Title: An Introduction to Lifestyle Management working with the person not the condition
1An Introduction to Lifestyle Management-working
with the person not the condition
- Ross Grieve
- Lifestyle Management Service
- Thistle Foundation, Edinburgh
- rgrieve_at_thistle.org.uk
2Self Management as a Process
- Transformative
- Regaining Purpose
- A process of moving towards acceptance of their
current health condition - Moving on in life in new and rewarding ways
despite limitations - Greater control, coping and confidence
3What people want Medical needs
- Knowledge of condition
- Support in managing medical aspects of the long
term condition - Rehabilitation long term review/ ongoing
contact
4What people want -Non medical needs
- Psychological support
- Assistance with coping with change/ emotional
impact - Lifestyle management - moving on with life
- Support to make health behaviour changes
- Advocacy
- Peer support -group based/ individuals/
volunteers - Support groups
- Exercise classes
- Relaxation classes
- Walking
- Weight management
- Smoking
- Support for carers
5 Management of People with Long Term
Conditions
Medical Management of Long Term Conditions
6Questions
- What could a LTC management facility look like ?
- What would the service designed specifically
around the person rather than the condition look
like ? - Can this service really fit all ?
- Can the service be adapted to become disease
specific eg cardiac/ pulmonary rehab ? - What are the core competencies required of
workers to deliver this service ?
7Questions
- Can non-health professionals deliver these
programmes ? - Which approaches can be most easily taught to
non-health professionals such that the spirit
of the approach ( collaborative, non expert ) is
ensured - From multi to inter disciplinary teams containing
both health and non health professionals ?
8Thistle Foundation Long Term Conditions
Management Facility
- Facility
- Gym
- Pool
- Café
- Yoga rooms
- Relaxation rooms
- Seminar rooms
- Therapy rooms
- Physiotherapy
- Lifestyle management service
- Non medical needs
- Individual, group services
- Support for maintenance groups
- Peers support training
- Carers
9(No Transcript)
10(No Transcript)
11(No Transcript)
12(No Transcript)
13(No Transcript)
14(No Transcript)
15(No Transcript)
16(No Transcript)
17(No Transcript)
18(No Transcript)
19(No Transcript)
20Lifestyle Management in Practice
Co- Facilitation
Referral/ self referral
Individual meeting - menu
Lifestyle courses
Peer Training
Individual support
Ongoing support groups
Use of facilities
Open access
21Lifestyle Management Courses
- 10 weekly, 3 hour sessions
- Review, change based discussion
- Exercise
- Relaxation
- Discussion topics -
- Lifestyle management philosophy, sleep, stress,
energy management, - relaxation, getting active/ goal setting,
- time management/ planning, communication skills,
- mind body connection, preventing, minimising,
recovering from relapse, - review and forward planning
22Biopsychosocial Model of Illness
- It is not just the extent of physical impairment
- but cognitive, behavioural and other psychosocial
factors - which most closely correlate with poor prognosis,
long term disability and quality of life
23Spiralling to Disability
Impairment
Disability
24Disability spirals
25Who can benefit from our service?
- People who
- Are struggling to come to terms with diagnosis
- Are struggling with the physical, mental and
emotional effects of living with a LTC - Are at risk of increasing disability due more to
psychosocial factors rather than
physical/biomedical factors - Are trying to cope with health issues and extreme
life situations - Have mild to moderate mental health problems
perhaps who are on a long waiting list for
psychological services - Are hoping to cope better, gain more control and
build confidence to move on in life in more
effective ways - Have not responded well to other treatment
options orientated toward that of learning more
about illness, compliance with medications, and
behaviour changes
26Outcomes
- 75 completion rate
- Independent review 2007
- Self- efficacy questionnaires
- Research and evaluation a priority for 2008/9
27Our Team
- Salaried - includes individuals with backgrounds
in physiotherapy, occupational therapy, mental
health, fitness management and Magic!! - Volunteer Peer Facilitators
28General Competencies the non expert stance
- We dont
- Assume an expert/ authoritative role leaving the
participants in a passive role - Lecture, teach - do most of the talking, or
function as a unidirectional information delivery
system - Offer direct advice or prescribe solutions to the
problem without the persons permission or
without actively encouraging the person to make
his/her own choices - Argue that the participants have problems which
should be fixed by the facilitators/ manuals
ideas - Impose diagnostic labels, including labelling of
personality traits - Behave in a punitive or coercive manner
29General Competencies
- We do
- Offer participants an experience of empathy,
respect and genuineness - Work with participants hopes for the course,
their stage of coming to terms with illness and
their readiness to change aspects of their lives
30Principles of Lifestyle Management Recovery and
the Solution Focused Approach
- Adopting a non expert stance, workers focus on
- what the client wants
- evidence of resource, coping, control, confidence
- signs of strength, achievement
- Competency, qualities that might help
- descriptions of clients preferred outcomes
- change
31Group Facilitation
- Basic communication/ counselling skills
- Engagement
- Solution Focused Approach
- Principles of adult education and group
facilitation - Relaxation training and mindfulness practice
- Principles of exercise prescription
32Specific Competencies in Individual meetings
- Engage successfully with clients
- Manage psychological distress/ anxiety if present
- Negotiate clients goals, hopes, motivation
- Create a future orientation/ expectant attitude
- Highlight and amplify
- Psychosocial predictors of recovery emphasising.
- Health beliefs and adaptive coping behaviour
- Internal, external resources (including)
- Clients existing knowledge
- Engage clients in change based conversations
- Related to clients goals
- Related to (workers defined/ negotiated?) health
behaviours - Review progress, manage relapse