Case: Why is my potty trained child having pee accidents?
Perceived Child Behavior: Day and/or Night time accidents
Possibility: The child is afraid of something
Child’s Emotion: fear
Parenting Goal: [To improve child’s emotion]
Action Strategy: [To improve parent’s emotion]
Actionable Script
Child’s Belief: I can just hold it
Motivation: stay safe by avoiding the fear
Relationship context with caregiver: parent dismisses fear
Parenting Goal: [Trying to improve relationship]
Action Strategy: [Trying to improve relationship]
Actionable Script
Mental Context: anxiety
Parenting Goal: [Trying to improve the child’s mental state]
Action Strategy: [Trying to improve mental state]
Actionable Script
Social Context: could be afraid to ask teacher to go to the bathroom
Parenting Goal: [Trying to improve the social context]
Action Strategy: [Trying to improve social context]
Actionable Script
Physical Context: new environments
Parenting Goal: Address fear that the new environment brings.
Action Strategy: [Trying to improve the physical context]
Actionable Script
Function: emotional regulation
Parenting Goal: Learn how to manage fear
Action Strategy: [Trying to improve the function]
Actionable Script
Possibility: The child is trying to claim a sense of independence
Child’s Emotion: self-confidence, desire for control
Parenting Goal: [To improve child’s emotion]
Action Strategy: [To improve parent’s emotion]
Actionable Script
Motivation: prove themselves, gain control/ autonomy
Relationship context with caregiver: caregiver is too controlling
Parenting Goal: [Trying to improve relationship]
Action Strategy: [Trying to improve relationship]
Actionable Script
Mental Context: Child is developing a sense of independence
Parenting Goal: [Trying to improve the child’s mental state]
Action Strategy: [Trying to improve mental state]
Actionable Script
Function: Executive Function, physical regulation
Parenting Goal: [Trying to improve the function]
Action Strategy: [Trying to improve the function]
Actionable Script
Possibility: The child is overwhelmed and needs attention
Child’s Emotion: overwhelmed/ unsupported
Parenting Goal: [To improve child’s emotion]
Action Strategy: [To improve parent’s emotion]
Actionable Script
Motivation: too overwhelmed to even be thinking about going to the bathroom or they may be hoping that an accident may lead to more interactions.
Relationship context with caregiver: parent is not providing enough support
Parenting Goal: [Trying to improve relationship]
Action Strategy: [Trying to improve relationship]
Actionable Script
Mental Context: stressed (some children are more likely to get overwhelmed, keep in mind psychiatric disorders)
Parenting Goal: [Trying to improve the child’s mental state]
Action Strategy: [Trying to improve mental state]
Actionable Script
Function: Emotional Regulation, physical regulation, resilience
Parenting Goal: [Trying to improve the function]
Action Strategy: [Trying to improve the function]
Actionable Script
Social Context: transition phases
Physical Context: tired, hungery
Parents’ Emotions: Frustration, blame, confusion, worry
Parenting Goal [Pitfall]: Punish the child
Action Strategy [Pitfall]: Shame or tease
Action Strategy [Pitfall]: Punish (not natural consequences)
Parenting Goal: Discover and address feelings that are preventing you from being the parent you want to be.
Action Strategy: Express and reflect on your emotions
Actionable Script: Listing partner
Actionable Script: Journaling
Action Strategy:
Actionable Script: Take care of yourself
Actionable Script: Get help
Actionable Script: Get more information
Parent’s Belief [Pitfall]: [A belief that is a stumbling block for the parent’s interaction with the child]
Potty training is a straightforward skill.
Once a child is potty trained they won’t have accidents because they know better.
Evidence-Based Belief: [Corrective to a parent’s belief pitfall]
Potty training depends on multiple parts of brain and body maturing and working together along with physical skills they are learning.
Regression is common in children.
Red Flags
It becomes a recurring issue
They have proved they are developmentally able to be potty trained.
Wets the bed (after having been able to stay dry)
Has symptoms that something is wrong.
Signs of constipation
Your child is experiencing great distress over the accidents to the point where it is causing limitations to day to day life.
Child has accidents past the age when parents wet the bed
Child is past 7 years old
Possibility: The child is constipated. (putting this here but waiting for diagnostic model to go further)
Physical Context: constipation
Parenting Goal: [Trying to improve the physical context]
Action Strategy: [Trying to improve the physical context]
Actionable Script
Possibility: The accidents are happening for genetic reasons. (putting this here but waiting for diagnostic model to go further)
Physical Context: underlying medical condition
Parenting Goal: Seek medical help
Action Strategy: Go see your doctor
Actionable Script: Make an appointment
Action Strategy: Keep accident diary
Actionable Script: Keeping an Accident Diary
Parent Goal: wait it out
Action Strategy: wait it out
Actionable Script: Being aware while waiting it out
Possibility: There is an underlying medical condition that needs to be addressed. (like UTI)(putting this here but waiting for diagnostic model to go further)
Physical Context: underlying medical condition
Parenting Goal: Seek medical help
Action Strategy: Go see your doctor
Actionable Script: Make an appointment
Action Strategy: Keep accident diary
Actionable Script: Keeping an Accident Diary
Perceived Child Behavior: Just Night Time Accidents (Include with PCB: Day & night accidents)
Parent’s Belief [Pitfall]: [A belief that is a stumbling block for the parent’s interaction with the child]
My child should be able to control their bladder at night.
Evidence-Based Belief: [Corrective to a parent’s belief pitfall]
Wetting the bed is involuntary.
Child's emotion: embarrassed
Possibility: The child's sleep patterns. (putting this here but waiting for diagnostic model to go further)
Physical Context: underlying sleep pattern
Parenting Goal: Seek medical help
Action Strategy: Go see your doctor
Actionable Script: Make an appointment
Action Strategy: Keep accident diary
Actionable Script: Keeping an Accident Diary
Perceived Child Behavior: Night time accidents after being accident free for >6 months (add on to night time accident nodes)
Possibility: Underlying physical reason (low ADH or delayed bladder maturation) (putting this here but waiting for diagnostic model to go further)
Physical Context: underlying physical reason
They should talk with doctor but if the child is under 7, and not overly stressed by the accidents then they will likely be told to try and wait it out, they can keep a accident diary in the meantime if they are concerned and want to find a pattern.
Perceived Child Behavior: Just day time Accidents (Include with PCB: Day & night accidents)
Possibility: The child is distracted/ very engaged in something.
Child’s Emotion: excited/ focused
Parenting Goal: [To improve child’s emotion]
Action Strategy: [To improve parent’s emotion]
Actionable Script
Subtopic
Motivation: fear of missing out if they leave, or too distracted to pay attention to their body's cues.
Relationship context with caregiver: Parent doesn't provide enough structure
Parenting Goal: [Trying to improve relationship]
Action Strategy: [Trying to improve relationship]
Actionable Script
Mental Context: some children are more likely to become very focused (remember to mention psychiatric disorders)
Parenting Goal: [Trying to improve the child’s mental state]
Action Strategy: [Trying to improve mental state]
Actionable Script
Physical Context: overstimulating environment, new environment
Parenting Goal: [Trying to improve the physical context]
Action Strategy: [Trying to improve the physical context]
Actionable Script
Function: Executive function, physical regulation
Parenting Goal: [Trying to improve the function]
Action Strategy: [Trying to improve the function]
Actionable Script