Family therapies for adults with diabetes

Abstract

Research and social ecological theory conclude that social support has positive effects on mental and physical health. Family support may “buffer” the effects of stress, and family members may model or encourage positive health habits. Although current findings indicate that social support relates to better diabetes outcomes for persons with type 2 diabetes (T2D), little is known about the impact of family relationships, or interventions, on adults with type 1 diabetes. For adults with T2D, most family intervention studies have substantive limitations: some do not describe the nature of the family member’s involvement in the intervention and some lack a meaningful control group. A major concern is that most studies lack an individual intervention comparator and therefore do not speak to the specific question of whether involving the family is more efficacious than not doing so. The Diabetes Support Project (DSP), based on interdependence theory, is described in detail. It was a practical, randomized controlled trial in which adults with T2D in poor glycemic control were randomized to a telephonic couples intervention, a comparable individual intervention, or individual-only diabetes education. Results supported the value of partner involvement. Unique challenges to studying family interventions are described. Future research must address how to implement tailored family interventions that are replicable, yet flexible, and also determine what works best for whom.