Invasive procedures such as vaccinations, injections, phlebotomy, and venipuncture cause significant pain, anxiety, and fear in children (Aarts et al., 2023; Canbulat Şahiner & Türkmen, 2019; Hedén et al., 2019). Failure to adequately manage pain and anxiety can lead to several short- and long-term negative outcomes. These include child uncooperativeness, unsuccessful medical procedures, prolonged procedure duration, adverse physiologic reactions, decreased analgesic efficacy in subsequent procedures, and fear of pain that can persist into adulthood (Aarts et al., 2023; Kara & Bal Yılmaz, 2020). Pain management before painful medical procedures in children can reduce negative emotional and social experiences associated with pain, anxiety, fear, and distress. This may contribute to less emotionally complex future medical procedures (Semerci et al., 2023). Pain management includes pharmacologic and non-pharmacologic approaches (Canbulat Şahiner & Türkmen, 2019; Semerci et al., 2023; Taddio et al., 2010). Non-pharmacologic pain relief methods are among the complementary care approaches in pediatric clinics and have a wide range of supportive, physical, and cognitive/behavioral aspects (Kara & Bal Yılmaz, 2020). Storytelling, one of the cognitive/behavioral methods, is a non-pharmacologic method used to reduce pain and anxiety in children (Özel & Çetin, 2020). Storybooks prepared for hospitalization, illness, surgery, or diseases are effective in providing children with information and explaining the concepts of illness and health (Oğuz Güner, 2020).

Stories, along with play and art, have been recognized for therapeutic purposes since the 1980s (Laing et al., 2017). Therapeutic storytelling is an effective communication and intervention method that facilitates understanding and recall of information in children, supports imagination and social behavior, and strengthens the artistic aspect of nursing (Çoban et al., 2025; Ramamurthy et al., 2024). Giving children initial information about their illnesses or procedures through suitable metaphors is important for helping them cooperate during the process (Oğuz Güner, 2020; Ramamurthy et al., 2024). Therapeutic stories are short-term, one-way interventions that contain solution-focused messages, specifically designed to address emotional difficulties experienced by the child, such as anxiety, fear, pain, or stress. The story content explores a theme similar to a child's coping situation and addresses the their inner world, providing modeling, emotional support, and coping strategies. By identifying with the characters, children make sense of their fears and feel safer (Çoban et al., 2025; Sunderland, 2000).

Therapeutic stories have been reported in the international literature to be used in situations such as abuse, adjustment difficulties, aggression, problem-solving, social skills training, anxiety, parental loss, and hospitalization (Oğuz Güner, 2020). Additionally, various studies have examined the effects of storytelling on pain, anxiety, and fear in children during situations such as hospitalization, dressing changes, vaccinations, venipuncture, and phlebotomy (Abd Elmoniem Syan et al., 2021; Çoban et al., 2025; Dewi et al., 2021; Köksal et al., 2025; Mete İzci & Çetinkaya, 2024; Sarah et al., 2023; Sekhavatpour et al., 2019; Valizadeh et al., 2022). However, to our knowledge, no studies in the literature have used therapeutic stories narrated using metaphors specifically tailored to children for intramuscular (IM) injections. This study aimed to determine the effectiveness of therapeutic storytelling in reducing pain, anxiety, and fear associated with IM injections in children aged 6–10 years. The hypotheses of the study were as follows: Therapeutic storytelling significantly would reduce IM injection-related pain (H1), significantly reduce anxiety (H2), and significantly reduce fear (H3).