Experiences with a group intervention for adolescents with type 1 diabetes and their parents

Abstract

Background: Increased adolescent-parent engagement in diabetes-related tasks appears to decrease diabetes-related family conflict. Group intervention may be a good approach when caring for adolescents with chronic conditions, including diabetes. Aim: This article aims to describe how group intervention may be useful in the treatment of adolescents with type 1 diabetes. When these children enter puberty and become adolescents, it can become difficult. In many cases, family-related conflict has a negative impact on an adolescent's blood sugar levels and self-care behaviour. Method: 19 adolescents (age 13-17 years) and their parents participated in group intervention. Families were recruited from outpatient clinics in two centres in MiddleNorway. Separate groups met once a month for 1 year. All adolescents and parents completed a battery of self-report measures. In addition, HbA 1c values were obtained five times from the adolescents' medical records. Results: In terms of metabolic control there was a significant decrease in HbA 1c values in the girls studied. In adolescents of both sexes, the process of deterioration was stopped. Conclusion: The development of efficient interventions for this group of patients is highly needed. Our intervention was peer-oriented and psycho-educative. Although the sample size in this study was small, one may still consider that group intervention may improve parent-adolescent relationships. Results from the study also demonstrate that group intervention may improve metabolic control in girls, without deterioration in health-related quality-of-life.

Getting (the Most) Out of the Research Business: Interventions for Youth with T1DM

“…Often, the process of organizing and facilitating group-based therapy takes considerable effort and coordination. Further, only three existing studies using group-based treatment show that intervention improves glycemic control [29,38,40], an important outcome variable with youth with T1DM. Although this is not the only important outcome variable, more work needs to be done to determine whether the costs and effort of conducting groupbased therapy are reasonable given the potential benefits.…”

“…In contrast, interventions that target variables know to interfere with glycemic control (eg, problem solving, family conflict) showed improvements in control [37•]. More positive perceptions and attributions about ones' self have also been shown to occur for youth via group therapy [40][41][42].…”

“…Several studies have examined the effects of a group-based intervention with youth with T1DM [38][39][40][41][42]. Interventions have varied as to their specific focus and structure.…”

“…Interventions have varied as to their specific focus and structure. For example, some studies involved structured, skills-based approaches to intervention such as cognitive-behavioral therapy or problem-solving training [38,41,42], whereas others emphasized a process-oriented/transactional approach without specific, a priori objectives or foci of therapy [39,40]. In addition, various outcomes have been examined in these studies, including emotional status of youth (eg, symptoms of depression), family functioning, youth and parent perceptions of diabetes, and glycemic control, among others.…”

A systematic review of parent/peer-based group interventions for adolescents with type 1 diabetes: interventions based on theoretical/therapeutic frameworks

“…Two domains of outcome measures were extracted: diabetes functioning/medically performing/HbA1c and psychosocial functioning. Studies were excluded if they involved improving education alone, had no explicit theoretical background, 6,7,[44][45][46] were not a RCT, 15,[46][47][48][49][50] included children only 51,52 or adults 53 54 ) were checked in order to capture other relevant publications (see Appendix A for search terms at www.bjd-abcd.com).…”