Graduation Year


Document Type


Degree Type


Degree Name

Doctor in Psychology (Psy. D.)


Procedural anxiety is a broad concept that encompasses fear, distress, and pain. Anxiety is the most critical factor affecting pain perception. There is a growing body of literature suggesting that early pain might have long-term consequences. There is also research evidence that has linked inadequately managed pain in the pediatric population to negative behavioral and physiological consequences later in life. Pediatric patients with inflammatory bowel disease (IBD) refers to Crohn’s disease and Ulcerative Colitis. These chronic conditions often require multiple and repeated medical procedures that may cause pediatric patients to experience procedural anxiety. Needle related procedures are any procedures involving the use of needles for medical purposes such as immunization, venipuncture, IV insertions, intramuscular, or subcutaneous injections. The literature and relevant theories are discussed. A proposed training protocol for nursing staff in an infusion center is presented and this author created resource handouts for nurses, parents, and caregivers. A social narrative written by this author is presented. Also included are distraction card easel prototypes developed by this author to be used as a distraction technique to reduce procedural anxiety. An illustrative case study is presented to show the application of psychological interventions in reducing procedural anxiety. The future utility of the protocol, adapting to individual differences, and future directions are discussed.

Keywords: Procedural anxiety, pediatric, Inflammatory Bowel Disease (IBD), social narrative, distraction, needle related procedures, comfort positions, procedural support.

Faculty Mentor

Theresa Botts, Ph.D.

Department Affiliation


Committee Member

Dustin Wygant, Ph.D.

Department Affiliation


Committee Member

Michael McClellan, Ph.D.

Department Affiliation


Included in

Psychology Commons