DIAGNOSIS: Depression
TREATMENT: Cognitive-Behavioral Therapy for Depression in People with Diabetes

2015 EST Status: Treatment pending re-evaluation Very strong: High-quality evidence that treatment improves symptoms and functional outcomes at post-treatment and follow-up; little risk of harm; requires reasonable amount of resources; effective in non-research settings

Strong: Moderate- to high-quality evidence that treatment improves symptoms OR functional outcomes; not a high risk of harm; reasonable use of resources

Weak: Low or very low-quality evidence that treatment produces clinically meaningful effects on symptoms or functional outcomes; Gains from the treatment may not warrant resources involved

Insufficient Evidence: No meta-analytic study could be identified

Insufficient Evidence: Existing meta-analyses are not of sufficient quality

Treatment pending re-evaluation

1998 EST Status: Strong Research Support Strong: Support from two well-designed studies conducted by independent investigators.

Modest: Support from one well-designed study or several adequately designed studies.

Controversial: Conflicting results, or claims regarding mechanisms are unsupported.

Strength of Research Support

Empirical Review Status
2015 Criteria
(Tolin et al. Recommendation)
Very Strong
Insufficient Evidence
Treatment pending re-evaluation
1998 Criteria
(Chambless et al. EST)

Find a Therapist specializing in Cognitive-Behavioral Therapy for Depression in People with DiabetesList your practice

Brief Summary

  • Basic premise: Diabetes is a group of chronic diseases that requires the patient to make lifestyle changes and regularly engage in many complicated health behaviors in order to prevent the development of medical complications, some of which are life-threatening. People with diabetes are twice as likely to develop depression compared with the general public and commonly experience a condition that often overlaps with depression called “diabetes distress”. Diabetes distress is the emotional distress directly related to the burden of living with diabetes. Psychological factors can affect adherence to the diabetes regimen, which directly affects the physiological well-being and quality of life of a person with diabetes.
  • Essence of therapy: Cognitive-Behavioral Therapy addresses both the psychological and adherence issues that are important to overall well-being in people with diabetes. CBT skills are used to address cognitions and behaviors inherent in depression that affect self-care behaviors necessary to be adherent to the medical regimen. The result is improved self-efficacy for managing diabetes self-care behaviors and acquisition of coping skills for managing both depressive symptoms and self-care behaviors.
  • Length: 10-12 sessions, though the protocol is flexible and can be tailored to patient needs.

Treatment Resources

Editors:Amanda S. Phillips, Ph.D.

Note: The resources provided below are intended to supplement not replace foundational training in mental health treatment and evidence-based practice

Treatment Manuals / Outlines

Treatment Manuals
Books Available for Purchase Through External Sites

Measures, Handouts and Worksheets

Self-help Books

Important Note: The books listed above are based on empirically-supported in-person treatments. They have not necessarily been evaluated empirically either by themselves or in conjunction with in-person treatment. We list them as a resource for clinicians who assign them as an adjunct to conducting in-person treatment.

Video Descriptions

Clinical Trials

Type 2 diabetes

Type 1 diabetes

Mixed Type 1 and Type 2 Diabetes

Meta-analyses and Systematic Reviews

Other Treatment Resources