Short-term effects of coping skills training as adjunct to intensive therapy in adolescents

• Published in: Diabetes care Vol. 21; no. 6; pp. 902 - 908
• Main Authors: GREY, M, BOLAND, E. A, DAVIDSON, M, CHANG YU, SULLIVAN-BOLYAI, S, TAMBORLANE, W. V
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01-06-1998
• Subjects: Adaptation, Psychological; Adolescent; Behavior modification; Biological and medical sciences; Child development; Children & youth; Cognition & reasoning; Coping; Counseling; Depression - epidemiology; Diabetes; Diabetes Mellitus; Diabetes Mellitus, Type 1 - psychology; Diabetes Mellitus, Type 1 - therapy; Diabetes. Impaired glucose tolerance; Drug Administration Schedule; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Glycated Hemoglobin A - analysis; Humans; Hypoglycemia - epidemiology; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - adverse effects; Hypoglycemic Agents - therapeutic use; Insulin; Insulin - administration & dosage; Insulin - adverse effects; Insulin - therapeutic use; Intervention; Male; Management. Various non-drug treatments. Langerhans islet grafts; Medical sciences; Metabolism; Obesity; Pediatrics; Psychology, Adolescent; Quality of Life; Research design; Self Care; Skill development; Socioeconomic Factors; Teenagers; Time Factors; Endocrinopathy; Human; Short term; Immunopathology; Pancreatic hormone; Intensive care; Autoimmune disease; Method; Educational schedule; Insulin; Protein hormone; Chemotherapy; Treatment; Surveillance; Cohort study; Adolescent; Insulin dependent diabetes; Self control; Influence
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.21.6.902

Short-term effects of coping skills training as adjunct to intensive therapy in adolescents.
M Grey ,
E A Boland ,
M Davidson ,
C Yu ,
S Sullivan-Bolyai and
W V Tamborlane
Department of Pediatrics, School of Medicine, Yale University School of Nursing, New Haven, Connecticut 06536-0740, USA. [e-mail]
Abstract
OBJECTIVE: Given the urgent need to develop effective programs that improve the ability for adolescents to achieve metabolic
control equivalent to programs studied in the Diabetes. Control and Complications Trial, we have undertaken a clinical trial
to determine if a behavioral intervention (coping skills training [CST]) combined with intensive diabetes management can improve
metabolic control and quality of life in adolescents implementing intensive therapy regimens. RESEARCH DESIGN AND METHODS:
A total of 65 youths between the ages of 13 and 20 years, who elected to initiate intensive insulin therapy, were randomly
assigned to one of two groups: the intensive management with CST group and the intensive management without CST group. CST
consists of a series of small group efforts designed to teach adolescents the coping skills of social problem-solving, social
skills training, cognitive behavior modification, and conflict resolution. Data were collected at pre-intervention and at
3 months following the use of the Self-Efficacy for Diabetes scale, Children's Depression Inventory, Issues in Coping with
IDDM scale, and the Diabetes Quality of Life: Youth scale. Clinical data (HbA1c, adverse effects) were collected monthly.
RESULTS: The experimental and control groups were comparable on all measures at baseline. Results show that adolescents who
received CST had lower HbA1c and better diabetes self-efficacy and were less upset about coping with diabetes than adolescents
receiving intensive management alone. In addition, adolescents who received the CST found it easier to cope with diabetes
and experienced less of a negative impact of diabetes on quality of life than those who did not receive CST. CONCLUSIONS:
CST is useful in improving not only an adolescent's metabolic control, but also their quality of life. As more pediatric providers
aim for improved control, in adolescents with diabetes, the addition of this behavioral intervention may be helpful in achieving
metabolic and life goals.