1. Focused Conversation Conversations to understand and assist parents and school age children with access to care and performing self-care.

2. Old habits and patterns • Impatience: interrupt others • Uneasiness of being interrupted • Self-indulgent talk • Over-emphasis on being witty and use of jargon • Failure to balance advocacy and inquiry • Expected to judge everything that everybody says or does. • Conversations where the best man wins

3. Old habits and patterns • Focus on finding “the truth” versus on search for and honoring different perspectives of each other • We need to work toward holding a number of different perspectives at the same time. • People are tired of blaming and demanding. People want to solve problems • A focused conversation is a method to help people work together as a team and solving problems from different perspectives.

4. A focused conversation • Way to focus • Provides for real listening • Encourages understanding rather than criticism • Helps discourage negative thinking • Helps to establish a rational and emotional experience • Promotes honesty

5. Focused conversation situations • To collect data and ideas • Discuss tough issues • Reflect on issues and events • Reflect and learn from accomplishments and failures • Explore levels of consensus in a group • Avoid heated arguments • Promote productive discussion

6. Focused conversation method • Objective level questions • Reflective level questions • Interpretive level questions • Decisional level questions • Process: • Open ended questions • Specific questions to help focus • Seek information rather than present • Honor each other, non-judgmental & sensitive to diversity

7. Objective level questions • Engage 5 senses • Invite inclusive participation • Get at the facts and objective data

8. Reflective level questions • Acknowledge person’s emotions • Acknowledge the association with emotions • Invite persons to use their imagination

9. Interpretive level questions • Help to engage persons to share experience and meaning • Help to identify options and possibilities

10. Decisional level questions • Help persons understand how relevance and meaning leads to decisions and action

11. Objective Questions • What are some things you are doing in your home to help your child to manage her asthma? • What are some things you are participating in at school?

12. Reflective Questions • What is the hardest thing for you in caring for yourself with diabetes? • What is difficult for you to do to avoid asthma triggers in your home? • What is hard for you to do when you don’t feel well in school? • How do you feel when you take good care of yourself and take your medicine?

13. Interpretative Questions • How does having diabetes affect your life in school? • What are the pros for you getting health insurance for your child? • What are the obstacles that keep you from accessing health care? • What are the cons in purchasing health care insurance?

14. Decisional Questions What are some options for making it easier to remember to take your medicine? What are some options you have for getting health insurance? What might be the best option right now to get health care for David? What are two things you can change at home to help prevent asthma triggers for Joan? ( harm reduction)

15. A focused conversation • Objective: What stands out for you about the focused conversation approach? • Reflective: What might be difficult for you in using this method? • What feels good about this kind of conversation? • Interpretative: What impact could focused conversation questions have for you in your work? • Decisional: What is one thing you could try the next time you are interacting with one of your students with a chronic illness?