Modeling clay is an effective tool to help children realize what is happening to them. For example, they can see how it dries out when stored for a long time in a dehydrating container, thus teaching them that the longer they resist the urge to defecate, the harder the feces will become, making the expulsion more painful. If a child's fear of defecation is not addressed in any manner, there can be no effective change in his or her behavior. Both the clay and the Fun Factory are likely to give these children a better understanding of their bowel problem, and can help them learn how to resolve it. In addition, since the children in the study were playing with the Playdoh Fun Factory at their doctor s office, they might have associated the setting with their problem, even though this was not indicated to them by a physician or therapist.
Group therapy is a highly effective and underutilized intervention for many dilemmas.
Many encopretic children develop a coping style of feigned unawareness and nonchalance when queried about their problem. If left uneducated about their conditions these children will invent fantastic stories to explain to themselves what is wrong. Group therapy is an effective way to demystify the encopresis experience, since some children may be more willing to accept information from peers than from an adult authority figure, especially if they are engaged in an emotional power struggle for control of defecation. Toilet learning, whether under the supervision of a clinician or in a group, is most efficient when defecation is consistently painless. Katie Devlin, PhD, is a pediatric psychologist at Children's Hospital of Orange County.