We guide healthcare professionals in a solution-focused approach so clients can embrace possibilities, opportunities, and a fresh vision for the future.
Success is built sequentially. It’s one thing at a time. – Gary W. Keller
Building on our last blog about how to have a productive type 2 diabetes (T2D) diagnosis conversation using a solution-focused approach, NOW let’s focus on how to incorporate these techniques into follow up visits. These follow-up visits are ideally “diabetes only” visits. In a brief primary care visit that is addressing multiple issues, it can be too challenging to focus on specific diabetes priorities. The American Diabetes Association recommends scheduling “diabetes only” appointments to focus on and address diabetes-related concerns. This diabetes only visit is an opportunity to be a think partner with your client to answer questions, address concerns, and map out a plan together.
Using a solution-focused approach at a “diabetes only” visit?
Since asking eliciting questions is a primary tenet of a solution-focused encounter, we encourage starting all visits by listening and learning from your client. Even though the client is new to diabetes, they are the expert in that they know what works in their life in other aspects, and they know what they are capable of doing now. (Read more about experts here)
The goal is to focus on things that are working well, and when something works, do more of it! Help your clients to recognize their strengths by identifying exceptions. We’ve written about exceptions here). “Diabetes only” visits can be structured in a systematic way.
10-step model for a “diabetes only” visit
Start with a question.“I’m looking forward to hearing how things have been going since our last visit. Can you tell me one thing that went well for you this past week (or since we last met)?”
Explore the reply further. “How do you think you can do more of (that)?”
Personalize. “I want to make sure this visit is successful for you, what do you need to know or learn by the end of the visit?”
Empower. Empower people with diabetes with tailored education and support to ensure their questions, needs and desires are met.
Set a SMART goal. A SMART goal helps move the individual towards the direction they want to move based on your conversation. It helps quantify progress with measurable steps and keeps things reasonable and achievable.
Ask a scaling question. “On a scale of 0-10 where zero is never and 10 is all the time, how confident are you that you can achieve your goal?
Use their answer to finish the visit and provide one action for them to focus on.
If 0-4: Encourage them to revise their smart goal, it might be too difficult to achieve.
If 5-7: Identify one strength they already have and build upon it. “What is one thing you do where you feel confident in your actions? How can you do more of that?”
If 8-10: Encourage them to challenge themselves and consider a goal that might move them closer to their overall health behavior outcomes.
Review the four critical conversations. As we discussed in the last blog, we encourage you to build upon these conversations at each visit. (adapted from ADA Overcoming Therapeutic Inertia)
Conversation 1: The nature of T2D is to change over time, as your insulin production changes.
“Although diabetes is progressive, and can change over time, your actions can make a difference in slowing the progression over time.”
Conversation 2: Your treatment plan will change over time as your diabetes changes.
“We will work with you to find a treatment plan that achieves health goals while also considering your preferences and values.”
Conversation 3: You can’t do this alone.
“Seek help from family, friends and community support resources.”
Conversation 4: Share your difficulties with managing your diabetes.
“Your healthcare team is on your side and we will support you in whatever ways you need to manage your diabetes”
Refer for diabetes self-management education and support.
Thank them for coming in and for working hard.
Plan follow-up. Plan the next diabetes only visit.
Join us next time as we continue our series on incorporating a solution-focused approach when managing T2D in the primary care setting. We’ll continue to help you build your solution-focused tool-kit. Our goal is to start slow and share small, achievable bite-size practice changes you can implement over time.
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 employed by Dexcom, but her words and opinions in this blog are her own.
Tami is employed by the University of Kentucky HealthCare Barnstable Brown Diabetes Center, but her words and opinions in this blog are her own.
We hope you’re finding a little fun and relaxation this summer, and that you’re enjoying a few inspiring and fresh views along the way! If you’ve been following us, you know that we often share a fresh view that has inspired us, in coordination with our fresh point of view of the week…all as we guide healthcare professionals in a solution-focused approach to practice, so clients can embrace possibilities, opportunities, and a fresh vision for the future.
Last time we shared some #ADCES21 sessions we are interested in attending and this week we’d like to share a little more about our A Fresh POV for You session!
Wondering what is a solution-focused approach to practice?
As a quick summary of how a solution-focused approach compares to a “traditional” counseling approach, we’re sharing with you a snapshot from our upcoming presentation Saturday August 14, 3:15-3:45 Central at the virtual Association of Diabetes Care and Education Specialists Annual Conference. The presentation is titled “Adopt a Fresh Point of View: A Solution-Focused Approach to the ADCES7”. (The ADCES7 refers to the 7 identified self-care behaviors related to managing diabetes.)
We invite you to join us at our presentation where we’ll:
Describe elements of a solution-focused approach to client interactions.
Share how to apply a solution-focused approach when using the ADCES7 self-care behaviors in practice. AND
How to guide clients in identifying “exceptions” to strengthen resilience and confidence to manage diabetes
We’ll be there live chatting with you throughout to get all of your questions answered! Please reach out to us on social media during the conference!
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.
Deb is employed by Dexcom, but her words and opinions in this blog are her own.
Tami is employed by the University of Kentucky HealthCare Barnstable Brown DIabetes Center, but her words and opinions in this blog are her own.
We hope your summer has been going well! We’ve been busy with work and spending time with family. Here @AFreshPOVforYo we are getting excited for the upcoming ADCES21 Virtual conference. For those of you that are attending, we have highlighted 13 presentations that are interesting to us and align with our thinking around behavior change, person-centered care, use of language, and of course use of technology. While there are many, many more sessions we plan to join, we are showcasing just a few!
We hope you’ll attend our session on Saturday 8/14/21 at 3:15 pm CT, S30 – Adopt A Fresh Point of View: A Solution-Focused Approach to the ADCES7 Self-Care Behaviors™. We presented two years ago at #AADE19 and shared an overview of what a solution-focused approach is all about. This year we’ll go a little farther and address the ADCES7 self-care behaviors. We’ll be sharing more info about our program in two weeks, so stay tuned for that!
While we wish we were connecting with our colleagues in person this August, we appreciate the great program put together virtually. We’re crossing our fingers that we’ll be grabbing a coffee or a glass of wine at ADCES22 in Baltimore next year!
Enjoy the meeting if you’re attending! We’ll share some of our thoughts about the meeting in a future post. We’ll also be Tweeting during the conference to share some pertinent information!
T02 – Help People With Diabetes Shift Their Mindset and Change Their Approach to Self-Care Behaviors
In this session, presenters will show a framework for how diabetes care and education specialists can empower people with diabetes to take a new relationship approach to change their entire emotional experience with diabetes to improve self-care behaviors.
Learning Objectives:
At the completion of this activity, participants should be able to:
Describe a framework for empowering people with diabetes to change their emotional experience with diabetes
Describe how different types of relationships with diabetes impacts psychosocial and emotional functioning
Utilize practical tools to help people change their relationship with diabetes
T10 – Achieve Better Outcomes by Using Individually Customized Messages
This session will discuss how to achieve better results by combining smart goals, virtual programs, motivational interviewing, coaching, stages of change and behavioral strategies with customized messages designed individually to improve outcomes.
Learning Objectives:
At the completion of this activity, participants should be able to:
Combine behavior change techniques with customized messaging designed to improve individual outcomes
Embrace fears and help an individual to overcome barriers
Identify a starting point and build an action plan
T17 – Collaborative Psychosocial Care for Youth With Diabetes
Psychosocial care for youth with diabetes presents challenges for the care team. This presentation will cover engagement and treatment strategies that optimize diabetes care in youth and collaborative care provided by diabetes care and education specialists and mental health professionals.
Learning Objectives:
At the completion of this activity, participants should be able to:
Identify psychosocial care opportunities in youth with diabetes
Select validated surveys and screening formats for identifying psychosocial issues in youth with diabetes
Adopt concrete strategies to help youth with diabetes
T18 – Language in Diabetes Care From a Personal and Professional Perspective
Living with a disease that focuses on numerical values and patterns can be physically and mentally exhausting. Presenters will examine statements that trigger sensitive emotions and how to replace them with optimistic, inspirational coaching.
Learning Objectives:
At the completion of this activity, participants should be able to:
Collaborate with individuals to understand how they approach management of their diabetes
Articulate optimistic coaching methods to encourage individuals to live in partnership with diabetes
Reframe the standard clinical approach to a perspective that focuses on the individual experience
T27 – Diabetes Stigma: Causes and Consequences for the Concerned Clinician
In this session, participants will learn how diabetes stigma at individual, interpersonal and structural levels intersect and can compound other forms of social marginalization, contributing to health disparities and poorer outcomes.
Learning Objectives:
At the completion of this activity, participants should be able to:
Define diabetes stigma and name at least four dimensions of stigma
Name pathways by which diabetes stigma is associated with medication taking among people with diabetes
Promote diabetes pride in your practice and across the interdisciplinary diabetes care team
F04 – Too Good? The Potential Dangers of Perfectionism in Diabetes
This session will provide ways to recognize signs of unhealthy perfectionism in diabetes management, its medical and emotional risks, and tangible steps for helping individuals become more flexible, mindful and compassionate approach.
Learning Objectives:
At the completion of this activity, participants should be able to:
Explain how perfectionism exhibits in diabetes management
List possible consequences of perfectionism in people with diabetes
Utilize strategies for preventing perfectionism pitfalls among people with diabetes
F17 – Practical Approaches for Addressing Behavioral Health Needs
Nicole Bereolos, PhD, MPH, MSCP, CDCES, FADCES
Friday, August 13, 2021
12:40 PM – 1:10 PM
Performing an assessment of behavioral health needs in individuals with diabetes can be limited by lack of training, resources and time. This session will provide practical tools, resources and real-world examples to augment learning in this area for diabetes care and education specialists.
Learning Objectives:
At the completion of this activity, participants should be able to:
Identify the importance of addressing the behavioral health needs of PWD
Demonstrate real-world applications of addressing behavioral health needs
Utilize tools and resources appropriately to help address behavioral health needs in practice
D07 – Diabetes Care and Education Specialists and Behavioral Coaching For Mental Health: Creating Successful Partnerships
Korey Hood, PhD,
Brooke Benton, CDCES, MS, RD, LDN
Sunday, August 15, 2021
10:05 AM – 10:35 AM
Mental health issues can prove challenging to address for diabetes care and education specialists. This session will discuss how a behavioral coach can work alongside them to screen for mental health issues, recognize when individuals are struggling and connect them to available support resources.
Learning Objectives:
At the completion of this activity, participants should be able to:
Highlight models that promote partnership between the diabetes care and education specialist and the mental health specialist
Discuss the relationship between diabetes and mental health
Incorporate screening tools and identify referring sources to collaborate with for providing mental health care
D19 – Diabetes Distress: An Overview of Prevalence, Assessment and Treatment
Lawrence Fisher, PhD, ABPP
Sunday, August 15, 2021
11:15 AM – 11:45 AM
This presentation will review the definition, clinical presentation, prevalence, assessment and treatment of diabetes distress due to its high prevalence and consistent links with self-management, making it an important target of clinical care.
Learning Objectives:
At the completion of this activity, participants should be able to:
Perform a clinical assessment for diabetes distress
Utilize recommended tools for clinical assessment of diabetes distress
Discuss the treatment of diabetes distress
D25 – Optimize Support During Crises With Supplemental Peer Support
Anna Norton, MS
Sunday, August 15, 2021
11:50 AM – 12:20 PM
During the COVID-19 pandemic, peer support communities can serve as a supplemental resource for people with diabetes to maintain their mental health well-being. This session will provide strategies for diabetes care and education specialists to connect people with diabetes to these communities.
Learning Objectives:
At the completion of this activity, participants should be able to:
Recognize the need for psychosocial support for people with diabetes during a crisis
Provide suggestions and strategies for connecting people in their practice to peer support communities
Identify reputable resources for diabetes management outside of the healthcare environment
Here are a few technology sessions you may be interested in as well.
T24 – Facebook Collaborative To Improve Diabetes Management
Sharing diabetes challenges and engaging with peers through Facebook groups helps people with diabetes make connections and learn/reinforce actionable self-care behaviors. This session will discuss how to use social media to teach, reinforce and support people with diabetes.
Learning Objectives:
At the completion of this activity, participants should be able to:
Discuss how sharing diabetes challenges fosters connections and improves self-care habits
Increase diabetes education support outside of the provider’s office using social media marketing strategies
Create engaging social media content to obtain measurable results
ET07 – Powered by Dexcom: Continuous Glucose Monitoring Empowers Self-Management and Expands the Horizons for Connected Care
Lindsay Vettleson, RDN, CDCES, ACE-CPT, ACE-CHC, One Drop
Friday, August 13, 2021
10:45 AM – 11:30 AM Join the discussion with DCES digital health experts that are leading the development and implementation of digital platforms to support people with type 2 diabetes to engage in personalized, data-driven, self-management and support coaches and HCPs to inform therapeutic decisions.
S04 – Technology Interventions in High-Risk Populations: The Identify, Configure, and Collaborate (ICC) Framework in Action!
This presentation will describe the ADCES technology framework Identify, Configure and Collaborate (ICC) using a program that delivers care with technology-enabled devices in high-risk communities.
Learning Objectives:
At the completion of this activity, participants should be able to:
Describe the Identify, Configure, and Collaborate (ICC) framework and its application to high risk populations
Discuss the role of the diabetes care and education specialist in evaluating technology interventions within their practice
Discuss a technology assessment tool that can be utilized to assess specific technology needs
We’ll see you in two weeks with a more detailed description of our Saturday educational session!
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.
Deb is employed by Dexcom, but her words and opinions in this blog are her own.
Tami is employed by the University of Kentucky HealthCare Barnstable Brown DIabetes Center, but her words and opinions in this blog are her own.
A new year, new decade, and renewed focus for us here @AFreshPOVforYou! This blog is over a year old now, and while our overarching focus remains the same, our Mission has evolved over time.
Our overarching goal
Our broad goal at A Fresh POV for You is to focus on Possibilities, Opportunities and creating a Vision (POV) for the future, based on strengths and leveraging positive learnings from past experiences. Initially the primary focus of this blog was people living with or at risk for diabetes. However, we realized that we also want to share our learnings and how-to’s with other diabetes care and education specialists in order to begin to flip the paradigm to embrace a solution-focused approach in practice.
Our new Mission
We guide healthcare professionals in taking a solution-focused approach to practice to enable clients with diabetes to embrace possibilities, opportunities, and a fresh vision for the future.
Who are we?
We are solution-focused diabetes care and education specialists . We are passionate about doing diabetes care and education differently. Too much of life is spent focusing on problems. Forget the “problems”! Let’s turn attention instead to possibilities, opportunities, and a fresh vision for the future. As diabetes care and education specialists, let’s step alongside our clients as “think partners” to focus on what’s important to them, what’s already going well, and build upon that to reach their goals so that they may live life to the fullest.
We have both spent our entire careers partnering with people with diabetes to leave a positive imprint. In our discussions and research with people with diabetes, we’ve heard loud and clear that many are not happy with the diabetes care and education services they have received. A remark that has frequently bubbled up is related to leaving a healthcare appointment feeling badly because of significant negative talk and attitudes – feeling as if they, the person with diabetes, has done something wrong, and thus are not motivated or inspired to do things differently. We are advocates for person-centered, strengths-based language, and believe that self-compassion is essential when living with a chronic condition.
A peek at our research findings
From our research we’ve learned that incorporating a solution-focused approach into our interactions with clients makes a difference. Five themes emerged from our qualitative study regarding what “would happen” in a desired future state, including: more living life; laughter and humor; self-compassion; resilience; and support.Together, let’s do more of what works, and focus less on what’s wrong.
Top 10 things we accomplished in 2019
Conducted a survey around the perceptions and impact of current diabetes education services. (You can learn more in this post)
Hosted 2 #DSMA Twitter Chats around taking a solution-focused approach to life with diabetes. (Read more about them here and here)
Conducted a qualitative research study via Twitter around the impact of implementing a solution-focused tool, the Miracle Question, with people living with diabetes.
Conducted in-depth focus groups with people living with diabetes to gain insight around wants and needs to co-design the future of diabetes care and education services. (Read more about co-design here)
Presented at the American Association of Diabetes Educators annual meeting on implementation of the solution-focused tool, the Miracle Question adapted for diabetes. (Read about that here)
Presented at the 55th Annual Meeting of the European Association for the Study of Diabetes (EASD) on our Twitter Chat research. (Read our abstract here and our blog posts here and here)
In follow-up to the EASD presentation, had our work published in the European Medical Journal focused on diabetes. (Find it here)
Submitted a paper on taking a solution-focused approach to diabetes care and education accepted for publication in AADE in Practice journal.
Submitted a paper sharing some of our research findings to The Diabetes Educator journal.
Outlined the content for a solution-focused handbook (more to come in the next year!)
Top learning from 2019
A solution-focused approach to diabetes care and education resonates with people with diabetes and diabetes care and education specialists!
Our fresh views
We’ve called our weekly blog posts our “Fresh Views” because not only do we share views and practical guidance in the diabetes realm, we also often share inspiring fresh views we’ve experienced in our travels, be it a beautiful sunset, a sandy beach, or towering mountains.
Getting to know us personally, beyond professionally is important. We believe in the concept of a “therapeutic alliance”- which means that the relationship between health care professionals and people with diabetes is the most important component. So, aside from being passionate diabetes care and education specialists, we are also speakers, authors, wives, moms, adventurers, and avid travelers always in search of the next fresh and magnificent view! We have lots of creative ideas and ways we hope to engage in innovative diabetes education services!
Follow us @AFreshPOVforYou on Twitter, Instagram, and Pinterest and learn more about our fresh views!
If you are a healthcare 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.
