“Knowing That You’re Not the Only One”: Perspectives on Group-Based Cognitive-Behavioral Therapy for Adherence and Depression (CBT-AD) in Adults With Type 1 Diabetes

Abstract

Depression and illness-specific distress are more common among adults with Type 1 diabetes (T1DM) than the general population and have been associated with poorer control of blood glucose and increased risk for serious diabetes-related complications. Treatment nonadherence has also been associated with depressive symptoms and diabetes-related distress, and has repeatedly been suggested as an important modifiable behavioral pathway linking depression and diabetes outcomes. The present study reports on the feasibility and acceptability of a pilot intervention using group-based cognitive-behavioral therapy to improve treatment adherence among adults with T1DM and elevated levels of diabetes-related distress or depressive symptoms. We describe the components of the intervention and utilize qualitative data along with descriptive outcome data. Our findings suggest that participation in the group was acceptable and associated with reductions in depressive symptoms and diabetes-specific distress. Challenges to feasibility and future directions are discussed.

Identification of Psychological Factors Associated with Adherence to Self-Care Behaviors amongst Patients with Type 1 Diabetes

“…Negative emotional status can be a major barrier and can interfere with motivation for self-care. Cognitive behavioral therapy (CBT) has been shown to improve adherence and depression and glycemic control and raise levels of self-care in patients with type 2 diabetes [47] and has also shown to reduce depressive symptoms and diabetes-related anxiety in adults with type 1 diabetes [48].…”

Psychotherapy and Psychological Support for Severe Heart Conditions

“…We take into account other studies, not included in the previous meta-analysis, and we summarize them in Table 4 [45][46][47][48][49][50].…”

Reasons for Open and Closed Attitudes Regarding Type 1 Diabetes

“…Additionally, research shows that adults who have diabetes experience personal and psychological problems and are twice as likely to be depressed as those without diabetes (18). Depression is related to poor diabetes self-management, diabetes-related complications, hyperglycemia, and higher mortality rates (18).…”

“…Additionally, research shows that adults who have diabetes experience personal and psychological problems and are twice as likely to be depressed as those without diabetes (18). Depression is related to poor diabetes self-management, diabetes-related complications, hyperglycemia, and higher mortality rates (18). Researchers suggest that it is important to address the personal and psychological burdens associated with living with type 1 diabetes (18); however, the literature on psychosocial factors and challenges related to type 1 diabetes outcomes is lacking (19).…”

“…Depression is related to poor diabetes self-management, diabetes-related complications, hyperglycemia, and higher mortality rates (18). Researchers suggest that it is important to address the personal and psychological burdens associated with living with type 1 diabetes (18); however, the literature on psychosocial factors and challenges related to type 1 diabetes outcomes is lacking (19). Understanding reasons for openness can help promote healthy, open attitudes and behaviors throughout the life span and perhaps help diminish the psychological challenges associated with type 1 diabetes.…”