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CBT Improves Adherence and Depression in Patients with Uncontrolled Type 2 Diabetes

According to a new study published in Diabetes Care, cognitive behavior therapy (CBT) may be an effective intervention for medication adherence, depressive symptoms, and glycemic control in adults with type 2 diabetes and depression.  In the current study, 87 adults with unipolar depression and uncontrolled type 2 diabetes were randomized to receive either enhanced treatment as usual (ETAU) (medication adherence, self-monitoring of blood glucose, and lifestyle counseling) or ETAU plus 9 to 11 sessions of CBT for adherence and depression (CBT-AD). At four months, immediately following treatment, the CBT-AD group showed greater improvements in medication adherence, depressive symptoms, and glycemic control than the ETAU group.  At 8- and 12-month follow ups, CBT-AD remained superior to ETAU on adherence and glycemic control. There was no between group difference on depression, though some evidence of continued improvement was noted for both groups. These findings suggest that CBT is an effective intervention for medication adherence, glycemic control, and depression with lasting benefits for self-management and control among patients with type 2 diabetes and depression.

Safren, S. A., Gonzalez, J. S., Wexler, D. J., Psaros, C., Delahanty, L. M., Blashill, A. J., Margolina, A. I., … Cagliero, E. (January 01, 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, 625-33.

CBT with Depressed Caregivers

In this video from a recent Beck Institute workshop, Dr. Aaron Beck discusses how to structure treatment with depressed caregivers under a limited number of sessions. Dr. Beck explains that depressed caregivers often have negative beliefs about illness, and that they often withdraw from others and from pleasurable activities. When time is limited to just a few sessions with this type of client, it may be helpful to spend time explaining and teaching the client to use a Thought Record, to engage in Activity Scheduling, and to develop a plan to continue to use these tools into the future.

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