Cognitive Behavior Therapy (CBT) is usually short-term, goal-directed, and skills based. Therapists help patients identify and solve problems and learn specific skills to change their thinking and behavior so they can make lasting changes in their behavior and general functioning. At each session, patients record responses to their unhelpful and inaccurate thinking, along with steps they have committed to take in the coming week.
A growing body of literature has demonstrated the effectiveness of CBT for people with diabetes. For example, a randomized controlled trial published last year in Diabetes Care showed that CBT enhanced treatment adherence and decreased depression in type 2 diabetes patients. In this study, participants received either enhanced usual care or enhanced usual care plus a CBT intervention. Four months after treatment, the group receiving CBT intervention showed greater improvements in medication adherence, depressive symptoms, and diabetes control compared to the usual care group. At the 8-month follow up, the CBT intervention group maintained their gains in adherence and diabetes control.
As an example, a patient might react to a high blood glucose reading by thinking, “This is horrible! I’ll never get my diabetes under control. I’m a failure.” He may then feel sad, become discouraged, and give up on trying to manage his disease. In CBT treatment, therapists help patients identify and modify their automatic, negative thoughts and unhelpful behaviors. They teach them specific, empowering skills to help them manage their disease. Thus, with the help of CBT, instead of thinking “I’m a failure” and wanting to give up, the patient thinks, “This reading is high. I better take steps to get it under control.”
Safren, S. A., Gonzalez, J. S., Wexler, D. J., Psaros, C., Delahanty, L. M., Blashill, A. J., Margolina, A. I., … Cagliero, E. (February 20, 2014). A Randomized Controlled Trial of Cognitive Behavioral Therapy for Adherence and Depression (CBT-AD) in Patients With Uncontrolled Type 2 Diabetes. Diabetes Care, 37, 3, 625-633.