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Group behavioral treatment of retentive encopresis
L J Stark1, J Owens-Stively, A Spirito
1Brown University Program in Medicine, Providence, Rhode Island.
Insights
Behavioral group treatment effectively improved encopresis in children who did not respond to medical care. This approach combined education, dietary changes, and toileting skills, showing lasting positive results.
Area of Science:
- Pediatric Psychology
- Behavioral Medicine
Background:
- Retentive encopresis often persists despite medical management.
- Behavioral interventions are crucial for children with treatment-resistant encopresis.
Purpose of the Study:
- To evaluate the effectiveness of a behavioral group treatment for children with retentive encopresis.
- To assess the integration of behavioral strategies with ongoing medical care.
Main Methods:
- Eighteen children (4-11 years) and parents participated in 6 group sessions.
- Treatment included education on encopresis, dietary fiber increase, and toileting techniques.
- Parents and children learned to administer enemas and implement behavioral procedures.
Main Results:
- Children showed a 40% increase in fiber intake and a 116% increase in appropriate toileting.
- Soiling accidents decreased by 83% post-treatment.
- Treatment gains were maintained or improved at 6-month follow-up.
Conclusions:
- Behavioral group treatment is a cost-effective intervention for retentive encopresis.
- Integrating psychological and medical approaches enhances pediatric care outcomes.
- This intervention offers a successful alternative for children with encopresis refractory to medical treatment.
Abstract:
Investigated the efficacy of behavioral group treatment for children with retentive encopresis who had previously failed medical management. Eighteen children between the ages of 4 and 11 years and their parents were seen in small treatment groups of 3 to 5 families over 6 sessions. The sessions focused on education about retentive encopresis, and the integration of behavioral parenting procedures with medical management. Parents and children were taught to deliver an enema clean-out, increase the children's dietary fiber, and appropriate toileting techniques. The results indicated that children significantly increased their fiber consumption by 40%, increased appropriate toileting by 116%, and decreased their soiling accidents by 83% pre- to posttreatment. Further, these treatment gains maintained or improved at the 6-month follow-up. The results are discussed in terms of cost-effective interventions and the interface between psychology and medicine in pediatric psychology.