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Diabetes and the family: Treatment manual for a family psychotherapy of recurrent diabetic ketoacidosis and recurrent hypoglycemia in children and adolescents

26 July 1991


A treatment manual for a program to ameliorate the psychosocial aspects of recurrent diabetic ketoacidosis (RDKA) and recurrent diabetic hypoglycemia (RDH) in children and adolescents is presented. The literature, focusing on the differentiation of normative from pathological responses to diabetes onset and progression, is reviewed. utilizing this definition, pathological family and individual patterns are explicated. RDKA and RDH patients are viewed as suffering difficulties from three distinct problem domains; metabolic, psychiatric, and familial. These patients are viewed as radically noncompliant to their medical regimens due to psychosocial causes. The literature is briefly reviewed for past and contemporary models of understanding youth with diabetes. Developmental issues for children and adolescents are reviewed, and the Peabody Family Development Model is utilized to clarify the topography of the diabetic family system. The psychophysiological model is presented to better understand the individual diabetic, and the behavioral medicine paradigm is included to target and intervene with each of the disparate forces within these complex and disordered systems. It is noted that few pro9rams exist for the treatment of RDKA or RDH. A group treatment manual based on the research literature is presented. The core of the program is designed to facilitate parents in becoming more skillful at providing appropriate structure, discipline, and monitoring of diabetes related and non-diabetes related child behaviors. A case study utilizing this methodology is presented. Also outlined are a research plan, program limitations, product dissemination plans, and some directions for future research.


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