• Fresh Views

    Adopting a Growth Mindset is a Game-Changer

    September 14, 2022

    #ADCES22 conference is in the books! We not only had a great time reconnecting with colleagues and friends, we also learned a lot. We were particularly interested in sessions that incorporated solution-focused tenets to see how our ideas and practices align. One that particularly struck us was the keynote speaker, Heidi Grant, PhD from Columbia University Motivation Science Center and author of 9 things successful people do differently, who spoke on what successful people do differently. Today’s blog is a little longer, but we think it may transform your thinking.

    When getting ready to do something, or pursue a goal, people bring  2 mindsets

    • Fixed mindset. The first, a fixed mindset – is about proving your ability, demonstrating your skills to others, and comparing yourself to others. The minute something goes wrong, you start to question yourself, and thoughts can turn to, “Maybe I don’t have the ability” when things are hard, which becomes a self-fulfilling prophecy. This can lead to anxiety which makes it even harder to move forward. You think you can’t do something, so you don’t do it. 
    • Growth mindset. On the other hand, a growth mindset is rather than thinking about proving your ability, the focus is on IMproving your ability over time and developing skills. Those with a growth mindset are more concerned with ” how am I doing TODAY,” compared to yesterday or last week, as opposed to comparing self to others. 

    Adopt a growth mindset

    We believe that a growth mindset aligns with using a solution-focused approach, in which we encourage small steps to move someone forward in the direction of their goals. The growth mindset draws focus to one’s own progress. According to Grant, “The growth mindset is the single best predictor of persistence and resilience in the face of setbacks and challenges.” We frequently write about persistence and resilience in solution-focused practice. Grant referred to the growth mindset as a “super power” when it comes to persistence and resilience.

    In taking a solution-focused approach to diabetes care and education, we can step alongside our clients/patients and help them recognize a fixed mindset and shift to foster this growth mindset. For example if you hear someone say “I’m not good at this”, you can encourage them to shift to saying, “I’m not good at this YET.” Or, “It’s not about doing good, it’s about getting better.” This shift helps to create the desire to do something and move forward. It’s a journey and about growing over time. The more one does this shifting, the less they’ll have to do it. It will become a habit.

    One solution-focus tactic to help to evaluate progress over time is to incorporate scaling questions. For example, on a scale of 0 to 10 where 0 is not confident and 10 is very confident, compared to yesterday, how confident are you that you can work towards your goal.

    Dr. Grant noted that there are not many things as impactful as a mindset with which you approach a task. Those that adopt a growth mindset experience:

    • More willingness to take smart risks ( willing to make mistakes, learn and grow)
    • More persistence and resilience
    • Creativity
    • Deeper thinking
    • Interest and enjoyment

    Growth mindset language

    We frequently touch on the power of person-first, strengths-based language. When we think of language associated with a growth mindset, Dr. Grant encouraged use of these words:

    •  Grow
    •  Progress
    •  Become
    • Over time
    • Develop
    • Improve

    Be a realistic optimist

    Of course, pessimism  – which is believing you’ll fail – can be challenging. As can unrealistic optimism – which is believing you’ll succeed easily. Realistic optimism on the other hand, is believing you’ll succeed, but at times it can be difficult. We call attention to this as it’s important to help clients build realistic optimism. We can help prepare people for their journey. The future is something to be achieved. A simple formula is to vividly imagine the future is similar to the Miracle Question we’ve shared in prior blogs. We can encourage clients to consider how they will feel, what they willI be doing, and how they will overcome obstacles. Using  future-visioning questions as we’ve shared, can help move clients towards their desired future. 

    Make if-then goals

    As Dr. Grant noted, two of the biggest obstacles to achieving a goal are 

    •  Knowing EXACTLY what to do (not being specific enough)
    •  Missing opportunities to act

    As we all know, there is a “knowing-doing” gap. People often know what they “should” do, but don’t do it for many reasons.There are times when the goal “could” have happened but the opportunity is missed. One solution is to make “if-then plans” (forming implementation intentions) – a very effective form of planning to overcome this gap. For instance, “If (or when) situation X occurs, THEN I will perform Behavior Y”.

    For example, IF I go into the breakroom and there are donuts, THEN I will have a cup of coffee.”  Advance planning is very effective. By incorporating eliciting questions a client can be guided to develop several if-then plans. By asking “What else?” you can drill down to make a very specific plan. Creating these plans can equip your client to have them ready in their back pocket when potentially challenging situations arise. By creating if-then plans you’re also helping the client to practice problem-free talk. If-then is similar to using exception questions, which we’ve shared in prior blogs. A successful if-then plan replaces challenging habits with positive changes and helps to develop small changes over time.

    Our challenge to you as a think partner with your clients/patients

    • Guide them in building resilience with a growth mindset.
    • Equip them to be ready to act with realistic optimism.
    • Support them in learning to bridge the knowing-doing gap with if-then plans.

    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

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

    April 1, 2020
    Deb’s “office kitty” has a mindset that is always focused on envisioning how to get outside and climb those trees!

    Instead of worrying about what you cannot control, shift your energy to what you can create.― Roy T. Bennett, The Light in the Heart

    Given the chaos, worry, hurry, and stress that COVID-19 has rained upon the world, it’s timely that April is national Stress Awareness month. And who could have guessed several months ago when we slotted the word “Mindset”  as the focus for today’s blog that it would in fact be so relevant. We know you’re all busy and have many things on your mind, so we’re hoping this blog can help everyone take a short stress break and identify opportunities to reduce stress today.

    Today’s word is MINDSET: So what exactly is a Solution-Focused Mindset? 

    In a general sense, “mindset” is the way you think about your world, what you focus on, and how you relate to the world day-to-day. Change, like we’re all  experiencing now, means the emergence of new and challenging problems requiring new solutions. In matters big and small, diabetes-related or not, by embracing a mindset that focuses on solutions, and channeling energy into leveraging strengths and possibilities, you can cultivate a solution-focused mindset. One that envisions success. One which helps manage stress. Focusing on solutions and getting a plan in place helps reduce stress.

    Mindset has a more positive connotation than does stress, and implies that one has some control over the way they interpret and interact with their world during times of increased stress. Today we share with you 7 strategies you can use to help you as you function in your new environment, and also can help you step alongside your clients and support them in embracing a solution-focused mindset and managing stress:

    1. Create a morning mindset routine. We find that starting the day by making a list of each thing you’re looking forward to in that day (or even in the future) creates a feeling of anticipation and excitement that creates momentum for the entire day. Aim for at least 3 things. While you can note them mentally, in your phone’s Notes sections, or in a journal, if you write it them on a post-it note, you can easily post it somewhere that you’ll see it throughout the day (such as on your blood glucose monitoring supplies, on the car dash, on the refrigerator, you get the idea…) By focusing on the positive at the beginning of the day, it’s much easier to be happy, be focused, get work done more quickly. And often,  getting work done seems easier too.
    2. Live your Miracle Day. You may be familiar with the book by Stephen Covey, The Seven Habits of Highly Effective People. In his book, Habit 2 is called Begin with the end in mind. In thinking about this process, the solution-focused tool The Miracle Question can be employed to change mindset. It guides in envisioning how life would be different tomorrow if a miracle occurred tonight and your challenges were gone. It helps know what you want.You can read more about it and how to use it here. 
    3. Build on your past success(es). While we  might not have any specific past successes that directly relate to our world today, we can apply successes in similar areas. What has worked well for you in the past when you’ve been under stress? Or maybe you can learn from others and what has worked for them. On social media we saw a post about how people are outside taking walks more often while staying and working at home. In one neighborhood someone started writing messages in chalk to give people passing by some hope and strength. We thought this was a great idea and so started doing this too. We now have neighbors writing back to us!
    4. Move your body. It might be simply taking a walk. Physical activity lowers stress hormones and triggers the brain to release chemicals that make you feel better. (We’re finding that taking short walks to clear our minds is helping us to feel less stress and think more clearly). During this time of crisis, many physical activity outlets are offering free online opportunities for those staying at home.
    5. Use positive affirmations. We wrote about using positive affirmations in a blog last December on Healthy Coping here. When life is feeling especially challenging, we’ve found that practicing “daily affirmations” greatly helps us. An affirmation is a short, positive statement that you say to yourself to build yourself up: I can do this. I am strong. Each moment brings choice. I will not hold onto bitterness.I can live an overflowing life. Have you ever tried affirmations? The reality is that we believe what we tell ourselves and what we hear others say about us. Using affirmations can help to “rebuild” negative thinking and strengthen positive thoughts. When working with clients in a solution-focused way, we can  help them to create their own affirmations as one Healthy Coping mechanism.
    6. Surround yourself with positive mindset people. Stress can cause some to turn inward and isolate themselves.Talking to others about your stressors and seeking their support is one way to de-stress. A positive social circle can act as an echo chamber for positive ideas, focusing on a great future and supporting your dreams. Maybe it’s taking a walk outside with a friend (practicing social distancing, of course) or chatting via Google Hangout or Facetime. Whenever the two of us are together we have lots of fun and laughter. That is one way we cope with stress. Find your tribe.
    7. Close out the day with a “wins”checklist. These may be linked to some of the things you were looking forward to, or different things. They don’t have to be monumental. The point is to keep your focus on your day’s best experiences and recognizing how you were able to leverage strengths and doing more of what’s worked well in the past. Finding ways to practice gratitude may be helpful.  You can read more on gratitude here.

    Each week we’ve been inviting readers to participate in a solution-focused challenge. Given all of the real world challenges we are all facing…..we didn’t think you needed another this week! So, we encourage you to try out one or more of the strategies we shared today, and please reach out and let us know how you’re doing! We’d love to help you de-stress and focus on a positive mindset.

    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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  • Fresh Views

    Seeing with new eyes: Perceptions of life with diabetes

    October 2, 2019

    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. 

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  • Fresh Views

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

    November 12, 2018

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

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

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

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

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

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

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

    Disclaimer: A Fresh POV for You is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com.

     

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