Highlights
- •Cognitive Behavioral Therapy (CBT) was feasible and acceptable in adolescents with T1D.
- •CBT shows promise in improving diabetes management outcomes.
- •CBT improves self-efficacy, stress, and quality of life.
- •Online delivery of CBT was effective in adolescents with T1D.
Abstract
Problem
Type 1 Diabetes (T1D) is a complex chronic condition that impacts physiologic and
psychosocial outcomes in adolescents. Adolescents with T1D experience anxiety and
depressive symptoms at 2 to 3 times the rate of the general adolescent population.
Anxiety and depressive symptoms negatively impact disease management. Cognitive behavioral
therapy (CBT) is considered the gold standard therapeutic technique for treating anxiety
and depressive symptoms. The aim of this integrative review was to examine and synthesize
the extant literature exploring the effect of CBT on physiologic and psychosocial
outcomes in adolescents with T1D.
Eligibility criteria
Electronic databases were searched with the terms “type 1 diabetes” and “cognitive
behavioral therapy.” Studies were included if they were published between 2000 and
2020, evaluated a pediatric population (≤18 years of age), and included individuals
with diagnosed T1D.
Sample
475 articles were identified in our initial search, and after removal of duplicates
353 articles remained. 339 did not meet inclusion criteria. A total of 14 papers met
inclusion criteria.
Results
All studies included CBT, but differed in delivery methods. Several studies demonstrated
evidence of the feasibility and acceptability; however, there were mixed results regarding
improvement of physiologic and psychosocial outcomes.
Conclusions
CBT is a feasible and acceptable intervention in adolescents with T1D. It may be a
method of improving psychologic and psychosocial outcomes for this high-risk population.
Implications
In adolescents with T1D, screening and treatment for psychosocial comorbidities should
occur regularly at endocrinology visits. CBT can be operationalized to fill this gap.
Keywords
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Article info
Publication history
Published online: July 02, 2021
Accepted:
June 24,
2021
Received:
March 4,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
