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Clinical Pediatrics, Vol. 45, No. 2, 157-164 (2006)
DOI: 10.1177/000992280604500207

Treatment of Encopresis and Chronic Constipation in Young Children: Clinical Results from Interactive Parent-Child Guidance

Helen Reid, LCSW

Early Childhood Center, Cedars Sinai Medical Center, UCLA Geffen School of Medicine, Los Angeles, CA.

Ron J. Bahar, MD

Division of Pediatric Gastroenterology, UCLA Geffen School of Medicine, Los Angeles, CA.

To describe the source of and treatment for encopresis in a series of 40 children under age 9 years. Referral for psychological based treatment followed upon limited success of standard gastroenterologic intervention. The treatment provided is defined as interactive parent-child family guidance. This includes a variety of specific psychologically based recommendations offered to parents, and, when indicated, direct interventions with the symptomatic child. These are different from various forms of behavioral corrective reward-punishment interventions frequently recommended for young children with encopresis. The pediatric and the psychological literature offer few reports of successful treatment of young children with this syndrome. Also, there are few specific descriptions of psychologically based interventions. The results reported here are of the successful treatment of 38 of 40 cases referred specifically for psychologically based intervention following the prior limited success of standard gastroenterologic treatment. The interactive parent-child family guidance intervention described in this report, differentiated from typical behavior therapies, is a notably successful mode of psychologically based therapy for these children. It offers an important alternative to standard pediatric gastroenterological treatment for encopresis, as well as to reward-punishment oriented behavioral therapies.


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