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Acceptability of ACT group intervention for adolescents with type 1 diabetes

Journal of Contextual Behavioral Science (JCBS)

Volume 31, January 2024, 100722

Authors

Iina Alho, Päivi Lappalainen, Raimo Lappalainen

Abstract

Background

Type 1 diabetes (T1D) is a demanding condition for both adolescents and their parents. The first aim of this study was to investigate the acceptability of an acceptance and commitment therapy (ACT) group intervention for 12–16-year-old adolescents with T1D. The second aim was to investigate how adolescents whose glycemic control improved during the intervention differed from those who did not improve.

Methods

A total of 28 adolescents and their parents who completed the intervention were interviewed at the end of the intervention. The adolescents filled in questionnaires regarding diabetes-related psychological flexibility (DAAS) and acceptance and mindfulness (CAMM) before and after the intervention. Glycosylated hemoglobin (HbA1c) levels were obtained from the medical records before and after the intervention. The experiences of the intervention were investigated using semi-structured questionnaires and a thematic analysis. Statistical analyses were performed to study the group differences between adolescents who improved in glycemic control and those who showed no improvement.

Results

Of those who completed the intervention, 86% of the adolescents and 89% of the parents reported being very satisfied or satisfied with the intervention. The thematic analysis showed that among the themes arising from the experiences of adolescents were increased motivation for the treatment of diabetes and a better attitude toward diabetes. Among the parents, themes such as positive changes in mood, a better attitude toward diabetes, and increased motivation for treatment emerged. In terms of group differences, those who improved with regard to glycemic control were older, their HbA1c was higher at the start, and they reported greater changes in diabetes-related psychological flexibility.

Conclusions

The ACT-based group intervention was well accepted and complemented the usual treatment. Thus, this intervention is recommended, especially for adolescents who have not met the glycemic targets.

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