• Fresh Views

    Inspire self-care with your words

    September 13, 2023

    Self-care is how you take your power back. – Lalah Delia

    We recently returned from the ADCES23 conference in HOT Houston and are still processing all that we heard and learned from the speakers and exhibitors! This was an extra special conference as we were celebrating the 50th Anniversary of the Association. As Past Presidents, both Tami and Deb were recognized on-stage during the opening session. There were so many special events and opportunities to network with colleagues and friends, both old and new.

    As we close out our summer self-care series, two sessions that particularly resonated with us that we want to share were presented by. Lauren Plunkett, RDN, LD, CDCDES, Frame a Healthy Relationship with Food Using Nutrition-Focused Language Skills and an engaging presentation by co-presenters Dr. Natalie Bellini, Dr. Diana Isaacs, and Dr. Sean Oser, Use Time in Range to Congratulate, Celebrate, Recognize, Align and Partner. (Lauren’s presentation is available On-Demand if you registered for the conference and didn’t catch it live.) All of these speakers emphasized the power of words and how we, as healthcare professionals (HCPs), can inspire self-care through the words that we use by using empowering language.

    Optimistic Coaching & A Positive Food Vocabulary

    Lauren, a person living with diabetes (PWD) reminded us that PWD have it in themselves to be exceptional! She acknowledged the significant impact that diabetes has on emotional health and that awareness of emotional health can help sharpen communication skills.She encouraged leading client/patient encounters with a positive attitude and engaging in “optimistic coaching” to support self–efficacy and quality of life. GIven that she’s an RDN, her particular focus was around addressing immediate needs and using positive food vocabulary, such as “colorful”, “flavorful”, “nourishing”, and “abundance”. She reframed food as “energetic nourishment” and that eaters focus on quality and addition (such as eating more plants, more fiber) rather than subtraction. 

    Asking Questions and Focusing on the Positive

    During the discussion on time in range (TIR) the speakers emphasized that getting to know your patients can help to understand their daily lives which will lead to a greater understanding of their challenges and successes with diabetes management. When reviewing ambulatory glucose profile (AGP) data, HCPs were encouraged to find something positive to discuss, no matter how small. Only focusing on the negative is not empowering. As we @AFreshPOVforYou have discussed before, these presenters reminded the audience to not focus on data as “good” or “bad” but as neutral in order to help reduce the stigma often associated with diabetes. In addition, the presenters recommended technology to support people with diabetes in their management. While this ADCES23 presentation is not on-demand, we’re told there may be a repeat at the December ADCES Technology 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. 

    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.

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  • Fresh Views

    Transform Primary Care Encounters: Tackling the Diabetes Diagnosis

    April 20, 2022

    “Health is a state of body. Wellness is a state of being.” ~ J. Stanford

    Our prior post in our series on transforming primary care encounters focused on combating therapeutic inertia. Today, we’d like to start from the very beginning – the conversation when the client first learns they have type 2 diabetes (T2D).  When beginning diabetes conversions using a solution-focused approach, we believe you will find that your relationship with your clients can improve and it will create an opportunity for ongoing shared decision-making.

    As a reminder, a solution-focused approach is the opposite of a “problem-focused” approach. The goal is to help the person with T2D recognize exceptions (when their problems did not happen) and help them to focus on their health behavior changes by doing “more of what works.”

    Using a solution-focused approach at the T2D diagnosis conversation?

    When preparing for the diagnosis conversation, first put yourself in your clients shoes. How would you want the conversation to go? What would you want to hear? Also consider your body language, your tone and word choice. We know in a busy primary care office, so much time is spent documenting in the EHR, but for this very important discussion, take a moment and step away from the computer, lean in to your client, show empathy and compassion while you say some very important words. Many are overwhelmed when they hear the news that they have T2D, and often won’t hear much of the rest of the conversation. Ask questions and engage in problem free talk, instead of giving a list of instructions. Maybe you simply state, “I know this is hard to hear, how can I help?” and “What information would you like to hear from me today as you start to learn about T2D?” Consider making this appointment brief and bring them back for a follow up “diabetes only” visit once they have time to absorb and process the information. 

    To build upon our blog on therapeutic inertia, we’re including some impactful information from the American Diabetes Association that encourages four critical conversations that promote “early positive conversations about the nature of diabetes.” These conversations address many tenets we value in a solution-focused approach, including person-centered, strength-based language, problem-free talk, listening, and building a partnership with clients.

    4 critical conversations

    There are four critical conversations that need to happen very early in the diagnosis. We encourage you to build upon these questions at each visit. Start small with a few comments and then build upon them as the person is learning to accept the diagnosis and is ready to learn more. At diagnosis, conversation #1 is the most significant. (adapted from ADA Overcoming Therapeutic Inertia)

    1. The nature of T2D is to change over time, as your insulin production changes.

    “I want you to know that diabetes is not a personal failure and it doesn’t mean you’ve done something wrong.”

    1. Your treatment plan will change over time as your diabetes changes.

    “You may need to add new medications as your diabetes changes. This is not a personal failure, just a part of how diabetes treatment progresses.”

    1. You can’t do this alone.

    “I am here to help you.”

    1. Share your difficulties with managing your diabetes.

    “Managing diabetes day in and day out can be hard. Share anything that may be getting in the way of managing your diabetes and also share your successes.”

    Close the diagnosis visit with a scaling question.

    “On a scale of 0-10 where zero is no stress and 10 is the worst stress you’ve ever experienced, where are you right now?“

    Use their answer to finish the visit and provide one action for them to focus on.

    • If 0-4:  encourage them to do some research online at trusted sources like the ADA, Diatribe, or ADCES.
    • If 5-7:  identify one strength they already have and build upon it
      • “What is one thing you do for yourself every day that makes you feel healthy? How can  you do more of that?”
    • If 8-10: just encourage them to breathe and take some time to let it sink in and to come back with questions in one week
      • “I know how hard this can be, take some time, write down questions you have, and let’s meet and talk more next week.”

    Reinforce that small changes can help move them in the right direction, and that you do not expect perfection. If they do the best that they can do, that’s the best they can do.  Remind them that you are partners on this journey. We believe that creating a supportive environment from day one, can empower people to learn to live with their diabetes.

    Keep reading our series on incorporating a solution-focused approach when managing T2D in the primary care setting. Next time we will focus on the first follow up visit after diagnosis.  Stop back by in 2 weeks as we share more tips to build your solution-focused tool-kit 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.

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  • Fresh Views

    Transform Primary Care Encounters: 7 Practical Tips to Get Started

    March 23, 2022

    If it ain’t broke, don’t fix it. Once you know what works, do more of it. If it’s not working, do something different. – Steve de Shazer and Insoo Kim Berg, pioneers of solution-focused brief therapy

    Our last blog spotlighted the power of words and using person-first, strengths-based language in diabetes related conversations in primary care. As we continue our series on transforming primary care encounters by incorporating solution-focused techniques, maybe your interest is piqued by this new approach, but you’re not quite sure how to begin to incorporate it into your practice?  Today we share 7 practical tips to get started. 

    1 – Ask “exception” questions. Exceptions are times when an expected problem does not occur. These are times we want to identify, focus on, and encourage the client to explore. These exceptions help the client move towards their desired future. Here are 2 examples of “exception” questions:

    • You mentioned that you typically struggle to be physically active in the evenings but you were able to go to the gym after work last week? How did you manage to do that?
    • Cooking meals at home has been a challenge for you, yet you cooked two times last week. What changed to allow you to make that happen? And what else?

    2 – Use person-first, strengths-based language. This may seem simple, but is hugely impactful. This means using language that is neutral, non-judgmental, and free from stigma. Language that is inclusive, respectful, and imparts hope. Word choice that fosters collaboration with your client and is person- centered. Focusing on language can remove the stigma associated with diabetes.

    3 – Practice problem-free talk. By incorporating this one impactful change you will already notice how the quality of visits and client engagements will improve – building the therapeutic relationship, hope, and motivation. The conversation at the beginning of an encounter is critical to build the therapeutic relationship. By starting the conversation with the goal of the client, you acknowledge that you are focused on their needs and desires and are committed to helping to meet their goals.  Two great ways you could begin a visit are to ask your client:

    • What would make this a successful appointment for you? 
    • At the end of this visit, what would you need to know/learn to say this was worth your time?

    4 – Ask the Miracle Question.

    The Miracle Question applied to diabetes is one tool or technique in a solution-focused tool-box to help clients envision a future that is more problem-free. 

    • Miracle Question: 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?

    You can learn more about the Miracle Question applied to diabetes in a previous blog post here. The Miracle Question helps people identify those “exceptions” mentioned in #1. The Miracle Question challenges a person to look past their obstacles and feelings of hopelessness to focus on possibilities, opportunities, and a vision for the future. The goal is to help one identify what they’ve actually known all along, and that they have the power to make choices and changes that can move them forward. By focusing on “exceptions”, goals become different. Focus turns to what is desired in our life instead of what “won’t happen” anymore.

    5 – Ask eliciting questions. When incorporating a solution-focused approach you need to ask eliciting questions to uncover solutions and guide the individual. It is key that these questions are open-ended and help the individual see how they can be successful. Instead of asking  questions that focus on the problems (since living with a chronic condition cannot benefit from a “quick fix”), instead, explore their strengths and resources they already possess and how those resources can apply to their diabetes management.

    • What has been going well since I last saw you?” 

    That one question can  start the visit on a positive note, acknowledge  the work that it took to accomplish that, and then leverage how the client can continue those positive behaviors and build on them for future health success. Questions can also focus on details when the person identifies a success:

    • How exactly did you do that? What exactly did you do differently?

    6- Ask future visioning questions. These questions can focus on the short-term or long-term views of the client’s preferred future. These questions help the individual realize that solutions are possible and help them see their desired future state. As you recall one of the key tenets is the client is the expert about their own life and their own diabetes. (Read more about experts here)

    • What would you like to see yourself doing in the next (day, week, month) to move you forward towards your goals? And what else? 

    Following up with “what else?” encourages people to dig deeper and think through in detail what they are capable of.

    7 – Use scaling questions. Scaling questions are a great tool to move away from all or nothing thinking. They focus on progress, motivation, and confidence.

    • On a scale of 0-10 where 0 is not confident at all and 10 is very confident, how much confidence do you have that you can meet your goal to (insert personal goal here)?  

    If less than a 7, follow up with one of these:

    • What could move you to a 7? 
    • What would need to happen to move you one number higher?
    • What would one number higher look like? 
    • How would others notice you’re more confident?
    • How come you’re not at a lower number? How did you do that?

    Keep reading our series on incorporating a solution-focused approach when managing T2D in the primary care setting. Our next blog will focus on therapeutic inertia. Curious what that means? Stop back by in 2 weeks as we share more tips to build your solution-focused tool-kit 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.

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  • Fresh Views

    Transform Primary Care Encounters: The Power of Person-First, Strengths-Based Language

    March 9, 2022

    The language for solution development is different from that needed to describe a problem. Steve de Shazer, pioneer of solution-focused brief therapy

    If you are just catching up on our thoughts around transforming primary care visits by incorporating solution-focused (SF) tools and techniques, check out our last post about the benefits of using a SF approach. This week in our series we are spotlighting the power of words – meaning the words that we choose in conversations and interactions with clients. As the authors of the transformative paper The Use of Language in Diabetes Care and Education (Diabetes Care 2017;40:1790–1799 | ) call out: 

    “Words are immediately shaped into meanings when people hear or read them, and those meanings can affect how a person views him or herself…Words have the power to “elevate or destroy”.”

    Person-first, strengths-based language

    We’ve written extensively about the power and benefit of using person-first, strengths-based language in diabetes care and education and how #languagematters. Research clearly shows that positive language is associated with positive health outcomes. And on the flip side, when people are faced with language that is judgemental, blames and shames, they are less likely to share openly with their healthcare team. 

    3 examples of how flipping a few words can flip the conversation:

    • Refer to one as a “person with diabetes”, rather than a “diabetic” (which labels them).
    • Refer to “check” blood glucose, rather than  “test” blood glucose” (which implies good/bad or pass/fail)  
    • Describe the scenario such as, “You take your medicine about half the time.”, rather than labeling one “noncompliant” (which shames)

    A SF approach is not possible unless there is open communication facilitated by strengths-based language. 

    Why does language matter in primary care?

    Again, language is powerful. We’ve discussed that the relationship between the healthcare provider (HCP) and the client is different. Instead of a hierarchical position, in SF relationships, the HCP and the client are considered “think partners”. They work together to identify solutions to move that individual forward towards achieving their goals. Thus, the language must follow to build the relationship.

    Importantly, the goal for those with type 2 diabetes (T2D) is to feel they are part of a partnership in their diabetes management with their HCP, where they can discuss their challenges and their strengths and work together. Is it possible to create and strengthen this relationship when words such as non-compliant, cheating, not working hard enough, or other shaming and blaming words are used? 

    When we use words that focus on what people “can do”, and words that describe their actions, we recognize and acknowledge that diabetes is managed by the person living with it and we acknowledge that it’s one piece of their life and not their whole life. When a person living with diabetes engages with their primary care team as a partner, much can be accomplished. As we’ve noted before, you are able to “flip” the conversation from a negative to a positive and foster that “think partner” relationship.

    Imagine a situation where an individual living with T2D looks forward to their primary care appointments because they are going to share with and learn from their HCP with no fear of judgment. They’ll talk about their struggles and challenges in a truthful manner and together they’ll identify areas that are working and small steps that can be taken to lead towards success.

    The most important lesson you can take away from this discussion is that using strengths-based language is actually easy to do. As our friend and colleague Jane K. Dickinson says, “when you put the person first (not the diabetes), the language will follow.” 

    Our goal is that people living with T2D will develop a positive relationship with their primary care team, and all involved will understand the challenges, the opportunities, and the need for an empowering approach towards diabetes care and education. And we believe that a change in language can lead that.

    If you’re not sure how to begin, consider starting your next encounter with one of these questions:

    1. Thanks for coming in today. What’s been going well for you in your diabetes management?
    2. It’s so nice to see you today, managing diabetes is really hard work – it’s like a part-time job. Tell me what  you’ve been happy/pleased with  about your diabetes management since we last met?
    3. We all need support in some manner. Diabetes is a team effort. How can I support you and support the changes you want to make? I’m here for you.

    We hope you’ve been learning little nuggets with each blog post as you build your solution-focused tool box for managing T2D in primary care. Keep reading our series on incorporating a solution-focused approach when managing T2D in the primary care setting. 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.

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  • Fresh Views

    Transform Primary Care Encounters: Here’s Why

    February 9, 2022

    Problem talk creates problems. Solution talk creates solutions. – Steve de Shazer, pioneer of solution-focused brief therapy

    Managing diabetes is complex.  We know that. Constant focus on “problems” can erode confidence. So, clients may turn to us, their healthcare team, looking for guidance to do something different. 

    As we continue our new series on transforming primary care encounters by using a solution-focused approach, today let’s talk about WHY use this approach. We’ve had several primary care providers encourage us to share more on this approach as they found it to be a transformational way of thinking and engaging with clients. So let’s delve a little deeper today…this is one way of thinking that may help.

    Before we begin, one significant difference in a solution-focused approach is use of the term “client” instead of “patient.”  In a solution-focused approach the clinician and person with diabetes are considered “think partners” working together to manage diabetes. Thus, the term client is more inclusive and more indicative of the approach, and is what we use. (That said, we realize that the term “patient” is widely used in many healthcare settings and we respect that.)

    Why use a solution-focused approach in primary care? 

    Since the majority of type 2 diabetes (T2D) is managed in primary care, it seems that the best place to start to change the way we engage with clients is through primary care. Without a doubt there are many competing demands during a primary care visit. And visits can often focus on “fixing” “problems” as the limited appointment time flies by.

    The Taxonomy of Burden of Treatment, published in 2015, identifies three areas where people with chronic conditions, such as diabetes, have “work to do”. So, if a person does “everything” the guidelines ask them to do, that would take about  2.5 hours/day… that’s like a part-time job – a job they didn’t ask for! And those 2.5 hours don’t take into account the nuances of the impact on their life, and factors that make living with chronic conditions challenging, like work, travel, lack of income etc.The constant focus on problems can make living with T2D even harder.

    Considering the complexity of chronic care can help build compassion and recognize the reality of day to day life – what we’re asking people to do  – and how it is impacting everything else. The way a person is treated and the way they feel about living with diabetes impacts outcomes. When doing all this work to manage their diabetes and then see their care team focus on what’s wrong or what’s not happened, instead of what is working well, negates all their hard work. This is where language and communication are key. 

    In the image at the top of this blog you can see a quick summary of how the interaction can be “flipped”. Incorporating a solution-focused approach can enhance your client relationships and build trust and open communication needed for successful diabetes management.

    Join us as our series continues on  incorporating a solution-focused approach when managing T2D in the primary care setting. We’ll share how you can incorporate the tenets into a brief visit and how you can build your solution-focused tool-kit over time. Our goal is to start slow and share small, achievable, bite-size practice changes you can implement over time. Our next post will focus on benefits of this approach for the primary care team, both clinician and person 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

    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.

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  • Fresh Views

    Transform Primary Care Encounters: Do Things Differently in 2022

    January 26, 2022

    Doing things differently leads to something exceptional. – unknown

    Watching the sun set at Wise Villa Winery, Lincoln, California and thinking of new opportunities for 2022

    With the start of the new year, one of our goals is to share the basic tenets of a solution-focused approach and how to incorporate these techniques into a brief primary care visit. We’ve had several primary care providers encourage us to share more on this…so here we go launching a series to slowly guide the evolution of practice! Follow our blog so you don’t miss out on practical guidance and tips to transform primary care encounters. (And if you work in a setting other than primary care, you’ll still want to follow because many of the tips can be applied to other practice settings.)

    Why do we embrace a solution-focused approach?

    Consider this…the traditional medical model of care is “problem-focused” – meaning you need to identify the “cause” to “fix the problem”. However, when faced with a life-long chronic condition (such as diabetes) that requires changes in health behaviors, “fixing a problem” is not so simple. One can quickly feel a sense of failure, feeling at fault where they’ve made “ bad decisions”, or some other negative feeling. 

    In our experience, it is common for those living with type 2 diabetes (T2D) to not want to reveal their health condition because of negativity towards T2D in the press, in the community, as well as from the medical field. Blame and shame are rampant. It is hard to be positive and move forward when viewing your whole life through this negative lens. This is where incorporating a solution-focused approach can be a game changer for both the clinician and the person living with diabetes. The whole conversation is “flipped” from a negative to a positive, helping to identify strengths and solutions instead of rehashing all of life’s issues that are not going well.

    What is a solution-focused approach to care and education?

    A solution-focused approach has its beginnings in counseling psychology, but has made inroads in a number of fields, and we are focusing on application to life with diabetes.  

    Here are 7 key tenets of this approach:

    1. Ask questions.  In a solution-focused approach asking eliciting questions is the key to uncovering solutions and guiding the individual. These questions help the individual realize that solutions are possible and help them see their desired future state.
    2. The client is the expert. Key to this approach is first recognizing the individual is a person that lives with their chronic condition on their own and manages their daily life, so they are not a “patient” in this model. They know what they need and understand their condition and how it impacts their greater life. We recognize they are the center of the team and we value their input. Read more about experts here.
    3. If something works, do more of it. The premise here is that if you do “more” of what is going well, then in general you will have less time and opportunity to engage in what is not working well. Helping the individual recognize their strengths and successes builds confidence needed to manage a complex condition. It can be as simple as opening the visit with the question, “What do you feel like has been going well with your diabetes?”
    4. Focus on exceptions.  Exceptions are times when the problem “might” have occurred but didn’t. This could be something small and often overlooked, but when you can highlight these opportunities you can then focus on solutions that are in front of you. You can read blogs we’ve written about exceptions here.
    5. Small changes move you forward.  The goal is to help the client take small steps to move their goals forward and each small step can lead to more success.
    6. Clients already possess the resources they need for change.  Most people are aware of what works for them and have the ability to identify solutions. We can help people to recognize these resources and help them to develop resiliency to manage their condition.
    7. Language matters. We know and evidence shows that the language we use in healthcare is associated with health outcomes. When people are blamed and shamed for their health condition they are less likely to see their healthcare team and less likely to talk with their care team when they are not meeting health goals. The use of person-first, strength-based language in a solution-focused approach is critical to develop a therapeutic relationship with clients.

    We hope you will see that this approach can help both clinicians and people with diabetes to collaborate in managing diabetes.

    Join us for our series on incorporating a solution-focused approach when managing T2D in the primary care setting. We’ll share how you can incorporate these tenets into a brief visit and how you can build your solution-focused tool-kit over time. 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.

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  • Fresh Views

    Language Matters Global Summit

    October 20, 2021

    We’re taking a bit of a detour this week in our “Diabetes Technology and Solution-Focused Practice” series to focus on a special event – a Facebook Livestream Language Matters Global Summit. 

    We @AFreshPOVForYou have been supporters of the #LanguageMatters movement in diabetes care and education since early on. You can read previous blog posts here and here.

    Initially, when the Diabetes Australia Language Guidance Paper was published here, we were off and running, trying to incorporate strength-based, person-first language into all that we did. Deb was working at Sutter Health at the time and started a National Diabetes Month/World Diabetes Day campaign to educate healthcare professionals within the system about the rationale behind the movement and the meaning behind the words.

    Soon after the United States guidelines were published jointly by both the Association of Diabetes Care and Education Specialists (ADCES- formerly AADE) and the American Diabetes Association (ADA) the Use of Language in Diabetes Care and Education (Dickinson, JK, 2017) here. We were then even more inspired.

    As we’ve written about before, we were involved in the script development and production of the Telly Award winning video “Changing the Conversation,” with a purpose to raise awareness of the power of language and the impact language can have on a person’s well-being, quality of life and overall sense of self while living with diabetes. We’re so proud that this video has been shown around the world!

    And the use of language is the foundation of this solution-focused blog. We believe and live these principles every day and work to help others embrace the important messages and translate them into their relationships with their clients and co-workers.

    Yesterday, October 19, 2021 Diabetes Australia celebrated 10 years of moving the needle forward in the #LanguageMatters movement by hosting a Facebook Livestream Language Matters Global Summit. We were thrilled that this event included a showing of the Changing the Conversation video and Deb was so humbled to introduce the video once again to new audiences.

    As October turns to November and Diabetes Month activities, please consider sharing the YouTube link to this event and continue to raise awareness about the importance of and need to change the way we talk about diabetes to help stop the stigma, shame and blame often associated with a lack of knowledge combined with media hype around diabetes.

    We can all make a difference when we believe that #LanguageMatters!

    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.

    Read More
  • Fresh Views

    Diabetes Technology and Solution-Focused Practice: Words are Powerful

    June 2, 2021
    Word cloud from participants with diabetes in some of our research

    “Words are, of course, the most powerful drug used by mankind.” – Rudyard Kipling

    Words are powerful! Consider these famous brands whose whole identity is defined by a few  words. 

    • Bounty: The Quicker Picker Upper. 
    • American Express: Don’t leave home without it. 
    • United Airlines: Fly the friendly skies. 
    • Disney: The happiest place on earth. 

    We remember these words. These words have power. These words have certainly left an imprint!

    In our series on diabetes and technology, today we’re revisiting a previous post about the power of language. When using technology tools, especially for virtual visits, the words we choose are just as important, if not more so than with in-person conversation. It’s hard (or even impossible) to read body language, voice tone and inflection, etc. So choosing person-centered, strength-based language during technology discussions is critical. 

    If you’ve followed our blog over the last 3 years, you’ve seen that we’ve focused a lot on the power of words. Words can define how people view themselves and their situations. Words can empower. Or words can stigmatize and judge. Our belief and practice @AFreshPOVforYou centers around using words that focus on strengths and create solutions, instead of words that dwell on the past and on problems. 

    Changing the conversation

    You may know that we partnered to help create the Telly Award winning video, Changing the Conversation (you can find it here), that focuses on the impact words have when living with a chronic medical condition. The video begins with Words are powerful!  We’ve watched this video hundreds of times and yet, it still brings a tear to our eyes. Why? Because the words resonate with our emotions and what we believe to be true, but most importantly, the words came directly out of the mouths of individuals who live with diabetes – Every. Single. Day. They shared their thoughts, feelings and emotions with us to create the inspiring words incorporated in the video.

    Now what if the same thing happened with healthcare communication? If careful thought was given to words used in conversation with clients; choosing words that resonated with people living with diabetes. Words that mattered. We can change the way they feel. Words that empowered them. Words that could transform them for the better. 

    Over the course of writing our blog, engaging in research, and connecting with the diabetes community we have been compiling words that align with the tenets of a solution-focused approach to care and education. You see some of those in the word cloud above. Words spoken by people with diabetes in surveys, research and focus groups. Words expressed during Twitter chats. You can read a few of our blogs about strengths, exceptions and possibilities here.

    How are your words impacting others today? 

    Together, we can slowly evolve our vocabulary and ultimately change our messages. Together we can embrace possibilities, opportunities and create a fresh vision for the future.

    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 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. 

    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.

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  • Fresh Views

    NO JUDGEMENT: Today’s words to jump-start solution-focused practice

    October 28, 2020
    Pumpkin Mania at Transylvania University

    Often people who criticize your life are the same people that don’t know the price you paid to get where you are today. – Shannon Alder

    Halloween is just around the corner! Pumpkin Mania at Transylvania University in Lexington, KY (pictured above) always gets Tami in the holiday spirit and ready to see all of the costumes and trick or treaters on Halloween night. (That’s something we both will miss thanks to the pandemic). Halloween doesn’t have to be all tricks and no treats though for those living with diabetes. Many clients with diabetes have shared over the years the “judgement” they have felt and received from others when choosing to enjoy a small Halloween sweet treat or two. Having heard that again just recently, it prompted us to focus on “No Judgement” in this post. 

    TODAY’S WORDS ARE: NO JUDGEMENT

    Stigma and “judgement” are common around diabetes, and can contribute to stress and feeling shame. Receiving negative and blameful comments and judgement, whether through “a look” or through words, has an impact on motivation and behavior. Each member of the healthcare team can play an important role in serving people with diabetes by taking a respectful and inclusive approach. Clients may not even remember all you said to them in the encounter, but they’ll always remember how you made them feel – if you made them feel good or feel bad, if you made them feel valuable or invaluable, That’s where listening and replying  without judgement comes in. What we say and how we say it matters. 

    In fact one respondent’s comment from a #DSMA Twitter Chat we hosted on World Diabetes Day a couple years back has stuck with us: “Success would look like people realizing what diabetes is and we can stop with these assumptions and jokes about diabetes.” So powerful. (By the way, you may want to read more about insights we gained, published this month in The Diabetes Educator journal: “Applying a Solution-Focused Approach to Life With Diabetes: Insights Gleaned via Twitter ” Volume 46, Issue 5 of The Diabetes Educator.  We’re super excited to have these findings published!)

    Putting “no judgement” with a solution-focused approach into practice
    On the topic of Halloween, Tami recalls a client with diabetes she worked with a few years back that absolutely adored Halloween candy, particularly the fun-size chocolate bars. This individual was struggling with trying to manage her carbs, “stay strong”, and “resist” the treats she encountered every time she stepped into the grocery store. And then there were the “after Halloween” sales to navigate when all the treats were 50% off!  She shared that she had learned if she bought 1 bag and kept it out of sight, rather than in a bowl on the counter where she would be reminded of the chocolates, she wasn’t as tempted, but still found herself reaching for the bag more often than she desired. How would you approach this conversation applying solution-focused principles? Tami, acting as her “think partner” spent some time talking with her – no judgement – acknowledging the positive discovery she made and exploring how she could leverage that. Tami rephrased and included the clients own words, “How were you able to decide to keep the candy bag out of sight? What else can you do?” Building on that, the client decided that when she bought a bag of chocolates, she would put the bag in the freezer and only take out 1 or 2 chocolates at a time to help reduce her temptation further. She reported back that this was hugely helpful. Building on her discoveries and areas where she was having some success, helped to discover a new solution and achieve her goals to fit in a favorite Halloween sweet treat without compromising her blood glucose. 

    If you haven’t seen it yet, JDRF has an excellent easy-to-use Halloween Guide with tips on how to keep the holiday fun and safe, along with carbohydrate counts for popular Halloween candies. Helpful information for “kids of all ages”. 

    So whether you choose a low- or very-low carbohydrate eating approach without sweet treats in the mix, or you choose to fit in and enjoy an occasional sweet treat, we hope these real life examples illustrate how others have found success around managing holiday treats, and how to apply a think partner approach with clients in a “no judgement” way, to find solutions leveraging past successes. 

    EACH WEEK WE INVITE READERS TO PARTICIPATE IN A SOLUTION-FOCUSED CHALLENGE… This week, we challenge you to strive to be mindful and consider how you may convey judgement in both words and actions in client interactions. Think about:

    1. The strength, courage, and time it takes for individuals to carry out their daily diabetes self-care.
    2. Using person-first, strengths-based language. (View a previous blog on language here.)
    3. Practicing cultural humility.

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

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

    Follow us on Twitter and Instagram @AFreshPOVforYou

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

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  • Fresh Views

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

    July 8, 2020

    Every accomplishment starts with the decision to try ~ Author unknown

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

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

    Today’s word is: OPPORTUNITIES

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

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

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

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

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

    Ask your client:

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

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

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

    Follow us on Twitter and Instagram @AFreshPOVforYou

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