Effects of behavioral family systems therapy for diabetes on adolescents' family relationships, treatment adherence, and metabolic control

J Pediatr Psychol. 2006 Oct;31(9):928-38. doi: 10.1093/jpepsy/jsj098. Epub 2006 Jan 9.


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.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Child
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Family Relations
  • Family*
  • Female
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Male
  • Parent-Child Relations
  • Patient Compliance*
  • Self Care*
  • Surveys and Questionnaires


  • Hypoglycemic Agents