Diabetes-related psychological distress and avoidance of diabetes self-care behaviour present barriers to achieving optimal glycaemic control. Educational, motivational and technological interventions are important, but for a significant proportion of patients these may not be sufficient for long-term behavioural change. We describe a multi-component behavioural intervention for people living with type 1 diabetes mellitus (T1DM). The program is based on well-established principles of behaviour and previous translational work involving a series of within-subjects experiments undertaken by the first author. Enhanced Self-Care for Diabetes is presented in a small group format of between 6-8 participants consisting of 6 x 2hour sessions, over a 2-month period, and is facilitated by a Clinical Psychologist, Credentialed Diabetes Educator and Dietitian. An overview is provided of how the program selects and reinforces approach behaviours pertinent to the individual, taking into account their learning history, diabetes self-management skills and environment, and reduces avoidance. Participants are taught to self-manage the intervention components in efforts to minimise resurgence of avoidance behaviours. Patients attending a tertiary hospital multidisciplinary diabetes clinic with a diagnosis of T1DM for ≥2years duration, presenting with suboptimal glycaemic control (HbA1c ≥8.5%) and/or diabetes-related psychological distress were invited to participate in the pilot group intervention. Program evaluation measures comprised: (1) frequency of diabetes self-care behaviours, (2) psychological avoidance and activation, (3) diabetes-related distress including measures of problematic eating and hypoglycaemia fear, (4) quality of life, and (5) empowerment; (6) social validity; (7) HbA1c and (8) diabetes-related hospital admissions. We discuss changes within-subjects comparing pre-, baseline, mid- and post-program of up to 12months and share lessons learnt from our recruitment, program delivery and evaluation. We argue for the need to integrate behavioural interventions within mainstream diabetes care, to address issues underlying suboptimal self-care behaviours, thereby increasing opportunities for improved glucose control and preventing complications.