Deborah Greenwood, PhD, RN, BC-ADM, CDCES, FADCES, Adjunct Assistant Professor, UT Health San Antonio School of Nursing, 2015 AADE President (now ADCES); Tami Ross RD, LD, CDCES, MLDE, FADCES, Lexington-Fayette County Health Department, Lexington, Kentucky, 2013 AADE President (now ADCES)
As diabetes care and education specialists, we understand how challenging it can be for people with diabetes to self-manage diabetes day after day, often without much support, and typically focusing on solving problems. Is there a different way we can approach education, care and counseling that might strengthen the resilience and confidence needed to manage a chronic condition? We believe there is.
In our recent publication in The Diabetes Educator, Applying a Solution-Focused Approach to Life With Diabetes: Insights Gleaned via Twitter we describe outcomes of our solution-focused brief therapy (SFBT) intervention during a Twitter chat. When one engages in a solution-focused approach, traditional conversation is reframed towards one of generating solutions.
The focus is on an individual’s existing strengths and resources, and helping them build those skills, so they can do more of what is working for them as opposed to focusing on everything that is wrong or not working. One solution-focused tool that diabetes care and education specialists can use in practice is called the Miracle Question (MQ). Ask the question, “Suppose tonight while you sleep, a miracle happens. When you wake tomorrow morning, what will you see yourself doing, thinking, or believing about yourself that will tell you a miracle has happened in your life?” This exercise helps people to describe their “best hope” for their future. The process helps them to walk through this process in small, focused and realistic steps to move forward towards that vision.
During the Twitter chat we asked ten SFBT questions and then analyzed the data using a qualitative content analysis. While many individuals described their experience of burden from living with diabetes, there were five positive themes that emerged: living life, laughter and humor, self-compassion, resilience and support. This data suggests that incorporating SFBT tools into DCES practice may support individuals with diabetes in developing their strengths, including resilience, needed to live a full life with diabetes.
Here are 5 suggestions of SFBT strategies diabetes care and education specialists can employ in practice:
- First, recognize your own implicit biases and check any judgement at the door. Set the stage for all engagements with a positive tone regardless of current lab values, medication taking behaviors, weight or other self-management choices.
- Listen more than you speak and become a “think partner” with your client. In this role you can guide them in their self-development, identifying and reinforcing their strengths.
- Focus on what is working well and then encourage small personal experiments to take steps towards their goals, helping to build resilience.
- Identify the types of support they need to move towards their goals and desired future state. Support can be in many forms and needs may differ from one person to the next. There’s a variety of peer support communities available and the ADCES website has resources you can share.
- A SFBT approach requires the use of person-first, strengths-based, empowering language to have fully meaningful communications and move away from feelings of blame and shame.
Anyone can incorporate SFBT tools into their practice. We hope these strategies help get you started.
ADCES Perspectives on Diabetes Care
The Association of Diabetes Care & Education Specialists Perspectives on Diabetes Care covers diabetes, prediabetes and other cardiometabolic conditions. Not all views expressed reflect the official position of the Association of Diabetes Care & Education Specialists.
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