An Inside Look at Behavioral Health Coaching for Chronic Conditions

“I hope that there is a continued emphasis focusing on the correlation of physical and mental health.
Today so many people are focusing on someone’s physical health which is very important
but not focusing enough on the impact that the diagnosis and chronic condition may
have on their mental health.”

Connecting to Care Changes Lives Series

In the Connecting to Care Changes Lives series, Uprise Health behavioral health coaches and clinicians are exploring their role in creating a world where mental and physical healthcare is delivered with skill, patience, kindness and empathy. Innovation in care and digital resources are highlighted as Uprise Health develops new ways to access care and provide services.

In the first of the series, we introduced a few of our behavioral and mental health coaches and clinicians, who shared tips for how to start the new year with healthy habits. In the second installment, Dr. Darryl Huels shared his insights as a leader in managing our clinical care team and views on the future of mental health care. In the third blog, Nurse Team Leader Pedro Gago shared insights about chronic disease management and thoughtful approaches to mental health.

In this fourth installment in our Connecting to Care Changes Lives blog, we had the opportunity to speak with Uprise Health Nurse and Case Manager, Maribel Alvarez-Vargas. Maribel has worked with the nurses at Uprise Health for 11 years. She is an RN and diabetes educator. Maribel has been in the field of nursing for 31 years. She entered healthcare working in Community Health serving primarily low-income patients with limited resources.

She started as a CNA and advanced to LPN/Lead Nurse. While pursuing her RN, she worked in the prison system and eventually became Director of Nursing. After leaving that post, she worked in public health in the fields of pediatrics, adult med and in the lab as a phlebotomist.

Maribel is a certified CPR instructor and has done work for Catholic Charities. Maribel also volunteered and provided education and support for diabetes management and hypertension which are prevalent conditions in her community. Her work with local non-profits for HIV education, outreach and setting up test sites was also a valuable community resource.

Maribel is still a proud resident of the community where she initially started her medical journey with the Community Health Center. Some of her former pediatric patients went into the nursing field because of the impact she had in their lives.

Maribel shares her insights about educating our members regarding diabetes management. A diabetes diagnosis can feel like not just a threat to health, it can also seem like a threat to a person’s way of life, because managing diabetes means making changes to their day-to-day routine. Added responsibilities like dietary changes, medication adherence, and tracking blood sugar can be hard to remember at first. Also, doctors’ appointments can cause time away from work, and the costs of appropriate care may be burdensome for some people. These changes can be emotionally draining and might make it difficult to carry out important tasks to manage their condition.

A collaborative behavioral health care approach that includes both mental and physical health care can improve overall diabetes management. Research has shown that treating mental health issues and diabetes together can help people better manage both. Maribel’s work with our members is significant because during her screening she may identify mental health issues that would otherwise go unnoticed and untreated and could get in the way of properly managing their disease. Her screening, support, and education improve the members’ lives by helping them successfully manage their diabetes and in some cases reverse it or they enter a remission. Maribel’s ability to do behavioral health coaching for lifestyle changes while she works with them on the medical and clinical elements of the disease make her invaluable to Uprise Health’s members.

What’s your role at Uprise Health?

“I am the Nurse Health Advocate. I work directly with members in providing education to help them manage their chronic conditions and also do behavioral health coaching to improve their lifestyle which will ultimately improve their physical health. I complete an assessment with members and focus on their physical and mental health during the call. I review the member’s health history, medications and discuss the results from their health screenings.”

What makes you passionate about what you do?

“I absolutely love working with people, just trying to help them and make their lives better in any way I can. It gives me great joy to hear and to know that I was able to make just a little of a difference or an impact on someone’s life to make it easier and enhance their physical and mental health. It is important to me to make sure I can keep things as real as possible with the members. I am grateful to be able to share my personal experiences dealing with my own medical conditions with the members.

Sharing my own medical journey reminds them that they are not the only ones who have experienced or are experiencing challenges regarding their physical condition, meds, diet, and exercise. I feel that this really is helpful in connecting with the members and can help them become more motivated to make positive changes in their own lives. I know the tips, strategies and routines that helped me. But I am also aware of setbacks and personal issues associated with managing a chronic disease. I am a nurse and coach to them, but I am also a peer since I have dealt with a chronic condition. I think I can share my perspective that with diabetes, feeling physically good is half the battle. Feeling mentally good is the other half.”

What does your day to day look like?

“I am up around 5:30 a.m. I have a teenager to get up and off to school. I usually get ready for my day around 6:30 a.m. I have been trying to practice what I preach to our members take some time for myself and use some stress reduction techniques. I will usually pray, read my bible, or listen to music. Music is one of my favorite ways to feel positive and grounded.

At 7:30 a.m. I start to look at what is on my schedule, review member’s profiles and come up with a plan. I try to do my best to review as much info regarding their history as possible. The more info I can obtain on the member ahead of time makes it easier to connect with them and be more productive with the time we have together. Every day is different and comes with its own challenges.

Most times, the members are receptive to the programs and participation, however, you will have people that are not happy with having to participate and they can even be very difficult. These members can be quite challenging; it is important to try to find a way to address/acknowledge their concerns while at the same time reminding them of the benefits related to participating. These types of members can be very emotionally and physically challenging.

I have really been working on myself mentally over this past year, trying to employ strategies that help keep a more positive attitude even when dealing with negative individuals. I remind myself that often a member’s poor mood and mental health is connected to their physical health issues, and it makes me want to connect more and help them improve their mental health and physical wellbeing. It’s important to remember my past members who were resistant who became some of our biggest success stories and I can also share that with the members who are new to the program.”

How has your work contributed to how you think about mental health?

“I’ve been educating and coaching members for many years, and it has helped me focus even more on mental health during all their appointments. It definitely helps keep me focused and reminds me of the impact of mental health on physical health.  It reminds me of the importance of addressing and paying attention to both and how they are connected whether it be regarding my own life or when I am working to help a member.

When dealing with a chronic condition, a doctor might instruct you to change your diet by eating certain kinds of foods, avoiding sugary beverages, or restricting alcohol intake. Changing daily habits can be difficult for anyone regardless of a diabetes diagnosis. Healthy behavior changes that target a person’s physical, emotional, or social health take time – it is a process and requires patience. I always teach and remind my members that small steps over time can lead to big change.”

What is your vision for the future of mental health care?

“I hope that there is a continued emphasis focusing on the correlation of physical and mental health. Today so many people are focusing on someone’s physical health which is very important but not focusing enough on the impact that the diagnosis and chronic condition may have on their mental health. There is often a certain stigma placed on people with mental health issues like depression and anxiety.

People do not realize how a new diagnosis can take a toll on both body and mind, people have to worry about meds, lifestyles changes, affording new meds, affording healthy foods, what will other’s think etc. So, on top of all the issues with their physical health, individuals with a chronic condition are faced with all these additional mental stressors. Often members are going through these feelings and emotions on their own. Many doctors will give them a new diagnosis, instructions and meds and send them on their way. They are often left alone to process things, how to use new meds and their side effects, changing their lifestyle, adjusting to any restrictions. I feel that this is a very important and vulnerable time for members.

Member’s often feel alone, helpless and overwhelmed. It is at these times that the depression and anxiety really set in. I believe that continuing to provide education and support to people regarding the correlation of physical and mental health is essential. Even provider’s sometimes they need to be reminded that they are dealing with actual human being that has feelings and emotions. I along with other nurses and coaches focus on the individual like we would want for ourselves or a family member. Members should be provided additional support education and new resources especially with a new diagnosis.”

With the skills you’ve learned on the job, and the experiences you’ve had in it, what is one thing you would recommend family, friends and everyone incorporate into their daily routine for optimized mental health?

“I think the biggest thing that people should do going into the New Year to improve physical and mental health is just take the time to slow down and enjoy each other and family. The way the world is today, all of us so busy running this ‘rat race we call life’; we often forget about the most important things. Especially right after the holidays when so many people feel there is so much pressure from everywhere. People feel overwhelmed by thoughts like work needs more from you. They’re just trying to recover from the stress of the holidays when they were trying to figure out how can I afford to get/do this for my loved ones and on and on.

We put so much physical and mental strain on ourselves trying to focus on all the things that ‘had to get done’, when the best and most important thing that we can do especially after the last couple of years is take a step back and remember the important things. The best way to enter 2022 is focus on positive living, laughing, and loving. Keep in mind that this affects how we think, feel, and act as we cope with life!”

Our behavioral health professionals are the heartbeat of Uprise Health and help people discover how to be the best mentally and physically. We track progress and adapt to individual’s changing needs. Uprise Health guides people to meet personal goals and assists through any difficulties a person may encounter during their health journey. We will have a fifth installment of our Connecting to Care Changes Lives series coming soon, and you can learn more about Uprise Health’s solutions for chronic condition management.