If you've been diagnosed with type 1 or type 2 diabetes, you know the scenario. Besides dealing with the ''basics" of managing blood sugar, your diet and your exercise, you have to deal with the stress of it all. Diabetes brings an increased risk of anxiety, depression and eating disorders.1
So it’s understandable that sometimes, well, you just need someone to talk to—someone who gets all this.
If you need a pro to listen and help, your search for a therapist who is in-the-know has just gotten easier, thanks to a training initiative called the Mental Health Provider Diabetes Education Program. Launched in 2017 by the American Diabetes Association (ADA) and the American Psychological Association (APA), it now has more than 100 providers listed in the directory, including those who underwent the training and some with extensive experience who were ''grandfathered" in. Additional training is scheduled for this year.
Some therapists listed in the directory provide in-office counseling, while others do telephone counseling.1 Some provide adult services, others provide children's and some offer both. Click here to search the Mental Health Provider Referral Directory.1
To maintain their listing, therapists need to keep up their membership in the ADA, which is a minimum of $75 a year. While the co-sponsor is the American Psychological Association, all mental health professionals, not only psychologists, may participate in the program.
Susan Guzman, PhD, director of clinical education at the Behavioral Diabetes Institute in San Diego, an educational nonprofit organization, applauds the new program. She is a therapist who has worked with patients with diabetes for 20 years. With all that experience, she was ''grandfathered'' into the directory.
If a patient goes to a therapist who is not knowledgeable about diabetes, Dr. Guzman says, he or she may make a well-meaning suggestion, but miss the mark. For instance, a therapist may tell patients it's important to drink water—which it is for those with diabetes and everyone else—but for those with diabetes, she says, multiple other suggestions would be even more helpful.
Much of her work helping patients with diabetes, she says, is helping them change their lifestyle. "I think of myself as a behavior change expert," she says. And changing behavior, for those with diabetes, often translates to better blood sugar control and better overall health
The program is ''very, very important," says Caroline Apovian, MD, FACP, FACN, professor of medicine and pediatrics, Boston University School of Medicine and director of the Center for Nutrition and Weight Management, Boston Medical Center. She is a member of the OnTrackDiabetes editorial board.
The directory will help both people dealing with diabetes and the doctors who are looking to refer them for mental health help, Dr. Apovian says. "If the mental health provider is listed [in the directory as being trained], it is a big relief for patients and providers to refer." Otherwise, she says, neither doctors nor patients know who has expertise in diabetes management and who does not.
The ADA and the APA, respectively, offer the in-person component of the training, a 7-hour course, at their annual conventions. Following that, there is a 5-hour online course discussing common issues faced by those with diabetes and management strategies and a knowledge exam. Providers who have been treating people with diabetes for at least two years are accepted into the program if they can demonstrate competence addressing the mental health needs of those with diabetes. The program is supported by a $1 million grant from the Leona M. and Harry B. Helmsley Charitable Trust.1
The program is a logical first step after the ADA issued its first position statement on psychosocial care for people with diabetes in 2016. In that, it notes that those with diabetes often face anxiety, food issues, financial hurdles in securing their care and other problems--and that the challenges need attention and support from professionals who understand those issues.2
The ADA recommends your doctor routinely screen for these issues and refer you when needed to a mental health provider with experience in diabetes.2
If your area does not yet have a therapist trained in the program, you may be able to find someone who can offer telephone counseling. Be aware, however, that states have different laws on providing telemedicine, Dr. Guzman warns.
If you can't find a therapist who offers either in-person or telephone help from the directory, you can ask for a referral from your physician. If he or she is not knowledgeable, a diabetes educator is often another good source of information, Dr. Guzman says.
You can also simply ask potential therapists if they have experience helping people manage the psychosocial aspects of diabetes.
Dr. Apovian has no relevant disclosures. Dr. Guzman has no relevant disclosures.