Therapy for Adults Living with or Caring for Someone with Type 1 Diabetes

Dialectical Behavior Therapy (DBT), originally developed by Marsha Linehan for borderline personality disorder, has been increasingly adapted for chronic illness management, including Type 1 Diabetes. It focuses on helping individuals manage intense emotions, improve distress tolerance, and develop healthier coping behaviours—all of which are relevant in living with Type 1 Diabetes.

The main aim of DBT is to help you foster a meaningful and fulfilling life. DBT encompasses mindfulness, distress tolerance (acceptance-oriented skills), emotion regulation, and interpersonal effectiveness (change-orientated skills) that can be applied to everyday life.

Schema Therapy is used to treat chronic issues, such as longstanding depression and anxiety, emotion regulation difficulties, interpersonal problems, and trauma. Schema therapy addresses underlying emotional schemas that may contribute to unhelpful behaviours and distress.

Schema Therapy aims to improve people’s ability to cope with difficult feelings and to develop more adaptive ways of coping.

People who may benefit include individuals with chronic struggles in diabetes self-care; those with co-occurring depression, anxiety, or trauma; people experiencing diabetes distress or burnout, and those whose emotional patterns interfere with healthy Type 1 Diabetes management.

ACT uses evidence-based techniques of acceptance, mindfulness, and self-compassion to help people develop psychological flexibility to build a meaningful and fulfilling life.

ACT emphasises psychological flexibility, acceptance of difficult experiences, and values-based action — making it well-suited for supporting individuals with Type 1 Diabetes, a condition requiring lifelong self-management and emotional resilience.

ACT can help people shift from control and avoidance (e.g., trying to “fight” the disease or avoid dealing with it) to acceptance and committed action aligned with their values.

Cognitive Behavioural Therapy (CBT) aims to improve psychological and behavioural outcomes in people with chronic illnesses — including Type 1 Diabetes.

CBT focuses on the relationship between a person’s thoughts (cognitions), emotions, and behaviours. It aims to help individuals identify and change unhelpful thinking patterns and behaviours that contribute to psychological distress and increase self-awareness.

CBT addresses diabetes distress, depression, anxiety, and problematic health behaviours that interfere with diabetes self-care.

CBT-E is a transdiagnostic approach, which addresses the underlying mechanisms that maintain various types of eating disorders (especially bulimia, anorexia, and atypical cases) and eating disorder symptoms — many of which are also relevant for individuals with Type 1 Diabetes who struggle with disordered eating or diabetes-related emotional challenges.

The goals of CBT-E include reducing disordered eating patterns (cognitions and behaviours), normalising eating, and improving body image.

Emotionally Focused Therapy is a short-term form of therapy that focuses on adult relationships. It is an attachment-based therapy that focuses on improving emotional awareness, emotional regulation, and relationship dynamics.

While it was originally developed for couples therapy, EFT has since been adapted for individuals — making it a useful framework for supporting people with Type 1 Diabetes, especially in the context of emotional distress, family conflict, and partner relationships.

It focuses on understanding and increasing awareness of patterns in the relationship, helping people to take steps to create a more secure attachment. This approach helps people who are struggling with anger, fear, and loss of trust in their relationship.