There is growing evidence that psychosocial programs are effective for people with chronic disease in general and diabetes in particular. As documented by Mazzuca in a meta-analysis, a large range of health status changes can be expected. The mean effect size of these changes is approximately .3.27 Programs have been shown to lower blood pressure;28-30 reduce mortality from hypertension,31 melanoma,32 from hematologic malignancies,33 and from breast cancer;34 and, for people with diabetes, increased health-related quality of life and metabolic control.26, 35-43