APPROACHES to BEHAVIOR
Changing the dynamic between patients and professionals in diabetes care and education
Janis Roszler, MS, RD, LD/N, CDE, FAND, and Wendy Satin Rapaport, PsyD, LCSW
Director, Book Publishing, Abe Ogden; Managing Editor, Greg Guthrie; Acquisitions Editor, Victor Van Beuren; Production Manager, Melissa Sprott; Production Services, Cenveo Publisher Services; Cover Design, Kim Woody.
©2015 by the American Diabetes Association, Inc.® All Rights Reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including duplication, recording, or any information storage and retrieval system, without the prior written permission of the American Diabetes Association.
Printed in the United States of America
1 3 5 7 9 10 8 6 4 2
The suggestions and information contained in this publication are generally consistent with the Clinical Practice Recommendations and other policies of the American Diabetes Association, but they do not represent the policy or position of the Association or any of its boards or committees. Reasonable steps have been taken to ensure the accuracy of the information presented. However, the American Diabetes Association cannot ensure the safety or efficacy of any product or service described in this publication. Individuals are advised to consult a physician or other appropriate health care professional before undertaking any diet or exercise program or taking any medication referred to in this publication. Professionals must use and apply their own professional judgment, experience, and training and should not rely solely on the information contained in this publication before prescribing any diet, exercise, or medication. The American Diabetes Association—its officers, directors, employees, volunteers, and members—assumes no responsibility or liability for personal or other injury, loss, or damage that may result from the suggestions or information in this publication.
ADA titles may be purchased for business or promotional use or for special sales. To purchase more than 50 copies of this book at a discount, or for custom editions of this book with your logo, contact the American Diabetes Association at [email protected].
American Diabetes Association
1701 North Beauregard Street
Alexandria, Virginia 22311
DOI: 10.2337/9781580405386
Library of Congress Cataloging-in-Publication Data
Roszler, Janis, author.
Approaches to behavior : changing the dynamic between patients and professionals in diabetes care and education / Janis Roszler, Wendy Satin Rapaport.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-58040-538-6 (alk. paper)
I. Rapaport, Wendy Satin, 1947- author. II. American Diabetes Association, issuing body. III. Title.
[DNLM: 1. Attitude of Health Personnel. 2. Diabetes Mellitus--therapy. 3. Health Communication. 4. Professional-Family Relations. 5. Professional-Patient Relations. WK 815]
RC660
616.4’62--dc23
2014008450
eISBN: 978-1-58040-595-9
To the professors who inspired me as a student at UMass Boston’s Marriage and Family Therapy program: Drs. Gonzalo Bacigalupe, Alisa Beaver, Esmaeil Mahdavi, MaryAnna Ham, Dawn Shelton, and Margarita Tarragona. Your insightful life lessons transformed how I interact with others. May you continue to inspire your students to learn, grow, and reach out to those in need.
—Janis Roszler
To my wonderful husband Jim, my soul mate and inspiration, who makes me dig deep to be a better wife to a person who has diabetes.
—Wendy Satin Rapaport
Contents
Everyone plays a role in communication
The environment matters
3 Connecting With Your Patients
Ways to build communication pathways
4 For Your Toolbox, Part I
Approaches to use with patients
5 For Your Toolbox, Part II
More approaches to use with patients
6 Emotions: Yours, Mine, and Ours
How you and your patients may feel
7 It Takes a Village
Group communication
8 Singing Kumbaya
Workplace communication
9 All in the Family
Communication with patients and their families
10 Heading Home
Ways to emotionally transition from work to home
References and Resources
Index
As a health care professional you have a wealth of knowledge to share. So why don’t some of your patients listen, participate, and follow through?
This book examines the emotional “noise” that makes it more difficult for patients to gain from interactions they have with you, their health care provider. Some of the interference comes from the patients themselves. Living with a chronic disease like diabetes can prompt such feelings as worry, anger, fear, guilt, frustration, and denial that make it harder for patients to learn, collaborate, and make behavioral decisions. Some of the “noise” may also come from you—your mood, energy level, frustration, and even patience level can accompany you in the conversations you have with patients. So, as you read, we not only will focus on your patients’ feelings and emotions, but also will discuss yours as well.
This book focuses on evidence-supported “strength-based” resiliency strategies from family therapy, cognitive–behavioral therapy, emotionally focused therapy, and positive psychology (Norcross, 2002, Hofmann, 2012, Johnson, 2012, Seear, 2013). Many strategies are based on two assumptions: 1) We affect our patients and others in our lives in a bidirectional or