Speaker: John Zrebiec, MSW, CDE
Cultivating Family Support in Diabetes Care
Speakers: Teresa Pearson, MS, RN, CDE, FAADE and Hope Warshaw, MMSc, RD, CDE, BC-ADM, FAADE
Social Context of Diabetes
Speaker: William Polonsky, PhD, CDE
Engaging the Disengaged: Strategies for Promoting Behavior Change in Diabetes
Webinar Description: The provision of appropriate psychosocial support to people with diabetes is crucial to maintaining and improving overall health. William H. Polonsky, PhD, CDE discusses engagement strategies for promoting behavior change in diabetes care.
Speaker: Dr. Jen Nash, CPsychol, AFBPsS, ClinPsyD, BSc
Psychological Strategies for Weight Change Conversations
Webinar Description: Jen Nash, CPsychol, AFBPsS, ClinPsyD, BSc discusses the psychological aspect of people who are struggling to implement weight loss advice. Dr. Nash reviews skills that address the emotional and motivational barriers to implementing weight loss education, and participants will be equipped with strategies to approach weight change conversations.
Psychological Strategies to Improve Weight Management Conversations Q&A
with Dr. Jen Nash, Chartered Clinical Psychologist
1. Do you have any suggestions about how to approach teenagers who overeat and eat junk food? Their executive functioning is not completely developed.
I am qualified in adult psychology, so am not able to comment professionally on working with adolescents. I am aware of the following resource for adolescents which you may find useful: http://www.energykrazed.org.
2. Do you use a motivational interviewing style when talking with clients? It seems like some of these questions are yes/no answers.
Motivational interviewing is a valuable style for weight change conversations. Some of these suggested questions purposefully encourage a 'yes/no' response as they are designed to be used in time limited conversations to allow healthcare professionals to quickly 'screen out' individuals for whom non-hunger eating is not an issue. You are encouraged to use a motivational interviewing style to follow up these questions.
3. What is furlongs and feet?
‘Furlongs and feet' is a colloquial term for the physical distance between a person and food. It describes the well-known phenomenon that if food is within our reaching distance we’re more likely to eat it. ‘Furlongs and Feet’ is part of my '30 Day Why the F? Challenge' which is a self-help programme that encourages people to reflect on the 30 reasons why we eat, and gives psychological strategies about how to make changes. You can find out more here: http://eatingblueprint.com/products/.
4. What does flap mean?
‘Flap' is a colloquial term for overwhelm. ‘Being in a flap’ is an informal way of describing those times when we feel overwhelmed, in a way that leads us to become agitated or flustered. Eating can be a way of attempting to soothe against this internal feeling of chaos, and many people find that they nervously or anxiously eat when they are in this ‘flap’ like state. 'Flap' is part of my '30 Day Why the F? Challenge' which is a self-help programme that encourages people to reflect on the 30 reasons why we eat, and gives psychological strategies about how to make changes. You can find out more here: http://eatingblueprint.com/products/.
5. How to handle conversations with people who love to eat?
I generally come from the stance of agreeing with the person that food is designed to be pleasurable, and we have evolved to find food immensely rewarding, so there is nothing at all wrong with loving to eat! However, like most things in life that are pleasurable, if we overindulge in seeking pleasure from one source, we may be at risk of other problems. If they feel inclined, writing out a pros and cons list of ‘loving food’ can be a way of exploring the downsides (e.g. increased weight and health problems) and the impact of this on other areas of their life (e.g. their work or family roles, their appearance, mobility, etc.).
One of the areas of the Eating Blueprint approach is ‘Fun’ – which is helping people see that it may benefit their health if they can increase the number and range of ways they receive fun and pleasure into their life so that food becomes just one, rather than the only, or main way to get pleasure. People are often using food to show themselves care and self-love and may be helped by finding non-food ways that are pleasurable. You can find out more here: http://eatingblueprint.com/products/.
6. Do you recommend Take off Pounds Sensibly (TOPS) program?
TOPS is not available in the UK, however I believe it to be a sound resource for healthy weight loss education and principles. I encourage people towards healthy weight loss approaches that resonate with them. I often prefer two or three approaches to recommend, so the person feels free to explore and make their own choice independent of my viewpoint.
7. What advice would you give for patients who binge and purge?
If someone is binging and purging then I would recommend referring to the DSM criteria for eating disorders. You can find the bulimia criteria here at https://www.allianceforeatingdisorders.com/portal/dsm-bulimia. If the person meets the criteria, please follow your local protocols for referral to a mental health professional. Individuals who use binging and purging are likely to be using these behaviors to manage their feelings/life experiences and need professional support from a psychologist or other mental health professional to be able to work through these issues.
Speaker: Rita A. Kenahan, RN, EdD
Adult Learning Theories & Teaching Strategies
Webinar Description: The majority of adults engage with learning experiences to create change in their skills, behavior, knowledge or attitudes. When providing diabetes education, it is important to acknowledge what people with diabetes bring to a learning situation such as hopes and fears, motivations, and questions. By combining adult learning principles and skill-building strategies, healthcare professionals can more successfully help people with diabetes identify and address their needs and successfully manage their health.
Speaker: Mark Heyman, PhD, CDE
Acceptance and Diabetes: Helping patients integrate diabetes into their lives
Webinar Description: Acceptance of diabetes and its related self-management principles is complex and involves a number of skills and tasks. Assessment of diabetes acceptance may aid in the identification of high risk patients for whom interventions can be targeted. Mark Heyman, PhD, CDE shares his experience and case studies related to working with people who are having difficulty with acceptance and diabetes.
Acceptance and Diabetes Webinar Question and Answer
Mark Heyman, PhD, CDE
Question: How do you help patients change their language to facilitate acceptance?
Language can be a window into how a person is doing with accepting diabetes. When a patient says things like 'I can't handle diabetes', 'I'm not good at managing diabetes', or 'I'll focus on my diabetes when I feel less depressed/anxious', that is a sign that they are having a hard time with accepting diabetes.
However for many people, changing patients' language is not enough. The language people use is a symptom, not the cause. It's important to focus our efforts on the issues underneath the language. There are several things we can do to support patients along the continuum of acceptance and help them change their language in the process.
First, is to work to make people with diabetes feel empowered. Specifically this means showing them that their diabetes management behavior impacts their glycemic control. This can help move the language from 'I can't' to 'I can'.
Second, help your patients be more flexible in their thinking. Often, people who are having trouble with acceptance have very rigid thinking, which comes out in the language they use. Techniques including asking open-ended questions (e.g., ‘Tell me more about why you can't handle it?’) and gently challenging rigid thinking (e.g. 'You can't work to manage diabetes, or sometimes you just don't want to?’) can help people think about their situation in a more flexible manner.