• Fresh Views

    Highlights of #AADE19: Behavioral Health, Language, Peer Support and Social Media

    We’re getting excited for the #AADE19 Annual Meeting in Houston August 9-12!  For us, a little  advance planning and mapping out a schedule with the online planner helps us to successfully navigate the packed meeting, get to the sessions that peak our interest, and catch-up with friends! 

    Deb, Karen, Joan and Tami at #AADE18 President’s Reception

    As always, this meeting offers a multitude of cutting edge topics and excellent presenters. So, if you’ll be joining us in (hot) Houston at #AADE19 but haven’t had a chance to check out the sessions, here is the scoop on the 8 we’re excited about on Friday which 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.  

    F06-Friday 9:45-10:45 AM Shame and Diabetes: Practicing Resilience in a Culture of Weight Stigma, Disordered Eating, and Healthism by Nikki Estep 

    Description:

    Nearly 3/4 of people with type 2 diabetes report feeling shame about having diabetes, and shame-based self-talk and behaviors have been correlated with all types of diabetes. Presenters will define shame and how it is exacerbated in a culture of weight stigma and healthism, which can lead to disordered eating and other barriers to diabetes management.

    Our take away:

    Their slides are intriguing, sharing the work of Dr. Brene Brown on shame and vulnerability (love her books). From their slides: “Healthism is a belief system that sees health as the property and responsibility of an individual and ranks the personal pursuit of health above everything else, like world peace or being kind. It ignores the impact of poverty, oppression, war, violence, luck, historical atrocities, abuse and then environment from traffic, pollution to clean water and nuclear contamination and so on. It protects the status quo, leads to victim blaming and privilege, increases health inequalities and fosters internalized oppression.” – Lucy Aphramor

    The concept of “healthism” is new to us and yet the impact on stigma is so clear.  We also love the concept of Weight-Neutral Diabetes Care (WNDC) that “Focuses on establishing self-care behaviors. It DOES NOT promote restriction, endorse unsustainable exercise, or encourage disordered eating as a way to ‘get healthy’.”Looking forward to this one. 

    F07- Friday 11:00-12:00 Bright Spots & Landmines: A Diabetes Toolkit for Meaningful Behavior Change by Adam Brown

    Description:

    Why is changing behavior so difficult in diabetes? Why aren’t more people motivated? Why is there so much negativity in diabetes? Can we do better? Adam Brown will discuss the concepts of Bright Spots & Landmines as a toolkit for diabetes specialists to assist individuals to change behaviors, including specific food, mindset, exercise and sleep strategies. Attendees will learn how to apply “Bright Spots” and “Landmines” thinking to different individuals and scenarios, including easy-to-implement question guides.

    Our take away:

    While there were no slides to review, we are big fans of Bright Spots & Landmines and interviewed Adam Brown in our blog post on April 3, 2019.  Adam’s “Bright Spots” are very similar to “Exceptions” in a solution-focused approach (where one evaluates what’s going well and what they can “do more of” instead of focusing on the problems). Of course, there are obstacles that people face every day, and those are the “landmines” where things are not working as well.  You won’t want to miss his PDF handout of the 42 Factors that Affect Blood Glucose.

    F12-11:00 am-12:00 pm Reducing Stigma to Improve Outcomes: How to Reduce Stigma Effects by Laurie Klipfel , Eileen Rivera and Ann Williams

    Description:

    Health care professionals work with people who experience stigma, such as stigmatized racial/ethnic identities and other stigmatizing conditions. Recently stigma itself has been recognized as a fundamental cause of health disparities, that is, persistently associated with health inequalities across different times, diseases, risk factors, and health interventions. In other words, stigma affects outcomes. This panel presentation will explore what stigma is, how it produces health disparities, and what diabetes specialists can do to decrease its effects. It will include discussion by people from three stigmatized groups: People who are legally blind, transgender individuals, and those experiencing weight stigma.

    Our take away:

    The slide deck revels a presentation on how stigma affects health and how we can decrease the effects of stigma.  Looks like some powerful personal stories will be shared. Unfortunately, this session is the same time as Adam’s Brown’s. So many decisions!

    F23 Friday 3:15-4:15 pm Peer Support Communities for Self-Management Support: Research Trends by Perry Gee

    Description:

    The “S” on the end of DSMES is for support. Peer support is a resource being used by millions of people with diabetes. In this session, you’ll learn the latest research on the impact of social media and peer support communities on the promotion of self-management of diabetes.

    Our take away:

    The slides for this presentation show a historical look at past AADE presentations as well as published research supporting the #DOC or Diabetes Online Communities.Happy to see iDOCr research council mentioned in the presentation. This is at the same time as the Language  presentation below.

    F24A -3:15 pm-3:45 pm How Language Affects Person and Provider Communication by Jana Wardian

    Description:

    Communication between people with diabetes and providers plays an important role in engagement, conceptualization of diabetes management, treatment outcomes and behavior. Healthcare teams can be more effective through respectful, strengths-based communication. Empowering language can enhance motivation and well-being for people with diabetes. While this skill may take time, it is well worth the effort.

    Our take away:

    The slides are available for this presentation. Jana states she has lived with diabetes for 26 years and wears a pump and CGM. It’s always good to hear the language perspective from a person living with diabetes. If you follow us you know we often speak about person centered, strengths based language, so we’re happy to see several sessions on language at this conference. There was one slide that we would challenge however around the use of “bad vs. unhealthy blood sugar”. We don’t see “unhealthy” as a positive word choice or a biological factor. We’d go with “in range” or “out of range”. 

    F26A-4:30-5:00 pm Applying the Miracle Question in Diabetes Care by Tami Ross and Deborah Greenwood

    Description:

    Managing diabetes is complex and the constant focus on problems can erode confidence. Presenters will introduce “The Miracle Question,” a step-by-step solution-focused approach to work with people with diabetes. Participants will learn to use “exceptions,” the times when life works better or when problems are less likely to take over, to guide them toward attaining a personal action plan and goals. By focusing on abilities and possibilities, there are ready-to-use solutions. This approach assists diabetes specialists to help people strengthen their resilience and confidence.

    Our take away:

    Of course we are really looking forward to our presentation and hope you will join us! We will share one solution-focused tool called “The Miracle Question” as an exercise to move people forward in their thinking and actions when living with diabetes – to create a sense of hope and acknowledge possibilities. You can read our past blog post about the Miracle Question to learn more. If you’d like to further explore the Miracle Question, check out this book we’re fans of! 

    F29-4:30-5:00 F29 – Impact of Diabetes Self-management Education and Support on Psychological Distress among African Americans and Hispanic/Latinos with Diabetes by Ninfa Pena-Purcell

    While it conflicts with our session, this is another interesting topic.

    Description:

    Attention to the emotional side of diabetes is necessary in the delivery of DSMES. This has been found to be particularly critical for diverse racial and ethnic groups that have unique lived experiences. Two culturally appropriate community-based DSMES programs responded to this need, one aimed at African Americans and the other at Hispanic/Latinos with type 2 diabetes. Findings suggest that for both groups psychological distress was reduced and diabetes-related outcomes improved. Participate in this interactive session to dive deep into an exploration of the complexities of culturally appropriate diabetes interventions.

    Our take away:

    The slides for this presentation address the ADA guidelines for psychosocial care, how and when to assess people for diabetes distress, and describes a culturally tailored program to address these issues.

    F26B-5:00-5:30 Peer Support Communities: Data, Resources, Tips and Tricks, Ashley Ng 

    Description:

    People with diabetes and caregivers are increasingly turning towards online peer support communities to share and exchange information and experiences that impacts health behavior outcomes and emotional health. While the popularity of online communities continues to grow, it is crucial that diabetes specialists start to integrate evidence based online peer support networks as part of mainstream diabetes care. This presentation will discuss current challenges that surround people with diabetes and healthcare providers with the widespread sharing of personal data.

    Our take away:

    Ashley a dietitian, researcher, person living with diabetes, and colleague will discuss the privacy, security, and safety concerns of sharing personal data online, along with the role of the healthcare provider in helping people stay safe while online. 

    Wow, Friday is going to be a jam packed day! We’re thinking it may be Saturday before we make it to the Exhibit Hall this year!

    Deb, Tami and our good friend Lorena as we explored the exhibit hall at #AADE18

    We can’t wait to get to Houston to learn and re-energize! We are thrilled to see so many presentations addressing the behavioral side of living with diabetes and the essential component of peer support. Join us in tweeting using the #AADE19 hashtag – share what you are learning along with others in your network. Drop back by next week when we’ll share other  sessions of interest throughout the rest of the conference.

    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

    Language can change your POV

    As National Diabetes Month comes to a close, we’d like to share this blog post written for the Society for Participatory Medicine blog post published November 2, 2018.  

    The language used in healthcare has such a significant impact on how a person living with diabetes FEELS about living with diabetes and how they trust and engage with healthcare professionals.

    If you already know us, you know we support the language movement and encourage everyone to think about language in a new and fresh way. When we drafted the scripts for the two #LanguageMatters videos (links on our web page on the lower right and in the blog post) that’s when we began to think about creating A Fresh POV for You because we knew there were more opportunities to impact the diabetes community in a new and positive way.

    Here are a few quick and easy suggestions, that while simple can be a game changer and help stop the blame, shame, stigma and judgement often associated with diabetes.

    • Instead of using words like adherence and compliance, focus on what the person is actually doing to manage their diabetes.  You can ask about when and how they are taking their medication, focusing on their strengths instead of judging behaviors.
    • Refrain from using language that implies the person living with diabetes is unmotivated or doesn’t care. Instead, recognize the time required to manage a chronic condition and appreciate the hard work they are doing every day.
    • Replace the word diabetic with person living with diabetes all of the time! (However, a person living with diabetes can choose the language that best suits them.)

    As we suggest in the blog mentioned earlier, language choice is a habit, and just like anything else, it takes a little practice to change behavior!  If you start to think about diabetes management from a solution focused approach you will naturally use language that is strengths based and action oriented, and not focused on blame. We can embrace a healthier way of talking about diabetes by changing perspectives on language and the impact it has on anyone living with diabetes. Let’s create fresh, new behaviors because #LanguageMatters!

     

  • Fresh Views

    Flipping the Paradigm: Applying a Solution-Focused Approach to Reducing Risk

    You are braver than you believe, and stronger than you seem, and smarter than you think. – Christopher Robin

    National Diabetes Month is almost over, what informative and interesting activities were you engaged with this year?  

    Taking a solution-focused approach to diabetes self care

    As we near the end of the month, we are also finishing our 7-week series on applying a solution-focused approach to the AADE7 Self-Care Behaviors for managing diabetes. This series is focusing on “flipping” the conversation from a “problem focused” (traditional medical) approach to a solution-focused conversation. Last week we shared about taking a solution-focused approach to Problem Solving. And the prior weeks we focused on Taking Medications here, Monitoring blood glucose here, Healthy Eating  here, Being Active here, and Healthy Coping here. This week, we are talking about Reducing Risks 

    When looking at this picture above of the friendly neighborhood kitty balancing precariously across the covered porch rails, it reminds us of life with diabetes… trying to stay in balance never knowing when the bottom may fall out.  

    AADE7 Self-Care Behavior #7: Reducing Risks

    Taking care diabetes today can help people feel good today AND in the future. When blood glucose is in range, one is more likely to:

    • have more energy, both physical and emotional
    • be less tired and thirsty
    • pass urine less often
    • heal better and
    • have fewer skin or bladder infections

    Many say they are their “best self” when their blood glucose is in range. And managing diabetes TODAY means there will also be less chance of having health issues caused by diabetes over time. The important words there are “over time.” Taking care of diabetes now will help reduce the risk of heart attacks, stroke, damage to kidneys and nerves, and loss of vision. But It’s not just about the diabetes, it’s about supporting those with diabetes in living their best life! 

    A journey of a thousand miles begins with a single step. (Chinese Proverb)  Just one step.

    We want to support and guide our clients toward actionable steps they can take now to live well with diabetes and help reduce the risk or delay issues down the road. Then, the key is replicating that small step over and over again to build momentum and actually feel progress. Small steps add up. You may be surprised by the great impact these small, yet simple things can have! 

    The language we use when talking about diabetes complications is important to think about. When we use words like “prevent” as opposed to “reducing risk or delay progression” we imply that ALL complications CAN be prevented. Science tells us that this isn’t always true. Some people have genetic predispositions to either be “protected” from complications or to be at a higher risk. Healthcare providers can add to the stigma, shame and blame associated with diabetes when they don’t acknowledge the fact that some people will end up with complications……just because. We don’t want people to shy away from discussing health concerns, so let’s use our #LanguageMatters voice when we #TalkaboutComplications. That’s what The Grumpy Pumper (AKA Chris Aldred) has been doing this past year. Traveling around the globe, including a stop at #AADE19,  speaking openly and frankly about living with a complication from diabetes. You can read his blog here.  As Grumpy says, “Even with the best of care, people can get complications.” (from Diabetes Connections Podcast) So let’s use a solution-focused approach when talking with people with diabetes complications instead of rehashing any problems.

    When working with clients 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:  By no means is smoking a simple habit to change. What can you do more of that may help you smoke less? Or what needs to happen to help you make changes?

    Instead of this: You need to stop smoking. Smoking is bad news with diabetes.

    Try this: How can you fit in an extra visit to see your eye doctor during national diabetes month?

    Instead of this: You are behind on getting your eye and dental exams.

    Try this: On a scale of 0 to 10, with 0 being never and 10 being always, how often are you able to get an annual flu shot to help prevent illnesses?

    Instead of this:  You haven’t gotten your flu shot.

    Three follow-on questions to help you not only feel  better today, but to help prevent problems down the road:

    • What is one action you can take to reduce your risk? Work closely with your healthcare team to identify the best strategies for you to help manage them and prevent progression to live your best life.
    • What can you do NOW, right this second…to make life better now, as well as down the road.
    • What single change can you make over the next week?

    And consider how people in your life can help. Loved ones, family, and friends can be close allies in your diabetes management. (last week we discussed VIPs, you can read it here)

    We can encourage clients to keep taking those small steps each day. Consistency and routine build on each other. Small steps add up. If people do the best that they can do…then they can say at the end of the day, I did the best I could, and that’s a good feeling.

    We hope you’ve enjoyed our series and that we’ve made you think before engaging with clients. And if you’re a person living with diabetes, we hope our choices resonate with you. Each week we’ve challenged you to try some flips into your conversations. Let us know what impact they have had. Please reach out to us to share feedback.  Let’s continue to join together  to raise awareness of all issues that can improve living with diabetes.

    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

    Flipping the Paradigm: Applying a Solution-Focused Approach to Taking Medications

    Self-care is never a selfish act – it is simply good stewardship of the only gift I have, the gift I was put on earth to offer others. Anytime we can listen to true self and give the care it requires, we do it not only for ourselves, but for the many others whose lives we touch. -― Parker Palmer 

    Big Ben in London, England 

    @AFreshPOVforYou is one-year old!

    Happy birthday to us @AFreshPOVforYou! Our blog is officially one-year old, 56 posts later! 

    Over the last year we have focused on Possibilities, Opportunities and creating a Vision (POV) for the future by taking a solution-focused approach to life with diabetes. We’ve been excited to share our work and learnings by speaking at the AADE19 Annual Meeting, helping diabetes care and education specialists learn how to incorporate a solution-focused approach into their practice. We also shared our Twitter research findings at the European Association for the Study of Diabetes conference in Barcelona, Spain. And we’ve conducted a survey, focus groups, and have a few papers in process. It’s been a great year and we’re excited to see where this next year leads us!

    And it’s now national diabetes month 

    We purposely launched this blog right before #WorldDiabetesDay last year, to kick off our new adventure. And here we are again. What are you doing for diabetes month? Do you have an event or an idea you’d like to share with us or our readers? Please let us know in the comments. We’ll be adding in some diabetes month discussions throughout November, along with sharing insights about using solution-focused approach to self-care behaviors.

    Taking a solution-focused approach to diabetes self care

    This  week is week 5 of our 7-week series on applying a solution-focused approach to the AADE7 Self-Care Behaviors for managing diabetes. This series is focusing on “flipping” the conversation from a “problem focused” (traditional medical) approach to a solution-focused conversation. Have you tried any “flips” in the past 4 weeks? Please let us know if you have, and what your experience was. 

    Last week we shared about taking a solution-focused approach to Monitoring blood glucose – you can read it here.  And the weeks prior we focused on Healthy Eating  here, Being Active here, and Healthy Coping here.. This week, we are talking about taking medications. 

    AADE7 Self-Care Behavior #5: Taking Medications

    While taking medication of some type is often required somewhere in the journey with type 2 diabetes, it’s not always simple to engage in this self-care practice. We hear that routinely from clients we work with. Here are 3 challenges that frequently bubble up…

    1- Remembering. No matter what one’s age, remembering to take medication can be a challenge at one time or another. After all, life happens and can derail even the best intentions. In our experience, missing medication doses can also be linked to the dosing frequency, side effects, or diabetes distress. When it comes to remembering to take medication, solution-focused strategies to consider include, using a medication reminder app, using a pill box, pill packs, keeping the medication in view as a reminder (if it doesn’t require refrigeration), marking a calendar when a dose is taken, and setting an alarm on a smartphone or clock. (The mention of a clock, reminded us of Big Ben in London, so that’s our fresh view for today!)              

    2 – Stigma. With type 2 diabetes, there is often stigma associated with taking medicine. There is a false sense that people “should” be able to manage diabetes through healthy eating, being active and losing weight. But we know that is not always reality. Given that diabetes has a genetic link and is a progressive condition, things change over time. What works today, might not work next month or next year. So talking about diabetes medicine using a positive, solution-focused approach can help build a trusting relationship and a therapeutic alliance in which to discuss medicine choices and barriers while using a shared-decision making approach.  

    3 – Cost/Access. We must also be cognizant of the cost of medicine when considering options. Although there are some incredible, effective new medications that impact the patho-physiology of diabetes, these new drugs often come with a high price tag. And they may not be included on insurance formularies. And the cost of insulin is beyond crazy. The American Diabetes Association has a website to help people navigate this complex issue and provide a list of resources. Unless we have open conversations, we may not know that people are not taking their medicine because they are not able to afford it. How can we say they are “non-compliant” or “non-adherent” when this is the case?  We need to change the language we use in diabetes, especially around medication taking. The #LanguageMatters conversation is essential when talking about medications.

    When working with clients 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: Diabetes is a progressive condition. It’s common for people to need more medicine over time. Can we talk about the benefits of adding insulin?

    Instead of this: You’ve failed oral medicine, you need to take insulin.

    Try this: What challenges do you have when taking your medicine?

    Instead of this: You’re not compliant with your medicine.

    Try this: How many days each week do you take your medication?

    Instead of this:  How often do you forget to take your medication?

    We challenge you each week to try some flips into your conversations and let us know what impact they have. Let’s join together throughout the month of November to raise awareness of all issues that can improve living with diabetes.

    Join us next week as we discuss a solution focused-approach to the self-care behavior around problem-solving.

    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

    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

    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. 

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  • 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?

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

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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.

  • Speaking

    INVITE US TO SPEAK!

    Email: afreshpovforyou@gmail.com -or- (847) 917-4277

    UPCOMING SPEAKING ENGAGEMENTS

    Friday, August 9th Applying the Miracle Question in Diabetes Care. American Association of Diabetes Educators Annual Meeting 2:30pm-3:00pm
    Houston, Texas
    Saturday, August 10th Use of Social Media and Peer Support in Diabetes Care: A Panel from AADE Project Leaders. American Association of Diabetes Educators Annual Meeting2:30pm-3:30pm
    Houston, Texas
    Sunday, August 11th Tic-Tac-Tech: An Expert Panel on the Game of Integrating Technology into Practice. American Association of Diabetes Educators Annual Meeting 9:15am-10:15am
    Houston, Texas
    Thu-Mo, Dec 5th-9th What is the value of language guidance statements? Symposium: The global diabetes and language movement, Living with Diabetes Stream, International Diabetes Federation World Congress8:00am-7:00pm
    Busan, Korea

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