Brief Acceptance and Commitment Therapy for Children and Adolescents with Type 1 Diabetes

Overview

Journal Front Psychol

Date 2024 Jul 11

PMID 38988396

Authors

Cristina Stefanescu

Aurel Nechita

Claudia Iuliana Iacob

Affiliations

Soon will be listed here.

Abstract

Introduction: Children and adolescents with diabetes face challenges that can significantly impact their quality of life. Investigating psychological interventions for stress management can equip them with the skills needed to cope with type 1 diabetes. This study investigated the impact of a brief Acceptance and Commitment Therapy (ACT) intervention on stress management, diabetes acceptance, psychological flexibility, and patient-doctor relationships among this population.

Methods: A total of 55 children, and adolescents from Romania participated in a four-session ACT intervention for type 1 diabetes. The evaluation instruments used were the Perceived Stress Scale for Children (PSS-C), Acceptance and Action Diabetes Questionnaire (AADQ), Children's Psychological Flexibility Questionnaire (CPFQ), and Patient-Doctor Relationship Questionnaire (PDRQ-9).

Results: The participants (mean age = 14.14, SD = 2.26; 67% girls) reported lower stress levels, increased acceptance of diabetes, and greater psychological flexibility after the intervention. Additionally, the patient-doctor relationship was enhanced, potentially improving patient adherence to treatment. Positive qualitative feedback mirrored previous ACT research in the paediatric population, highlighting the beneficial role of experiential activities and metaphors when working with this target group.

Discussion: This study adds to the growing body of evidence supporting the effectiveness of ACT in enhancing healthy coping strategies among children and adolescents with chronic illnesses.

Citing Articles

Impact of the Patient-Doctor Relationship on Treatment Outcomes in Children with Type 1 Diabetes: A Meta-Analysis and Systematic Review.

Stefanescu C, Boroi D, Iacob C, Stefanescu V, Nechita A Children (Basel). 2024; 11(9).

PMID: 39334574 PMC: 11430008. DOI: 10.3390/children11091041.

References

Clery P, Starbuck J, Laffan A, Parslow R, Linney C, Leveret J . Qualitative study of the acceptability and feasibility of acceptance and commitment therapy for adolescents with chronic fatigue syndrome. BMJ Paediatr Open. 2021; 5(1):e001139. PMC: 8488698. DOI: 10.1136/bmjpo-2021-001139. View

Lowes L, Eddy D, Channon S, McNamara R, Robling M, Gregory J . The experience of living with type 1 diabetes and attending clinic from the perception of children, adolescents and carers: analysis of qualitative data from the DEPICTED study. J Pediatr Nurs. 2014; 30(1):54-62. DOI: 10.1016/j.pedn.2014.09.006. View

Yapanis M, James S, Craig M, ONeal D, Ekinci E . Complications of Diabetes and Metrics of Glycemic Management Derived From Continuous Glucose Monitoring. J Clin Endocrinol Metab. 2022; 107(6):e2221-e2236. PMC: 9113815. DOI: 10.1210/clinem/dgac034. View

Suh J, Choi Y, Oh J, Song K, Choi H, Kwon A . Association between early glycemic management and diabetes complications in type 1 diabetes mellitus: A retrospective cohort study. Prim Care Diabetes. 2023; 17(1):60-67. DOI: 10.1016/j.pcd.2022.12.006. View

Lowes L, Lyne P, Gregory J . Childhood diabetes: parents' experience of home management and the first year following diagnosis. Diabet Med. 2004; 21(6):531-8. DOI: 10.1111/j.1464-5491.2004.01193.x. View

Chikani U, Bisi-Onyemaechi A, Oguonu T, Ugege S, Ogugua C . Childhood diabetes: a myth or reality?- perception of the public from a low-income country: a cross-sectional study. BMC Public Health. 2018; 18(1):852. PMC: 6038320. DOI: 10.1186/s12889-018-5744-7. View

Hayes S, Hofmann S . "Third-wave" cognitive and behavioral therapies and the emergence of a process-based approach to intervention in psychiatry. World Psychiatry. 2021; 20(3):363-375. PMC: 8429332. DOI: 10.1002/wps.20884. View

Gregory G, Robinson T, Linklater S, Wang F, Colagiuri S, de Beaufort C . Global incidence, prevalence, and mortality of type 1 diabetes in 2021 with projection to 2040: a modelling study. Lancet Diabetes Endocrinol. 2022; 10(10):741-760. DOI: 10.1016/S2213-8587(22)00218-2. View

Sullivan-Bolyai S, Grey M, Deatrick J, Gruppuso P, Giraitis P, Tamborlane W . Helping other mothers effectively work at raising young children with type 1 diabetes. Diabetes Educ. 2004; 30(3):476-84. DOI: 10.1177/014572170403000319. View

10.

Howe C, Cipher D, LeFlore J, Lipman T . Parent Health Literacy and Communication With Diabetes Educators in a Pediatric Diabetes Clinic: A Mixed Methods Approach. J Health Commun. 2015; 20 Suppl 2:50-9. DOI: 10.1080/10810730.2015.1083636. View

11.

Hayes S, Luoma J, Bond F, Masuda A, Lillis J . Acceptance and commitment therapy: model, processes and outcomes. Behav Res Ther. 2005; 44(1):1-25. DOI: 10.1016/j.brat.2005.06.006. View

12.

Haskard Zolnierek K, DiMatteo M . Physician communication and patient adherence to treatment: a meta-analysis. Med Care. 2009; 47(8):826-34. PMC: 2728700. DOI: 10.1097/MLR.0b013e31819a5acc. View

13.

Akbarizadeh M, Naderi Far M, Ghaljaei F . Prevalence of depression and anxiety among children with type 1 and type 2 diabetes: a systematic review and meta-analysis. World J Pediatr. 2021; 18(1):16-26. DOI: 10.1007/s12519-021-00485-2. View

14.

Compas B, Jaser S, Bettis A, Watson K, Gruhn M, Dunbar J . Coping, emotion regulation, and psychopathology in childhood and adolescence: A meta-analysis and narrative review. Psychol Bull. 2017; 143(9):939-991. PMC: 7310319. DOI: 10.1037/bul0000110. View

15.

Sakamoto R, Ohtake Y, Kataoka Y, Matsuda Y, Hata T, Otonari J . Efficacy of acceptance and commitment therapy for people with type 2 diabetes: Systematic review and meta-analysis. J Diabetes Investig. 2021; 13(2):262-270. PMC: 8847115. DOI: 10.1111/jdi.13658. View

16.

Inverso H, Moore H, Lupini F, Wang C, Streisand R, Shomaker L . Mindfulness-Based Interventions: Focus on Pediatric Type 1 and Type 2 Diabetes. Curr Diab Rep. 2022; 22(10):493-500. PMC: 10976454. DOI: 10.1007/s11892-022-01492-x. View

17.

Faul F, Erdfelder E, Buchner A, Lang A . Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009; 41(4):1149-60. DOI: 10.3758/BRM.41.4.1149. View

18.

Streisand R, Monaghan M . Young children with type 1 diabetes: challenges, research, and future directions. Curr Diab Rep. 2014; 14(9):520. PMC: 4113115. DOI: 10.1007/s11892-014-0520-2. View

19.

Argyropoulos T, Korakas E, Gikas A, Kountouri A, Kostaridou-Nikolopoulou S, Raptis A . Stress Hyperglycemia in Children and Adolescents as a Prognostic Indicator for the Development of Type 1 Diabetes Mellitus. Front Pediatr. 2021; 9:670976. PMC: 8107212. DOI: 10.3389/fped.2021.670976. View

20.

Lawrence J, Divers J, Isom S, Saydah S, Imperatore G, Pihoker C . Trends in Prevalence of Type 1 and Type 2 Diabetes in Children and Adolescents in the US, 2001-2017. JAMA. 2021; 326(8):717-727. PMC: 8385600. DOI: 10.1001/jama.2021.11165. View