HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wysocki, T. Articles by White, N. H. Search for Related Content PubMed PubMed Citation Articles by Wysocki, T. Articles by White, N. H. Social Bookmarking                What's this?

Randomized Trial of Behavioral Family Systems Therapy for Diabetes

Maintenance of effects on diabetes outcomes in adolescents

¹ Department of Biomedical Research, Nemours Children’s Clinic, Jacksonville, Florida
² Washington University in St. Louis School of Medicine, St. Louis, Missouri
³ St. Louis Children’s Hospital, St. Louis, Missouri

Address correspondence and reprint requests to Tim Wysocki, PhD, Nemours Childrens Clinic, Department of Biomedical Research, 807 Children’s Way, Jacksonville, FL 32207. E-mail: twysocki{at}nemours.org

OBJECTIVE—Studies showing that family communication and conflict resolution are critical to effective management of type 1 diabetes in adolescents have stimulated interest in evaluating psychological treatments targeting these processes. Previous trials have shown that Behavioral Family Systems Therapy (BFST) improved parent-adolescent relationships but not treatment adherence or glycemic control. This study evaluates a revised intervention, BFST for Diabetes (BFST-D), modified to achieve greater impact on diabetes-related family conflict, treatment adherence, and metabolic control.

RESEARCH DESIGN AND METHODS—A sample of 104 families of adolescents with inadequate control of type 1 diabetes was randomized to either remain in standard care (SC) or to augmentation of that regimen by 12 sessions of either a multifamily educational support (ES) group or 12 sessions of BFST-D over 6 months. Pertinent measures were collected at baseline and at follow-up evaluations at 6, 12, and 18 months.

RESULTS—BFST-D was significantly superior to both SC and ES in effects on A1C, while effects on treatment adherence and family conflict were equivocal. Improvement in A1C appeared to be mediated by improvement in treatment adherence. A significantly higher percentage of BFST-D youth achieved moderate or greater improvement (>0.5 SD) in treatment adherence compared with the SC group at each follow-up and the ES group at 6 and 18 months. Change in treatment adherence correlated significantly with change in A1C at each follow-up.

CONCLUSIONS—These results support the efficacy of BFST-D in improving A1C, but further research is needed to identify the mechanisms of this effect and to achieve cost-effective dissemination of the intervention.

Abbreviations: BFST, Behavioral Family Systems Therapy • BFST-D, Behavioral Family Systems Therapy for Diabetes • DRC, Diabetes Responsibility and Conflict • DSMP, Diabetes Self-Management Profile • ES, educational support • SC, standard care

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				D. C. Duke, G. R. Geffken, A. B. Lewin, L. B. Williams, E. A. Storch, and J. H. Silverstein Glycemic Control in Youth with Type 1 Diabetes: Family Predictors and Mediators J. Pediatr. Psychol., August 1, 2008; 33(7): 719 - 727. [Abstract] [Full Text] [PDF]

				F. J. Cameron, E. A. Northam, G. R. Ambler, and D. Daneman Routine Psychological Screening in Youth With Type 1 Diabetes and Their Parents: A notion whose time has come? Diabetes Care, October 1, 2007; 30(10): 2716 - 2724. [Full Text] [PDF]