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Intensive Psychotherapy Helps Diabetes Control in Adolescents

Intensive, home-based psychotherapy can significantly reduce diabetes-related stress in adolescents with type 1 diabetes.

"Although medical care providers often feel frustrated when caring for difficult families such as these," Dr. Deborah A. Ellis from Wayne State University, Detroit, Michigan stated that, " there are empirically-supported treatments that have been shown to make a difference in improving both psychosocial well-being, adherence, and health outcomes for seriously non-adherent youth."

Dr. Ellis and colleagues investigated whether intensive, multisystemic psychotherapy (MST) targeting family and other barriers to good adherence would affect the adolescent’s stress related to diabetes and whether this would influence adherence and metabolic control.

Adolescents who received MST experienced significantly reduced levels of stress compared with those in the control group, the authors report. The intervention appeared equally effective for younger and older, male and female, black and other adolescents.

Diabetes stress was related significantly to metabolic control both at baseline and after treatment, the results indicate, but there was no association with age or ethnicity.

Structural equation modeling indicated that the MST intervention directly affected diabetic stress and adherence, but there was no support for a specific effect of stress on adherence.

Improvements in metabolic control, as measured by HbA1c, were attributed mainly to the specific effect of MST on HbA1c levels through adherence, the researchers note.

In light of these encouraging findings, Dr. Ellis added that "we are currently following up our sample to determine the long-term stability of our intervention effects. We are also adapting the model for youth with other chronic illnesses such as HIV infection, asthma, and morbid obesity."

Pediatrics 2005;116:e826-e832.

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