MAKING THE SYSTEM WORK - TRAINING PEDIATRIC ONCOLOGY PATIENTS TO COPEAND THEIR PARENTS TO COACH THEM DURING BMA LP PROCEDURES/

Three 4- to 7-year-old pediatric oncology patients were taught to enga ge in distraction prior to painful bone marrow aspirations and lumbar puncture procedures and to use patty blowers as a breathing technique during the painful procedures. Parents were taught to coach their chil dren to use these coping behaviors. Using a multiple baseline across s ubjects design, results indicated that all of the parents increased th eir rate of coaching. Each child responded with increased coping and d ecreased observable distress after the first treatment session. One ch ild returned to baseline levels of coping and distress on the next two sessions. The other two children maintained their high rates of copin g and low rates of observable distress during the remaining treatment and during the maintenance sessions. Parents' coaching of their childr en to use coping behaviors also remained high during maintenance sessi ons.