The management of children's distress in response to painful medical treatment for burn injuries

The purpose of the current study was to develop an initial assessment of the efficacy of astress-management program designed to reduce the behavioral distress of children undergoing highlypainful medical treatments for their burn injuries. The stress-management program was delivered to 4 male patients, ages 5–12 yr and its effects assessed in a combined multiple-baseline and reversal design. Results indicated that the program was moderately effective at reducing behavioral distress during the burntreatment procedures for 3 of the 4 patients and less effective with the fourth. However, the design also revealed that the presence of a therapist to coach the patient in the use of these techniques was essential and that distress levels rose substantially on days when there was no therapist present. Finally, speculations concerning the factors responsible for the effectiveness of the stress-management program as well as its reduced efficacy with 1 S were discussed.