Toileting Therapy for Children in Portland, OR

What Are Toileting Concerns?

Toileting difficulties are common in childhood and can be stressful for both children and parents. These concerns may include soiling (encopresis), daytime or nighttime wetting (enuresis), challenges with toilet training, fear of using the toilet, or refusal to use the toilet. Although families often feel frustrated or worried, toileting difficulties are rarely caused by laziness, defiance, or lack of motivation.

Many factors can contribute to toileting concerns, including constipation, anxiety, sensory sensitivities, developmental differences, medical conditions, changes in routine, or past negative experiences related to toileting. With the right support, most children can make significant progress and develop greater confidence and independence.

Evidence-Based Toileting Treatment

As a child psychologist in Portland, OR, I provide evidence-based treatment for children experiencing a wide range of toileting concerns, including encopresis, enuresis, toilet training difficulties, and toilet refusal.

Treatment begins by understanding the unique factors contributing to your child's toileting challenges. Because successful toileting often involves medical, behavioral, developmental, emotional, and family factors, I take a collaborative approach that may include coordination with pediatricians and other healthcare providers when appropriate.

Using principles from behavioral therapy, parent training, and Cognitive Behavioral Therapy (CBT), I help children develop toileting skills while supporting parents in creating effective and low-stress routines. For children experiencing anxiety, fears, or avoidance related to toileting, treatment may include gradual exposure-based strategies to increase comfort and confidence.

For children with neurodivergent profiles, including ADHD or autism, interventions are adapted to fit their developmental, sensory, and learning needs.

What to Expect During Therapy

Therapy begins with a comprehensive assessment of your child's toileting history, medical background, developmental needs, family routines, and emotional well-being. Together, we identify factors that may be maintaining the problem and develop a personalized treatment plan.

Treatment often focuses on:

• Establishing predictable toileting routines

• Addressing fear, anxiety, or avoidance

• Supporting constipation management recommendations from medical providers

• Building motivation and confidence

• Reducing family stress and conflict around toileting

• Helping parents respond consistently and effectively

Parents play an important role in treatment and are active participants throughout the process. The goal is to help children develop age-appropriate toileting skills while increasing their independence, confidence, and quality of life.