and Metabolic Control

Background Behavioral family systems therapy (BFST) for adolescents with diabetes has improved family relationships and communication, but effects on adherence and metabolic con-trol were weak. We evaluated a revised intervention, BFST for diabetes (BFST-D). Methods One hundred and four families were randomized to standard care (SC) or to 12 sessions of either an educational support group (ES) or a BFST-D over 6 months. Family relationships, adherence, glycosylated hemoglobin (HbA1c), and health care utilization were measured at baseline and after treatment. Results BFST-D significantly improved family conflict and adherence compared to SC and ES, especially among those with baseline HbA1c ≥9.0%. BFST-D and ES significantly improved HbA1c compared to SC among those with baseline HbA1c ≥9.0%. Conclusions The revised intervention (BFST-D) improved family conflict and treatment adherence signifi-cantly, while both ES and BFST-D reduced HbA1c significantly, particularly among adolescents with poor metabolic control. Clinical translation of BFST-D requires further study. Key words adolescence; diabetes; family therapy. Family conflict, parent–adolescent communication, and problem-solving skills have been associated with diabe-tes outcomes among adolescents in cross-sectiona