Effects of behavioral family systems therapy for diabetes on adolescents' family relationships, treatment adherence, and metabolic control.
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 > or = 9.0%. BFST-D and ES significantly improved HbA1c compared to SC among those with baseline HbA1c > or = 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.
Wysocki
Tim
T
Center for Pediatric Psychology Research, Nemours Children's Clinic, 807 Children's Way, Jacksonville, Florida 32207, USA. twysocki@nemours.org
Harris
Michael A
MA
Buckloh
Lisa M
LM
Mertlich
Deborah
D
Lochrie
Amanda Sobel
AS
Taylor
Alexandra
A
Sadler
Michelle
M
Mauras
Nelly
N
White
Neil H
NH
D000293:Adolescent; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005190:Family; D005195:Family Relations; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D010287:Parent-Child Relations; D010349:Patient Compliance; D012648:Self Care; D011795:Surveys and Questionnaires
D007004:Hypoglycemic Agents