Brief clinical report: procedural pain and anxiety management with mother and sibling as co-therapists.

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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.

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