side effects. For example, medical treatment of con-stipation with or without bowel incontinence typi-cally calls for a bowel cleanout followed by atreatment regimen (laxatives, mineral oil) to softenfeces and maintain daily bowel movements. How-ever, the specific regimen for a bowel cleanout canvary and includes enemas, suppositories, and largedoses of mineral oil or a balanced electrolyte co-lonic lavage solution given by mouth or nasogastrictube. One argument that has been made for the useof oral methods of bowel cleanout is that enemasmay be “psychologically unsuitable” (Gleghorn,Heyman, & Rudolph, 1991). However, there is littleempirical data to support such an assertion; somesurvey data indicate that, although children findenemas difficult, over half of the children treatedwith this modality reported enemas to be useful(Bernard-Bonnin, Haley, Belanger, & Nadeau, 1993).Pediatric psychology can make a significant contri-bution to the treatment of this disorder by examin-ing the impact of the various medical approacheson children’s adjustment posttreatment. We canevaluate not only the efficacy but the potential“side effects” and thus help practitioners to makedata-based treatment decisions.A second limitation of psychological interven-tions for encopresis is sample selection. Most of thestudies reported, including research conductedby my colleagues and I, have used conveniencesamples: children referred for psychological treat-ment after failing medical management. Researchhas rarely taken the approach of prospectively re-cruiting children with this disorder and randomlyassigning them to treatment groups. One potentialreason for this is the lack of funding to conduct