• Fresh Views

    Highlights from American Diabetes Association Scientific Sessions (Part 1): Focus on Behavioral Health

    “Wellness is the complete integration of body, mind and spirit – the realization that everything we do, think, feel and believe has an effect on our state of well-being.” ~ Greg Anderson

    Tami, Mike, Deb and Mark enjoying the “Fresh Views” in Marseilles, France

    We’ve just returned from a relaxing vacation in the South of France where we imprinted enough “fresh views” to last us quite a while! But we are quickly back to work, with the first stop post vacation at The American Diabetes Association Scientific Sessions in San Francisco. A Fresh POV for You attended some inspiring sessions, particularly those focused around behavioral health. (If you’ve been following our blog, you know that’s a special interest of ours.) We thought we’d share highlights from several that were particularly impactful.

    Highlight #1

    One of the most rewarding presentations was the Richard R. Rubin Award lecture, presented by Dr. Frank J. Snoek, PhD. The award recognizes an individual who has contributed to the science of the behavioral aspects of living with diabetes. Dr. Snoek’s talk  #DiabetesPsychologyMatters focused on the important connection between behavior change and mental health. As one of his slides depicted…they are two sides of the same coin!

    Dr. Snoek noted that one goal is to shift the burden of diabetes distress, so that higher distress can be moved down to moderate, and moderate moved down to low. He also indicated that a single high score on a distress scale does not mean that an individual needs professional help, or is in a maladaptive situation. Everyone with diabetes experiences diabetes distress at some point and at some level.

    Additionally, he discussed the correlation between mood and behavior, an area of significant interest to us at A Fresh POV for You. He described that when someone actually feels good, they are able to shift their priorities towards less pleasant activities that might help them achieve more long term goals. However, when someone has a low mood, they tend to seek short term rewards to help them feel better in the present.

    Overall he emphasized the need to enhance access to care and specifically called out what he described as “indirect interventions” –  including Diabetes Self Management Education and Support (DSMES), psycho-education as well as internet/mobile interventions. Specifically, he called for incorporating behavioral techniques along with existing pure “education” practices.

    Photo of Frank Snoek’s slide at ADA Scientific Sessions showing the indirect psychological support that can be provided by nurses, diabetes educators, etc.

    We believe that by incorporating Solution-Focused Brief Therapy (SFBT) techniques and counseling approaches, diabetes educators can address the needs of people living with diabetes, incorporating “two sides of the same coin”. Addressing both the self-management education and support needed for behavior change, while at the same time, addressing mental health concerns, such as diabetes distress. In essence, we can “fill the gap” that exists in access to psychological care. Overall this lecture solidified our efforts in moving this approach forward within the diabetes community.

    Highlight #2

    Another impactful session focused on complications associated with diabetes. The emotional toll of diabetes complications-What have we done for them lately.  The panel was moderated by Dr. Korey Hood, a behavioral scientist. Panelists included Chris Aldred (aka The Grumpy Pumper), Kerri Sparling (Six Until Me), Matthew Heywood, and Ina Mendoza. They spoke frankly and candidly about their experiences living with diabetes complications. Managing diabetes is tiring enough, then add a complication, and it becomes so much more complex. Much of the discussion addressed the stigma associated with diabetes complications and how the panelists were/are often told that they “should have done better”. Ouch.  #LanguageMatters when talking about complications. Making people often feel “less than” when they have a complication.  Where is the compassion in care?

    One question from the audience was, “What can we do to make this better?” So, A Fresh POV for You posed an answer to consider….”How about incorporating a more solution-focused approach into practice?  With focus on the solutions and strengths an individual has to help move them forward, rather than focusing on past problems and trying to identify why they occurred.” We know that no matter how much effort goes into managing diabetes, sometimes people still get complications. We also referred to Adam Brown’s Book, Bright Spots and Landmines,, featured in one of our  April blog posts. Focusing on “bright spots” are similar to focusing on the “exceptions” or the things that are going well used in a solution-focused approach.  

    We look forward to sharing more of these concepts in our presentation at the American Diabetes Association Annual Meeting in Houston in August,  Applying the Miracle Question in Diabetes Care.. In fact, here we are finalizing our slides before the deadline while in Marseilles, France.

    What deadlines look like on vacation!

    Highlight #3

    Stigma was a theme common through many of the behavioral health sessions. As recipient of the Outstanding Educator in Diabetes Award, Virginia Valentine, shared a moving presentation, The most important thing we give to people is…Hope: Overcoming stigma in diabetes and obesity,. She explained that the stigma associated with diabetes causes blame and shame, and that “Shame is the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of being loved or belonging.”-Brene Brown. She reminded the audience that “the only thing people with diabetes did wrong is when they picked their grandparents.”  She ended her presentation with a review of the language guidelines that foster person-first, strength based language.

    Highlight #4

    Finally, there was the session on #LanguageMatters- Strategies to Improve Communications in Diabetes Care. Jane K Dickinson, and Joe Solowiejczyk, both healthcare providers and people living with diabetes, gave their perspectives on the use of language. Notably, Jane was the lead author on the publication , The Use of Language in Diabetes Care and Education (we’ve written about #languageMatters in the past here). Then Kevin Joiner connected the dots between the stigma associated with language when engaging in a healthcare discussion. Finally, Dr. Jane Speight, lead author of the Australian Position Paper, A New Language for Diabetes, helped to identify strategies for healthcare providers to communicate more effectively with people living with diabetes. We were excited to see them show the Telly Award Winning #LanguageMatters video that was co-designed with the #DOC and released last year at the AADE meeting, Changing the Conversation.

    Deb watching the Changing the Conversation #LanguageMatters video at the #ADA2019 meeting (Photo credit Renza Scibilia)

    Check back July 10th as we share another big highlight from ADA Scientific Sessions,  discussion of the recently published “Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report”.

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

    Follow us on Twitter and Instagram @AFreshPOVforYou.


  • Fresh Views

    Reflections on our #WDD2018 Twitter Chat

    On Wednesday, November 14, 2018, World Diabetes Day, @AFreshPOVforYou was honored to moderate the 7:00 pm ET hour of the #WDD2018 Twitter Chat for #DSMA. Thank you to Cherise Shockley for allowing us to engage with the DOC on such an important evening.The questions put before participants were thoughtfully planned so that the information gained could be used in a small research study. In the near future, we look forward to sharing some of our learnings.

    We were thrilled with the participation and the depth of the responses to our “miracle question” exercise (See our previous blog posts to learn about “the miracle  question” and a bit about Solution Focused Brief Therapy [SFBT])

    There were 32 participants who created 358 Tweets and generated 1.54 million impressions! Wow!  If you’re familiar with Twitter Chats, search the #DSMA hashtag for all of posts between 7:00 pm ET and 8:00 pm ET on November 14, 2018 to follow the conversation.

    An overarching goal of the Twitter Chat was to explore the perceptions of the diabetes online community (or DOC for short)  on the miracle question approach to strengthen resilience and confidence needed to manage diabetes. As usual, the DOC is incredibly insightful and we learned so much.

    Here’s a sneak peak at the many thoughts shared during our discussion.

    We look forward to moderating a future #DSMA Twitter Chat in 2019 as we delve deeper into incorporating SFBT in diabetes care and education. Stay tuned!

  • Fresh Views

    Let’s learn from the Diabetes Online Community (or the DOC for short)!

    We are big believers in “collective wisdom”, or rather the ability to learn from a greater community.  When sharing thoughts and experiences we can learn from others. Would you agree? As we are delving into the use of Solutions Focused Brief Therapy (SFBT) in diabetes we want to engage the DOC in a Twitter chat so we can learn first-hand from those living with diabetes every day!

    One practice used in SFBT is called the “miracle question.” This method helps people use the resources they already have and leverage “exceptions”. Exceptions are simply times when life works better, or times when problems are less likely to take over.  Focusing on personal “exceptions” means focusing focus on situations that went well in the past, or on positive things learned from past experiences (things maybe even forgotten about). Managing diabetes is challenging. Constant focus on “problems” can eroded confidence. We hear that repeatedly from clients we engage with. By  instead focusing on abilities and the possibilities, there are solutions ready to use right in front of us. We can envision the future differently.

    So, here is the miracle question:Suppose tonight while you sleep, a miracle happens. When you wake tomorrow morning, what will you see yourself doing, thinking, or believing, about yourself that will tell you a miracle has happened in your life?”  We challenge you to think about it. How would you answer it?

    By focusing on “exceptions”, goals become different. Focus turns to what is desired in our life instead of what “won’t happen” anymore. To modify this question for diabetes management, let’s consider the following:  If you could fast-forward to a time where you feel satisfied with your diabetes management, what will be different in your life that will let you know things are better?

    Weigh in with your thoughts to these questions and others on Wednesday, November 14, 2018, World Diabetes Day, as we moderate the 7:00 pm ET hour of the #WDD2018 for #DSMA.  During the chat we will be walking through a modified miracle question exercise to learn from all of you. We have received IRB approval to use the de-identified Twitter Chat data (that means we remove the Twitter handles before we review the data) for a qualitative research study to explore the perceptions of the DOC on incorporating the miracle question approach to strengthen resilience and confidence needed to manage diabetes. (And for those of you that may not be familiar with IRB approval, that just means a review committee applies research   ethics by reviewing the proposed research methods to ensure they are ethical). Don’t worry, if you want to participate in the chat, but prefer for us to not use your answers in our research study, you can do that too. We’ll ask who wants to not be included during the chat and will remove your answers.

    Please join in the discussion and let’s learn if this approach resonates with you!

    If you’d like to read more about the Miracle Question, we loved this book!

    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.

     

%d bloggers like this: