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Qualitative Health Research
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*Diabetes Type 1
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Identity and Adherence in a Diabetes Patient: Transformations in Psychotherapy

Barbara Tilden

Denise Charman

Victoria University of Technology, Melbourne, Australia

Jenny Sharples

Victoria University of Technology, Melbourne, Australia

Jackie Fosbury

St.Thomas’ Hospital, London

The authors present the case study of a 26-year-old woman who developed diabetes in early adolescence and who attended seven CAT sessions. They used phenomenology to analyze therapy transcripts, case notes, and a reflexive journal and extract the major themes. The client’s identity had been overshadowed by the development of a "diabetic identity" that the client rejected. Poor adherence was linked to the rejection. Motivation to manage her diabetes changed during the CAT sessions once her identity was confirmed as being separate from her diabetes. The client was then able to integrate diabetes into her life. Psychological and psychosocial factors are linked in complex ways, in both the personal development of adolescents with diabetes and their transition to adulthood. Understanding the impact of diabetes on identity can enhance the effectiveness of therapeutic interventions with nonadhering clients.

Key Words: diabetes • psychotherapy • identity • type 1 • qualitative methods • phenomenology

Qualitative Health Research, Vol. 15, No. 3, 312-324 (2005)
DOI: 10.1177/1049732304272965
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