The most overlooked experts in achieving diabetes health targets are the patients themselves. Learn how to bring out and work with your patients' skills and abilities by attending F05 "Dancing Together: The Power of a Relationship-Centered Approach" from 8:00 am to 9:30 am today in room 118. This breakout session features well-known diabetes patient expert and Huffington Post blogger, Riva Greenberg, also a Wellcoaches certified health coach, and Boudewijn Bertsch, MA, health researcher and executive adviser at the RSM Erasmus University Rotterdam, the Netherlands.
"The diabetes educator is the expert in general diabetes care, but patients are the experts on their diabetes and their lives," Greenberg said. "What we really want to do is take advantage of the expertise of both. That's the idea of ‘Dancing Together.' The past several years we've been focused on being patient-centric, but there's greater power in being relationship-centered."
Diabetes education that mostly imparts information is not working well. One limitation is that it becomes generic and doesn't address patients' specific needs. "Nor does this one-sided push of information ignite patients' creativity or passion to be healthy," she said. "We see the consequences every day — too many people with diabetes are not achieving their diabetes health targets."
However, cultivating a relationship with patients, looking at them, being fully present, deeply listening, and asking explorative and relationship questions, such as "How can we work well together?" and "What has to happen today for you to consider our visit successful?," dramatically changes the quality of interactions with patients and the outcomes achieved, even when time is brief, Greenberg said.
Greenberg cites something she calls "Rapport Before Report." First, establish rapport, through trust, respect, encouragement, and support, and then patients will be more eager participants to co-design next steps when you discuss their numbers and what to do about them.
Greenberg and Bertsch also offer coach-to-success approaches to help explore your patients' strengths and skills that they can bring to their diabetes self-management meeting.
"In the last few years, motivation has dominated our thinking to move patients forward," she said. "We have forgotten the importance of having the skills one needs to do new behaviors."
When her downstairs neighbor was first given an insulin pen, she called Greenberg in a panic asking her to come watch the woman take her first injection. After dialing her dose, the neighbor stuck the pen in her thigh and immediately pulled it out before pressing the plunger. No one had her demonstrate her ability to use the pen. "Motivation without skills is useless," Greenberg said. "If we want people to eat healthy and lose weight, it makes sense to find out if they know how to cook. And we should not forget ‘act as if.' Doing a new behavior often turns on motivation."
She is also a firm believer in fostering positive energy.
"I believe in creating a ‘happiness intervention' by helping patients look at what they're doing well, where they're making an effort or progress, and reframing disappointments into something positive," Greenberg said. "There is more energy available to us when we're positive than when we're negative."
As an added perk, Roche is making available to all attendees of this session a copy, at no charge, of Greenberg's book, "Diabetes Do's & How To's." The book guides readers through essential action steps — what to do and how to do it — to live healthfully with diabetes. It's a useful tool for educators to use with their patients to help them design new behaviors.