Evidence-Based Therapies for Enuresis and Encopresis

Among the most common, persistent, and stressful presenting complaints in primary medical care for children are two disorders involving developmentally inappropriate elimination of waste–enuresis (urine) and encopresis (feces). The author emphasizes that, although evaluation and treatment of these conditions absolutely requires the direct involvement of a physician, ideal management involves a partnership between the physician, therapist, and family. This united, empirically supported, biobehavioral approach can alleviate incontinence and eliminate or at least minimize the possibility of the damaging overinterpretation and dangerous forms of treatment that blemished the approach to enuresis and encopresis from antiquity throughout large portions of the twentieth century. Enuresis and encopresis are among the most treatable of all child behavior problems. The most effective treatments for enuresis and encopresis are multicomponent and effortful and therefore motivation to participate in treatment, by parents and children, is a significant concern. The chapter outlines the essential components of successful treatments following the evidence-base in the professional literature.