most effective when employed to cope with stressors over which the child has control, whereas secondary control strategies, strategies involving the child modifying emotional and behavioral reactions to the stressor, are most effective with uncontrollable stressors. Interventions to facilitate child and family coping often begin with providing basic information and education about their illness and treatment procedures, often using videotaped or in vivo models to demonstrate the use of positive coping strategies and teach mastery skills. Other coping interventions include cognitive-behavioral and strength-building interventions, operant reward programs, integrating parent participation, evaluation and mobilization of family and social supports, assisting patient and family in understanding and navigating the medical system, directive and expressive medical play therapy, pain and anxiety management skills training, sensitizing medical staff to patient needs and perceptions, and psychopharmacological interventions. Compliance (Adherence) Adherence to medical treatment regimens is a major pediatric health concern, with estimates on nonadherence as high as 50% or higher. Children's adherence to their medical regimens is heavily influenced by developmental, as well as family factors. Medical management of chronic and serious pediatric illness often requires stressful role relationship changes within the family that require redistribution of time and redefinition of responsibilities. The impact of these changes can be far reaching, affecting such factors as marital satisfaction and parent adjustment. Nonadherance to prescribed medical regimens can be the result of variety of factors including lack of education and training in the regimen, difficulty in understanding the procedures, fearfulness and anxiety, interference of the treatment with normal activities, and parent or child dynamics, among others. Nonadherence or poor adherence to medical regimens may adversely affect the health of the pediatric patient, resulting in hospitalization to address disease processes and adherence issues. Nonadherence issues include failure to administer medications as prescribed, failure to follow dietary guidelines, defiance of physical activity restrictions, and uncooperativeness with medical procedures. Several methods might be employed the help patients and their families monitor adherence, including direct observations of the patient's behavior; assays of blood, urine, or saliva; self-report, health care provider ratings, pill counts, and a variety of monitoring devices, for example, blood glucose meters. Interventions that can be sued to facilitate patient and family adherence in the inpatient pediatric setting include providing information and education, teaching mastery skills, behavioral management contracting, removing barriers, monitoring and charting performance of medical treatment components, addressing family or health care system dynamics, normalizing or reframing