We investigated the effects of a cognitive-behavioral treatment package on reduction of anticipatory fear of pain during self-administered insulin injections. Two patients diagnosed with insulin-dependent diabetes mellitus participated. An ABAB design was employed; the intervention conditions consisted of cue-controlled breathing, filmed modeling, pacing, and reinforcement. A substantial reduction in the mean time for injection and a reduction in behaviors indicative of anticipatory distress were achieved under intervention conditions. The clinical importance of the study is discussed and areas for future research are identified.
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