetes. Rather than working through a list of content that may or may not be relevant to your client, why not incorporate a solution-focused approach, and turn attention to the individual, their needs, their skills and strengths they already possess. This solution-focused approach is one OPPORTUNITY to address the challenge of “tedious, tiresome and dull education”.

    To spur thinking about different opportunities you can create in your practice to make diabetes self-management education and support meaningful, we want to share 3 of our previous blog posts:

    1. Co-design. Last April we discussed the concept of “co-design” and how gaining input from people with diabetes around the content and structure of diabetes services is critically important. You can read about co-design here.  
    2. Strengths-based language. In 2018, we wrote about using person-first, strengths-based language here. We continue to believe that this practice is essential for successful diabetes care and education.  
    3. New perspectives. In September 2019, we shared a glimpse of our presentation at the international European Association for the Study of Diabetes (EASD) conference. We began that post with this quote by Marcel Proust, “The real voyage of discovery consists not in seeking new landscapes, but in having new eyes.” We’d like to encourage fellow health care professionals to “have new eyes” in relation to diabetes management, and be open to new tools and solutions.This different view through “new eyes” may lead to creating incredible, innovative and visionary opportunities to evolve diabetes self-management education and support services.

    Our solution-focused challenge for you this week is to start each session with your clients by doing one solution-focused activity to create new opportunities.  Here are a few examples:

    Ask your client:

    • What would need to happen to make your meeting valuable to them?
    • What 3 questions do they want to discuss today?
    • What strengths do they already have that you can build upon today?

    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

    EXCEPTIONS: Today’s word to jump-start solution-focused practice

    A healthy outside starts from the inside – Robert Urich

    As these crazy and unsettled days wear on, June has silently snuck upon us, bringing with it the first day of summer. Did you know June is also National Fresh Fruits and Vegetables month? We hope you enjoy the picture above of juicy lemons harvested from Deb’s backyard. We are big advocates of finding ways to fit in more fresh fruit (over processed fruit and juice) and fresh vegetables, particularly of the non-starchy variety (which means little impact on blood glucose)! In our experience, many people are challenged with fitting in non-starchy vegetables. And when they’re successful, we’re always curious: How were you able to do that? 

    Today’s word is: EXCEPTIONS

    Today in our series on words to jump-start a solution-focused approach when managing diabetes, we’re focusing on EXCEPTIONS. Exceptions are those times when one’s able to deal with a problem (such as blood glucose out of range, too many carbs) in a way that makes it less burdensome. Exceptions are times when the presenting situation could have happened, but somehow did not.  It’s a time when things could have gone wrong, but didn’t. Most all problems have exceptions. However, some people have difficulty even identifying exceptions because they stay so focused on their problems. Identifying exceptions is essential in order to build future solutions. Exceptions are the tools that help people achieve the life they want. Exceptions are a core tool in solution-focused practice.

    Exceptions are addressed in the book by Adam Brown, Bright Spots and Landmines, which we’ve written about here. There are more than 42 factors that impact blood glucose, and that makes it challenging to stay in range all of the time. Focusing on what is going well, instead of what is wrong, changes the conversation and allows the client to identify strengths and successes, and feel there are those “bright spots” in their life that they can call upon and focus on to know they’ll be successful.

    Here is an example of how you can use exceptions when reviewing continuous glucose monitor (CGM) data

    Meet J.T. She has been experiencing glucose values above range after dinner quite frequently, while the rest of the day has been in-target most of the time. She’s shared CGM graphs similar to the one below, where you can see after dinner at 6pm her glucose rises above target. 

    Today when you meet with J.T. she shares her most recent CGM graph, and you notice that her after meal glucose values are all within her target range. You specifically call this out during your conversation. You might say, “J.T. I notice that your after dinner glucose values are within your target range, how did you manage to do that?”  J.T. tells you that she has been focusing on swapping out starchy vegetables for non-starchy vegetables, like broccoli, squash, tomatoes, and mushrooms, cooking them in a Wok at home with just a small amount of olive oil. She notes that when she eats these non-starchy vegetables she stays in range.  

    This is known as an “exception”, or a time when her typical problem (post-meal above target blood glucose) did not happen. This is when we see “positive differences.” We now want to amplify and intensify these differences. This is the time to focus on the healthy changes being made and time to support and encourage MORE of these choices.

    So you might follow up with, “How was it helpful for you? Or What else was different for you?”

    You might use a scaling question. “ On a scale of 1-10 where 10 is you are confident you could do this again and 1 is the opposite, where would you say you are now?”

    A fave tomato and cucumber salad that Tami enjoys in the summer. She makes it ahead and has it ready in the refrigerator to help her easily fit in more non-starchy veggies at meal time.

    THIS WEEK’S SOLUTION-FOCUSED CHALLENGE

    Each week we’re including a solution-focused challenge that can help evolve care and education in a solution-focused manner. Here’s this week’s challenge: Try incorporating some/all of the following guiding questions into conversations with clients to help elicit exceptions:

    1. Are there times when this has been less of a problem?
    2. What is different about the times when this was less of a problem?
    3. What did you (or others) do that was helpful? 
    4. What’s gone better for you today or over the past week?
    5. What thoughts kept you on track?
    6. At a time when you feel more optimistic and satisfied, what will you be doing more of or more often?

    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

    Peace and Reflection

    A double rainbow over an Irish castle

    During this challenging time in our lives, we have decided to take a pause to allow people time to discuss and read about the current challenges our nation is facing. We posted a photo today of something that makes us feel peace and hope and wanted to share it with you. 

    Our writing at A Fresh POV for You is always focused on the future, on developing strengths and identifying solutions. We are going to take time this week to think and reflect on how our world can move forward together in peace.

    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

    KEEP FRIENDS CLOSE: Today’s words to jump-start solution-focused practice

    “Friendship is born at that moment when one person says to another, ‘What! You too? I thought I was the only one.” – C.S. Lewis

    With friends in the Mediterranean this time last year (before the days of social distancing)

    As our world begins reopening from the pandemic, we are longing for the day when we can be in close proximity to friends and family again! Some of the most treasured moments for us personally are sharing life adventures, laughter, and good food and drink with friends (can you see that in our smiles in the picture above from our Mediterranean escape a year ago??) Yet in these days of physical distancing, we are reminded how critical it is to keep friends close, and stay connected while being physically away.   

    Today’s words are: KEEP FRIENDS CLOSE

    So with that, today in our series on words to jump-start a solution-focused approach when managing diabetes, we’re again using a few words (rather than just one) to generate thinking about how to focus on being healthy, living healthy, and making healthy choices, as a follow-on to our last blog “YOU CAN BE HEALTHY”.

    We chose today’s words – Keep Friends Close – because they were used frequently during Diabetes Social Media Advocacy (#DSMA) Twitter chats we hosted in 2018, and seem appropriate in these days of physical distancing. It became crystal clear during those Twitter chats that among people with diabetes, friendships are incredibly impactful and important – especially friendships with peers who also live with diabetes.

    Beyond the concept of friendship alone, we want to stress 3 things (maybe it’s 4 things):

    • Truly valuing friendship
    • Understanding how friendships can support one in living their best life
    • How even in crazy times like we are now living, it is possible to maintain friendships, and might we even suggest, strengthen them

    Video chats, calls, and linking up through social media can provide breaks from upsetting news coverage and help reduce feelings of isolation, loneliness, fear, disappointment (missed graduations, delayed weddings, and the list goes on), help cope with stress, and manage diabetes distress. Those who regularly engage in social media and online discussions, like the previously mentioned Twitter chats have some advantage during these pandemic days because they’ve already experienced the benefits of online friendship and support. 

    Deb’s friends and family participating in a Zoom graduation party.

    What does this mean for diabetes care and education specialists (DCES)?

    Here are 6 solution-focused questions you can use in your conversations to focus on VIPs (friends) and identify opportunities to receive support and strength:

    1. Who do you most enjoy spending your time with?
    2. What traits would your VIP say you have that will help you reach your goals?
    3. What do important people in your life consider to be your best qualities?
    4. How can you use those qualities now?
    5. Suppose your friend with diabetes had the same issue you are facing, what solution would he/she find?
    6. What would the important people in your life say that is different about you when you achieve your goal?

    In these days, here are 5 ways you can encourage your clients to Keep Friends (VIPs) Close virtually: 

    1. Talk about concerns, how they’re feeling, and share emotional support.
    2. Swap strategies for coping with changes in sleep or eating patterns.
    3. Do virtual stretching, workouts, or meditations to help care for you mind, body and spirit.
    4. Share ideas on how they’re eating healthy. Since May is National Mediterranean Diet Month, maybe find a Mediterranean-style recipe they and a friend can cook together virtually via Zoom. Or try this favorite of ours from a previous blog here.
    5. Provide an outlet to unwind and laugh.

    THIS WEEK’S SOLUTION-FOCUSED CHALLENGE

    Each week we’re including a solution-focused challenge that can help evolve care and education in a solution-focused manner. Here’s this week’s challenge: When working with clients these next few weeks, try asking at least 3 questions to understand their VIPs and how they are working to Keep Friends Close during this pandemic. Here are some examples:

    1. Who are the most important people in your life?
    2. How have they been helpful for you?
    3. How are you focusing on staying connected with them while we have been staying at home?
    Friends and colleagues from around the world with a connection to diabetes (looking forward to the days we can huddle in for a picture like this again!).

    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

    YOU CAN BE HEALTHY: Today’s words to jump-start solution-focused practice

    A view of the Mediterranean Sea from Eze sur mer, France

    Make one healthy choice. Then make another. – sparkpeople.com

    In the midst of the pandemic affecting our world, we have found ourselves intermittently feeling like we’re in the twilight zone, stuck in a time warp, with the hours and days running together. How did it get to be May?? During these “healthy at home” days, we’ve spent a lot of time reflecting…and what a difference a year makes! This time last year we were packing our bags preparing to hop on flights to the magical Mediterranean Sea. We are superfans of the Mediterranean culture and eating style, and to think that we weren’t even aware back then that May is National Mediterranean Diet Month! With that in mind, throughout this month of May as we continue our series focused on words to jump-start solution-focused practice, we’ll share a few favorite tips and swaps to eat “more Mediterranean-style”. We hope they’re helpful to you and your clients in the effort to make one healthy choice, and then another, during these stressful and challenging times.

    Today’s word is actually a few words: YOU CAN BE HEALTHY

    Words are powerful. Read more about ACCEPTANCE, STRENGTHS, POSSIBILITIES, MINDSET, SUPPORT, and GRATITUDE in solution-focused practice. “YOU CAN BE HEALTHY”  were words used frequently during Diabetes Social Media Advocacy (#DSMA) Twitter chats we hosted in 2018. Participants engaged in a solution-focused exercise (you can read about it here), and identified their desired future state, their strengths, and their resilient capacity. Many expressed their focus on the future was about living a healthy life and being healthy despite living with a chronic condition. They expressed they did not feel that diabetes made them “sick” or a “sick person”, and desired to focus on the fact that “you can be healthy” while living with a chronic condition. These words really resonated with us because in a solution-focused practice the goal for diabetes care and education specialists is to step alongside as a think partner to focus on what CAN happen, what one’s “best hopes” for their future are, to envision possibilities, and build upon strengths..

    One can BE healthy by making healthy food choices. While a variety of eating approaches have been proven helpful in managing blood glucose, in the spirit of National Mediterranean Diet month, we’re focusing on the Mediterranean eating pattern and sharing 8 tips toward a healthy Mediterranean-style eating plan. You can read more about Mediterranean-style eating in an earlier blog here. 

    Tomato and greens salad with olive oil and balsamic vinegar with a dash of Parmesan cheese

    8 Tips to Eat More Mediterranean-Style

    1. Fit in fish at least twice a week. Fish and seafood are primary protein sources in the Mediterranean diet with limited use of red meat. Fresh, foil-packed, or water-packed tuna, salmon, trout, mackerel, and herring are healthy options.Choose tuna or salmon to top a salad at least once a week (we’re fans of foil-pack varieties for simplicity) and make fish your “go-to” order when ordering out. There’s your two servings!
    2. Fill at least half of your plate with Mediterranean style non-starchy vegetables. Vegetables are a staple of the Mediterranean eating pattern. Mediterranean-style non-starchy options include artichokes, arugula, beets, broccoli, brussels sprouts, cabbage, carrots, celery, celeriac, chicory, cucumbers, eggplant, fennel, greens, leeks, mushrooms, nettles, okra, onions, peas, peppers, radishes, rutabaga, scallions, shallots, tomatoes, turnip, and zucchini. 
    3. Choose whole fresh fruit as the “sweet treat”. When the desire for something sweet arises, opt for Mediterranean-style fruits including apples, apricots, avocados, cherries, clementines, dates, figs, grapefruit, grapes, melons, nectarines, oranges, peaches, pears, pomegranates, strawberries and tangerines.
    4. Replace butter and margarine with healthful oils, such as olive or canola oil. Olive oil is the main dietary fat in the Mediterranean eating style.  Use these oils for cooking, dip bread in flavored olive oil, or lightly spread olive oil on whole-grain breads.
    5. Season meals with herbs and spices rather than salt. If you don’t have fresh herbs, 1 teaspoon of dried gives the same flavor boost ast 1 tablespoon fresh.
    6. Choose whole-grains. This includes whole-grain breads and cereals, as well as whole-grain pasta and brown rice. Other Mediterranean-style whole grains include barley bulgur, whole grain couscous, and farro.
    7. Crunch more nuts or seeds. Keep almonds, peanuts, pistachios, and walnuts on hand for a quick snack We keep small zip-top bags of pistachios at our desks at work.
    8. Make water the go-to beverage, with wine in low to moderate amounts if you choose to drink alcohol (cheers!).

    THIS WEEK’S SOLUTION-FOCUSED CHALLENGE

    Each week we’re including a solution-focused challenge that can help evolve care and education in a solution-focused manner. Here’s this week’s challenge around YOU CAN BE HEALTHY!

    1. Help clients identify at least one thing they’re already doing to be healthy by asking a question such as “What have you already tried that is helping you, even if only a little bit?”. 
    2. Explore how they are able to accomplish doing that by asking a question such as “What gave you the strength to …..” (fill in the blank….make that choice, make that change etc.).
    3. Then ask what additional healthy choice they desire to make. How can they build upon past success to do that? You may ask, “What will you be doing differently after this visit?”

    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

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