Individual-level intervention approaches

In caring for persons with diabetes (PWD), healthcare professionals (HCP) have an important role to play when it comes to offering psychosocial support as integral part of ongoing diabetes care. Inquiring about and discussing emotional health with PWD is appreciated by them and can help to identify problem areas that require further assessment. For this purpose practical, validated self-report measures of well-being and diabetes distress are available for use in routine care. Based on a needs assessment, PWD may be offered psychosocial support by one of the team members (physician, nurse educator, dietitian) or a referral to a specialized mental health professional, preferably as part of team care. There is convincing evidence that cognitive behavioral therapy (CBT) is effective in reducing emotional distress and enhancing coping skills in PWD, with subsequent improvements of self-care and glycemic control, at least on the short term. Next to diabetes distress and depression, chronic fatigue has shown to be prevalent among PWD. Here too, CBT has been shown to be effective. Internet-based CBT is increasingly used, which allows for economic and patient-friendly delivery of psychotherapy while reaching a large audience. Further research is warranted to develop effective strategies for successful implementation of integral psychological support for PWD with psychological comorbidity, addressing the medical and the psychological needs of PWD.