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 ≥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.