Friday, March 7, 2008

A case study using child-centered play therapy approach to treat enuresis and encopresis

Cuddy-Casey, M. (1997). A case study using child-centered play therapy approach to treat enuresis and encopresis. ELEMENTARY SCHOOL GUIDANCE AND COUNSELLING. 31 (3), 220-225.

Enuresis (bedwetting) and encopresis (bed-defecation) may come from one or more of the following causes: medical-genetic disorders, emotional disturbances, and failure to learn. Depending on the main cause, different treatments are used. Physicians are usually called to deal with the organic problems underlying medical-genetic disorders, while behavioral techniques are used to treat problems stemming from a failure to learn. However, problems rooted in emotional disturbances are commonly lumped into the "failure to learn" category and treated thusly. This article argues for an alternative treatment (i.e. non-directive play therapy) to be used in response enuresis and encopresis rooted in emotional disturbances.

A case example is provided in which an 8-year old male with enuresis and encopresis is treated with play therapy after medical-genetic disorders and failure-to-learn are ruled out. In these sessions, the child began to exhibit aggressive behavior and admitted to wanting to destroy the playroom's pictures and wall clock, which he believed to have cameras hidden behind them. After this admission was received with the permissiveness and acceptance that are the hallmarks of non-directive therapy, the child also admitted that he did not use public restrooms because of this fear of hidden cameras. He spent the next few sessions searching the playroom for cameras and, upon not finding any, began to have less and less problems with enuresis/encopresis.

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