Cognitive–Behavioral Therapy for Adherence and Depression (CBT-AD) in Type 2 Diabetes
Open accessAbstract
Depression is one of the most common psychological problems among individuals with diabetes, and is associated with worse treatment adherence and clinical outcomes. As part of a program of treatment research aimed at integrating interventions for depression and treatment nonadherence, five depressed patients with suboptimally controlled type 2 diabetes were treated with 10–12 sessions of individual cognitive–behavioral therapy for adherence and depression (CBT-AD) in a case-series design. The intervention was delivered in a hospital setting by a collaborative team consisting of a psychologist, a nurse educator, and a dietitian. Post-treatment, all participants demonstrated a decrease in depression severity and demonstrated improvements in diabetes self-care. Four of the five demonstrated improved glycemic control. These preliminary results provide evidence for the acceptability, feasibility, and potential utility of CBT-AD for patients with type 2 diabetes and depression.
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Newer intervention approaches integrate psychological treatments with exercise training, nurse-led self-management support, and nurse-, dietitian-, and mental health-specialist-delivered self-management interventions.
“These include interventions that integrate psychological treatments with exercise training (20), nurse-led self-management support (21), and nurse-, dietitian-, and mental health-specialist–delivered self-management interventions (22).”
From Depression in diabetes: have we been missing something important? (2011) · cites this paper as [21]
Interventions that focus on addressing both distress and diabetes management are likely to have stronger effects than those that focus on either in isolation.
“Second, because of the reciprocal influences between emotional distress and diabetes self-management, distress can indicate increased risk for poor treatment outcomes; interventions that focus on addressing both distress and diabetes management are likely to have stronger effects than those that focus on either in isolation (21).”
From Depression in diabetes: have we been missing something important? (2011) · cites this paper as [21]
There are reciprocal influences between emotional distress and diabetes self-management.
“Second, because of the reciprocal influences between emotional distress and diabetes self-management, distress can indicate increased risk for poor treatment outcomes; interventions that focus on addressing both distress and diabetes management are likely to have stronger effects than those that focus on either in isolation (21).”
From Depression in diabetes: have we been missing something important? (2011) · cites this paper as [21]
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“Adherence behaviors in patients with type-2 diabetes include five categories: adherence to medication, dietary recommendations, increased physical activity, self-control of blood glucose, and proper care of legs.(8) Failure to adhere to the therapeutic regimen accelerates the complications of diabetes.”
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“…available that have been shown to be efficacious in reducing depressive symptoms in patients with diabetes, such as cognitive behavior therapy (CBT; Gonzalez et al. 2010; Lamers et al. 2010; Lustman et al. 1998; Penckofer et al. 2012; van Bastelaar et al. 2011) and mindfulness-based cognitive…”
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- Authors
- Gonzalez, J. S., McCarl, L. A., Wexler, D. J., Cagliero, E., Delahanty, L., Soper, T. D., Goldman, V., Knauz, R., & Safren, S. A.
- Affiliations
- Albert Einstein College of Medicine (US)
- Harvard University (US)
- Venue
- Journal of Cognitive Psychotherapy
- Publisher
- Springer Publishing Company
- Published
- 2010-11
- Volume
- 24
- Issue
- 4
- Pages
- 329-343
- ISSN
- 0889-8391 (ISSN-L)
- 1938-887X
- PMC
- PMC3650858
- OpenAlex
- W2041976185
- Cited by
- 55
- References
- 63
- Citations by year
- 2025: 1 · 2024: 5 · 2023: 3 · 2022: 4 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 2 · 2017: 7 · 2016: 2 · 2015: 8 · 2014: 6 · 2013: 1 · 2012: 4
- FWCI
- 2.17
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Cognitive Psychotherapy (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (1r01mh078571-01)
- National Institute of Mental Health (R01 MH-078571)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- cognitive behavioral therapy, type 2 diabetes, depression, medication adherence, diabetes self-care, glycemic control, hospital-based intervention, feasibility and acceptability
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