Table 2.

Common components of seven efficacious behavioral interventions for youth with T1D (73–79).

Intervention Component	Practice Specifics	Purpose	Case Examples	Possible Provider(s)
Individual monitoring and feedback	Assess individual/family’s primary concerns Track target behavior(s) Review tracking data with patient Set goals and monitor progress	Tailors intervention to youth and family’s specific concerns Provides individual feedback based on concrete data	Ana has high blood glucose in afternoons after school. Family tracks lunchtime blood glucose checks. At next visit, review of meter download identifies patterns: lunch checks complete on weekends, but often missed on school days. Discuss ideas to facilitate completing checks during school lunch hour and track again after implementing plan.	Endocrinologist, Physician Nurse Practitioner, Physician Assistant Diabetes Educator Social Worker Psychologist
Diabetes-related psychosocial education	Give information about psychological and behavioral aspects of T1D Provide basic psychosocial recommendations	Normalizes difficulties, and negative feelings related to T1D Provides realistic expectations for youth and parent behavior	Brian has had diabetes since he was 5 years old and now at age 14 his parents believe he is old enough to take care of it independently. Provide information about adolescent development and competing demands to encourage ongoing parental involvement.	Endocrinologist, Physician (with training) Nurse Practitioner, Physician Assistant (with training) Diabetes Educator (with training) Social Worker Psychologist
Guided problem solving/goal setting	Identify major concern Guide patient/family in brainstorming possible solutions Discuss barriers to implementing solution Set goal that is specific, measurable, and achievable.	Teaches skill to systematically consider solutions for challenges that come up with diabetes care	Carlos often forgets to bolus for snacks after school, especially when out with friends. After considering possible solutions (e.g., eating only low-carb snacks, ask a friend to remind him, setting reminder alarm on phone) he decides to try the phone alarm. Check in after 2 weeks to see if reminder made it easier to remember – if not, pick another option to try.	Endocrinologist, Physician (with training) Nurse Practitioner, Physician Assistant (with training) Diabetes Educator (with training) Social Worker Psychologist
Enhance support	Promoting developmentally appropriate family roles in diabetes management Identifying sources of peer support Teaching communication and conflict management skills	Reduces feelings of stress and isolation Provide assistance with diabetes management tasks	Dominique is starting college and doesn’t know anyone else going there. Her mother is worried about not being there to help with diabetes care. Dominique tells her roommate about T1D and joins a T1D student group on campus, and texts updates to her mom every couple of days.	Diabetes Educator (with training) Social Worker Psychologist
Behavioral management/reinforcement	Establish clear expectations for diabetes care behaviors Enforce consequences or provide reinforcement for engaging in behaviors	Enhances motivation for engaging in diabetes care behaviors Recognizes and rewards effort	6 year-old Matt resists finger checks and pump site changes at night, causing parental stress and delaying bedtime. A new reward system allows Matt to earn 2 extra bedtime stories or 10 extra minutes of screen time for cooperating with checks and site changes.	Diabetes Educator (with training) Social Worker Psychologist
Cognitive behavioral skills	Teach cognitive restructuring skills to challenge and replace negative, unhelpful thoughts. Teach relaxation techniques for diabetes-related stressors	Reduces stress Increases relaxation Improves emotion self-regulation	Jackie gets very anxious when she comes to her diabetes clinic visits and sometimes becomes tearful in the clinic room. Her provider teaches her to use controlled deep breathing techniques to relax when she starts to feel upset during their visit.	Social Worker Psychologist