The Effectiveness of Third-Wave Therapies and the Role of Psychological Flexibility in Adults with Diabetes

Literature review: The daily pressures of living with diabetes results in many adults experiencing psychological distress and struggling to manage their condition. This review examined whether “third‑wave” psychological therapies can improve mental health and glycaemic control in adults with diabetes.

Sixty-two studies involving over 3,800 participants were included. Overall, third-wave therapies appeared to improve diabetes-related distress, depression, anxiety, stress, and glycaemic control, with many benefits maintained after treatment had ended. Adults with type 2 diabetes appeared to gain the most benefit, but no clear pattern emerged for the most effective third-wave intervention. However, the quality of evidence for psychological outcomes varied considerably, limiting confidence in these findings. Overall, the review suggests third-wave therapies may offer meaningful benefits for adults with type 2 diabetes, particularly for glycaemic control, but higher-quality research is still needed.

Empirical study: Many adults with type 1 diabetes experience emotional difficulties related to managing the condition, but it is unclear which psychological factors best support wellbeing. This study explored whether specific psychological flexibility processes – a person’s ability to accept difficult thoughts and feelings while still acting in line with their values – were linked to emotional wellbeing and glycaemic control.

Participants completed questionnaires of diabetes distress, depression, and anxiety, and provided information about their glycaemic control. They also completed a measure assessing three psychological flexibility processes. Openness to difficult thoughts and feelings was most strongly linked to lower diabetes distress, depression, and anxiety. Glycaemic control was also partly related to overall psychological flexibility, but not to any specific process.
These findings suggest that learning to respond more openly and flexibly to diabetes-related thoughts and feelings may be particularly important for emotional wellbeing in adults with type 1 diabetes, who therefore may benefit from psychological interventions that target specific psychological flexibility processes.