7.1.4 Nonpharmacologic Methods (Children)
Although little research has focused on the use of cognitive-behavioral methods
for children with cancer, they have a potentially important role in relieving
pain, and the methods used by adults can be adapted for children. For example,
distraction techniques might involve reading or telling a favorite story,
talking about the story's characters, or playing video games. Preparation for
painful events could involve the use of a puppet, a favorite cartoon character,
or an animal. Stuffed animals with inserted audiotapes of stories or music may
help to induce a state of relaxation. Something familiar to the child may
facilitate participation in these nonpharmacologic strategies.
When a child is in pain, the presence of a parent is usually helpful. Other
methods of psychological support include holding someone's hand, a stuffed toy,
or favorite blanket; asking questions;- using distraction; sleeping and
resting; relaxing or using imagery; changing positions; and engaging in humor;
these seemingly simple interventions can have powerful effects. Facilitating
the child's usual strategies for decreasing pain is important. Although not
well researched in child populations, measures such as physical therapy, TENS
(Eland, 1989), splinting a painful extremity, positioning, the application of
heat or ice, and massage may help relieve pain (see Chapter 4).
Physical Modalities
Counterstimulation
Relaxation and Imagery
Distraction and Reframing
Psychotherapy and Structured Support
Hypnosis
Peer Support Groups
Pastoral Counseling
Index