The effects of group motivational interviewing and externalizing conversations for adolescents with Type-1 diabetes

There is a generally appreciated need for psychosocial interventions to help adolescents with Type-1 diabetes cope more effectively with their diabetes, but guidance literature is scarce. We hypothesized perceptions and coping with diabetes could be changed using group motivational interviewing (MI) and externalizing conversations (EC). This paper reports qualitative research findings from a preliminary study of group MI - EC intervention for adolescents with Type-1 diabetes. Twenty adolescents with poorly controlled diabetes were allocated to treatment and control conditions. Treatment consisted of EC and MI over six 1-h weekly sessions. Control consisted of usual care. Participants completed semi-structured questionnaires assessing their perceptions and management of diabetes before, after and 6 months after the intervention. Questionnaires compiled for the study were analysed using content analysis. The treatment group shifted their perceptions of diabetes. They felt less threatened, had more feelings of control and acceptance. Consequences of having diabetes were seen as having a less restrictive influence on their lifestyle than previously. From this exploratory analysis we tentatively conclude this innovative group intervention led to an adaptive shift in illness perception. We are planning a larger RCT to investigate the relationship between shifts in perception and better diabetes management.