Facilitating the psychosocial adjustment of the child with cancer begins at the time of diagnosis. This paper reviews the current status of psychosocial research and interventions useful during the acute phase of cancer treatment. Factors related to a favorable adaptation include the child's understanding of what is happening and the ability of the family to provide emotional support. Recent data suggest that a child's adjustment is closely linked to the social supports available to the parents and to parental distress levels. Continued progress has been made in the use of psychological techniques to control the behavioral side effects of chemotherapy and children's distress levels during painful medical procedures. New research has also identified a number of factors related to treatment refusal and noncompliance among adolescent cancer patients. These new developments provide a basis for programs aimed at preventing or reducing the psychosocial problems of the child and family facing pediatric cancer.