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.