title: Brief clinical report: procedural pain and anxiety management with mother and sibling as co-therapists.
abstract: OBJECTIVE
  To describe a multidimensional family-focused intervention for pain and anxiety management during port-access with a Spanish-speaking preschool child being treated for acute lymphoblastic leukemia, using the patient's mother and one sibling as co-therapists.
  
  
  METHODS
  Assessment procedures included interviews with mother, sibling, and primary nurse and behavioral observations during port-access, and during a medical examination. Intervention consisted of two training and two "in-vivo" sessions, using behavioral and cognitive behavioral techniques.
  
  
  RESULTS
  Physical resistance was eliminated and anxiety responses reduced during port-access sessions. Maternal anxiety and sibling distress were also reduced.
  
  
  CONCLUSIONS
  This case study illustrates an empirically supported child and family focused in the clinical care context and highlights cultural factors that may influence the success of such interventions.
authors.affiliation: Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada. barrera@sickkids.on.ca
authors.forename: M
authors.initials: M
authors.lastname: Barrera
mesh_terms: D001007:Anxiety / Q000209:etiology* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005192:Family Health; D005260:Female; D006801:Humans; D008297:Male; D008425:Maternal Behavior; D009034:Mother-Child Relations; D010146:Pain / Q000523:psychology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D012801:Sibling Relations