Abstract
D.Litt. et Phil.
Encopresis is a complex problem which is often under-reported, and is not well known
by the general public. The humiliating nature of the problem results in denial and a
reluctance to seek help from professionals; parents will therefore rather attempt to
solve the problem themselves. Research on the subject is relatively scarce, especially
regarding effectiveness of treatment models. The etiological factors of this complex
problem are interlinked and it is often difficult to identify the primary cause of the
problem. A primarily physical problem may have secondary emotional implications,
while a primarily emotional problem may result in a physical problem. The complex
nature of encopresis results in referrals from one professional to the other, generally
without great success; this has resulted in parents often becoming desperate to get
effective help. Treatment in the past tended to be profession-orientated and fell either
into a medical or a psychological approach, with little, if any, acknowledgement of the
social factors. Only recently has the biopsychosocial approach been recognised and
received more credit. The low success rate in the treatment of encopresis gave rise
to the development of a holistic approach which attempts to address the problem in the
context of the physical, behavioural, cognitive and emotional modalities in order to find
appropriate assessment, diagnostic and management strategies.
The purpose of the present study was to integrate these modalities and to develop a
form of therapy tailored to the specific needs of the child. The holistic treatment model
attempts to bring relief to children suffering from encopresis and their families who are
burdened with the problem. The purpose was further to evaluate the effectiveness of
the holistic treatment model with regard to the prevalence of encopresis, depressive
symptomatology, parental involvement and self-image of the children. Standardised
measuring instruments used were the "Reynolds Child Depression Scale", the "Bene
Anthony Family Relations Test", as well as the "Human Figure Drawings".
Experimental and control groups were used in order to compare the variables prior to
any intervention. The experimental group received treatment while the control group
received treatment only after completion of the post-tests. The purpose was to
measure the degree of change as a result of the intervention.
The experimental group improved significantly with regard to all the variables, while the
control group showed no significant difference between the pre-test and post-test
results. The study indicated a relatively high success rate using the holistic treatment
approach. Promising results can be expected when applying this holistic form of
treatment to other children with similar problems in an endeavour to alleviate the often
silent burden carried by children with encopresis and by their families.