As DPP Coaches, we know that mental health and emotions play a significant role in the Diabetes Prevention Program. The CDC curriculum reveals this in the variety of session topics that address this: managing stress, coping with triggers, taking charge of  your thoughts, getting support, and even getting enough sleep. As participants regularly attend and become more comfortable with one another, discussion around emotional health will come up. In addition, difficult emotions can affect participant program adherence and goal achievement. An example, which demonstrates this, is found in research finding that depression can negatively impact the physical activity levels for those with diabetes. It would not be a leap then, to find this issue among those who are prediabetic. 
As we deliver our programs, how can we address difficult emotions and their negative impact on healthy eating, activity, and DPP retention?
As our participants engage with one another, sharing common experiences and problem solving with one another, our role as facilitators can be powerful as we build and encourage a positive environment, as well as consistently use key motivational interviewing skills to foster self efficacy and autonomy–open ended questions, affirmations, reflections, avoiding that “expert role” where we find ourselves “suggesting or telling” a participant what to do. Remembering that when a barrier or challenge comes up (including emotion-based issues), the power of “the group” is one of our best resources! So much knowledge and experience among our participants. Great to know, as well, we can ask participants to recall past successes! What was that success like? What motivated you? On a scale of 1 to 10, how motivated were you at that time? Why weren’t you at lower number?  Helping a participant uncover their motivation and recall their “Why?” can be key to building self efficacy. As coaches, we can then take those positive recalled experiences and reasons and bring them to the present to address any current barrier or challenge. 
Finally, it is important that we always remain within our scope of practice, privately referring a participant to mental health professionals if you feel his or her mental health is truly at risk. 
Interested in improving and building your motivational interviewing skills? Whether you are new to the practice or have been using MI for a while, the State of Wellness offers, Motivational Interviewing  a great training opportunity to work with Dr. Bill Matulich, PhD. 100% on line, approximately 6 week, 12 modules….and 15 CEU’s approved:  ICHWC, CHES, MCHES!  Consider signing up today!

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