Psychological distress is often associated with the bone marrow transplantation experience. This study focused on psychological distress for allogeneic and autologous bone marrow transplantation (BMT) patients and factors that relate to distress. The study examined bone marrow transplantation patients across time to determine whether they experienced distress, how the relationship between the physician and patient influences a patients' distress, the potential differences in psychological distress across ethnicity, and the relationships of anxiety and depression to distress. Research data relied on self-report measures. Of the 25 total BMT patients who participated in this study, 4 received allogeneic BMT, 21 received an autologous BMT, 11 (44%) were male and 14 (56%) were female, 17 (68%) BMT patients were Caucasian, five (20%) were Latino/a, two (8%) were African American, and one (4%) was Asian. This study utilized mixed methods by applying both quantitative and qualitative measures and analysis. Quantitative data were analyzed using multivariate repeated measures design, discriminate analysis, correlations, and multiple regression. Qualitative data were analyzed using grounded theory. Quantitative findings indicated that bone marrow transplantation patients experienced psychological distress pre-BMT and post-BMT. There was no significant finding between the physician-patient relationship. Additionally, the small sample size prevented the exploration of ethnicity and distress. Finally, anxiety was a significant predictor of psychological distress. In terms of the qualitative analysis, these finding revealed the importance of physician trust, spirituality, and informational needs for allogeneic and autologous BMT patients. The results have implications for the care of cancer patients undergoing bone marrow transplantation. This study has direct clinical implications, as it will aid physicians, psychologists, and other medical staff to understand the unique needs of BMT patients within a hospital setting.