Behavioral interventions for pediatric patients' acute pain and anxiety: Improving health regimen compliance and outcome

Three boys (ages 10 to 14 years) with chronic illnesses were referred to a pediatric psychology consultation service for behavioral assessment and intervention. Each case illustrates medical noncompliance as a complex set of child and caregiver behaviors with multiple environmental determinants. The following procedures are highlighted for each case: (a) operational definition of behavioral criteria for compliance; (b) identification of child, family, and environmental variables maintaining behaviors that prevent compliance; and (c) design and implementation of interventions to modify antecedents and contingencies in the physical and social environment. Effective techniques for shaping new child and family skills or strengthening infrequently performed health-enhancing behaviors are discussed.