Effects of Behavioral Family Systems Therapy for Diabetes on Adolescents’ Family Relationships, Treatment Adherence, and Metabolic Control

Abstract

The revised intervention (BFST-D) improved family conflict and treatment adherence significantly, while both ES and BFST-D reduced HbA1c significantly, particularly among adolescents with poor metabolic control. Clinical translation of BFST-D requires further study.

Commonalities in Effective Behavioral Interventions for Children and Adolescents With Type 1 Diabetes: A Review of Reviews

“…Specifically, adherence, psychological factors, and family factors have all been targeted in efforts to promote optimal diabetes outcomes in youth. 10,11,[18][19][20][21][22][23][24][25][26] For youth with diabetes, these factors are necessarily intertwined. Type 1 diabetes is embedded in the individual and family system, making nearly every component of daily life part of the diabetes lifestyle.…”

“…18 However, when the intervention was adapted to be more diabetesspecific (BFST-Diabetes, or BFST-D), improvements in adherence and diabetes control occurred. 19 Additional components of BFST-D have prior empirical support and include behavioral contracting related to diabetes management tasks, goal-setting, diabetes education, psycho-education, parental participation in simulated diabetes tasks (e.g., monitoring and treating simulated hypoglycemia), and possible extension into the social networks of the youth. Because diabetes is embedded in the daily lives of these youths and their families, even interventions specifically targeting family processes, such as communication, conflict, and problem solving, need to address these pro-• • cesses as they relate to diabetes management.…”

Treatment Adherence and Psychological Wellbeing in Maternal Carers of Children with Phenylketonuria (PKU)

“…With regards to treatment adherence, interventions to promote dietary compliance may be particularly important for older children, as metabolic control decreases with age. In addition, interventions such as family therapy, involving communication training and cognitive restructuring to promote metabolic control (Wysocki et al 2006), may be required.…”

Contributing Factors to Poor Adherence and Glycemic Control in Pediatric Type 1 Diabetes: Facilitating a Move Toward Telehealth

“…[90] Home telemonitoring can be further divided based on a timing distinction: real-time interaction or delayed. [92] Phone calls and videoconferencing fall into this category. Delayed telemonitoring involves data or information that is accessed by a provider after the patient initially sends the information.…”

“…Telephone support is provided by the clinician but does not necessarily require electronic transmission of patient data. [92] Video teleconferencing has been examined as a means of maintaining face-to-face contact between provider and patient. Stamm [89] noted that advances in technology are fueling improvements in the utility of these services.…”