A systematic review of group-based psychosocial interventions for adolescents with Type 1 diabetes

Abstract

Background: Adolescence is a challenging developmental period, marked by increased autonomy and reduced parental support. For adolescents with Type 1 diabetes (T1D), this often coincides with a sharp decline in glycaemic control and increased psychological burden. Group-based psychosocial interventions aim to improve coping skills, resilience and diabetes-related problem-solving, supporting adolescents as the transition towards independent self-management. We aimed to systematically review existing group psychosocial interventions for young people with T1D, and identify effective mechanisms of action. Method: A systematic review of six databases yielded 5,259 records, of which 22 studies were eligible for inclusion. Narrative and tabular synthesis were used to describe the interventions, their underpinning theories, active mechanisms, delivery models, and reported outcomes. Results: Six broad types of group-based psychosocial interventions were identified, cognitive behavioural/stress-management, guided self-determination for youth, psychoeducational, self-efficacy/social-cognitive, mindfulness/acceptance, and motivational/solution-focused approaches. Across studies, at least two of the nine core active techniques were consistently applied, including goal setting, problem-solving, cognitive behavioural strategies, communication training, relaxation, family teamwork, and diabetes education. Reported outcomes were heterogeneous: modest improvements were most commonly seen in psychosocial parameters (e.g. depression, diabetes distress, family functioning, self-efficacy), while effects on clinical and behavioural outcomes were mixed. Conclusion: Group-based psychosocial interventions for adolescents with T1D show potential, particularly in improving psychosocial wellbeing, but evidence is limited by small sample sizes, variable quality, and inconsistent reporting. Standardisation of intervention components and outcome measures, alongside larger, high-quality trials, is needed to guide effective practice.