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Clinical Case Studies
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Multisystemic Therapy Applied to the Assessment and Treatment of Poorly Controlled Type-1 Diabetes: A Case Study in the U.K. National Health Service

Clarissa Martin

South Staffordshire and Shropshire NHS Foundation Trust

Angela Southall

South Staffordshire and Shropshire NHS Foundation Trust

Katie Liveley

Grantham Hospital, Chronic Fatigue Syndrome/ME Team

Elizabeth Shea

Birmingham Children's Hospital

Karen Whitehead

Staffordshire General Hospital

The objective of this article is to describe the case of a twelve-year-old girl with Type-1 Diabetes, who had a history of hospitalisation due to Diabetes Ketoacidosis (DKA) and had been placed into the child protection register. The report advocates an Understanding of the Social Ecological Model (Bronfenbrenner, 1976) in relation to assessing poor metabolic control, and examines the use of Multisystemic Therapy (MST) in treatment adherence. The assessment explores the beliefs within the child’s systems and subsystems. Formulating from a Systemic Perspective allowed for integrated Cognitive Behavioural Therapy, Family Therapy and Systems Oriented intervention applied to the Microsystems’ beliefs. After treatment and at follow-up the child was removed from the Child Protection register and has remained to date without admission to hospital experiencing DKA. MST has the possibility of offering a new perspective for treatment in complex cases of children with diabetes and severe treatment adherence problems.

Key Words: diabetes • DKA • Multisystemic Therapy • social ecological model • treatment adherence

Clinical Case Studies, Vol. 8, No. 5, 366-382 (2009)
DOI: 10.1177/1534650109345155
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