Dry-bed training: rapid elimination of childhood enuresis

Enuresis has been treated with moderate effectiveness by the urine-alarm method which requires many weeks of training. The present procedure used a urine-alarm apparatus but added such features as training in inhibiting urination, positive reinforcement for correct urinations, training in rapid awakening, increased fluid intake, increased social motivation to be nonenuretic, self-correction of accidents, and practice in toileting. After one all-night training session, the 24 enuretic children averaged only two bedwettings before achieving fourteen consecutive dry nights and had no major relapses. Little or no reduction in bedwetting occurred within the first two weeks for matched-control enuretics who were given the standard urine-alarm training. The results of a control-procedure showed that the new procedure did not involve Pavlovian conditioning. The new method appears to be a more rapid, effective and different type of treatment for enuresis.     

Bladder training and enuresis: A controlled trial

This study was designed to test the effectiveness of a short bladder training procedure to increase bladder capacity and to improve enuresis. Eighteen enuretic children, aged 5–13 years, were randomly assigned to either an experimental or control group. Pre- and post-treatment measures of bladder capacity and frequency of bedwetting were obtained from subjects in both groups. The experimental group received 35 days of bladder training administered at first by the experimenter and then by the parents. The training consisted of required drinking, practice in holding and rewards for retaining progressively larger volumes of fluid before voiding. The control group received no training during the duration of the experiment. The results showed that the mean bladder capacity of the experimental subjects increased significantly with bladder training compared to controls. However, the frequency of bedwetting of the experimental subjects did not decrease significantly with training. Consequently, the efficacy of a bladder training procedure in the treatment of enuresis is questioned     

The effect of parent-administered dry-bed training on nocturnal enuresis in children

In this study, two substantial modifications were made to the Dry-Bed training procedure described by Azrin, Sneed and Foxx (Behav. Res. and Therapy, 12, 147–156 (1974). The first modification was to have parents administer the intensive all-night training programme rather than an outside trainer. With fourteen children treated in this manner, nocturnal enuresis was eliminated in all cases. The median time taken to the last night of wetting was only 12 days. There were two relapses in a 6-month follow-up. The second modification involved administering the Dry-Bed procedure without the adjunct of an enuresis machine. This resulted in significantly reduced frequency of bedwetting, although nocturnal enuresis was not completely arrested in any of the ten children treated. The implications of these findings are discussed.     

Making a case for case studies in psychotherapy training: A small step towards establishing an empirical basis for psychotherapy training

The evidence debate in psychotherapy pays little attention to developing an evidence base for training practices. Understanding effective training requires an examination of what makes training work. This article examines the role of case studies in psychotherapy training. This has not been articulated explicitly or researched systematically in spite of its cardinal importance. An analysis of the role of case studies in psychotherapy training is presented. Reading, watching, or hearing about cases can offer novice psychotherapists access to a closed world; access to psychological theory in action; access to whole courses of therapy; access to different approaches; access to significant moments; access to the therapeutic relationship; access to a wide range of client types; access to working in different contexts; and the opportunity of identifying with therapists and clients. Writing or presenting cases offer students the opportunity of: learning to integrate information into a relevant whole; being in the ‘hot seat’; learning to give appropriate feedback; assessing the validity of interpretations, inferences, and interventions; adapting methods to suit the client; and learning to collaborate with other professionals. The paper presents directions for future research into psychotherapy training, specifically proposing an international survey of training practices at psychotherapy training institutions.     

Control and maintenance effects of long-term relaxation training in a case of hypertension

The effects of long-term, varied relaxation in a case of essential hypertension are described. The client's unusual achievement of voluntary control over his blood pressure was discussed in terms of new directions in the search of a relaxation specific factor.     

The importance of case discussion in counsellor training

Case discussion is viewed as a central and integrating core of counsellor training, in that it brings together the 'theoretical', 'practical' and 'personal' components which form the basis of the training process. The aim of the trainer in case discussion is to help the trainee gain therapeutic understanding of the counselling relationship. This can be done at both micro and macro levels of analysis. An example is provided where a trainee was helped to view from a different perspective a counselling relationship that had become 'stuck'.     

The modification of a child's enuresis: some response-response relationships

The present study attempted to evaluate experimentally the relationship between two response classes, enuresis and oppositional behavior. One child who had a long history of bed-wetting was observed in his home setting. Parents' reports and initial observations confirmed that the child was oppositional much of the time. When a timeout operation and differential attention were presented, removed, and presented again, the frequency of oppositional behavior decreased, increased, and decreased accordingly. Fluctuations in enuretic activity also correlated with the presence and absence of the timeout and differential attention operations. The suppression of oppositional behavior and enuretic activity persisted over an 18-month treatment period. It was suggested that the parental operations performed on oppositional behavior may have led to an increase in the parents' social reward value. Cessation of enuretic activity was explained in terms of a shift in parental reinforcer effectiveness.