Living with a complex, chronic health condition like type 1 diabetes (T1D) is complicated, expensive, and burdensome. Most people live long, happy, healthy, and satisfying lives with T1D, yet there is a large body of evidence that mental health concerns and behavioral challenges are common, and interfere with self-management, quality of life, and health. At the same time, there are not enough professionals who have knowledge of the complex interplays between diabetes and psychosocial factors to meet the needs of the large and growing population of people with T1D, and their families.
To help address this gap, the Type 1 Diabetes Mental Health Workbook was created to provide a concise, practical resource for mental health clinicians and therapists to use in their care of young people with T1D. The workbook is divided into eight sections:
Overview of T1D
Language and communication about T1D
Challenges associated with a new T1D diagnosis
Approaches to addressing T1D self-management challenges
Emotions associated with T1D
Mood concerns and T1D
T1D-related worries and anxiety
Additional considerations
Chapter 3: Challenges Associated with a New T1D Diagnosis Available to Purchase
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Published:2023
"Challenges Associated with a New T1D Diagnosis", Type 1 Diabetes Mental Health Workbook: A Practical Resource for Providing Behavioral and Mental Health Support to Young People with Type 1 Diabetes, and Their Families
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A new T1D diagnosis may provoke profound grief in young children, parents, and other family members, leading to feelings of shock, denial, anxiety, sadness, guilt, anger, and frustration. Grief may focus on loss of a formerly healthy status, loss of control, and loss of freedom in daily activities. Often there is dis-belief that T1D is permanent, worry about acute and long-term health complications, and guilt that either the person with T1D or their parents caused T1D through genetics or actions (e.g., food choices). The newly diagnosed individual becomes a person with T1D; parents have a new focus on caring for a child with a lifelong, possibly life-threatening condition. In addition, a new T1D diagnosis necessitates learning and integrating many new health-behavior routines into daily life. An exercise that may help children identify or express feelings about a new diagnosis is to draw their T1D (see the “My T1D” worksheet) or write a letter to T1D (see the “Letter to T1D” worksheet for adolescents). This same exercise may also be helpful for caregivers (see the corresponding caregiver worksheets).
Mental health professionals can offer anticipatory guidance that there may not be a discrete end point to this grief. Symptoms of grief may ebb and flow across time. Grief may resurface when developmental milestones are met and as adolescents transition to young adulthood. Grief may also recur when there are challenges or changes in T1D management such as a T1D-related medical event or hospitalization or learning new technology. Triggers related to the initial T1D diagnosis may include the anniversary of the diagnosis (sometimes referred to as “Diaversary”) or learning about other people’s T1D challenges or the death of a person with T1D. Chronic unresolved grief has the potential to lead to diabetes distress or depressive symptoms. Guiding young children and parents to consider these possibilities around the time of the initial T1D diagnosis may help them anticipate and prepare for possible resurgence of grief. Some people benefit from using positive psychology-based approaches, such as recognizing or “celebrating” annual “Diaversaries” as a chance to reflect on how far they have come since diagnosis (see the “Diaversary party checklist” worksheet).
