A component analysis of dry-bed training for treatment for bedwetting

Abstract

The major components of Dry-Bed Training (DBT) (Azrin et al., 1974), in addition to the urine-alarm device, were identified as; (i) the waking schedule; (ii) retention control training; and (iii) positive practice and cleanliness training. Combinations of these components yielded six treatment groups. Together with an alarm-only group and a DBT group from a previous study (Bollard and Nettelbeck, 1981) these groups were compared for effectiveness in arresting bedwetting. Bedwetting frequency was reduced slightly below levels achieved with alarm-only treatment, by the addition of either retention control training, or positive practice and cleanliness training. A more substantial decrease in bedwetting resulted from the addition of the waking schedule, although none of the effects of the single components was statistically significant. The effects of the three components were cumulative, so that the more components added to the alarm-only procedure, the better the therapeutic response. Thus, the combination of waking, positive practice and cleanliness training with the alarm and the combination of all three components with the alarm (i.e. the complete DBT programme) did result in a significant reduction in bedwetting frequency compared with the alarm-only procedure. The practical and theoretical implications of these results are discussed.