Good morning colleagues and Happy November! November is often a challenging time of year for many of our patients- holiday party eating providing endless access to treats, atypical schedules that make exercise and blood sugar checks challenging, financial burdens that can impact ability to afford medications, and increased stress levels!
So this month, I challenge you to switch on the positivity with your patients! Something that was shared with me years ago that has been quite helpful is trying to start each follow up appointment with a simple question: “What do you feel like went the BEST since our last visit?”. I have found over the years that our patients do a very good job of focusing on their shortcomings when it comes to their diabetes management. I have also found that when you start an appointment this way, it completely changes the feel of the rest of the appointment. Patients will often change their physical stature right in front of your eyes from being closed off (arms crossed) to relaxed and more willing to open up to you once they realize that you are on their side. This also provides an opportunity to further explore the specific actions that they engaged in that allowed that particular goal to be successful. For example: Let’s say a patient’s goal was to avoid eating out during the weekdays and this went very well for the patient. You can further explore why this went well with simple questions such as: “What do you feel contributed to the success of this goal?” Or “What steps did you have to put into place to make sure it was simple for you to make dinners at home?” If the patient engaged in pre-planning, you could discuss how this might also be important for other goals such as exercise (planning what days they will be active at the beginning of the week, bringing a gym bag to work, etc.) or taking medications (placing insulin pen in your work bag after using it at night, etc.).
Clearly you will eventually discuss the challenges that occurred over the previous week/weeks, however by starting positive it often lends itself to a more open conversation where patients feel less judged and more willing to engage with you. It also provides an opportunity for them to realize they have accomplished some of their goals which is a great segue into strengthening their self-confidence regarding their ability to achieve even more goals in the future. I truly hope this counseling recommendation will have as big of an impact on your professional practice as it has on mine.
What other counseling techniques do you find helpful in your practice? Please share below to keep the conversation going!