Cognitive-behavioral interventions for children's distress during bone marrow aspirations and lumbar punctures: a critical review

J Pain Symptom Manage. 1994 Feb;9(2):96-108. doi: 10.1016/0885-3924(94)90162-7.


Children with cancer often have difficulty coping with the invasive medical procedures that are part of diagnosis and treatment. Bone marrow aspirations and lumbar punctures are painful and cause some children severe anxiety and distress. The increased risk and expense of general anesthesia and the relative ineffectiveness of sedatives and anxiolytics has prompted clinicians to examine nonpharmacologic methods for controlling pain and distress. This report critically examines intervention studies that focus on cognitive-behavioral strategies such as distraction, imagery, or hypnosis for reducing procedural distress in children with cancer.

Publication types

  • Review

MeSH terms

  • Analgesia*
  • Biopsy, Needle / adverse effects*
  • Bone Marrow / pathology*
  • Child
  • Child, Preschool
  • Cognitive Behavioral Therapy*
  • Humans
  • Pain / drug therapy*
  • Spinal Puncture / adverse effects*
  • Stress, Psychological / therapy*