2. Provide new strategies, tools, and skills to introduce ACP to children and their families. 3. Discuss the impact of effective ACP on grief and bereavement for families of children who have died. ACP is a process that integrates clinical and nonclinical preferences into a person’s plan of care for life-threatening illness. Despite evidence of improved satisfaction with care and decreased emotional distress for patients and families, only a minority of patients participate in ACP. Numerous individual, system, and societal barriers exist to the ACP process, including strong emotions often engendered by ACP discussions, societal and cultural stigmas against acknowledging end of life, cultural norms for family decision making, clinician time constraints, and insufficient clinician training for conducting ACP discussions. For pediatric patients, the process is further complicated by concerns regarding the child’s stage of cognitive and emotional development, the perceived additional emotional burden regarding discussions of serious medical illness and death, and the dynamics of triangulated communication among parents, children, and clinicians. Lack of successful ACP not only impacts the child’s clinical outcome and associated family distress, but has implications for survivors’ grief and bereavement. Incorporating data from focused literature reviews with case-based material, this interactive session will target three essential Objectives. First, Donna Zhukovsky, a medical oncologist and palliative care physician, will provide data regarding the ability and willingness of children to participate in ACP and will highlight tools and strategies that support the ACP process and communicate preferences. Next, Rhonda Robert, a child psychologist with extensive experience in the oncology and burn settings, will discuss methods to introduce the topic of ACP as well as useful language and strategies for successfully negotiating these conversations. Third, Marcia Levetown, a pediatric intensivist and palliative care physician, will review literature regarding family bereavement as it pertains to ACP and the outcomes of post-bereavement follow up with the child’s clinicians. These Objectives will enable clinicians to better support pediatric patients and their families during the care trajectory of serious medical illness. Understanding Interventional Pain Management: A Guide to Techniques and Applications for the Terminally Ill Patient With Severe Pain (SA523) Charles Harrison, MD, Evercare Hospice & Palliative Care, Elkridge, MD. (Harrison had no relevant financial relationships to disclose.)