Taught 4 preschool leukemia patients (ages 3-5) to engage in specific coping behaviors before and during painful intramuscular and intravenous injections. Parents were taught to coach their children in the use of the coping behaviors. Intervention was delivered in a multiple baseline across-subjects design. Parent and child behavior was coded using the Child-Adult Medical Procedure Interaction Scale-Revised (CAMPIS-R, Blount, Powers, & Sturges) and Observation Scale of Behavioral Distress (OSBD, Elliott, Jay, Woody). Parents and nurses rated child behavior as well. Results indicated that parents learned coping-promoting behaviors, children learned specific coping behaviors, and children displayed less behavioral distress. Maintenance of behavior change was addressed. Contributions of this study to the current literature on children's coping with invasive medical procedures and implications for future research and clinical practice are discussed.