Psychological interventions for needle-related procedural pain and distress in children and adolescents

Cochrane review of 59 RCTs (n=5,550). Distraction (videos, toys, virtual reality) and hypnosis showed the strongest, most replicable evidence for reducing self-reported pain and distress in needle procedures. CBT also effective but more resource-intensive. Effects moderate in magnitude (SMD ~-0.5 to -1.0). Authors emphasise that intervention should be the standard of care, not optional.