Each year in Iceland, approximately 23 children are hospitalized due to severe burns (Landspitali-University Hospital Database, 2002). Ages range from 3.5 to 16 years. All of these have pain associated with the burn. Severe burns are one of the most painful experiences known to people and well remembered [1]. Minor burns have fewer physiologic consequences than major burns, but may be equally painful during their treatment and healing, such as burn dressing change (BDC) [2]. Limited evidence exists concerning interventions to foster a sense of control and comfort in children undergoing treatment due to burn [3]. Although the key to control burn pain in children remains pharmacological [4], there is a growing recognition that other approaches may not only reduce the discomfort of painful procedures but may enable children to cope better with this difficult experience [5,6]. The limited references found in the literature are becoming dated; however, they are still used in clinical practice world wide. One of these is the Participation Intervention Method for BDC [7–9]. The theoretical basis for this approach is ‘‘learned helplessness’’ proposing that an organism experiences no contingency between behavior, responses and outcome [10]. That is, a person comes to believe that events can neither be predicted nor controlled, and this feeling is most intense when the outcomes are unpleasant and when the situation appears unchangeable. Learned helplessness is characterized by