Building Competency in Diabetes Education THE ESSENTIALS

SELF-MANAGEMENT EDUCATION & SUPPORT: PROGRAM DEVELOPMENT| 11-27

Helping relationships

Being open and honest with someone who cares.

Therapeutic alliance/relationships

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Self- help groups

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Advocating

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Social support

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Stimulus control

Avoiding or countering stimuli, cues or situations that elicit the behaviour targeted for change.

Cues

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Reminders

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Avoidance of tempting situations

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Skills training

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Practice

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Counter conditioning

Substituting alternatives for the undesirable behaviour.

Coping-skills training

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Assertiveness

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Problem-solving skill training

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Reinforcement management

Rewarding oneself or being rewarded by others for making positive changes.

Skills training/feedback

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Contracting

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Reward system

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Practice

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Giving feedback

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Experiential change processes — useful for facilitating learning in individuals not ready to change their self-care behaviours — include consciousness-raising, dramatic relief and self- and environmental evaluation. This means that education programs/strategies for people who are not ready to learn, or ambivalent about change, will be more effective if they have the following characteristics (27-30): • Information is geared toward increasing awareness and personal recognition of the benefits and the importance of carrying out the recommended health behaviour. Interventions may need to reach out to patients/groups in their usual social environments since many do not seek out contact with the health-care system. This is crucial for the Chronic Disease programs. • Interventions explore the potential emotional responses involved and offer support.