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Cognitive Behavioral Therapy for Encopresis

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Handbook of Cognitive Behavioral Therapy for Pediatric Medical Conditions

Part of the book series: Autism and Child Psychopathology Series ((ACPS))

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Abstract

Encopresis or fecal incontinence is a common childhood concern in which a child over the developmental age of 4 years passes stool into an inappropriate place (e.g., underwear or onto the floor). Although this condition can be diagnosed in adulthood, it is often first diagnosed in childhood or early adolescence. Encopresis has both biologic and behavioral components, is often very distressing for the youth and their family, and can cause significant disruption in day-to-day functioning. This chapter addresses biological and behavioral factors and reviews the evidence-based cognitive behavioral interventions for encopresis. The most common biological contributor to fecal soiling is constipation, which should be medically managed at the outset and throughout the course of treatment for this condition. Behavioral contributors such as stool withholding, delayed defecation, and noncompliance with toileting routines may also need to be addressed in order to achieve full symptom remission. Cognitive factors such as incorrect assumptions about the reasons for soiling, learned helplessness, and fear of the toilet or stooling should also be assessed and intervened upon if present. A combined medical and behavioral/psychological treatment approach is recommended.

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Notes

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    All cases, including names, are fictional.

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Author information

Authors and Affiliations

  1. Children’s Mercy Hospital—Kansas City, Kansas City, MO, USA

    Christina M. Low Kapalu & Edward R. Christophersen

  2. University of Missouri Kansas City School of Medicine, Kansas City, MO, USA

    Christina M. Low Kapalu

  3. Children’s Mercy Hospital—Kansas, Overland Park, KS, USA

    Edward R. Christophersen

Authors
  1. Christina M. Low Kapalu
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  2. Edward R. Christophersen
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Correspondence to Christina M. Low Kapalu .

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Editors and Affiliations

  1. Child Emphasis Area, Palo Alto University, Palo Alto, CA, USA

    Robert D. Friedberg

  2. Division of Developmental and Behavioral Pediatrics, Stead Family Department of Pediatrics, University of Iowa Stead Family Children’s Hospital, Iowa City, IA, USA

    Jennifer K. Paternostro

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Low Kapalu, C.M., Christophersen, E.R. (2019). Cognitive Behavioral Therapy for Encopresis. In: Friedberg, R.D., Paternostro, J.K. (eds) Handbook of Cognitive Behavioral Therapy for Pediatric Medical Conditions. Autism and Child Psychopathology Series. Springer, Cham. https://doi.org/10.1007/978-3-030-21683-2_16

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