Making the system work. Training pediatric oncology patients to cope and their parents to coach them during BMA/LP procedures.

Three 4- to 7-year-old pediatric oncology patients were taught to engage in distraction prior to painful bone marrow aspirations and lumbar puncture procedures and to use party blowers as a breathing technique during the painful procedures. Parents were taught to coach their children to use these coping behaviors. Using a multiple baseline across subjects design, results indicated that all of the parents increased their rate of coaching. Each child responded with increased coping and decreased observable distress after the first treatment session. One child returned to baseline levels of coping and distress on the next two sessions. The other two children maintained their high rates of coping and low rates of observable distress during the remaining treatment and during the maintenance sessions. Parents' coaching of their children to use coping behaviors also remained high during maintenance sessions.