Sonoma County doctor uses new tool to motivate healthy decisions

As a family physician in Sonoma County since 1983, Ellen Barnett has always tried to help patients feel better by making healthy lifestyle choices. But it wasn’t until she empowered herself to exercise more that she came up with a method that would engage and motivate others.

Back in 2000, Barnett was on a treadmill at the gym when she thought to herself, “What’s going to keep me on this treadmill?”

“My kids were teens, and I thought, ‘They are going to get married and have kids,’?” said Barnett, whose parents both died young. “Then I had an image of my grandmother, who would roll around on the floor with us.”’

That powerful image of her grandmother was exactly what she needed to help her lose 50 pounds over the course of a year while getting her blood sugar under control through exercise and diet.

“I had developed an image of health,” she said. “The light bulb is inside, and information will turn it on ... once you honor the light bulb.”

Barnett has taken a simple question - What Matters to You? - and is now using it to motivate people all over Sonoma County, from underserved teens and the homeless to seniors and cancer patients, to identify their own wellness priorities.

The international initiative, started by the Institute for Health Care Improvement, is supported by a coalition of local health care providers, including the Integrative Medical Clinic of Santa Rosa, where Barnett serves as executive director.

“My theory is that we engage people much more when we listen to them than when we talk,” she said. “Ask the question - what matters? - and then shut up for a minute. Help them link why they are there to what matters to them. This touches the need to be heard and to be valued.”

Relying upon her own experience, Barnett then developed a deeper program within the initiative called Imagine You, which provides techniques to clarify and set goals, reinforce those goals with a visual image and support the goals through a series of small steps.

Key to the program is to ask each person to draw an image that can remind them of their goal.

Marlene Lennon, a nurse navigator and nurse practitioner for St. Joseph Health Breast Surgery and Survivorship, was introduced to the Imagine You program when she herself was undergoing treatment for breast cancer in 2015. During that workshop, she drew a picture of herself surrounded by a circle of supporters.

Later, while leading an Imagine You workshop for others, she created a collage based on her drawing that also includes photos of nature and the reminder to have love and compassion for herself, because as a natural caregiver, she often loses sight of her own needs.

“I keep it hanging above my desk so I can look at it every day,” Lennon said. “It reminds me that I’m not alone in the world ... and it takes me into nature, which is one of the ways that I support myself. ”

Lennon said she has gotten positive feedback from the Imagine You workshops, because people can choose what they want to focus on and then come up with their own plan to get there.

“Nobody is telling them what they should be doing,” she said. “And they’re asking, ‘What’s one step I can take?’?”

Wanda Tapia-Thomsen, executive director and CEO of Latino Service Provides in Windsor, spends her days providing resources and information to Latino clients and connecting them to more than 1,300 Latino service providers.

For her Imagine You image, she drew a picture of a sun with a smile, so that she could recall what it feels like to walk on the beach and feel one with the ocean and nature.

“When I get stressed, I look at it and it centers me and reminds me to breathe, go for my walk and not skip my break,” she said. “It’s just a gentle reminder that you need to take care of yourself, too.”

What Tapia-Thomsen likes about the program is that it’s so simple a concept that she can share it easily with others. During a recent career exploration symposium, for example, she asked the 300 high school students to take an eight-second walk through their imagination, and think about what health means to them, and why they are interested in that field.

Celia Kruse de la Rosa, who works with the community outreach and marketing groups at Sonoma Valley Hospital, has used the What Matters To You program to help her elderly mother deal with the stress of multiple crises. Her mom was puzzled at first, then sat down and raised her hand and said, “OK, I get it.”

“It helped her get to a calming spot,” she said. “It can help someone get through the bottleneck ... it’s a couple of things moved over here and there, and the logjam has been removed.”

A few months ago, Kruse de la Rosa lost the use of one leg, and she was able to use the health tool to navigate the journey from crutches back to walking again. It’s as simple as pushing the pause button, then taking a moment to think things through.

“It’s always taking a step back, and that becomes part of my routine now,” she said. “It’s like the redwood forest by Monte Rio, where there’s a dogwood tree that needs sunlight ... on the right day, you’ll see those blossoms open and the sunlight is feeding and nourishing it.”

One of the most powerful parts of the program is the way it has changed the power equation between patients and their health care providers.

Barnett tried asking her patients what mattered, but ultimately decided it would be a more effective tool outside of the doctor’s office, where people feel less intimidated and are less likely to talk about all the guilt-evoking “shoulds.”

“There’s a power differential in the doctor’s office - patients only tell me what I want to hear,” she said. “They tell me what I had already told them.”

For example, when she asked a client what mattered to her, the woman thought it over, and then decided that she really wanted to go fly fishing with her husband.

“She could not feel the rocks because of her diabetes,” Barnett said. “So then I could work with her ... the power is in really engaging people. The power is in your individual choices.”

Having helped launch the patient navigator program at Sonoma State University, Barnett had already made a lot of community connections. Since 2012, she has been taking the Imagine You program out into the community, through workshops and training programs as the director of outreach and program development for the Imagine You program.

In the future, Barnett’s “fantasy” is that across the county, nearly everyone will be asking each other what their health goals are, then providing each other with the necessary support to get there.

“The research is pretty depressing on successful tools to change behavior. It’s very hard,” she said. “It needs that personal connection ... what doesn’t work is handing you a piece of paper with instructions on it.”

Eventually, she hopes that patients will be empowered to go back to their health care providers and work on those goals together, while providing them with an image of their own health.

“Bring it to your doctor,” Barnett recently told a group of older parishioners at the Santa Rosa Presbyterian Church of the Roses. “Instead of ‘What’s the matter with you?’ Make it ‘What matters to you.’?”

The Imagine You program is the primary program of the Integrative Medical Clinic Foundation, the nonprofit arm of the Integrative Medical Clinic of Santa Rosa. For more information about What Matters to You and Imagine You, go to imcfound.org or call 707-284-9225.

Staff writer Diane Peterson can be reached at 707-521-5287 or diane.peterson@pressdemocrat.com. On Twitter @dianepete56.