Once you know what works, do more of it. – Steve de Shazer and Insoo Kim Berg, pioneers of solution-focused brief therapy
As we continue our new series on transforming primary care encounters by using a solution-focused approach, today let’s talk about the benefits of this approach. Benefits to you as a health care provider and more importantly benefits to your clients. We’ve had several primary care providers encourage us to share more on this approach as they found it to be a transformational way of thinking and engaging with clients.
What are the benefits to the client?
Without a doubt, managing diabetes is complex and burdensome. In 2019, we conducted a qualitative research study with Twitter Chat data from a #DSMA chat we moderated around a solution-focused tool called “The Miracle Question”. We first presented these findings in 2019 at the 55th Annual Meeting of the European Association for the Study of Diabetes Conference in Barcelona, Spain. Two compelling comments from participants with diabetes that came out of that study.
- “Diabetes interrupts my life… every minute.”
- “Success would look like people realizing what diabetes is and we can stop with these assumptions and jokes about diabetes.”
As we’ve written about many times, individuals that live with type 2 diabetes (T2D) have many obstacles to overcome due to the lack of understanding about the condition.We know that T2D has a genetic link and is more common in individuals of color, those with a family history, and that risk increases with aging. While making more healthful behavior changes is critical to living a healthy life, the genetic nature of the condition is not well known in the general community and not discussed enough in medicine, the community at large, and the media.
The goal is to help the person with T2D recognize exceptions (a time when their problem does not happen) and help them to focus on their health behavior changes by doing “more of what works.” Give our previous blog here a quick read to get up to catch up on the basic tenets of the solution-focused approach and how implementing an approach that focuses on solutions instead of problems can “flip” the conversation in primary care and build stronger relationships.
Ultimately, developing stronger relationships will facilitate positive discussions about therapy including medication, food choices, physical activity and more.
What are the benefits to the provider?
Brief intervention. One of the most important benefits of incorporating a solution-focused approach in primary care is that it is a “brief” intervention. With often many competing demands to address during a primary care encounter, you do not need to delve deep into problem-solving mode. Instead you discuss what’s already working well and step alongside the client as a “think partner” to do more of what “works.”
Ownership transferred to the client. Ideally a solution-focused approach incorporates questions to generate discussion (we’ll share some of these in a future post). . In this way, the primary care provider helps the client elicit “change talk” instead of “telling” the client what to do. Tami had a client this past week that said those very words… “I really like that you’re not telling me what to do, but spending time talking to me and brainstorming ideas so I can decide what I want to do.” The client will have ownership over their decisions and be more invested in the next steps. This is really the first step in shared decision-making.
Greater individualization of care. The recent 2022 ADA Standards of Care presents much greater emphasis on individualization and personalization of care. What better approach to individualize the care plan than asking the individual what is working for them and what they think might be the best next steps. Together you can identify small steps towards their goals.
Come back in two weeks for our thoughts on the power of language when managing T2D in the primary care setting. We’ll re-introduce the concept of person-first, strengths-based language and use in a solution-focused approach with tips for the primary care team, both clinician and person with diabetes. We’ll continue to help you build your solution-focused tool-kit over time.
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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.