FAMILY-THERAPY IN POORLY CONTROLLED JUVENILE IDDM - EFFECTS ON DIABETIC CONTROL, SELF-EVALUATION AND BEHAVIORAL SYMPTOMS

Diabetic control, behavioural symptoms and self-evaluation were assess ed in 25 children with IDDM who were in poor metabolic control (P grou p), before and subsequent to one of two treatment conditions: family t herapy and conventional treatment (C). In addition, data were collecte d from 12 patients in optimal control (O group). Prior to treatment th e patients in poor control were rated higher than those in the O group for symptoms indicating somatization and internalization of conflict and showed a gloomier self-image. The O group patients had fewer behav ioural symptoms and a more positive self-image than non-diabetic refer ence groups. Diabetic control improved after family therapy only. Furt hermore, the family therapy group improved on a combined measure of be havioural symptoms and one aspect of self-evaluation (relations to par ents and family). The results suggest that IDDM may either interfere w ith or foster the child's development towards autonomy, depending on f amily interaction patterns which affect the child's behaviour and self -esteem. Family therapy is a treatment option which can mediate improv ed diabetic control by changing family relationships to allow for a be tter balance between parental and self-care of the child with poorly c ontrolled IDDM.