Counseling Skills Help Parents Support Children Living with Type 1 Diabetes
Michelle Sorensen, M.ED, Clinical Psychologist is passionate about increasing the counseling capacity of healthcare professionals who support people loving with type 1 diabetes. The majority of healthcare professionals have been trained in directing and educating clients but Sorensen sees that people living with type 1 diabetes respond better to a counseling approach. “It’s about understanding how you help the patient tap into their own resources,” says Sorensen.
The skills Sorensen teaches to professionals such as diabetes educators and psychologists are also valuable to parents who have a child with type 1 diabetes.
The following tips can help parents support their child with diabetes:
Connect before you correct.
Sorensen coaches professionals to connect with patients on a personal level before they advance to counseling them about diabetes management. This approach will set parents up for success. Don’t let every interaction with your child be about diabetes. When you greet your child after an absence, reconnect emotionally before you start asking about diabetes details.
“Everything in your life affects diabetes and diabetes affects everything in your life,” says Sorensen. It can become rote to jump in and direct your child to take certain actions to manage their diabetes. Step back and discover what else is happening in your child life. For example, if your child is being bullied at school their mood will affect how they deal with their diabetes.
Let them be sad.
Sorensen sees young people who are not caring for their diabetes to their best ability because they are still angry at diabetes. Everyone, patients and caregivers alike, needs to move through the stages of grief but they will do so at their own pace.
In some cases, young people do not feel they were permitted to be sad because parents went into problem solving mode at diagnosis and assured the child that they could do anything they wanted despite diabetes. Although it’s important to give positive messages to children at diagnosis, dismissing the grief that accompanies such a diagnosis may cause problems down the road. Sorensen calls this being “cheerleaded out of their grieving process.”
Help them adapt to the fact that type 1 diabetes is forever.
Sorensen was diagnosed with type 1diabetes at age 24. “Unless you have lived with diabetes, it’s difficult to understand how long forever can seem.” She explains that children do not process grief the same way as adults. Children diagnosed at a young age may quickly adjust to life with diabetes but when they are older they may struggle. “They may be grieving diabetes for the first time as they realize this is what forever feels like,” says Sorensen.
If your child is responding with anger when you inquire about blood sugars, this may be a warning sign that they have some unresolved grief. Sorensen suggests being in tune with your child and asking if they want to talk to a professional. This external perspective can be freeing for a child or teen who may be holding feelings in to protect their parents.
Focus on the process, not the outcome.
Endocrinologists and diabetes educators have been taught to focus on outcomes, the most obvious one being the A1C. Although this is an imperfect tool, it is hard data that both professionals and caregivers can fixate on. Sorensen believes the A1C is a good benchmark to use to motivate people but can be detrimental when used as a gold star. It’s simply an average and two children with the same A1C may have very different raw numbers.
Instead, celebrate how well your child adheres to a good process. Does your family carb count? Do you bolus before eating? Do you adjust for sugars out of range? Do you keep a logbook and review it regularly? Acknowledge how hard you are all working and if you see areas for improvement, work together to teak your process. Accept that you are not perfect.
Teach others that diabetes is unparalleled in the amount of self-management that a patient must do.
Unless you have lived with diabetes it’s impossible to know how consuming a condition it is. For parents, this lesson is quickly learned. But for healthcare professionals, even those trained in diabetes care, the full burden cannot be appreciated. Parents can educate members of their child’s healthcare team by sharing where they are struggling and telling stories that illustrate the burden of type 1 diabetes.
If you or your child doesn’t feel heard by your healthcare team, don’t become discouraged. Instead, look for ways you can illustrate how diabetes care is continuous. You may need to be the one who makes that first move toward connecting as people, but once you do the relationship is likely to improve.