What is behavioural therapy?

Behavioural interventions include a wide array of strategies designed to promote or maintain continence. They range from different lifestyle modifications and adaptations, across changes in voiding and toilet habits, to learning specific skills and techniques to maintain or regain bladder and bowel continence.

Lifestyle changes and behavioural therapies form the backbone of all continence promoting activities and are recommended first-line treatments in all evidence-based clinical guidelines, including NICE guidelines and the International Consultation on Incontinence[1-5].

Every person, regardless of condition or age, with lower urinary tract symptons (LUTS) or incontinence should be offered support to change their lifestyle and learn new techniques to recover their bladder and/or bowel function.

But many people who could benefit are not offered behavioural treatments because of a lack of knowledge of how to implement these techniques by staff.


Your task

Reflect on your own practice. Do you feel confident that you understand what is meant by a ‘behavioural intervention?’

Read the paper Practical aspects of lifestyle modifications and behavioural interventions in the treatment of overactive bladder and urgency urinary incontinence[6] and share your thoughts about lifestyle and behavioural techniques with fellow learners.


References

1. NICE Clinical guideline 49. Faecal incontinence: The management of faecal incontinence in adults. 2007. [Last reviewed June 2018, cited 28 August 2018] Available from: http://www.nice.org.uk/guidance/cg49

2. NICE Clinical Guideline 97. Lower urinary tract symptoms in men: management. 2010. [Last updated June 2015, cited 28 August 2018] Available from: https://www.nice.org.uk/guidance/CG97

3. NICE Clinical Guideline 148. Urinary incontinence in neurological disease: assessment and management. August 2012. [Last reviewed February 2014, cited August 2018] Available from: https://www.nice.org.uk/guidance/cg148

4. NICE Clinical Guideline 171. Urinary incontinence in women: management. September 2013. [Last updated November 2015, cited 28 August 2018] Available from: https://www.nice.org.uk/guidance/cg171

5. Abrams P, Cardozo L, Wagg A, Wein A. (Eds) Incontinence 6th Edition. ICI-ICS. International Continence Society, Bristol UK,. 2017. ISBN: 978-0956960733.

6. Wyman JF, Burgio KL, Newman DK. Practical aspects of lifestyle modifications and behavioural interventions in the treatment of overactive bladder and urgency urinary incontinence. Int J Clin Pract. 2009;63:1177–91. [Cited 28 August 2018] Available from: https://doi.org/10.1111/j.1742-1241.2009.02078.x


Further reading

7. Lukacz ES, Sampselle C, Gray M, MacDiarmid S, Rosenberg M, Ellsworth P et al. A healthy bladder: a consensus statement. Int J Clin Pract. October 2011;65:10;1026–1036. [Cited 28 August 2018] Available from: https://doi.org/10.1111/j.1742-1241.2011.02763.x

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Understanding Continence Promotion: Effective Management of Bladder and Bowel Dysfunction in Adults

Association for Continence Advice

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