Reconceptualizing Childhood Enuresis: A Biopsychosocial Medical Family Therapy Approach

초록

Treatment of childhood enuresis requires an integrative approach grounded in a biopsychosocial perspective. Family factors play a critical role in symptom regulation, social development, and treatment adherence. This study aimed to reconceptualize childhood enuresis and introduce medical family therapy (MedFT) as an integrative framework to enhance treatment effectiveness. A systematic literature review was conducted using international databases (PubMed, Web of Science, Scopus, and Google Scholar) and domestic databases (RISS, KISS, SCIENCEON, DBpia, and KCI). Studies addressing biological, psychological, and family-related factors in childhood enuresis were included, whereas those focusing solely on pharmacological outcomes were excluded. The selected studies were analyzed using a thematic approach. Interventions integrating biological, psychological, and social components were more effective than single-modality treatments. Family factors significantly influenced treatment adherence, children's social development and adaptation, and overall family functioning. Key factors included parental understanding of the condition, coping strategies, parenting attitudes, and intrafamily communication. Core MedFT components were identified as problem reconceptualization, multidimensional assessment, collaborative goal setting, facilitation of adaptive family-system changes, enhancement of problem-solving capacity, outcome evaluation, and relapse prevention. These findings suggest that MedFT, as a biopsychosocial integrative intervention, addresses both child-specific symptoms and family dynamics. It contributes to symptom reduction, improved psychological stability, and sustained improvements in family functioning, thereby enhancing clinical outcomes and overall family well-being. Further empirical research across diverse clinical contexts is needed to validate and refine this approach.

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