Group behavioral treatment of retentive encopresis.

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.