• 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

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

    A healthy outside starts from the inside – Robert Urich

    As these crazy and unsettled days wear on, June has silently snuck upon us, bringing with it the first day of summer. Did you know June is also National Fresh Fruits and Vegetables month? We hope you enjoy the picture above of juicy lemons harvested from Deb’s backyard. We are big advocates of finding ways to fit in more fresh fruit (over processed fruit and juice) and fresh vegetables, particularly of the non-starchy variety (which means little impact on blood glucose)! In our experience, many people are challenged with fitting in non-starchy vegetables. And when they’re successful, we’re always curious: How were you able to do that? 

    Today’s word is: EXCEPTIONS

    Today in our series on words to jump-start a solution-focused approach when managing diabetes, we’re focusing on EXCEPTIONS. Exceptions are those times when one’s able to deal with a problem (such as blood glucose out of range, too many carbs) in a way that makes it less burdensome. Exceptions are times when the presenting situation could have happened, but somehow did not.  It’s a time when things could have gone wrong, but didn’t. Most all problems have exceptions. However, some people have difficulty even identifying exceptions because they stay so focused on their problems. Identifying exceptions is essential in order to build future solutions. Exceptions are the tools that help people achieve the life they want. Exceptions are a core tool in solution-focused practice.

    Exceptions are addressed in the book by Adam Brown, Bright Spots and Landmines, which we’ve written about here. There are more than 42 factors that impact blood glucose, and that makes it challenging to stay in range all of the time. Focusing on what is going well, instead of what is wrong, changes the conversation and allows the client to identify strengths and successes, and feel there are those “bright spots” in their life that they can call upon and focus on to know they’ll be successful.

    Here is an example of how you can use exceptions when reviewing continuous glucose monitor (CGM) data

    Meet J.T. She has been experiencing glucose values above range after dinner quite frequently, while the rest of the day has been in-target most of the time. She’s shared CGM graphs similar to the one below, where you can see after dinner at 6pm her glucose rises above target. 

    Today when you meet with J.T. she shares her most recent CGM graph, and you notice that her after meal glucose values are all within her target range. You specifically call this out during your conversation. You might say, “J.T. I notice that your after dinner glucose values are within your target range, how did you manage to do that?”  J.T. tells you that she has been focusing on swapping out starchy vegetables for non-starchy vegetables, like broccoli, squash, tomatoes, and mushrooms, cooking them in a Wok at home with just a small amount of olive oil. She notes that when she eats these non-starchy vegetables she stays in range.  

    This is known as an “exception”, or a time when her typical problem (post-meal above target blood glucose) did not happen. This is when we see “positive differences.” We now want to amplify and intensify these differences. This is the time to focus on the healthy changes being made and time to support and encourage MORE of these choices.

    So you might follow up with, “How was it helpful for you? Or What else was different for you?”

    You might use a scaling question. “ On a scale of 1-10 where 10 is you are confident you could do this again and 1 is the opposite, where would you say you are now?”

    A fave tomato and cucumber salad that Tami enjoys in the summer. She makes it ahead and has it ready in the refrigerator to help her easily fit in more non-starchy veggies at meal time.

    THIS WEEK’S SOLUTION-FOCUSED CHALLENGE

    Each week we’re including a solution-focused challenge that can help evolve care and education in a solution-focused manner. Here’s this week’s challenge: Try incorporating some/all of the following guiding questions into conversations with clients to help elicit exceptions:

    1. Are there times when this has been less of a problem?
    2. What is different about the times when this was less of a problem?
    3. What did you (or others) do that was helpful? 
    4. What’s gone better for you today or over the past week?
    5. What thoughts kept you on track?
    6. At a time when you feel more optimistic and satisfied, what will you be doing more of or more often?

    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

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

    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

  • Fresh Views

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

    Take your mind off the problems for a moment, and focus on the positive possibilities. Consider how very much you are able to do.  ~ Ralph Marston

    Amidst the COVID-19 crisis our world is facing, and the accompanying anxiety and uncertainty,  we are trying to remind ourselves of the many things big and small that we are grateful for. And one of those is that tomorrow is the first day of spring! The change in seasons brings new beginnings and a fresh start. Buds pop open, as pictured on Deb’s peach tree above. And each of those new buds eventually brings beautiful juicy peaches. So with the arrival of spring, we are reminded that no matter what the situation today, there remain new possibilities for the future.

    We hope you find value and inspiration in our series focusing on words to jump-start solution-focused thinking and conversations. If you’re new to our blog, you can read more about our take on the power of word selection here. Last week’s word was “Strengths” – check out our perspective here.

    Today’s word is POSSIBILITIES

    In solution-focused talk, “possibilities” are interwoven with and build upon “strengths”, and what is working well. In theory, by doing “more” of what is “working”, there’s less time to dwell on things that are not going as well or as desired. Building upon strengths ultimately can create possibilities that you may not have even realized existed!

    In a survey we conducted last year, we asked individuals living with diabetes about their experiences with diabetes education services. As we’ve shared before, many people (71% in our survey) are not satisfied with their experiences. Largely, traditional diabetes care and education services have employed a “problem-focused” approach that concentrates on trying to pin-point causes of “problems”. (What caused your low? Why haven’t you been exercising? What led to your time out of range? You get the idea…) Overwhelmingly, the survey respondents expressed desire for their healthcare professionals (HCPs) to focus on non-judgmental communication with individualized, personalized care and education. The desire is that HCPs be positive and express “You can be healthy and we’re here to support your journey!”  Diabetes care and education specialists can play a key role in stepping alongside their clients with diabetes as think partners to envision possibilities. 

    THIS WEEK’S SOLUTION-FOCUSED CHALLENGE

    Each week we’re including a solution-focused challenge that can help evolve care and education in a solution-focused manner. This week the challenge is to consider conversations around continuous glucose monitoring (CGM). The expansion of CGM technologies means more people can have access to more data and use that data to learn much more about their diabetes than what a single number shows. In fact, in the previously mentioned survey, when we asked people what they wanted to be doing “more of” in the future, multiple individuals responded with “more time-in-range.” Of course, no one wants to have glucose values that swing up and down or remain above or below target, yet many conversations (while well-meaning), are often focused on pinpointing the cause of the time out of range and  the “whys”, when the cause is usually “diabetes”

    We’ve interpreted and applied learnings from the recent Advanced Technologies and Treatments for Diabetes meeting (ATTD) and presentation by renowned physician Dr. Rich Bergenstal to illustrate how to review CGM data using a solution-focused approach focused on possibilities and building upon strengths. (You can read the complete summary by diaTribe  here.)

    Here are 5 ways to evolve discussions around CGM:

    1. Flat, Narrow, In-Range (FNIR). When reviewing CGM trends, try using the FNIR approach, aiming for tracings that are flat, narrow, and in-range. It creates a goal and something that is possible with education, management, and support. More importantly, it steers clear of negative or disempowering terms while examining data. 
    2. Steady, Tight And in-Range (STAR). Another approach similar to FNIR, again focusing on possibilities of tracings that are steady, tight, and in-range.
    3. More Green, Less Red (MGLR). Are you familiar with the Ambulatory Glucose Profile (AGP)? An AGP report is a standardized glucose report that includes summary statistics, a glucose profile graph and glucose daily calendar graphs. It provides a report format that is consistent regardless of blood glucose monitoring device. Graphs help translate the numbers into a picture for easy, quick interpretation. Try using MGLR particularly with the bar graph that indicates time-in-range. With this approach focus on the green can draw focus to strengths. What and how did you achieve the amount of green we see on the chart? How can you do more of that to see more green and less red? This approach can help build possibilities and define actions.
    4. Thinking fast and slow. What this means is thinking about readings in real time – when one would need to act fast (like responding to a CGM low alert), then taking some time to look at retrospective data and “think slow”, spending time learning to pinpoint strengths and more realistically think about possibilities.
    5. Best Day. Another solution-focused option that we’re fans of is the “Best Day” pattern feature on the AGP report. Focusing on what went well on the “best day” when their glucose values were more in range can guide the individual to focus on their strengths.  Questions you could ask are, “What were you doing on this day to help you have more green and less red? What else was working for you?” This is also a good opportunity to practice “thinking slow” and encouraging individuals to spend time trying to learn from their CGM data.

    So with the arrival of spring, just as Deb’s peach blossoms have the possibility of turning into sweet, juicy peaches as they did last year (pictured below), taking a solution-focused approach to diabetes care and education can be a fresh new start and bring possibilities to light..

    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

    A Fresh POV for You in 2020: Our Renewed Focus

    A beautiful sunrise to start a fresh day!

    A new year, new decade, and renewed focus for us here @AFreshPOVforYou! This blog is over a year old now, and while our overarching focus remains the same, our Mission has evolved over time.

    Our overarching goal

    Our broad goal at A Fresh POV for You is to focus on Possibilities, Opportunities and creating a Vision (POV) for the future, based on strengths and leveraging positive learnings from past experiences. Initially the primary focus of this blog was people living with or at risk for diabetes. However, we realized that we also want to share our learnings and how-to’s with other diabetes care and education specialists in order to begin to flip the paradigm to embrace a solution-focused approach in practice. 

    Our new Mission

    We guide healthcare professionals in taking a solution-focused approach to practice to enable clients with diabetes to embrace possibilities, opportunities, and a fresh vision for the future.

    Who are we? 

    We are solution-focused diabetes care and education specialists . We are passionate about doing diabetes care and education differently. Too much of life is spent focusing on problems. Forget the “problems”! Let’s turn attention instead to possibilities, opportunities, and a fresh vision for the future. As diabetes care and education specialists, let’s step alongside our clients as “think partners” to focus on what’s important to them, what’s already going well, and build upon that to reach their goals so that they may live life to the fullest. 

    We have both spent our entire careers partnering with people with diabetes to leave a positive imprint. In our discussions and research with people with diabetes, we’ve heard loud and clear that many are not happy with the diabetes care and education services they have received. A remark that has frequently bubbled up is related to leaving a healthcare appointment feeling badly because of significant negative talk and attitudes – feeling as if they, the person with diabetes, has done something wrong, and thus are not motivated or inspired to do things differently. We are advocates for person-centered, strengths-based language, and believe that self-compassion is essential when living with a chronic condition. 

    A peek at our research findings

    From our research we’ve learned that incorporating a solution-focused approach into our interactions with clients makes a difference. Five themes emerged from our qualitative study regarding what  “would happen” in a desired future state, including: more living life; laughter and humor; self-compassion; resilience; and support.Together, let’s do more of what works, and focus less on what’s wrong.  

    Top 10 things we accomplished in 2019

    1. Conducted a survey around the perceptions and impact of current diabetes education services. (You can learn more in this post)
    2. Hosted 2 #DSMA Twitter Chats around taking a solution-focused approach to life with diabetes. (Read more about them here and here)
    3. Conducted a qualitative research study via Twitter around the impact of implementing a solution-focused tool, the  Miracle Question, with people living with diabetes.
    4. Conducted in-depth focus groups with people living with diabetes to gain insight around wants and needs to co-design the future of diabetes care and education services. (Read more about co-design here)
    5. Presented at the American Association of Diabetes Educators annual meeting  on implementation of the solution-focused tool, the Miracle Question adapted for diabetes. (Read about that here)
    6. Presented at the 55th Annual Meeting of the European Association for the Study of Diabetes (EASD) on our Twitter Chat research. (Read our abstract here and our blog posts here and here)
    7. In follow-up to the EASD presentation, had our work published in the European Medical Journal focused on diabetes. (Find it here)
    8. Submitted a paper on taking a solution-focused approach to diabetes care and education accepted for publication in AADE in Practice journal.
    9. Submitted a paper sharing some of our research findings to The Diabetes Educator journal. 
    10. Outlined the content for a solution-focused handbook (more to come in the next year!)

    Top learning from 2019

    A solution-focused approach to diabetes care and education resonates with people with diabetes and diabetes care and education specialists!

    Our fresh views

    We’ve called our weekly blog posts our “Fresh Views” because not only do we share views and practical guidance in the diabetes realm, we also often share inspiring fresh views we’ve experienced in our travels, be it a beautiful sunset, a sandy beach, or towering mountains.

    Getting to know us personally, beyond professionally is important. We believe in the concept of a “therapeutic alliance”- which means that the relationship between health care professionals and people with diabetes is the most important component. So, aside from being passionate diabetes care and education specialists, we are also speakers, authors, wives, moms, adventurers, and avid travelers always in search of the next fresh and magnificent view! We have lots of creative ideas and ways we hope to engage in innovative diabetes education services! 

    Follow us @AFreshPOVforYou on Twitter, Instagram, and Pinterest and learn more about our fresh views! 

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


  • Fresh Views

    Diabetes Bright Spots & Landmines: Insights from author Adam Brown

    Finding Bright Spots puts wind in the sails, rather than constantly tearing them down. -Adam Brown

    Adam Brown  is almost a household name in the diabetes community! He is the Senior Editor of diaTribe.org and author of acclaimed diaTribe column, Adam’s Corner as well as Head, Diabetes Technology + Connected Care, for Close Concerns.  He’s the author of the incredible book, Bright Spots & Landmines: The Diabetes Guide I Wish Someone Had Handed Me,

    His practical guide aligns with our thinking at A Fresh POV for You and our desire to educate the community about solutions focused therapy and coaching approach. We appreciate Adam taking time to share insights around finding and focusing more on what he calls diabetes “Bright Spots,” while setting up safeguards to steer away from stumbling upon diabetes “Landmines”.

    Q1: What are “Bright Spots” and “Landmines”?

    Adam: “Bright Spots” and “Landmines” is a framework for evaluating diabetes habits and decisions.

    The goal with “Bright Spots” is to identify what works and focus on doing those things more often. In other words, “What’s going well in my diabetes that I should keep doing? What happens on my best days? What foods and decisions keep my blood glucose in the tight range of 70-140 mg/dL? What puts me in a positive frame of mind? How can I do more of these things each day?” Examples from my own life:

    • Eat less than 30 grams of carbohydrates at one time.
    • Remember why in-range blood sugars benefit me TODAY (I’m happier, more productive, in a better mood, and a kinder person to loved ones).
    • Walk after I eat and to correct high blood sugars.
    • Get at least seven hours of sleep.

    Conversely, the point of Diabetes Landmines is to uncover what doesn’t work and find ways to do those things less often. “What decisions do I make repeatedly that explode into out-of-range blood sugars values over 180 mg/dl or less than 70 mg/dl? What happens on my most challenging days with diabetes? What choices do I always regret? What repeatedly brings on negative feelings? How can I do fewer of these things each day?” Examples from my own life:

    • Hypoglycemia binge: overeating to correct a low, only to go high afterwards.
    • Eating white bread, crackers, and sugary foods
    • Asking unproductive questions like “How is this this possible?” or “Why am I so terrible at this?”
    • Using all-or-nothing thinking: “Well, I don’t have an hour, so I can’t exercise.”

    Clarifying Landmines upfront helps develop a plan of attack: What safeguards can I set up to avoid them? How can I build routines that reduce the chances of stumbling onto them?

    Most of us are very good at identifying Diabetes Landmines (mistakes), but we rarely ask the opposite (Bright Spots) question: “What is working and how can I do more of it?” Diabetes requires both modes of thinking! And since Bright Spots are often overlooked and undervalued, we must actively cultivate this kind of thinking.

    Q2: How does this framework fit into your book, Bright Spots & Landmines?

    Adam: The book discusses my own “Bright Spots” and “Landmines” in four areas: Food, Mindset, Exercise, and Sleep. I consider these key pillars of living well with diabetes. My #1 goal was to make this book actionable, meaning anyone can pick it up and immediately improve some aspect of his or her life: more time in an ideal blood glucose range; less time managing and worrying about diabetes; less stress and guilt; better relationships and energy and sleep; and a happier mental state. Everything in Bright Spots & Landmines has made a positive difference in my life, and most things include a small step that can be taken immediately. The advice has resonated with people who are newly diagnosed all the way to those with 50+ years of diabetes.

    Q3: How can people get Bright Spots & Landmines?

    Adam:

    1.     Download a free PDF version at diaTribe.org/BrightSpots

    2.     Get it in paperback ($5.78) or on Kindle ($1.99)

    3.     Listen to it for free at diaTribe.org/BrightSpotsAudio or buy it on Audible or iTunes

    Q4: The work we @AFreshPOVforYou are doing is centered around the solutions focused brief therapy approach. How does that align with Bright Spots?

    Adam: It’s easy to come up with a vague list of things I “should” and “should not” do, but Bright Spots and Landmines need to be useful. That means hitting three criteria:

    1. Specific and actionable: “Eat healthy” does not count as a Food Bright Spot – it’s too vague. “Fill half my plate with vegetables” is much clearer.
    2. Realistic and sustainable: “Not eating” does not count as a Food Bright Spot either – it’s impossible to sustain. “Eat slowly and stop before I’m 100% full” is more realistic.
    3. In my control and changeable: “Bad weather” is not an Exercise Landmine – it’s out of my control. On the other hand, “overeating after exercise” is a Landmine that is changeable – I can find ways to avoid it.

    Q5: Tell us about the 42 factors that affect blood glucose.

    Adam: Over the past ten years, I have worn continuous glucose monitoring for over 60,000 hours, run thousands of personal experiments, and learned from some of the smartest minds in diabetes. One of my biggest takeaways is how absurdly complex diabetes is; it’s not as simple as “eat healthy, take your medications, and exercise and you’ll have on-target blood sugars.”

    In reality, there are at least 42 factors that affect blood sugar – food, medication, activity, environmental, biological, and decision-making factors. Many of these factors are barely talked about (e.g., sleep), others are impossible to measure in any given moment (e.g., stress, infusion set function), and we never know what factors are in play in a given moment. Most of Bright Spots & Landmines is about minimizing the impact of those 42 factors. But perfectionism is impossible, given the tools we have and the environment we live in. CGM, coupled with experimentation and reflection, is an amazing diabetes tool to cope with this complexity. Get a full downloadable PDF explaining all 42 Factors here.

    Q6: Would you share an impactful story/experience surrounding Bright Spots that might resonate with people living with either type 1 or type 2 diabetes?

    Adam: The Amazon reviews tell some remarkable stories – people who have dropped their A1c by multiple points, who spend significantly more time-in-range each day, who have renewed motivation to manage diabetes, etc.

    Q7: What guidance would you offer for DEs / HCPs to focus on bright spots?

    Adam: When someone is struggling, the temptation is to focus on what’s going wrong and brainstorm solutions. This “Diabetes Landmines” thinking has value, but it cannot be 100% of the focus!

    A “Bright Spots” orientation – what is working and how can I do more of it? – is just as valuable (and in many cases, far more valuable). Finding Bright Spots puts wind in the sails, rather than constantly tearing them down.

    Here are some questions to help Find Diabetes Bright Spots:

    1. What is going well in my diabetes? What am I doing well that I should try to do more often?
    2. What happens on my best days with diabetes?
      • What do I eat?
      • What does my diabetes self-talk sound like?
      • When and how do I exercise?
      • How did I sleep the night before?
      • What do loved ones do that is helpful?
    3. If I wanted to have one of these Bright Spot days today, what would I do to make it happen?
    4. What times of day or days of the week is my glucose consistently staying in range (70-140 mg/dl or 70-180 mg/dl, depending on your preferences)? What choices might be enabling that to happen?
    5. What is one Bright Spot decision from the past week that – if repeated consistently – would really improve my quality of my life?
    6. What are some small steps that I could take this week to increase my Diabetes Bright Spots? What am I willing to try?

    Thank you Adam for your enlightening solutions focused approach and sharing your first-hand understanding and experience about how to live well with diabetes!  We agree with you that “Bright Spots are often overlooked and undervalued, (and) we must actively cultivate this kind of thinking.” At A Fresh POV for you our goal is to do things differently and encourage building a strong therapeutic alliance by focusing on strengths, solutions, and yes, Bright Spots!

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    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

    Do you need a “secret drawer”? A strategy to reduce stress and identify solutions

    “Solitude is where one discovers one is not alone.” –Marty Rubin

    Puma in her secret drawer

    We love animals, and believe in the therapy pets can provide. We also believe we can learn from them.  

    One of Deb’s cats has a secret drawer where she hides when life gets a little too stressful.  She’ll use that alone time to calm down, and when she’s ready, she’ll come out and face the world again. Her resource to foster her strengths is a secret drawer. It’s her stress management.

    Do you ever feel like you need a “secret drawer”, where you can think about things and reframe your focus on things that are going well?  (Check out our January 2, 2019 post for more thoughts on reframing).

    Are you someone who re-energizes by taking some alone time? Or by spending time in a group?  If you’ve ever completed a Myers-Briggs Type Indicator Personality Test you understand this concept. In Myers-Briggs, an introvert replenishes their energy with much needed alone time, because their energy is drained when with a group (which differs from the common thought that introverts are simply quiet and shy). An extrovert, however, needs to be around others to “fill their tank” and recharge. 

    When employing a solution focused approach to help others create solutions, it’s key to understand how people re-energize. To help flush this out, we can explore where they get their strength from? How they have coped in the past? How they have managed?  When they answer these questions, it’s then possible to identify the type of solution they have engaged in, and encourage them to engage in these helpful behaviors more often. Keep in mind, when using a solution focused approach, the solutions do not have to be directly related to any identified problem. The focus is on what the desired future for the individual is, and pinpointing how to move in that direction.  So when things are going well, we want to encourage engaging in behaviors from that time, more often.

    What resources can you pull from when you need a secret drawer? If a little down time helps reduce stress or gives your mind the bandwidth to think and identify solutions, then take a secret drawer break. Or, maybe going out with people is what you need. Maybe you need a little of both, depending on the day.

    A secret drawer may help you focus on and identify your solutions.

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