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Journal of Pediatric Psychology Advance Access originally published online on January 9, 2006
Journal of Pediatric Psychology 2006 31(9):928-938; doi:10.1093/jpepsy/jsj098
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© The Author 2006. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oupjournals.org

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

Tim Wysocki, PhD1, Michael A. Harris, PhD2, Lisa M. Buckloh, PhD1, Deborah Mertlich, MSW2, Amanda Sobel Lochrie, PhD1, Alexandra Taylor, MA1, Michelle Sadler, BSN, CDE2, Nelly Mauras, MD1 and Neil H. White, MD, CDE2

1 Nemours Children’s Clinic, and 2 Washington University, St. Louis School of Medicine

All correspondence concerning this article should be addressed to Tim Wysocki, PhD, Center for Pediatric Psychology Research, Nemours Children’s Clinic, 807 Children’s Way, Jacksonville, Florida 32207. E-mail: twysocki{at}nemours.org.

Received May 10, 2005; revision received July 5, 2005 and August 1, 2005; accepted December 11, 2005

Background Behavioral family systems therapy (BFST) for adolescents with diabetes has improved family relationships and communication, but effects on adherence and metabolic control were weak. We evaluated a revised intervention, BFST for diabetes (BFST-D). Methods One hundred and four families were randomized to standard care (SC) or to 12 sessions of either an educational support group (ES) or a BFST-D over 6 months. Family relationships, adherence, glycosylated hemoglobin (HbA1c), and health care utilization were measured at baseline and after treatment. Results BFST-D significantly improved family conflict and adherence compared to SC and ES, especially among those with baseline HbA1c ≥9.0%. BFST-D and ES significantly improved HbA1c compared to SC among those with baseline HbA1c ≥9.0%. Conclusions 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.

Key words: adolescence; diabetes; family therapy.


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