Volume 17, Issue 6 e70112

REVIEW ARTICLE

Open Access

The Effectiveness of Psychological Interventions for Families of Children With Type 1 Diabetes on Caregiver and Child Functioning: A Systematic Review and Meta-Analysis

Katherine E. Wakelin,

Katherine E. Wakelin

orcid.org/0000-0003-3400-9233

School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK

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Rebecca K. Read,

Rebecca K. Read

School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK

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Ashely Y. Williams,

Ashely Y. Williams

School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK

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Rachel R. Francois-Walcott,

Rachel R. Francois-Walcott

School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK

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Nicola O'Donnell,

Nicola O'Donnell

School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK

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Rose-Marie Satherley,

Rose-Marie Satherley

School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK

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Megan P. Harrington,

Megan P. Harrington

School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK

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Mary John,

Mary John

School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK

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Christina J. Jones,

Corresponding Author

Christina J. Jones

[email protected]

orcid.org/0000-0003-3672-6631

School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK

Correspondence:

Christina J. Jones ([email protected])

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Katherine E. Wakelin,

Katherine E. Wakelin

orcid.org/0000-0003-3400-9233

School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK

Search for more papers by this author

Rebecca K. Read,

Rebecca K. Read

School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK

Search for more papers by this author

Ashely Y. Williams,

Ashely Y. Williams

School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK

Search for more papers by this author

Rachel R. Francois-Walcott,

Rachel R. Francois-Walcott

School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK

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Nicola O'Donnell,

Nicola O'Donnell

School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK

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Rose-Marie Satherley,

Rose-Marie Satherley

School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK

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Megan P. Harrington,

Megan P. Harrington

School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK

Search for more papers by this author

Mary John,

Mary John

School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK

Search for more papers by this author

Christina J. Jones,

Corresponding Author

Christina J. Jones

[email protected]

orcid.org/0000-0003-3672-6631

School of Psychology, Faculty of Health and Medical Science, University of Surrey, Guildford, UK

Correspondence:

Christina J. Jones ([email protected])

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First published: 17 June 2025

https://doi.org/10.1111/1753-0407.70112

Funding: The authors received no specific funding for this work.

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ABSTRACT

Background

Research suggests that the wellbeing of caregivers of children with Type 1 Diabetes can influence child health outcomes. Therefore, the aim was to conduct a systematic review and meta-analysis to estimate the effect of psychological interventions for families of children with Type 1 Diabetes on caregiver and child functioning.

Methods

A systematic search of the literature identified 58 randomized controlled trials (RCTs) that met inclusion. Study quality was assessed using the Cochrane Risk-of-Bias Tool.

Results

Fifty-one trials had sufficient data to be included in the meta-analysis, analyzing nine variables (caregiver and child psychological distress, diabetes distress, family conflict and child quality of life (QoL), diabetes QoL and blood glucose) over three timepoints (post-intervention, short-term and long-term follow-up). Results from 10 (n = 550), three (n = 347) and 16 RCTs (n = 1631) respectively indicated that psychological interventions significantly reduced caregiver psychological distress post-intervention (SMD = −0.64, 95% CI = −1.15, −0.12), child psychological distress post-intervention (SMD = −0.34, 95% CI = −0.55, −0.31) and child blood glucose at short-term follow-up (SMD = −0.11, 95% CI = −0.21, −0.01), relative to controls.

Conclusions

Participants allocated to controls showed greater reductions in caregiver diabetes family conflict at short-and long-term follow−up than those assigned to psychological interventions. This was explained by significant baseline differences influencing a small number of studies. Studies were highly heterogenous regarding outcome measures, follow-ups, and interventions, with high concerns of bias often observed, reflecting the complexity of real−world clinical practice. Findings are promising. Appropriately powered RCTs with robust randomization are recommended to investigate the significance of effects, whilst considering dose response.

Conflicts of Interest

The authors declare no conflicts of interest.

Open Research

Data Availability Statement

All available data is publicly available within the article.

Supporting Information

References

1E. A. Boland and M. Grey, “ Diabetes Mellitus (Type 1),” in Primary Care of the Child With a Chronic Condition, ed. P. L. Jackson and J. A. Vessey (Mosby, 2000), 350–370.
Google Scholar
2J. Spencer, H. Cooper, and B. Milton, “The Lived Experiences of Young People (13–16 Years) With Type 1 Diabetes Mellitus and Their Parents–a Qualitative Phenomenological Study,” Diabetic Medicine 30 (2013): e17–e24.
10.1111/dme.12021
CAS PubMed Web of Science® Google Scholar
3S. Abdoli, A. Vora, B. Smither, A. D. Roach, and A. C. Vora, “I Don't Have the Choice to Burnout; Experiences of Parents of Children With Type 1 Diabetes,” Applied Nursing Research 54 (2020): 151317.
10.1016/j.apnr.2020.151317
PubMed Web of Science® Google Scholar
4R. Khemakhem, Y. Dridi, M. Hamza, et al., “How Do Parents of Children With Type 1 Diabetes Mellitus Cope and How Does This Condition Affect Caregivers' Mental Health?,” Archives de Pédiatrie 27 (2020): 265–269.
10.1016/j.arcped.2020.05.001
CAS PubMed Google Scholar
5U. Yaqoob, M. A. Khan, L. Khemani, J. Rafiq, and A. S. Iftikhar, “Diabetes Mellitus in Children and Its Effect on Caregivers' Mental Health,” Cureus 10 (2018): e2409.
PubMed Google Scholar
6L. Lowes, J. W. Gregory, and P. Lyne, “Newly Diagnosed Childhood Diabetes: A Psychosocial Transition for Parents?,” Journal of Advanced Nursing 50 (2005): 253–261.
10.1111/j.1365-2648.2005.03388.x
CAS PubMed Web of Science® Google Scholar
7A. Horsch, F. McManus, P. Kennedy, and J. Edge, “Anxiety, Depressive, and Posttraumatic Stress Symptoms in Mothers of Children With Type 1 Diabetes,” Journal of Traumatic Stress 20 (2007): 881–891.
10.1002/jts.20247
CAS PubMed Web of Science® Google Scholar
8K. M. Clayton, S. M. Stewart, D. J. Wiebe, C. E. McConnel, C. W. Hughes, and P. C. White, “Maternal Depressive Symptoms Predict Adolescent Healthcare Utilization and Charges in Youth With Type 1 Diabetes (T1D),” Health Psychology 32 (2013): 1013.
10.1037/a0032761
PubMed Web of Science® Google Scholar
9A. Butwicka, A. Zalepa, W. Fendler, A. Szadkowska, and W. Mlynarski, “Maternal Depressive Symptoms Predict Acute Hospitalization Among Children With Type 1 Diabetes,” Pediatric Diabetes 14 (2013): 288–294.
10.1111/pedi.12010
PubMed Web of Science® Google Scholar
10D. J. Wiebe, D. Gelfand, J. M. Butler, et al., “Longitudinal Associations of Maternal Depressive Symptoms, Maternal Involvement, and Diabetes Management Across Adolescence,” Journal of Pediatric Psychology 36 (2011): 837–846.
10.1093/jpepsy/jsr002
PubMed Web of Science® Google Scholar
11L. D. Cameron, M. J. Young, and D. J. Wiebe, “Maternal Trait Anxiety and Diabetes Control in Adolescents With Type 1 Diabetes,” Journal of Pediatric Psychology 32 (2007): 733–744.
10.1093/jpepsy/jsl053
PubMed Web of Science® Google Scholar
12C. Piazza-Waggoner, A. C. Modi, S. W. Powers, L. B. Williams, L. M. Dolan, and S. R. Patton, “Observational Assessment of Family Functioning in Families With Children Who Have Type 1 Diabetes Mellitus,” Journal of Developmental & Behavioral Pediatrics 29 (2008): 101–105.
10.1097/DBP.0b013e31815f24ce
PubMed Web of Science® Google Scholar
13S. S. Jaser, R. Linsky, and M. Grey, “Coping and Psychological Distress in Mothers of Adolescents With Type 1 Diabetes,” Maternal and Child Health Journal 18 (2014): 101–108.
10.1007/s10995-013-1239-4
PubMed Web of Science® Google Scholar
14M. E. Hilliard, C. S. Holmes, R. Chen, K. Maher, E. Robinson, and R. Streisand, “Disentangling the Roles of Parental Monitoring and Family Conflict in Adolescents' Management of Type 1 Diabetes,” Health Psychology 32 (2013): 388–396.
10.1037/a0027811
PubMed Web of Science® Google Scholar
15J. Spencer, H. Cooper, and B. Milton, “Qualitative Studies of Type 1 Diabetes in Adolescence: A Systematic Literature Review,” Pediatric Diabetes 11 (2010): 364–375.
10.1111/j.1399-5448.2009.00603.x
CAS PubMed Web of Science® Google Scholar
16E. R. Mackey, L. Herbert, M. Monaghan, F. Cogen, J. Wang, and R. Streisand, “The Feasibility of a Pilot Intervention for Parents of Young Children Newly Diagnosed With Type 1 Diabetes,” Clinical Practice in Pediatric Psychology 4 (2016): 35–50.
10.1037/cpp0000123
PubMed Google Scholar
17L. Indelicato, V. Calvo, M. Dauriz, et al., “Depressive Symptoms and Glycaemic Control in Adults With Type 1 Diabetes: An Exploratory Study on the Role of Family Functioning,” Acta Diabetologica 57 (2020): 23–30.
10.1007/s00592-019-01356-z
PubMed Web of Science® Google Scholar
18L. A. McBroom and M. Enriquez, “Review of Family-Centered Interventions to Enhance the Health Outcomes of Children With Type 1 Diabetes,” Diabetes Educator 35 (2009): 428–438.
10.1177/0145721709332814
PubMed Web of Science® Google Scholar
19M. A. Feldman, L. M. Anderson, J. B. Shapiro, et al., “Family-Based Interventions Targeting Improvements in Health and Family Outcomes of Children and Adolescents With Type 1 Diabetes: A Systematic Review,” Current Diabetes Reports 18 (2018): 1–2.
10.1007/s11892-018-0981-9
PubMed Web of Science® Google Scholar
20A. Lohan, A. Morawska, and A. Mitchell, “A Systematic Review of Parenting Interventions for Parents of Children With Type 1 Diabetes,” Child: Care, Health and Development 41, no. 6 (2015): 803–817.
10.1111/cch.12278
CAS PubMed Web of Science® Google Scholar
21X. Zhao, Z. Ai, Y. Chen, J. Wang, S. Zou, and S. Zheng, “The Effectiveness of Parenting Interventions on Psychosocial Adjustment in Parents of Children and Adolescents With Type 1 Diabetes: A Meta-Analysis,” Worldviews on Evidence-Based Nursing 16, no. 6 (2019): 462–469.
10.1111/wvn.12399
PubMed Web of Science® Google Scholar
22K. Winkley, S. Landau, I. Eisler, and K. Ismail, “Psychological Interventions to Improve Glycaemic Control in Patients With Type 1 Diabetes: Systematic Review and Meta-Analysis of Randomised Controlled Trials,” BMJ 333, no. 7558 (2006): 65.
10.1136/bmj.38874.652569.55
PubMed Web of Science® Google Scholar
23D. A. Ellis, A. I. Carcone, S. J. Ondersma, S. Naar-King, B. Dekelbab, and K. Moltz, “Brief Computer-Delivered Intervention to Increase Parental Monitoring in Families of African American Adolescents With Type 1 Diabetes: A Randomized Controlled Trial,” Telemedicine and e-Health 23, no. 6 (2017): 493–502.
10.1089/tmj.2016.0182
PubMed Web of Science® Google Scholar
24J. Higgins, J. Thomas, M. Cumpston, T. Li, M. Page, and V. Welch, Cochrane Handbook for Systematic Reviews of Interventions(Version 6.3) (Cochrane, 2022).
Google Scholar
25S. Sullivan-Bolyai, C. Bova, M. Lee, and P. A. Gruppuso, “Mentoring Fathers of Children Newly Diagnosed With T1DM,” MCN: American Journal of Maternal Child Nursing 36, no. 4 (2011): 224–231.
10.1097/NMC.0b013e3182183bf5
PubMed Web of Science® Google Scholar
26J. A. C. Sterne, A. J. Sutton, J. P. A. Ioannidis, et al., “Recommendations for Examining and Interpreting Funnel Plot Asymmetry in Meta-Analyses of Randomised Controlled Trials,” BMJ 343 (2011): d4002.
10.1136/bmj.d4002
PubMed Web of Science® Google Scholar
27S. M. Amrock and M. Weitzman, “Parental Psychological Distress and Children's Mental Health: Results of a National Survey,” Academic Pediatrics 14, no. 4 (2014): 375–381.
10.1016/j.acap.2014.02.005
PubMed Web of Science® Google Scholar
28Y. M. Aljawarneh, N. M. Al-Qaissi, and H. Y. Ghunaim, “Psychological Interventions for Adherence, Metabolic Control, and Coping With Stress in Adolescents With Type 1 Diabetes: A Systematic Review,” World Journal of Pediatrics 16 (2020): 456–470.
10.1007/s12519-020-00352-6
CAS PubMed Web of Science® Google Scholar
29A. Efthymiadis, M. Bourlaki, and A. Bastounis, “The Effectiveness of Psychological Interventions on Mental Health and Quality of Life in People Living With Type 1 Diabetes: A Systematic Review and Meta-Analysis,” Diabetology International 13, no. 3 (2022): 513–521.
10.1007/s13340-021-00564-9
PubMed Web of Science® Google Scholar
30M. Grey, S. S. Jaser, R. Whittemore, S. Jeon, and E. Lindemann, “Coping Skills Training for Parents of Children With Type 1 Diabetes: 12-Month Outcomes,” Nursing Research 60, no. 3 (2011): 173–181.
10.1097/NNR.0b013e3182159c8f
PubMed Web of Science® Google Scholar
31R. Rubin, D. Young-Hyman, and M. Peyrot, “Parent-Child Responsibility and Conflict in Diabetes Care,” Diabetes 38, no. Suppl 2 (1989): 28A.
Google Scholar
32J. W. Varni, M. Seid, and P. S. Kurtin, “PedsQL 4.0: Reliability and Validity of the Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales in Healthy and Patient Populations,” Medical Care 39, no. 8 (2001): 800–812.
10.1097/00005650-200108000-00006
CAS PubMed Web of Science® Google Scholar
33J. W. Varni, T. M. Burwinkle, J. R. Jacobs, M. Gottschalk, F. Kaufman, and K. L. Jones, “The PedsQL in Type 1 and Type 2 Diabetes: Reliability and Validity of the Pediatric Quality of Life Inventory Generic Core Scales and Type 1 Diabetes Module,” Diabetes Care 26, no. 3 (2003): 631–637.
10.2337/diacare.26.3.631
PubMed Web of Science® Google Scholar
34T. Wysocki and L. Gavin, “Paternal Involvement in the Management of Pediatric Chronic Diseases: Associations With Adherence, Quality of Life, and Health Status,” Journal of Pediatric Psychology 31, no. 5 (2006): 501–511.
10.1093/jpepsy/jsj042
PubMed Web of Science® Google Scholar
35Y. Yaffe, “Systematic Review of the Differences Between Mothers and Fathers in Parenting Styles and Practices,” Current Psychology 42, no. 19 (2023): 16011–16024.
10.1007/s12144-020-01014-6
Web of Science® Google Scholar
36L. Gavin and T. Wysocki, “Associations of Paternal Involvement in Disease Management With Maternal and Family Outcomes in Families With Children With Chronic Illness,” Journal of Pediatric Psychology 31, no. 5 (2006): 481–489.
10.1093/jpepsy/jsj043
PubMed Web of Science® Google Scholar
37 World Health Organization, “ Violence Prevention the Evidence: Preventing Violence Through the Development of Safe, Stable and Nurturing Relationships Between Children and Their Parents and Caregivers,” 2009, http://apps.who.int/iris/bitstream/10665/44088/1/9789241597821_eng.pdf.
Google Scholar
38D. M. Haslam and A. Mejia, “ Accommodating Race and Ethnicity in Parenting Interventions,” in The Power of Positive Parenting: Transforming the Lives of Children, Parents, and Communities Using the Triple P System, editors M. R. Sanders and T. G. Mazzucchelli vol 20 (Oxford University Press, 2017), 332–343.
Google Scholar
39M. Saghaei, P. Omidi, E. H. Dehkordi, and P. Safavi, “The Effectiveness of Cognitive-Function Stress Management Training in Glycemic Control in Children and in Mental Health of Mother Caring for Child With Type 1 Diabetes Mellitus,” Diabetes & Metabolic Syndrome 11, no. S2 (2017): S925–S928.
10.1016/j.dsx.2017.07.017
PubMed Google Scholar
40S. Majidi, M. W. Reid, J. Fogel, et al., “Psychosocial Outcomes in Young Adolescents With Type 1 Diabetes Participating in Shared Medical Appointments,” Pediatric Diabetes 22, no. 5 (2021): 787–795.
10.1111/pedi.13212
PubMed Web of Science® Google Scholar

Volume17, Issue6

June 2025

e70112

The Effectiveness of Psychological Interventions for Families of Children With Type 1 Diabetes on Caregiver and Child Functioning: A Systematic Review and Meta-Analysis

ABSTRACT

Background

Methods

Results

Conclusions

Conflicts of Interest

Open Research

Data Availability Statement

Supporting Information

References

Figures

References

Information

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The Effectiveness of Psychological Interventions for Families of Children With Type 1 Diabetes on Caregiver and Child Functioning: A Systematic Review and Meta-Analysis

ABSTRACT

Background

Methods

Results

Conclusions

Conflicts of Interest

Open Research

Data Availability Statement

Supporting Information

References

Figures

References

Related

Information