Acceptance or challenge?

Diabetes can have a significant impact on many areas of life. As a result, people with diabetes frequently experience stress, feelings of sadness and loss of pleasure. These depressive symptoms may again have a negative impact on health and diabetes self-care. Therefore, it is important to identify effective treatments. Psychological treatments such as Mindfulness-Based Cognitive Therapy (MBCT) and Cognitive Behaviour Therapy (CBT) are promising. MBCT is usually given in a group, although not everyone likes to share thoughts and feelings in a group of strangers. Little is known about the acceptance and effectiveness of an individual type of MBCT.

This thesis investigated whether individual MBCT and individual CBT are helpful for diabetic patients with depressive symptoms and also for whom which treatment works best. We have found that most people were very satisfied with the individual training. In addition, the results showed that both MBCT and CBT were effective in reducing depressive symptoms, anxiety and diabetes-related distress, and in improving well-being, in the short and long term. Both interventions are effective for a broad population. Only people who have already had psychological treatment, or experienced high levels of diabetes-related distress, were less likely to benefit from the treatments. In addition, people with lower levels of education and those with an anxious attachment style, thus people who are afraid of rejection in relationships, benefit more from CBT than MBCT. To sum up, both individual MBCT and CBT work well for people with diabetes who suffer from depressive symptoms.