Contributed by Hannah Frazee, symposium intern

When it comes to counseling patients with diabetes there are countless approaches that can be taken. Between motivational interviewing (MI), illness integration support (IIS) and guided self-determination theory (GSD), it can begin to feel like a recipe for alphabet soup, instead of a means to provide patient-centered care in practice. In addition, the three different approaches can begin to feel overwhelming when deciding which one is “best” in terms of supporting a client. As Mosadi Brown, BA, BASc, MEd, RD, CDE, explains in her webinar, “all approaches support autonomy and seek to engage people in collaborative explorations of strategies for living well with chronic disease”.

Throughout her presentation, Mosadi will work to give listeners a deeper understanding of the three approaches, and how they can be applied to diabetes care. By the end, attendees will be left with three concrete ways to approach client-centered counseling.

Motivational interviewing is rooted in the goals of helping clients reach their full potential. Within motivational interviewing, there are four key processes that should occur to have the most successful conversation possible. Establishing a strong connection to the client, and providing a trusting relationship is the first step to motivational interviewing. The whole goal of motivational interviewing is to allow the client to develop a commitment for change coupled with a plan of action.

Photo by Jason Leung on Unsplash

Illness integration support (IIS) works by “integrating the illness into daily life as a way to facilitate self-management.” This practice focuses on the client’s own perception of understanding their illness.

There are several steps within this approach which allows the client’s illness to no longer define them, rather it just becomes a part of their everyday life.

Guided self-determination theory is grounded in self-reflection and providing space for self-exploration, self-understanding, shared decision making. The goal is to invoke the client not only to take action in ways that they feel will improve their health, but to reflect on the consequences of the action, and explore if their action is something that they want to continue.

When comparing the three approaches one element becomes clear, they are all client-centered. A client-centered approach allows the client to decide on changes that would improve their life.

How can you begin to apply this into your current practice?

Look for ways to center your client’s interests, and how you discuss change. By allowing them space to explore, and feel the emotions that can come with diabetes you are allowing them to be centered on their journey toward health. If you are feeling overwhelmed or this sounding like alphabet soup this may mean there is room to grow. The WN4DC Symposium offers in-depth courses, weight neutral coaching and the 2021 WN4DC Symposium.