• Fresh Views

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

    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. 


    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.

  • Fresh Views

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

    Every accomplishment starts with the decision to try ~ Author unknown

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

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

    Today’s word is: OPPORTUNITIES

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

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

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

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

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

    Ask your client:

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

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

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

    Follow us on Twitter and Instagram @AFreshPOVforYou

  • Fresh Views

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

    The strength in the Dolomite Mountains towering over a lovely placid lake in Northern Italy from Deb’s travels in 2018.

    We find ourselves in the middle of National Words Matter week. Did you know there was such a week? Words are the basis for communication, no matter what language is spoken. Because words matter, we’ve written about the #LangaugeMatters movement many times, you can read more here and here. Here at AFreshPOVforYou, we embrace the importance, power, and impact of words, not just this week, but all year long!

    Our series focusing on words to inspire solution-focused thinking and practice continues this week. You can read more about our take on the power of word selection here. Last week’s word was “Acceptance” – check out our perspective here.

    Today’s word is “Strengths”

    According to the Miriam Webster Dictionary, “strength” is: the quality or state of being strong : capacity for exertion or endurance: a strong attribute or inherent asset. In solution-focused talk, “strengths” are tasks or actions an individual can do well. For instance, seeking support. In a 2018 #DSMA Twitter Chat we asked participants about their strengths. One individual with diabetes replied:

    “I am strong when it comes to seeking support. When I am down, I am self-aware enough to address my hardship. I’m not afraid to be vulnerable.”

    Another replied:

    “My strength is that I refuse to give up. I am tenacious and do not take no for an answer.”

    An individual typically can recognize and clearly identify things they are able to do or achieve and feel happy. We can then encourage focus on those strengths, doing more of what is working, and leveraging those strengths, skills and qualities to create new opportunities. In the same Twitter Chat mentioned above, another participant shared:

    “I concentrate on the lifestyle. The day to day life of a person with diabetes. I work for overall health through exercise, and diet for BGL [blood glucose] results. The support I receive takes care of the rest. So, cure or not, let’s make it as good as we can and support the other.”

    We’ve learned that sometimes self-identified strengths are not areas we might immediately think of in the healthcare world, as evidenced by this individual’s reply:

    “My strengths are passion, humor, and striving to connect with the human being that is each of us. And reminding myself I’m a work in progress.”

    Diabetes care and education specialists can learn a lot from simply asking people what strengths they have to help them live well with diabetes. Those words speak volumes, as evidenced in this individual’s reply:

    “I have the strength to keep on going even [when] I have a few bad readings here and there.  I keep living and doing what I do.”

    The Association for Diabetes Care and Education Specialists (ADCES, formerly AADE) embraces using strengths-based language in diabetes care and education, and has a page of resources here that you may find helpful. 

    A solution-focused challenge

    So our challenge to you this week is to focus on using strengths-based language in your communications to help uncover strengths your clients have. And encourage them to build upon those strengths to do more of what is working for them.

    Here are 5 solution-focused questions you can incorporate to focus on strengths:

    1. What strengths do you have and use to help you manage your diabetes every day? 
    2. What other strengths can you identify? (Note: whenever possible we ask “what else” to expand the thought process)
    3. What would success look like for you (e.g. in life, in living with diabetes etc.)?
    4. How can you use your strengths to create opportunities for success?
    5. What else would you like to share with me today?

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

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

    Follow us on Twitter and Instagram @AFreshPOVforYou

  • Fresh Views

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

    Half Dome, Yosemite National Park, California

    “Acceptance means to be in the embrace of what is without resistance. True acceptance is one of the most powerful and life-changing practices you can choose for your life journey.” ~Kirra Sherman 

    In our last blog we asked… 

    How can we draw attention to words that are powerful, impactful and transformative. More importantly, how can we build a new vocabulary in healthcare so these words easily flow into conversations between diabetes care and education specialists and their clients?

    Join us today as we launch into a series of posts that will focus on words to inspire solution-focused thinking and practice…words which we embrace in practice and believe you will find them impactful in your conversations too. Each post will introduce a new word to weave into your conversations when talking about diabetes or life in general. (Think of this as similar to Merriam-Webster’s Dictionary “Word of the Day”.)

    Today’s word is Acceptance

    We’re referring here to self-acceptance, as well as acceptance by the healthcare team in recognizing that people respond to change differently. We chose this as the first word because we believe it is foundational to solution-focused thinking. It underlies everything else. 

    Accepting oneself can be hard! 

    Being realistic about personal strengths and challenges is often easier said than done. For instance, we both love the outdoors and hiking, especially to take in a beautiful fresh view. However, with the ticking by of the years and impact of a couple injuries, we find we can’t quite embrace all of the things we used to do……like hiking up to mountain tops! Yes, that’s a bit of a bummer. We will never climb Half Dome in Yosemite National Park, pictured above! Yet, we’ve come to eventually accept that, and focus now on what we can do and find joy and happiness in that. So, we take flat hikes instead of climbing, we take a cable car ride to the top of the mountain, and we simply enjoy the beauty of it. 

    Here we are enjoying a beautiful view at Urquhart Castle, Inverness, Scotland.

    Striving to be honest with ourselves and accept who we are, our abilities, and acknowledge when we’ve reached our limits is the goal. Without acceptance it’s impossible to move forward.

    Acceptance is critical when living with a chronic condition like diabetes. 

    People need to feel safe when engaging with their care team to acknowledge what they can do, along with what is challenging for them. Diabetes care and education specialists on the other hand, need to support those that live with diabetes as they learn to accept changes and new challenges in dealing with diabetes.And, practice acceptance understanding that people react to challenges differently. It’s critical to accept the person in front of you as they are, without judgement.

    A solution-focused challenge

    So our first challenge to you is to build your capacity for acceptance. Bring this word front and center in each encounter. Develop acceptance as a personal strength and help cultivate it in others. 

    Here are 5 solution-focused questions you can incorporate to focus on building acceptance:

    1. Could  you tell me about your strengths and qualities you are happy about?
    2. What is one thing you have come to accept in your life that took some time to process?
    3. How did you feel when you were finally able to accept that challenging situation?
    4. How could you use those experiences and feelings to move you forward to accept a new challenge now?
    5. How can I help you come to realize acceptance in your life?

    We hope you will enjoy this new series. Please share with colleagues and students and encourage others in keeping acceptance top of mind in interactions. 

    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

    Words Are Powerful!

    “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!

    We’ve focused a lot on the power of words over the last year in this blog. 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. 

    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. Words spoken by people with diabetes in surveys, research and focus groups. Words expressed during Twitter chats. Words written in papers. 

    So we considered…

    How can we draw attention to these words and have them easily flow into conversations between diabetes care and education specialists and their clients?

    As a step in that direction, we are launching into a new series of blog posts focused on some of these key words that inspire solution-focused thinking. These words, their meanings, and impact are so powerful that we will devote a blog to each word. Our hope is that each post will spur thinking, inspire, motivate and provide practical guidance as we’ll challenge you to incorporate the word into your daily practice and encounters. 

    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

  • Fresh Views

    A recap of solution-focused sessions from IDF Congress 2019

    Busan Gamcheon Culture Village (부산 감천문화마을)

    “A mind that is stretched by a new experience can never go back to its old dimensions.” – Oliver Wendell Holmes

    Hi, this is Deb writing today. I just recently returned from the International Diabetes Federation Congress, in Busan, Korea. A few of our readers made it to this conference, along with many more friends from the diabetes community who presented interesting sessions that we @AFreshPOVforYou thought you might appreciate.

    Living with Diabetes Stream

    My main reason for attending was to present on a panel discussing #LanguageMatters as part of the Living with Diabetes Stream, a series of sessions that focus on life with diabetes where many people living with diabetes discuss their strengths and challenges and share real world experiences. It was a great opportunity to share lessons learned over the past several years about how empowering, person-first, strengths-based language can not only improve healthcare communication, but also health outcomes. I co-chaired the panel with Renza Scibilia, from Australia, one of the early adopters the #LanguageMatters movement. There were three speakers, each with a slightly different focus. 

    First, Shinomi Takahashi,  a nurse and PhD candidate from Japan, presented on the meaning of the word “diabetes” in different languages. It was fascinating to learn that in Japanese, diabetes, tou-nyou-byou (糖尿病) means “sugar-urine disease”, and many people feel this adds to the stigma of living with diabetes. There was a movement in Japan to change the names of type 1 and type 2 diabetes to describe the physiological differences of the conditions, similar to U.S. discussions. However, as several mentioned in the session – the differentiation between types actually leads to more stigma associated with type 2 diabetes.

    Next, I spoke on the Value of Language Guidelines. The key takeaway was that the use of guidelines helps to change the practice of healthcare. When educating healthcare professionals (HCPs) about the impact of language on engagement in care AND health outcomes, HCPs start to listen. If only all medical, nursing, dietetics and other health profession education programs began each year with a review of the use of strengths-based, person-first language, we’d all be in a better place. The more I learn, write, and speak about incorporating a solution-focused approach into diabetes care and education, the more I realize that this approach makes the use of strengths-based language so easy and natural. So, if we can help HCPs incorporate this approach into practice, we can help change the language at the same time! As always, I ended my presentation with the film co-designed by people living with diabetes and HCPs,  “Changing the Conversation”, that continues to resonate with audiences who engage with people with diabetes. (I think it was shown at least three times during the conference!)

    Deb presenting at the Diabetes Spotlight stage

    The final speaker, Elizabeth Snouffer, Editor for DiabetesVoice.org, presented information around the messaging and advertising that has wrongly portrayed diabetes in the eyes of the public. She shared how creating a culture of fear, victim blaming, and stereotyping does nothing but fuel the myths and misconceptions. What was really fascinating was the focus on how advocacy organizations and other consumer focused groups actually contribute to the stigmatizing language. Some of the images she shared were unbelievable (You can see some of those here on Twitter). She concluded with examples of successful campaigns that have made a difference in changing the conversation around diabetes. 

    Digital Health

    I also sat on a digital health panel, Technology; The future is now, with a line-up of amazing individuals representing the spectrum of the digital health:

    • Kyle J. Rose (Healthcare Enthusiast and Innovator), a newly elected Vice President for IDF Global, and previously with mySugr, chaired the panel 
    • I represented the perspective of the HCP, diabetes care and education specialist, and the realm of digital coaching 
    • Renza Scibilia (Type 1 Diabetes and Consumer Voice at Diabetes Australia), as she proclaimed, was the “most important person on the panel, the person living with diabetes” (and of course we all agreed) 
    • Manny Hernandez (Head of Community, Livongo) represented the health technology industry
    • David Staehler (VP, Eli Lilly, Global Brand Development), represented the pharmaceutical industry
    • Dr. Mahmood Kazemi (VP Global Medical and Scientific Affairs, Abbott Diabetes), represented the medical device industry, and 
    • Dr. Jane Speight (Foundation Director, The Australian Centre for Behavioural Research in Diabetes), represented the psychological side of living with diabetes and technology 

    Some of the key takeaways from the session were: 

    • Technology is not one-size-fits-all; tools need to be individualized.
    • Both population level data analysis and individual data interpretation are needed to change health outcomes.
    • There is a burden associated with technology and data for both the person living with diabetes and the HCP.
    • And from my perspective: There is often too much focus on data that is “out of range” taking a problem-focused approach, and not enough implementation of a solution-focused approach. 
    Deb, Manny Hernandez, Jane Speight and Renza Scibilia getting ready for the panel

    Diabetes Distress

    I also chaired a session on Diabetes Distress. Dr. Jane Speight, from Australia, gave a brilliant talk about the benefits of peer support for diabetes distress. Although not much research has focused on this issue, she shared a few research studies that showed significant and meaningful improvement in diabetes distress, especially in a group setting. Attending in-person group meetings can be challenging for people, but there is promise that online peer support groups can have the same impact as in person. She suggests that while more research is needed, peer support is beneficial.

    Living with Diabetes Award Lecture

    Manny Hernandez showing his now famous blue circle slide representing the time a person actually spends self-managing diabetes

    One of the highlights for me was the Living with Diabetes award lecture by Manny Hernandez.  Manny shared his journey with diabetes beginning with initially being misdiagnosed with type 2 diabetes. Fortunately, Manny had a primary care doctor who knew when he “was out of options” and referred Manny to an endocrinologist, who finally diagnosed him with LADA. For years, Manny was not connected with other people living with diabetes. Then one day he attended a group with other people with diabetes, and learned more in that one hour than he had in the previous four years. This experience led him to develop the tudiabetes.org online peer support community (and EsTuDiabetes.org in Spanish), and eventually The Diabetes Hands Foundation (DHF). The peer support experienced from these communities has impacted so many lives, so people no longer feel alone. I was on the Board of DHF when it closed with Manny’s transition  to work in industry (Manny was caring for his mother living with Alzheimers, so he needed to leave the nonprofit world and now works for Livongo). Yet, Manny had the foresight to ask Beyond Type One to take over the DHF communities and they continue to thrive. (Excitingly, I’m now working on a research study and engaged again with the EsTuDiabetes.org community….more to come on that next year!). The love for Manny in the diabetes community is strong and was evident during his presentation. I felt privileged to be there in person when he received this well-deserved honor.

    Manny’s diabetes “Tribe” after his award lecture (Photo courtesy of Boudewijn Bertsch)

    There were many other sessions I wanted to listen to, but they conflicted with my sessions. They included Riva Greenberg’s presentation on the Flourishing Approach (we wrote about it here), and a presentation on #TalkaboutComplications with Renza Scibilia and The Grumpy Pumper, which addressed language used when talking about diabetes complications, and the stigma and bias those discussions often lead to.

    The more we support using strengths-based language, the more we realize how closely connected language is to a solution-focused approach. Focusing on strengths and what’s working well generates solution-talk and a uniquely different experience between clients and HCPs. 

    Exciting advantages of speaking at conferences are the opportunities to learn something new,  meet new people, see new sights, and of course see fresh views. I’ve broadened my diabetes colleague network and made new friends on this trip, while reconnecting with old friends. I  saw many interesting sites in Busan and ended my conference by spending a few sightseeing days in Seoul before heading home. I even got to connect with my daughter’s freshman year college roommate who lives outside of Seoul. Hopefully I’ll make it to IDF 2021 in Bangkok, Thailand!

    Sunset over Busan

    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

    #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


    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


    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


    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


    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


    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


    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


    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


    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


    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


    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


    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


    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!

    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

    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.

%d bloggers like this: