Behavior modification is a psychological approach to treatment that was first developed by an American behaviorist by the name of B.F. Skinner (1904-1990). Behavior modification has its roots in operant conditioning, which means, “undesirable behaviors are replaced with more desirable ones through positive or negative reinforcement.” Positive reinforcement is by far the most widespread use of this treatment whereby specific behaviors are rewarded. Behavior modification has been used effectively to treat bed wetting in both children as well as adults. Other problems behavior modification has been helpful in treating include generalized anxiety disorder, separation anxiety disorder, attention-deficit/hyperactivity disorder (ADHD), phobias, obsessive-compulsive disorder (OCD) and a variety of others.
Forms of behavior modification to treat bed wetting are safer than medical types of treatment and they also tend to be more effective in the long run. However the only drawback is that you need to be patient as it takes longer to see results. The aim of behavior modification for bed wetting is that the child learns to be responsible for his or her bladder control. With this method a child is both praised and encouraged by parents upon waking in the morning and being dry. Children tend to respond more favorably to positive reinforcement then to being scolded or punished when they wake up wet. Keep in mind that nocturnal enuresis is not the child’s fault or his doing.
It is important to always gently remind a child to go to the bathroom before he or she turns in for the night. Even if the child doesn’t feel a tremendous need to urinate, tell him or her to go to the bathroom and just make sure because you want to avoid any accidents at night if possible. It is wise to decrease your consumption of liquids at least two to three hours before bedtime. According to behavior modification principles, it is a good idea to encourage the child to change his or her own sheets when they are wet. But be careful to not make the child feel as if he or she is being punished.
One form of behavior modification is known as retention control training. In this instance the child is encouraged to strengthen the muscles of the bladder by delaying going to the bathroom when the need first arises. It is a gradual process. First he is encouraged to delay it by a few minutes and then working up to longer periods of time (not until it actually causes discomfort in the abdominal area of course!). This simple exercise serves to “extend the capacity of the bladder and strengthen the muscle that holds back urination.” Retention control training should never be done without a doctor’s permission to do so.
Night-lifting is a form of behavior modification whereby a parent periodically awakens their child during the night to inquire if the child needs to pee. The parent physically walks with the child to the bathroom and then does the same when the child returns to his or her bed. The goal of night-lifting is to support and encourage the child in waking itself up when the need to void arises in the night.