A Unique Approach to Helping Kids Cope with Bladder Problems
Published on in CHOP News
Published on in CHOP News
Bladder problems (anything from daytime or nighttime wetting or surgery to a complex bladder disorder) can be upsetting for a child and their family and can affect a child socially, emotionally and psychologically. Progress can be slow going and hard-won, and often requires maintaining a rigorous bathroom regimen or undergoing complex surgery. It can be disheartening and depressing for a child to struggle so much with a process that seems so easy for other kids.
When the Urology team at Children’s Hospital of Philadelphia notices that a child is exhibiting emotional or behavioral issues due to their bladder problem, they refer the child to in-house pediatric psychologist, Christina Rouse, PsyD. Her goal is to help them live life to the fullest, despite what they’re going through, and not be defined — and consumed — by their medical issues.
Rouse and a patient working together on a super-secret bathroom mission.
Most children don’t want to acknowledge they have a bladder disorder, let alone talk about it to a stranger. As a result, it can take some patients a while to warm up to Rouse. She often needs to think outside the box to help patients get comfortable. Some ice breaking methods she uses are:
When Lindsey and Derek began potty training Rally at age 3, it didn’t go well. Rally suddenly started withholding urine, and when he could no longer hold it, he would have an accident. It got to the point where he was holding his urine for up to 24 hours at a time.
Rally’s primary care physician said she’d never seen a child withhold urine for so long. She referred the family to CHOP’s DOVE Center for Voiding and Bladder Function, which is among the largest, most comprehensive clinics in the United States devoted to pediatric bladder and urinary tract dysfunction.
At Rally’s first appointment with the DOVE Center, the team performed an ultrasound to determine if he had an obstruction or other medical condition. They found that medically, Rally was fine; his bladder issues were the result of anxiety over going to the bathroom.
The DOVE team referred the family to Rouse. She gave them practical behavioral interventions to lessen Rally’s anxiety around potty training and taught Rally different ways he could go to the bathroom. Slowly, Rally started to make progress. First, his parents got him comfortable with going to the bathroom at home; then he became comfortable going at his grandparents’ house; and then came the final frontier: preschool. Now 4, Rally has been fully potty trained for going on four months.
When Adam is anxious, he has bathroom issues. It got to the point where he was having about three accidents a week in school. He began meeting with Rouse to address his feelings and make the bathroom less of a cause of anxiety.
Adam’s mom, Kim, was immediately impressed with how Rouse got down on the floor and played with him to connect and make him comfortable. Adam’s anxiety over going to the bathroom has reduced significantly since he began working with Rouse. He has grown to love the super secret bathroom missions because they are silly and make him laugh, which helps him relax. Last year, he had only one accident … the whole year.
“For me as a parent, it’s very helpful to have a partner in helping my kid learn and overcome these challenges,” says Kim. “This is a necessary and amazing service for our community, and we are very grateful for it.”
Rouse tailors her therapeutic approach to each child, reading the room to determine what the child needs in the moment. She offers the following tips to parents of children struggling with bladder disorders or other chronic conditions.