• Fresh Views

    When Life Happens: 5 Tips to Help You Get Back on Track

    July 19, 2023
    Hiking path in Crete, Greece

    Doing the best at this moment puts you in the best place for the next moment. ~ Oprah Winfrey

    When we began 2023 we decided to “go back to the basics” and revisit some solution-focused tools and skills while we focused on our own strengths and set personal goals. Now that we are half-way through the year, we wanted to look back and check-in on our progress. To do this, we’ve created a “Summer Self-Care” series; short and simple ideas to build upon these existing tools and to help focus on strengths in a solution-focused way. 

    In today’s installment we focus on how to get back on track after facing a “twist” in the road.

    Back in January, Deb’s New Year’s solution was focused on sleep and developing a healthy bedtime routine. My goal in 2023 was to be more intentional each evening, by taking small steps to develop new healthy sleep habits. The first step was to use the “sleep schedule” in Apple Health to set a bedtime with a “reminder” an hour before, stopping TV, phone and computer screens and focusing on relaxing, reading, and other quiet and peaceful activities. While I started out motivated, the reality of work and family life seemed to intrude and I was staying up late again. I was off track and needed some motivation to get back to my new routine. I never owned a Kindle before and wondered if it might help me stick to my routine if I could travel easier with reading material. With the simple addition of the Kindle, I had new motivation for my routine and I was looking forward to my reading. I am now back on track, going to bed on-time (most nights!) and getting up early to walk before work and the heat of a Sacramento summer day. I’m not 100% successful, but I’m okay with that. If we recall the words by Winston Churchill, “Perfection is the enemy of progress.”

    Here are 5 tips to help you get back on track:

    1. Remember your why. Take a minute to remind yourself why you wanted to set your goal in the first place. What were you trying to achieve? Take the opportunity to review your purpose and be intentional as you revisit your plans.
    1. Don’t dwell on the past. Solution-focused principles help an individual focus on the future and how to do more of what’s working. We don’t look backward. It sounds simple, but we can’t change the past, so let’s not waste our mental energy on things we do not have control over.
    1. Use your VIPs. Sometimes we do best when we have a close friend or family member help us be accountable.  Simply sharing goals out loud with another individual can help us stay focused on our goals. In a solution-focused approach we engage with the VIPs (very important people) in our lives to support us in our journey. 
    1. Journal your thoughts and feelings.  While journaling typically means putting pen to paper, sometimes just talking to yourself and verbally addressing your goals, obstacles and challenges may be helpful. Always focusing on what’s going well and how you can do more of that.
    1. Be compassionate towards yourself. Affirming self-talk, which we’ve written about here,  is important as a general practice, but even more so during times of encountering a “twist” in the road. Greet your inner critic with compassion, even if it may be challenging. After all, you’re only human. 

    We are living in a fast paced world, with competing demands on our time. Sometimes we need to just do our best and focus on the now, and hopefully we’ll be ready to move forward and get back on the best path for us.

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

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

    Follow us on Twitter and Instagram @AFreshPOVforYou

    Deb is employed by Dexcom, but her words and opinions in this blog are her own.

    Tami is employed by the University of Kentucky HealthCare Barnstable Brown Diabetes Center, but her words and opinions in this blog are her own.

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  • Fresh Views

    Expressing Gratitude: 6 Strategies To Get Started 

    March 15, 2023
    Deb’s gratitude bird waiting to be “fed” a message of gratitude

    I am happy because I’m grateful. I choose to be grateful. That gratitude allows me to be happy.

    ~Will Arnett

    Expressing gratitude is something we strongly believe in and practice in our daily lives. The expression of gratitude and acknowledging things that have gone well in the day is a powerful tool in solution-focused practice. We’ve written about gratitude many times in this blog. 

    Recently when traveling in Colorado, Deb happened upon a unique art shop and was called to two beautiful “gratitude birds” (pictured above and below). She knew immediately that we needed them. Each morning, we start the day by “feeding” our gratitude birds with a daily message or two (or three) of things we are grateful for. Some are big, some are the tiny things in life. Today as we write, Deb is grateful for her kitties and Tami is grateful for the sunshine and spring daffodils ready to burst into bloom. Gratitude does not need to be huge or all encompassing, a simple statement can start your day off in a positive direction.

    The simple definition of gratitude is “a feeling of thankful appreciation for favors or benefits received; thankfulness.”  But the practice of gratitude means so much more.

    Gratitude is good for health

    Practicing gratitude is powerful. 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. 

    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. It’s also been noted that grateful people have healthier eating habits, are more physically active, have improved sleep, are less likely to smoke and abuse alcohol, and have higher rates of taking medications as prescribed. Several studies suggest that gratitude can decrease stress and anxiety by activating the areas in the brain that release feel-good hormones serotonin and dopamine. It’s difficult to feel sorry for yourself or feel down if you’re practicing gratitude.

    Today we offer 6 strategies to help develop daily gratitude habits: 

    1. Keep a gratitude journal. For us recently, when we pick up our 5-minute daily journal which we shared about here, it prompts us to record those things we are grateful for in the day. Our personal goal is to identify at least 3 things daily for which we’re grateful. 
    2. 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. 
    3. 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. We shared some favorites in this post here.
    4. Practice sharing positive feedback with others. A little different angle on the practice of expressing gratitude, the next time a restaurant or store employee is helpful or you enjoy a product, tell others about your experience. Leave a positive review or tell managers about helpful, positive employees. That’s a simple but impactful way to express gratitude for great service.
    5. 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. 
    6. Listen, smile, be respectful and choose kindness. Applying this to solution-focused practice, our actions and treating others as we would like to be treated are another way to express gratitude. It lets others know that we value them.
    Tami’s gratitude bird

    3 tips to keep your gratitude practice going:

    1. Find a daily time to practice gratitude and try to be consistent. Maybe it’s when you get up in the morning. Maybe it’s before you go to bed at night. Maybe it’s when you’re exercising.
    2. Write what you feel. Don’t censor it.  
    3. Refrain from making the list repetitive. Pause, reflect and be specific about the small and the big things you are grateful for in the day.

    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 @AFreshPOVforYou

    Deb is employed by Dexcom, but her words and opinions in this blog are her own.

    Tami is employed by the University of Kentucky HealthCare Barnstable Brown Diabetes Center, but her words and opinions in this blog are her own.

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  • Fresh Views

    Perspective over comparison

    October 26, 2022

    No one can make you feel inferior without your consent. – Eleanor Roosevelt

    The trees in Kentucky are bringing their showy fall foliage. Each does not think about competing with the tree beside it. They just do their thing and bring their color.

    Our last post focused on the impactful words that Tami keeps on a post-it note stuck to her computer monitor: Progress, not perfection. These words build on how the growth mindset draws attention to one’s own progress. Today we turn our attention to 3 more impactful words shared by a mentor over the years: Perspective over comparison.

    Accepting oneself can be hard! 

    In life it can be easy to default to comparing yourself to others. Just last week Tami heard these words from a patient, “I’m bad…I don’t eat the way I’m supposed to. I don’t keep my blood sugars as well controlled as my friend who also has diabetes.”  It’s so easy to get caught up in creating our own opinions of ourselves and how we measure up to others. We can play the comparison game all day long but how helpful is that really? Comparison can leave us feeling down. 

    Being realistic about personal strengths and challenges is often easier said than done. Striving to be honest with ourselves and accept who we are, our abilities, and acknowledge when we’ve reached our limits is the goal. Without acceptance it’s impossible to move forward. 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.”

    Acceptance is critical when living with a chronic condition like diabetes

    When encountering clients/patients facing this comparison scenario, diabetes care and education specialists (DCES) can step alongside as a think partner and give perspective to the circumstances. We can offer caring, support and encouragement.

    People need to feel safe when engaging with their care team to acknowledge what they can do, along with what is challenging for them. This past week in an educational symposium for people with diabetes that Tami spoke at, the participants voiced loud and clear the theme of feeling judgment from their healthcare providers. DCES have a unique opportunity to support those that live with diabetes as they learn to accept changes and new challenges in dealing with diabetes. And, practice acceptance, understanding that people react to challenges differently. It’s critical to accept the person in front of you as they are, without judgment.

    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, do more of what is working, and leverage 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.”

    Diabetes care and education specialists can learn a lot from simply asking people what strengths they have to help them live well with diabetes, keeping top of mind, it’s all about perspective over comparison.

    Here are 6 solution-focused questions you can incorporate to focus on perspective, strengths, and self-acceptance:

    1. What would success look like for you (e.g. in life, in living with diabetes etc)?
    2. What strengths do you have and use to help you manage your diabetes every day? 
    3. How can you use your strengths to create opportunities for success?
    4. What is one thing you have come to accept in your life that took some time to process?
    5. How did you feel when you were finally able to accept that challenging situation?
    6. How could you use those experiences and feelings to move you forward to accept a new challenge now?

    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 @AFreshPOVforYou

    Deb is employed by Dexcom, but her words and opinions in this blog are her own.

    Tami is employed by the University of Kentucky HealthCare Barnstable Brown Diabetes Center, but her words and opinions in this blog are her own.

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  • Fresh Views

    Transform Primary Care Encounters: “Diabetes Only” Visits

    May 4, 2022

    Success is built sequentially. It’s one thing at a time. – Gary W. Keller

    Building on our last blog about how to have a productive type 2 diabetes (T2D) diagnosis conversation using a solution-focused approach, NOW let’s focus on how to incorporate these techniques into follow up visits. These follow-up visits are ideally “diabetes only” visits. In a brief primary care visit that is addressing multiple issues, it can be too challenging to focus on specific diabetes priorities. The American Diabetes Association recommends scheduling  “diabetes only” appointments to focus on and address diabetes-related concerns. This diabetes only visit is an opportunity to be a think partner with your client to answer questions, address concerns, and map out a plan together.

    Using a solution-focused approach at a “diabetes only” visit?

    Since asking eliciting questions is a primary tenet of a solution-focused encounter, we encourage starting all visits by listening and learning from your client. Even though the client is new to diabetes, they are the expert in that they know what works in their life in other aspects, and they know what they are capable of doing now. (Read more about experts here)

    The goal is to focus on things that are working well, and when something works, do more of it! Help your clients to recognize their strengths by identifying exceptions. We’ve written about exceptions here). “Diabetes only” visits can be structured in a systematic way.

    10-step model for a “diabetes only” visit

    1. Start with a question. “I’m looking forward to hearing how things have been going since our last visit. Can you tell me one thing that went well for you this past week (or since we last met)?”
    1. Explore the reply further. “How do you think you can do more of (that)?”
    1. Personalize. “I want to make sure this visit is successful for you, what do you need to know or learn by the end of the visit?”
    1. Empower. Empower people with diabetes with tailored education and support to ensure their questions, needs and desires are met.
    1. Set a SMART goal.  A SMART goal  helps move the individual towards the direction they want to move based on your conversation. It helps quantify progress with measurable steps and keeps things reasonable and achievable.
    1. Ask a scaling question. “On a scale of 0-10 where zero is never and 10 is all the time, how confident are you that you can achieve your goal?
    • Use their answer to finish the visit and provide one action for them to focus on.
      • If 0-4: Encourage them to revise their smart goal, it might be too difficult to achieve.
      • If 5-7: Identify one strength they already have and build upon it. “What is one thing you do where you feel confident in your actions? How can  you do more of that?”
      • If 8-10:  Encourage them to challenge themselves and consider a goal that might move them closer to their overall health behavior outcomes.
    1. Review  the four critical conversations. As we discussed in the last blog, we encourage you to build upon these conversations at each visit. (adapted from ADA Overcoming Therapeutic Inertia) 

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

    “Although diabetes is progressive, and can change over time, your actions can make a difference in slowing the progression over time.”

    Conversation 2: Your treatment plan will change over time as your diabetes changes.

    “We will work with you to find a treatment plan that achieves health goals while also considering your preferences and values.”

    Conversation 3: You can’t do this alone.

    “Seek help from family, friends and community support resources.”

    Conversation 4: Share your difficulties with managing your diabetes.

    “Your healthcare team is on your side and we will support you in whatever ways you need to manage your diabetes”

    1. Refer for diabetes self-management education and support.
    1. Thank them for coming in and for working hard.
    1. Plan follow-up. Plan the next diabetes only visit.

    Join us next time as we continue our series on incorporating a solution-focused approach when managing T2D in the primary care setting. We’ll continue to help you  build your solution-focused tool-kit. Our goal is to start slow and share small, achievable bite-size practice changes you can implement over time. 

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

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

    Follow us on Twitter and Instagram @AFreshPOVforYou

    Deb is employed by Dexcom, but her words and opinions in this blog are her own.

    Tami is employed by the University of Kentucky HealthCare Barnstable Brown Diabetes Center, but her words and opinions in this blog are her own.

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  • Fresh Views

    Diabetes Technology and Solution-Focused Practice: Applied to Mobile Apps

    April 7, 2021

    “You`re only as weak as you let yourself become, and you`re only as strong as you allow yourself to be.”

    ~ Daniel Hansen

    Beautiful bougainvillea, Palm Desert, CA

    In this week’s installment of Diabetes Technology and Solution-Focused Practice we’re discussing mobile apps. In our last blog we focused on using a solution-focused approach to interpreting and discussing continuous glucose monitor (CGM) data. This week’s blog we’ll focus on a new discovery for us – the WW mobile app. We will share insights on other apps in future blogs. We believe that using solution-focused language within mobile applications can improve user engagement with the app, as well as encourage individuals to make progress towards their health behavior goals.

    WW App: Deb’s experience…

    As you may know, Weight Watchers is now known as WW. I have been using their app, the WW app, to help  stay on track during the COVID-19 lockdown. You can learn about the different WW programs and pricing here. There are several options to choose from, I only use the app for logging and motivation.  I was encouraged to continue using the app because of the nature of the messaging. Then I began to wonder if they were incorporating a solution-focused approach? 

    From a weekly in-App push a few weeks ago, the headline was “Why you should do what works: You might already have more tools in your toolbox than you think.” If that doesn’t sound like solution-focused messaging, I’m not sure what does! The post reminds us that people typically focus on what isn’t working well and how to deal with challenges. Of course, that is not motivating, and not helpful when trying to make hard health behavior changes.

    But, what if you “Flip the switch” so to speak? (See our many blog posts from 2019 about “Flipping the paradigm” –  here’s one on healthy eating, and here’s one on healthy coping). The WW message goes on to encourage focusing on the things that come naturally and leverage strengths or what’s worked in the past! Wow! We’ve written about strengths in this blog multiple times (you can read about strengths here), and so believe in focusing on what one does well,  building confidence, and increasing happiness by doing so. 

    Make Strengths your Secret Weapon. According to WW, leveraging your strengths will help you be successful. They suggest asking 3 questions to uncover strengths:

    1. When do I feel like my best self?
    2. What makes me unique?
    3. What comes most naturally to me?

    Those are questions that diabetes care and education specialists (DCES) can easily incorporate into diabetes-related conversations with clients as well. Once those questions are answered, WW suggests creating an “affirmation” to help remember to focus on personal strengths. You can read their post here. One exercise that helps people think through writing their own affirmation includes showing a word cloud to help direct thinking about potential ideas of strengths (including humor, cleverness, bravery, creative etc.). What a powerful visual tool, that would be so easy to employ in any diabetes care and education program! Finally they suggest saying the affirmation out loud every morning or posting on your computer so it will be visible every day. For instance, “I am strong.” “I am resilient.” You get the idea

    I loved this way of thinking about making healthy choices, and reading and engaging with the content. I created my own affirmation and have it posted on my computer with a sticky note so I  glance at it multiple times during the day! Tami has affirmations on her desk and in the kitchen that she sees when making coffee in the morning to start the day off.

    Helping clients create their own affirmation using solution-focused principles is a great opportunity to highlight what is working well already and focusing on their strengths, as well as supporting the development of resilience. 

    Do you recommend mobile apps to your clients? 

    If you have a client interested in weight loss or adopting healthy eating habits, the WW mobile app might be a good option. (We are not endorsed by WW and do not receive any compensation from WW). Knowing the positive strength-based language that is being used is so encouraging. Also of note, WW recently hired Adam Kauffman, formerly of Canary Health,  to head their diabetes program (read the press release here) so we’re excited to see what’s to come in the future.

    We plan to continue to write about a variety of other technologies that impact and influence diabetes care and education including diabetes apps, digital health tools, diabetes devices, online peer support and online coaching. Stop back by in 2 weeks to see what’s up next!

    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. 

    Deb is employed by Dexcom but her words and opinions in this blog are her own. Tami is employed by the University of Kentucky Barnstable Brown DIabetes Center, but her words and opinions in this blog are her own.

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  • Fresh Views

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

    September 16, 2020

    Today’s word is: EXPERTS

    If you’ve been following our blog, you know that we’re in a series addressing how to move towards a solution-focused practice….one word at a time. This week our word, EXPERTS, applies to both diabetes care and education specialists (DCES) and people with diabetes (PWD). You can read more about STRENGTHS, OPPORTUNITIES, and incorporating the input from experts in their diabetes management here.

    The Association of Diabetes Care and Education Specialists (ADCES) recently published two technology focused papers in The Diabetes Educator journal addressing the role of DCESs in leveraging technology to improve outcomes in people with diabetes. You can find a link to the ADCES landing page here that highlights both papers and includes links to two different podcasts with the primary authors of each paper.

    The Identify, Configure, Collaborate (ICC) Framework

    Deb and co-authors of A Framework for Optimizing Technology-Enabled Diabetes and Cardiometabolic Care and Education document a systematic approach to incorporating technology into the diabetes self-management plan known as The Identify, Configure, Collaborate (ICC) Framework. It is a model to support DCESs to maximize and ensure successful use of technology. We’ll walk you through the 3 components of this framework when incorporating technology into care…

    IDENTIFY: First, identify technology tools that will support self-management and decrease the burden of living with diabetes. It’s important to identify individual bias regarding technology to ensure everyone is offered tools to support them regardless of their age, gender, race and socioeconomic status among others. DCESs are technology champions and can have a big influence regarding technology use. However, we don’t want to be “gatekeepers” denying technology based on our assumptions. 

    CONFIGURE: Once a tool is identified, configuring the settings and plan for use is just as important.  Technology can only improve outcomes if the tools are used to their fullest potential. For example, helping PWD enable alerts and alarms or weekly email notifications when using continuous glucose monitors (CGM)  can help them learn from their own diabetes data in real-time. Mobile apps can be configured to capture patient generated health data (PGHD) that is meaningful to the individual.

    COLLABORATE: Finally, viewing all of the data generated from the technology tools then engaging in collaborative discussions around what the data means and how to make health behavior or medication changes is essential. The DCES is the key team member to support  PWD in the use of technology. DCESs have been focusing on PGHD since the invention of blood glucose monitors and are experts in using data to manage diabetes. And, the use of PGHD can support PWD as experts in their own diabetes as they learn how  food choices, activities, stress, and medication, among other things affect them.

    When incorporating a solution-focused approach into practice, the client is recognized as the expert in their own life and their own diabetes. Clients already have the resources and strengths to move forward to achieve their desired future state. When considering incorporating technology to support diabetes self-management, begin by acknowledging PWD as EXPERTS, prior to identifying and configuring tools, and then collaborating to modify the treatment plan. Create an opportunity to learn from your clients and discuss the value and benefits technology has provided them, as well as the challenges and burdens. This collaborative discussion can help all of your clients as technology evolves.

    Each week we invite readers to participate in a solution-focused challenge. Our solution-focused challenge for this week is to focus on your clients as the experts when incorporating technology and applying the ICC Framework.

    1. Identify and highlight the client’s strengths, positive qualities, resources, and ability to generate solutions prior to suggesting technologies.
    2. Configure technology tools that focus on the details of the solution instead of the problem.
    3. Collaborate to develop action plans that support what is working well for the individual.

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

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

    Follow us on Twitter and Instagram @AFreshPOVforYou

    Deb is an employee of Dexcom but view here are her own

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  • Fresh Views

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

    July 8, 2020

    Every accomplishment starts with the decision to try ~ Author unknown

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

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

    Today’s word is: OPPORTUNITIES

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

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

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

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

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

    Ask your client:

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

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

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

    Follow us on Twitter and Instagram @AFreshPOVforYou

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  • Fresh Views

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

    June 24, 2020

    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

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  • Fresh Views

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

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

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

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

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

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

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

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

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

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

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

    Follow us on Twitter and Instagram @AFreshPOVforYou

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  • Fresh Views

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

    March 18, 2020

    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

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