Pediatric diabetes is linked with adverse medical outcomes, the risks of which increase with poor or intermittent adherence (Diabetes Control and Complications Trial Research Group, 1994). Further, during adolescence, diabetes management tends to deteriorate (Anderson & Laffel, 1996; Bryden et al., 2001; Insabella, Grey, Knafl, & Tamborlane, 2007; La Greca, Follansbee, & Skyler, 1990). This paper proposes that cognitive fusion and experiential avoidance negatively influence diabetes management behaviors in adolescents. To date, no published interventions address these psychological processes in this patient group. Acceptance and Commitment Therapy (ACT) is presented as an approach for targeting experiential avoidance and cognitive fusion among adolescents with diabetes.