This Workshop will appeal to nursing, medical and allied health professionals who wish to develop their knowledge and skills in managing pain; especially procedural pain in children and adolescents.  It extends the ‘Distraction and Pain’ workshop by including skills in guided imagery.  As with the Distraction and Pain workshop the ACT (Acceptance and Commitment Therapy) framework takes pain management in a new direction with emphasis on developing psychological flexibility.


The Workshop is not a series of lectures, it is interactive with an emphasis on engagement, discussion, participation and practice especially in the afternoon sessions.

There are a number of approaches to guided imagery including audio tapes and scripts that have been used for many years in managing pain (Broome, Lillis, McGahee, & Bates, 1992; Bullock, & Shaddy, 1993; Weydert, Shapiro, Acra, Monheim, Chambers, Ball, 2006.  The approach in this workshop is on spontaneous and imaginative storytelling as the child’s the imagery unfolds (Whitaker 1994; 2003; Zahourek, 1988).  It is child-centred (including the choice of imagery) and relies on two-way communication and interaction between the person guiding, the child and the imagery.

The morning sessions of this workshop will deepen your understanding of the psychology and neurophysiology of pain and fear.  You will be introduced to the principles of Personal Construct Psychology (PCP) and Acceptance and Commitment Therapy (ACT) in relation to pain. Practice skills in this workshop include: Focused Breathing, Relaxation with Mindful Distraction and Guided Imagery; these interventions can be combined with pharmacological approaches to managing pain.  The afternoon sessions focus on guided imagery with theory, demonstration, videos of actual cases and practice.  The workshop integrates the following theoretical and practical components.

The theoretical component focuses on:  

  • Shifting from the bottom-up sensory appraisal view to a top-down constructivist view of pain;
  • Defining pain as an alarming sensory and cognitive experience encompassing memory, emotion, attention, language, learning, thought and consciousness and the relevance of each of these in pain assessment and management;
  • Emotions, particularly waves of fear and feelings of threat and strategies for reducing their impact on pain; 
  • A combined PCP and ACT approach to working with pain in children and adolescents.

The practical component focuses on: 

  • Practice in mindfulness techniques,  focused breathing and relaxation - individually and with a colleague.
  • Engaging in Guided Imagery both as the person in the imagery and guiding a colleague through a guided imagery session.
  • Putting skills into practice in a multidisciplinary approach to managing pain in children and adolescents 
  • Advice on how to approach the notion of using these techniques with children and parents.
  • Ways of maximizing the efficacy of these techniques.
  • What to do if a child is distressed and losing control.


08.00 – 10.00     Introduction to pain neurophysiology, cognitive theory and emotions in health                                 care: Why pain is more than nociception.

Two psychologies in pain management and change: Personal Construct Psychology (PCP) and Acceptance and Commitment Therapy (ACT).

10.00 – 10.20    Tea Break

10.20 – 12.00    Distraction, relaxation and mindfulness: techniques for pain, fear and anxiety in                                 children and adolescents.                                             

12.00 – 13.00    Lunch

13.00 – 15.00     Guided Imagery Technique: theory, practice and demonstration.

Guided Imagery Cases: review and discussion of videos.

15.00 – 15.20    Tea Break

15.20 – 17.00    Small group practice in guided imagery.  Group discussion and feedback: preparing                           for clinical practice.                                 


Broome, M. E., Lillis, P. P., McGahee, T. W., & Bates, T. (1992). The use of distraction and imagery with children during painful procedures. Oncology Nursing Forum, 19(3), 499-502.

Bullock, E. A., & Shaddy, R. E. (1993). Relaxation and imagery techniques without sedation during right endomyocardial biopsy in pediatric heart transplant patients. Journal of Heart and Lung Transplantation, 12(1), 59-62.

Caputi, P., Foster, H. & Viney, L. (2008). Personal construct psychology: New Ideas.  New York: Wiley.

Hayes, S.C., Strosahl, K.D. & Wilson, K.G. (2011).  Acceptance and commitment therapy: the process and practice of mindful change. (2nd ed.).  New York: Guildford.

Kelly G.A. (1955).  Psychology of personal constructs.  New York: Wiley.

Kuttner, L. (1998) No fears no tears, 13 years later the long-term benefits of children's pain management [DVD].  Boston: Fanlight.

Weydert, J., Shapiro, D.. Acra, S., Monheim, C., Chambers, A., Ball, T.  (2006).  Evaluation of guided imagery as treatment for recurrent abdominal pain in children: a randomized controlled trial.  BMC Pediatrics, 6 (29). 6-29

Whitaker, B.H.  (1994).  Helping children through painful procedures: relaxation therapy with guided imagery; an adjuvant nursing intervention.  Masters thesis La Trobe University Melbourne, Australia.

Whitaker, B.H.  (2003).  The effects of distraction, relaxation and guided imagery on procedural fear and pain in children.  PhD thesis University of Ballarat, Victoria, Australia.

Zahourek, R. P. (Ed.). (1988). Relaxation and imagery: Tools for therapeutic communication and intervention. Philadelphia: W.B. Saunders.