Telemedicine-Delivered Unified Protocol for Cognitive Behavioral Therapy for Anxiety and Depression

This project will evaluate a telemedicine-delivered, Unified Protocol for Cognitive-Behavioral Therapy (UP-CBT) enhanced with continuous glucose monitor (CGM) review to target anxiety and depressive symptoms and glycemic control in young adults with type 1 diabetes.

Inclusion Criteria:Type 1 diabetes (T1D) duration ≥ 6 months18-35 years oldHbA1c = 7.5-14%English- or Spanish-speakingAnxiety or depressive mood disorder as per structured diagnostic interview.Exclusion Criteria:Developmental or sensory disability interfering with participationCurrent pregnancyBipolar disorders, psychotic disorders, severe eating disorders, severe substance abuse disorders, or acute suicidal risk or self-harmUse of medications or recent medical procedures that would impact glycemic control or use of continuous glucose monitoring (CGM) over the studyReceived cognitive behavioral therapy (CBT) in last year or plans to initiate CBT; (6) temporary exclusion for recent initiation of psychotropic medication - must be on a stable dose for 6 weeks prior to enrollment.