• Fresh Views

    Make New Year’s Solutions (Instead of Resolutions) for 2020!

    With the start of the new year, many find themselves reflecting on the past year, re-evaluating life, and pondering what “resolutions” they will set for the new year.  New year’s resolutions often focus on “stopping” doing certain things and starting to make changes. Many resolutions revolve around trying to be healthier in some way.  Yet evidence shows that about 80% of people fail to stick to their New Year’s resolutions longer than six weeks.  That means by the time that Valentine’s Day rolls around, many have abandoned their desire to change. Often resolutions are attempts to find ways to solve problems.

    What if, instead of making New Year’s Resolutions which require change and “fixing”  problems (and change is hard!) – you focus instead on making New Year’s Solutions?

    Who doesn’t like a solution after all? One way to identify solutions is to focus on things that have gone well in the past, and pinpoint how you can do more of that (rather than trying to change).

    As you reflect on the past year, here are 5 questions to ask yourself and guide your thinking as you identify solutions:

    1. What went well for you in 2019?
    2. What did you feel happy about?
    3. What behaviors helped you feel successful and were doable?
    4. How can you do more that?
    5. Instead of thinking about “problems”, how can you reframe your thinking into positive “opportunities” and solutions? (Reframing a situation, idea, or belief can bring a fresh perspective. You can read more about this in our January 2, 2019 post.)

    We’d love to hear what your’re thinking about for your New Year’s Solutions. Connect with us on Twitter or Instagram @AFreshPOVforYou!

    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. 


  • 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

    In All Things We Give Thanks

    Gratitude makes sense of our past, brings peace for today, and creates a vision for tomorrow – Melody Beattie

    We are always grateful for the sunshine and beautiful outdoors

    On this Thanksgiving eve, we are reminded of ALL that we are grateful for…including YOU, our readers and followers!

    Gratitude is good for health

    According to the American Heart Association several clinical trials show that engaging in a practice of gratitude can lower blood pressure and help the immune system. “Grateful people engage in more exercise, have better dietary behaviors, are less likely to smoke and abuse alcohol, and have higher rates of medication (taking)”. Several studies suggest that gratitude can decrease stress and anxiety by activating the areas in the brain that the release feel-good hormones serotonin and dopamine. 

    Research discussed in the Jan/Feb, 2019 issue of Diabetes Self-Management also shows that positive psychological states such as gratitude are associated with improved physical health in people with diabetes, improved sleep, and increased self esteem. While the relationship is not fully understood, positive emotions such as expressing gratitude, are linked to healthier lifestyle choices. And healthy lifestyle choices including healthy eating and being active are in turn linked to overall health.

    How to get started with gratitude in this season of Thanksgiving? 

    Here are 5 strategies to help develop daily gratitude habits: 

    1. Have gratitude reminders. These are simple cues to remind you to focus on gratitude daily. Maybe it’s an alarm on your phone, a bracelet or wristband, a photo, a magnet, or a post it note. And with that reminder, pause, take a breath and focus on being grateful in that moment.
    2. Keep a gratitude journal. We both have found this to be a good personal practice to express gratitude more readily and maintain focus on finding things to be grateful for. Some log entries in their journal weekly, and others daily. Our personal goal is to identify at least 3 things daily for which we’re grateful.While the goal is to write in the journal daily, sometimes life happens and weeks may go by without an entry, but we pick right back up with our entries. 
    3. Start a gratitude box. Keeping a box (jar, album, folder, or whatever works for you) filled with notes, pictures, and moments you are grateful for can bring a boost when needed. 
    4. Voice or write down one (two, or three) good things that happened in your day. On the homefront, this is a gratitude practice Tami has used with her son over the years. In the days when she would take and pick him up from school, she found that the drive time was a good time to learn about his day. That conversation always began with these words, “Tell me something good that happened today.” He knew he needed to answer that, acknowledging something good, before talking about the challenges of the day. 
    5. Use gratitude apps. There are a number of apps with a range of capabilities including sending reminders, sharing uplifting thoughts, and organizing memories for which you are grateful. 

    You can glean other insight in this post we wrote on Gratitude here.  

    Happy Thanksgiving!

    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 Reducing Risk

    You are braver than you believe, and stronger than you seem, and smarter than you think. – Christopher Robin

    National Diabetes Month is almost over, what informative and interesting activities were you engaged with this year?  

    Taking a solution-focused approach to diabetes self care

    As we near the end of the month, we are also finishing our 7-week series on applying a solution-focused approach to the AADE7 Self-Care Behaviors for managing diabetes. This series is focusing on “flipping” the conversation from a “problem focused” (traditional medical) approach to a solution-focused conversation. Last week we shared about taking a solution-focused approach to Problem Solving. And the prior weeks we focused on Taking Medications here, Monitoring blood glucose here, Healthy Eating  here, Being Active here, and Healthy Coping here. This week, we are talking about Reducing Risks 

    When looking at this picture above of the friendly neighborhood kitty balancing precariously across the covered porch rails, it reminds us of life with diabetes… trying to stay in balance never knowing when the bottom may fall out.  

    AADE7 Self-Care Behavior #7: Reducing Risks

    Taking care diabetes today can help people feel good today AND in the future. When blood glucose is in range, one is more likely to:

    • have more energy, both physical and emotional
    • be less tired and thirsty
    • pass urine less often
    • heal better and
    • have fewer skin or bladder infections

    Many say they are their “best self” when their blood glucose is in range. And managing diabetes TODAY means there will also be less chance of having health issues caused by diabetes over time. The important words there are “over time.” Taking care of diabetes now will help reduce the risk of heart attacks, stroke, damage to kidneys and nerves, and loss of vision. But It’s not just about the diabetes, it’s about supporting those with diabetes in living their best life! 

    A journey of a thousand miles begins with a single step. (Chinese Proverb)  Just one step.

    We want to support and guide our clients toward actionable steps they can take now to live well with diabetes and help reduce the risk or delay issues down the road. Then, the key is replicating that small step over and over again to build momentum and actually feel progress. Small steps add up. You may be surprised by the great impact these small, yet simple things can have! 

    The language we use when talking about diabetes complications is important to think about. When we use words like “prevent” as opposed to “reducing risk or delay progression” we imply that ALL complications CAN be prevented. Science tells us that this isn’t always true. Some people have genetic predispositions to either be “protected” from complications or to be at a higher risk. Healthcare providers can add to the stigma, shame and blame associated with diabetes when they don’t acknowledge the fact that some people will end up with complications……just because. We don’t want people to shy away from discussing health concerns, so let’s use our #LanguageMatters voice when we #TalkaboutComplications. That’s what The Grumpy Pumper (AKA Chris Aldred) has been doing this past year. Traveling around the globe, including a stop at #AADE19,  speaking openly and frankly about living with a complication from diabetes. You can read his blog here.  As Grumpy says, “Even with the best of care, people can get complications.” (from Diabetes Connections Podcast) So let’s use a solution-focused approach when talking with people with diabetes complications instead of rehashing any problems.

    When working with clients 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:  By no means is smoking a simple habit to change. What can you do more of that may help you smoke less? Or what needs to happen to help you make changes?

    Instead of this: You need to stop smoking. Smoking is bad news with diabetes.

    Try this: How can you fit in an extra visit to see your eye doctor during national diabetes month?

    Instead of this: You are behind on getting your eye and dental exams.

    Try this: On a scale of 0 to 10, with 0 being never and 10 being always, how often are you able to get an annual flu shot to help prevent illnesses?

    Instead of this:  You haven’t gotten your flu shot.

    Three follow-on questions to help you not only feel  better today, but to help prevent problems down the road:

    • What is one action you can take to reduce your risk? Work closely with your healthcare team to identify the best strategies for you to help manage them and prevent progression to live your best life.
    • What can you do NOW, right this second…to make life better now, as well as down the road.
    • What single change can you make over the next week?

    And consider how people in your life can help. Loved ones, family, and friends can be close allies in your diabetes management. (last week we discussed VIPs, you can read it here)

    We can encourage clients to keep taking those small steps each day. Consistency and routine build on each other. Small steps add up. If people do the best that they can do…then they can say at the end of the day, I did the best I could, and that’s a good feeling.

    We hope you’ve enjoyed our series and that we’ve made you think before engaging with clients. And if you’re a person living with diabetes, we hope our choices resonate with you. Each week we’ve challenged you to try some flips into your conversations. Let us know what impact they have had. Please reach out to us to share feedback.  Let’s continue to join together  to raise awareness of all issues that can improve living with diabetes.

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

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

    Follow us on Twitter and Instagram @AFreshPOVforYou


  • Fresh Views

    Flipping the Paradigm: Applying a Solution-Focused Approach to Problem Solving

    I will breathe. I will think of solutions. I will not let my worry control me. I will not let my stress level break me. I will simply breathe. And it will be okay. Because I don’t quit. – Shayne McClendon

    Tomorrow, November 14 is #WorldDiabetesDay! Deb and Tami have had some impactful moments in recent years during diabetes month and on #WDD. Deb has been involved in hosting events at the California state Capitol with speakers, music and lighting of the Capitol in blue. Deb’s also spend #WDD 2017 at the headquarters of  Novo Nordisk in Denmark. Tami has done TV spots, radio shows, Facebook Live and videos, provided community programs, participated in screening events and published articles – all to raise awareness and encourage people to know their risk for type 2 diabetes. 

    The theme of #WorldDiabetesDay this year is the impact that diabetes has on the family. One of the goals is to promote the role of the family in the prevention, management, care and education of diabetes. In a solution-focused approach, the family is important, and we call them VIPs – .and this definition is broad – it includes any one who is a “very important person” in your life. Someone who can provide support when needed, who will notice changes being made, and  who can respect personal decisions and choices. What’s really important is that these VIPs are not the “diabetes police”, or people who make managing diabetes harder. As you think about problem-solving, think about including VIPs in both the discussion and the plan to help foster success and respect.

    Taking a solution-focused approach to diabetes self care

    This is week 6 of our 7-week series on applying a solution-focused approach to the AADE7 Self-Care Behaviors for managing diabetes. This series is focusing on “flipping” the conversation from a “problem focused” (traditional medical) approach to a solution-focused conversation. Last week we shared about taking a solution-focused approach to Taking Medications here.  And the weeks prior we focused on Monitoring blood glucose here,  Healthy Eating  here, Being Active here, and Healthy Coping here. This week, we are talking about Problem Solving.

    AADE7 Self-Care Behavior #6: Problem Solving

    With diabetes, “problem” solving is part of the daily routine…figuring out when, what, and how to eat for meals and snacks. What kind, how much, and when to fit in physical activity. When to check blood glucose, how to time any medications, and the list goes on.

    And then life throws curve balls, and no matter how well you plan, unexpected things happen that can send blood glucose out of range. And that’s when more problem-solving skills are called into action to determine how to handle the scenario and what to do to prevent it from happening again. 

    Also, diabetes needs may change over time, requiring adjustments because previous solutions no longer work.

    In taking a solution-focused approach, we typically don’t focus on solving problems….as you know. We focus on solutions…looking for what is already working and trying to do more of that.  So this self-care behavior is not as intuitive to translate. Here are 4 strategies to help diabetes care and education specialists and people with diabetes flip the problem-solving paradigm.

    1. Practice self-compassion. Diabetes is different every day, even when people make similar choices. We learned from our Twitter research that people living with diabetes would like to practice more self-compassion. They want to be kinder and not blame themselves. 
    2. What has gone well today? When you are faced with challenges, think about what DID work for you during this challenging time. Instead of doing a deep dive into all of the issues that might have impacted you, spend some time focusing on your successes. Then tomorrow, try to do more of what worked.  
    3. Keep a journal of solutions. When things are going well, keep track of these small wins so the next time you are faced with a challenge, you have some “go to” solutions ready to try.
    4. Share with your VIPs. Ask your VIPs about their ideas.  Do they have some ideas about what works well for you and the times they see your successes.

    When working with clients, instead of traditional problem-solving exercise, try to focus on existing solutions to create change.  Begin by exploring these 3 questions to flip the conversation.

    1. Tell me about a time when you felt the happiest about your diabetes management?
    2. What was it about that day or time that made it better?
    3. Can you think of times when the challenge you are facing now was not present in your life? What were you doing then?

    We challenge you each week to try some flips into your conversations and let us know what impact they have. Let’s join together throughout the month of November to raise awareness of all issues that can improve living with diabetes.

    Join us next week for our final installment as we discuss a solution focused-approach to the self-care behavior around reducing risks.

    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 Taking Medications

    Self-care is never a selfish act – it is simply good stewardship of the only gift I have, the gift I was put on earth to offer others. Anytime we can listen to true self and give the care it requires, we do it not only for ourselves, but for the many others whose lives we touch. -― Parker Palmer 

    Big Ben in London, England 

    @AFreshPOVforYou is one-year old!

    Happy birthday to us @AFreshPOVforYou! Our blog is officially one-year old, 56 posts later! 

    Over the last year we have focused on Possibilities, Opportunities and creating a Vision (POV) for the future by taking a solution-focused approach to life with diabetes. We’ve been excited to share our work and learnings by speaking at the AADE19 Annual Meeting, helping diabetes care and education specialists learn how to incorporate a solution-focused approach into their practice. We also shared our Twitter research findings at the European Association for the Study of Diabetes conference in Barcelona, Spain. And we’ve conducted a survey, focus groups, and have a few papers in process. It’s been a great year and we’re excited to see where this next year leads us!

    And it’s now national diabetes month 

    We purposely launched this blog right before #WorldDiabetesDay last year, to kick off our new adventure. And here we are again. What are you doing for diabetes month? Do you have an event or an idea you’d like to share with us or our readers? Please let us know in the comments. We’ll be adding in some diabetes month discussions throughout November, along with sharing insights about using solution-focused approach to self-care behaviors.

    Taking a solution-focused approach to diabetes self care

    This  week is week 5 of our 7-week series on applying a solution-focused approach to the AADE7 Self-Care Behaviors for managing diabetes. This series is focusing on “flipping” the conversation from a “problem focused” (traditional medical) approach to a solution-focused conversation. Have you tried any “flips” in the past 4 weeks? Please let us know if you have, and what your experience was. 

    Last week we shared about taking a solution-focused approach to Monitoring blood glucose – you can read it here.  And the weeks prior we focused on Healthy Eating  here, Being Active here, and Healthy Coping here.. This week, we are talking about taking medications. 

    AADE7 Self-Care Behavior #5: Taking Medications

    While taking medication of some type is often required somewhere in the journey with type 2 diabetes, it’s not always simple to engage in this self-care practice. We hear that routinely from clients we work with. Here are 3 challenges that frequently bubble up…

    1- Remembering. No matter what one’s age, remembering to take medication can be a challenge at one time or another. After all, life happens and can derail even the best intentions. In our experience, missing medication doses can also be linked to the dosing frequency, side effects, or diabetes distress. When it comes to remembering to take medication, solution-focused strategies to consider include, using a medication reminder app, using a pill box, pill packs, keeping the medication in view as a reminder (if it doesn’t require refrigeration), marking a calendar when a dose is taken, and setting an alarm on a smartphone or clock. (The mention of a clock, reminded us of Big Ben in London, so that’s our fresh view for today!)              

    2 – Stigma. With type 2 diabetes, there is often stigma associated with taking medicine. There is a false sense that people “should” be able to manage diabetes through healthy eating, being active and losing weight. But we know that is not always reality. Given that diabetes has a genetic link and is a progressive condition, things change over time. What works today, might not work next month or next year. So talking about diabetes medicine using a positive, solution-focused approach can help build a trusting relationship and a therapeutic alliance in which to discuss medicine choices and barriers while using a shared-decision making approach.  

    3 – Cost/Access. We must also be cognizant of the cost of medicine when considering options. Although there are some incredible, effective new medications that impact the patho-physiology of diabetes, these new drugs often come with a high price tag. And they may not be included on insurance formularies. And the cost of insulin is beyond crazy. The American Diabetes Association has a website to help people navigate this complex issue and provide a list of resources. Unless we have open conversations, we may not know that people are not taking their medicine because they are not able to afford it. How can we say they are “non-compliant” or “non-adherent” when this is the case?  We need to change the language we use in diabetes, especially around medication taking. The #LanguageMatters conversation is essential when talking about medications.

    When working with clients 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: Diabetes is a progressive condition. It’s common for people to need more medicine over time. Can we talk about the benefits of adding insulin?

    Instead of this: You’ve failed oral medicine, you need to take insulin.

    Try this: What challenges do you have when taking your medicine?

    Instead of this: You’re not compliant with your medicine.

    Try this: How many days each week do you take your medication?

    Instead of this:  How often do you forget to take your medication?

    We challenge you each week to try some flips into your conversations and let us know what impact they have. Let’s join together throughout the month of November to raise awareness of all issues that can improve living with diabetes.

    Join us next week as we discuss a solution focused-approach to the self-care behavior around problem-solving.

    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 Monitoring

    Taking a break to enjoy the final days of Fall and the changing leaves

    Happy fall and Halloween eve! And welcome to week 4 of our 7-week series on applying a solution-focused approach to the AADE7 Self-Care Behaviors for managing diabetes. This series is focusing on “flipping” the conversation from a “problem focused” (traditional medical) approach to a solution-focused conversation. Have you tried any “flips” in the past 3 weeks? Please let us know if you have, and what your experience was. 

    Last week we shared about taking a solution-focused approach to Healthy Coping – you can read it here. And the weeks prior we focused on Healthy Eating here and Being Active here. This week, we are talking about monitoring. Monitoring blood glucose. in the spirit of  Halloween, can be very helpful to see how a Halloween treat, and other things in life, impact blood glucose. 

    While many people use meters to stay in touch with their blood glucose, a CGM (short for continuous glucose monitor), may be a helpful choice for some. With a CGM one can see patterns and trends over time, not just one single number at one moment in time.  Also, they can receive real time alerts for when blood glucose is going above or below target. Around holidays such as Halloween, a CGM can be a great monitoring tool to see how the choices made impact glucose levels.  

    Let’s look at some examples…

    AADE7 Self-Care Behavior #4: Monitoring

    Below you see a CGM tracing over a 24-hour period, beginning at midnight. The goal is more green – more time in range – more time feeling better. Have you heard of the acronym FNIR?  It means flat, narrow and in-range. That is the goal of CGM tracings.

    Suppose this tracing below is a few hours after “throwing caution to the wind” and sampling a few more fun size Halloween treats than planned. The Halloween treats are just around for a day or two. It’s just one day. It’s important to keep the big picture in mind. 

    While the focus may be drawn to the time out of range (in red), let’s turn focus to the green (the time in range). How was that accomplished? We learn that the individual made it to the gym for an early morning workout and enjoyed a healthy lower carb breakfast. Monitoring helped them learn.

    From our years in practice we’ve learned that people who live with diabetes have different perceptions around monitoring. For some, it can become an obsession – they need to know where their blood glucose is all the time. It can certainly be a mental burden. And others may not want to focus on their blood glucose. Knowing their number may create negative feelings, fear of judgement and guilt. So, they choose to not check their blood glucose to provide a sense of safety and self-preservation.

    We know that glucose numbers are simply that……they are numbers, and numbers provide information.  The goal of monitoring is to generate data to help people make choices and changes. Numbers are not good or bad and are certainly not a test score. You may have recently seen this image below on Twitter and/or the discussion around it. This is NOT a solution-focused approach! 

    Photo credit: Renza Scibllia’s Twitter account

    When working with clients 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: You’ve been working hard to fit in physical activity. In looking at your CGM tracinings, what small steps can you take in the direction toward the goal of seeing more time in range (green in the tracing)?

    Instead of this:  What happened when your CGM was red (out of range)?

    Try this: I know you’ve had a lot going on. You mentioned that you checked your blood glucose twice this past week. How did you manage to check twice?

     Instead of this:  You only checked your blood glucose twice this past week?

    Try this: I see that your A1C is in your target range. How did you manage to do that?

    Instead of this: Your A1C is outstanding, A+!

    We 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 the self-care behavior around taking medications.

    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

    Flipping the Paradigm: Applying a Solution-Focused Approach to Healthy Coping

    In times of stress, the best thing we can do for each other is to listen with our ears and our hearts and to be assured that our questions are just as important as our answers. ~ Fred Rogers

    Getting some “beach therapy”

    Today we greet you from our first @AFreshPOVforYou writing retreat! “Writing Retreat”…those are BIG words that have been more than a year in our minds, and are now a reality as we sit across the table from each other drafting the content for our first book!  No small feat, but one we are excited about! We are passionate about taking a solution-focused approach to life with diabetes…so let your mind imagine just what this book may be about. We’ll share some sneak peeks as things move along.  

    Now back to our to our blog…

    Welcome to week 3 of our 7-week series on applying a solution-focused approach to the AADE7 Self-Care Behaviors for managing diabetes. This series is focusing on “flipping” the conversation from a “problem focused” (traditional medical) approach to a solution-focused conversation. Have you tried any “flips” in the past 2 weeks? Please let us know if you have, and what your experience was. 

    Last week we shared about taking a solution-focused approach to Being Active – you can read it here. And the week prior we focused on Healthy Eating here. Today we’re concentrating on Healthy Coping

    AADE7 Self Care Behavior #3: Healthy Coping

    It goes without saying that stress is a part of life…family stressors, work stressors, financial stressors, health-related stressors…at times it might seem like stress is all there is. Add to that the relentless demands of diabetes. The combination can bring a variety of coping challenges and ultimately impact self-care. On the flip side, there are many positive ways to deal with stress and cope with life with diabetes in a healthy manner. It’s all about having a tool-box of resources or tactics to pull out or call upon needed. Here are 6 ways that resonate with us to give you ideas:

    1. 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 our writing effort).
    2. Take a break. It might be taking a walk on the beach or simply having a cup of coffee and listening to the waves hit the sand (as we were in the photo above…wishing we were there now!). Or you might enjoy curling up in a comfy chair and reading a book. Or standing and stretching, taking deep breaths inhaling and exhaling slowly.
    3. Use positive affirmations. When life is feeling especially challenging, we’ve found that practicing “daily affirmations” greatly helps us: I can do this. I am strong. Each moment brings choice. I will not hold onto bitterness.I can live an overflowing life. An affirmation is a short, positive statement that you say to yourself to build yourself up. 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.
    4. Get enough sleep. In our experience, many people discount the value of sleep. When chronically sleep deprived the stress response can be even greater. (yep, we’re getting our zzz’s this week!)
    5. Spend time with people that make you happy. 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. Maybe it’s getting together with a friend for lunch. Whenever we are together we have lots of fun and laughter. That is one way we cope with stress.  
    6. Practice gratitude. You can read more about this in a blog we wrote on gratitude here.  

    When working with clients 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: How do you manage on the most challenging days with diabetes to keep moving forward?

    Instead of this:  Managing diabetes requires a lot of time and effort. It’s something you just have to do.

    Try this: On the nights you’ve been able to get to bed earlier and get more sleep, how were you able to do that? How did you feel the following morning?

     Instead of this: You mentioned you’re only getting 5 hours of sleep each night. You need to get to bed earlier. 

    Try this: Where is your stress level around ____ on a scale of 1-10? What would it take to reduce it 1 point? What do you need to accomplish that? How can I support you?

    Instead of this: You just need to stop thinking about this issue and move forward.

    Focus most of the time and energy on thinking about and discussing what is already good, effective, and successful then leverage that to identify solutions.

    When you meet again, here is a 3-step follow-up approach to try:

    Try to incorporate this approach with clients to reframe conversations and see if you can help them to focus on the exceptions (those times when the “problem” could have occurred but somehow did not) and their desired future state, rather than ruminating on what is not working.

    • Step 1 – Have you seen any improvements since we last met? (if yes, ask about it. If not, go to step 2)
    • Step 2 – Have you noticed times when the problem (defined using the clients own words) did not occur or happened less? (here you are identifying exceptions. If yes, ask about it. If no, go to step 3)
    • Step 3 – Describe for me what would be different if the problem had been solved? (this is the Miracle Question approach we’ve written about many times. Here and here are two of them)

    The solution-focused decision tree is adapted from Fredrike Bannik’s 1001 Solution-Focused Questions.

    We 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 Monitoring

    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

    Flipping the Paradigm: Applying a Solution-Focused Approach to Being Active

    Remember that any exercise is better than no exercise. – Anonymous


    Pisgah National Forest in the mountains of Western North Carolina. It was a beautiful hike to the falls!

    Welcome to week 2 of our 7-week series on applying a solution-focused approach to the AADE7 Self-Care Behaviors for managing diabetes. Last week we shared about taking a solution-focused approach to Healthy Eating – you can read it here.  Today we’re focusing on  Being Active. Being active can take many forms, from simply moving more during the day to intentional bouts of exercise. You can also find ways to incorporate fitness through activities that bring you pleasure or joy (such as our beautiful hike to the falls pictured above).  

    As a refresher, the AADE7 is a framework for organizing diabetes self-management education and support, as well as for identifying key areas for behavior change to manage diabetes. The 7 core behaviors are:

    Our series is focusing on “flipping” the conversation from a “problem focused” (traditional medical) approach to a solution-focused conversation. 

    AADE7 Self Care Behavior #2: Being Active

    “I hate to exercise” may be a familiar comment heard by many diabetes care and education specialists (DCES). (In fact, it’s the title of a great book too, The I Hate to Exercise Book for People with Diabetes) For those who are challenged to fit physical activity into their day we feel empathy and understanding because some days it’s a challenge for us too! Life happens! 

    Some people are born athletes. And physical activity may always be a priority them. If you fall into that category, you might find it hard to understand the challenges other people face with being active. If you can relate, try to take a step back, and think of something that is really challenging for you to engage in. Then try to keep that frame of reference when you’re talking about being active with your clients.

    Beyond lack of enjoyment in exercise, finding time to fit physical activity into a busy, challenging day, can also be hard. As DCES’s, solutions that we may generate and propose to others, may not always be realistic. Using solution-focused talk, together, we can help clients identify what they like, and what makes sense to them. We can also guide them in identifying things that make them happy, and find existing strengths. From there, we can help them create opportunities to be active.

    It’s important to take care to refrain from “all or nothing” thinking, described by Adam Brown in his book Bright Spots and Landmines (we interviewed Adam here). We need to help clients take small steps towards a more active lifestyle and acknowledge their success, even if it doesn’t align with our thinking of what being active means. Let’s flip the focus of the discussion and help people feel successful and recognize their strengths.

    Deb and Diana (Deb’s daughter) hiking in the Dolomite Mountain Range in Northern Italy

    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 know how hard it is to have a job where you sit at the computer all day. Tell me more about your office and work setting. Let’s think of some ways you can increase your movement and get you up from your chair. 

    Instead of this:  Did you know sitting is the new smoking, sitting all day is going to kill you. You need to move more.

    Try this: You mentioned you’ve been using the MapMyWalk app on your phone. How has this helped you be more active? What else can you do to be more active?

     Instead of this: You’re using the MapMyWalk app but you still not getting 10,000 steps a day.

    Try this: When you’ve been successful adding physical activity into your schedule, what did that look like? How did you do it? How can you do more of that?

    Instead of this: You’re falling short of the goal of getting 150 minutes of exercise each week..

    Focus most of the time and energy on thinking about and discussing what is already good, effective, and successful.

    During a solution-focused conversation, the DCES’s focus is on discussing and exploring what is already working, is effective, and is successful, then leveraging that to identify solutions, rather than focusing on past problems. 

    When you meet again, here are 3 follow-up questions to try:

    • How were you able to focus on solutions to try to fit fitness into your schedule?
    • What kept you on track toward achieving your activity goal? 
    • What was different about the days you were able to be more active?

    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 Healthy Coping!

    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

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