Psychotherapy or Counseling to treat bedwetting

Psychotherapy or counseling showed positive effects in reducing bedwetting but specific interventions were not well described. Cochrane reviewed six trials with psychotherapy or counseling as the intervention group. During treatment, psychological or supportive interventions resulted in less wet nights than desmopressin or rewards, such as a star chart. Psychological support was less effective than imipramine. There was the same number of recurrence of wet nights after stopping psychotherapy or desmopressin. One small trial did show that psychotherapy was better than alarm or rewards.  One weakness was whether it was appropriate or not to combine the six trials for analysis because the therapies were so different.  Unfortunately, the positive effect was lost when a random effect model was use.  There is also the unknown of how the patient did after therapy was stopped in some of the trials.

My thoughts: The overall take-home message is that there is no harm in using psychotherapy or counseling in combination without other therapies to get the best chance for success. This would also give families an opportunity to develop a relationship if there are other areas of the child’s life that needs support.

Huang, T., Shu, X., Huang, Y. S., & Cheuk, D. K. (2011). Complementary and miscellaneous interventions for nocturnal enuresis in children. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.cd005230.pub2