308 | Toileting Battles and the Need for Power: CCPT Parent Coaching

In this episode, I respond to a question from Rachel in Missouri about a 5½-year-old client who refuses to poop in the toilet and insists on using a pull-up. We explore how this long-standing habit is likely a reflection of control and vulnerability, and how Child-Centered Play Therapy can gently address the emotional drivers behind it.

I offer specific parent coaching strategies, including how to introduce a future transition date to allow the child time to adjust. I also explain how giving children limited choices—like choosing music or a book while using the toilet—can offer autonomy without re-engaging in power struggles. This episode is a practical case consultation focused on how CCPT principles guide both our clinical decisions and the way we support families through deeply rooted behavioral patterns.

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Common References:
Cochran, N., Nordling, W., & Cochran, J. (2010). Child-Centered Play Therapy (1st ed.). Wiley.
VanFleet, R., Sywulak, A. E., & Sniscak, C. C. (2010). Child-centered play therapy. Guilford Press.
Landreth, G.L. (2023). Play Therapy: The Art of the Relationship (4th ed.). Routledge.
Bratton, S. C., Landreth, G. L., Kellam, T., & Blackard, S. R. (2006). Child parent relationship therapy (CPRT) treatment manual: A 10-session filial therapy model for training parents. Routledge/Taylor & Francis Group.
Benedict, Helen. Themes in Play Therapy. Used with permission to Heartland Play Therapy Institute.

Episode Transcript

(00:00):
You're listening to the Play Therapy Podcast with Dr. Brenna Hicks,
your source for centered and focused play therapy coaching.
Hi,
I'm Dr. Brenna Hicks,
The Kid Counselor.
This is the Play Therapy Podcast where you get
a master class in child-centered play therapy
and practical support and application for your
work with children and their families.
In today's episode,
I am answering a question from Rachel in Missouri.

(00:24):
About a 5.5 year old that is her client,
and the child will not
poop in the toilet
and how to navigate that.
Obviously,
she's starting child-centered play therapy,
which means it will likely address itself,
but just some thoughts about what parents might do
and just

(00:44):
some processing of this.
So I'll read parts of the email,
then we'll dive in.
I'd like your perspective on a 5.5 year old I'm working with.
This child does not poop in the toilet.
She only uses pull-ups when it's time to go.
Parents have tried rewards,
goal setting,
and practice,
which have not worked.
Mom and dad have been able to redirect responsibility
to their child when it comes to cleaning up.

(01:05):
By setting the expectation,
if you choose to poop in a pull up,
you choose to take care of the rest on your own.
So the client can now retrieve the pull-up,
poop,
empty the pull-up into the toilet,
wrap the pull-up in a bag,
place it in the trash and wash up all on her own.
Oh my gosh.
Her parents set that expectation a year ago,
and it has been successful,

(01:25):
but she still shows no interest in graduating from the toilet.
She is healthy and can pass stools easily and regularly,
and it seems like her mom and dad have done a helpful
job of being patient and removing themselves from the power struggle.
I think the CCPT will be such a wonderful outlet
for her to give herself more autonomy and control,
hopefully displacing some of the need for control she has around bathroom habits.

(01:48):
Do you have any specific parent coaching tips you would provide a family in
these circumstances or any limit setting that
you'd recommend the parents re-engage in?
All right.
So yes,
Rachel,
I agree with you.
I think as this child continues in CCPT,
the
anxiety levels will reduce,
the self-esteem will increase,

(02:08):
and the need for power and control will lessen.
So I think it will kind of naturally sort itself out.
Let's backtrack to something we've talked about before,
but probably not in a while.
Kids have control over a handful of things and they fit on one hand.
Toileting is one of them.
There are a very few
number of options for

(02:30):
what a child has control over in their life,
especially at 5.
So,
for whatever reason,
this child has grasped at this measure of control,
and is perfectly content to keep things the way they are.
You have to keep in mind too that when you have a child that wants control,
giving up control makes them vulnerable,

(02:52):
and so I don't know that it's necessarily that she
continues to still want to poop in the pull up.
I don't know that it's that she continues to not want to poop in the toilet,
but it seems as though she's not willing to become vulnerable potentially
by all of a sudden changing behavior.
That could be a consideration.
So as far as things that

(03:13):
I might provide in the way of parent coaching
or limit setting that the parents might engage in.
I think first and foremost they've already sought CCPT
that will be the most effective approach for this,
but as far as what's happening at home,
one of the things that I encourage families to
do when they're in a scenario like this wherein
it is consistent

(03:34):
and pervasive.
In other words,
it's been going on for a long time
and
it doesn't seem like there's an end in sight.
We encourage parents to
set an expectation of time limit.
In other words,
she's 5 1/2.
Does that mean she is 4 months away from her birthday,
3 months away from her birthday?
We don't

(03:54):
have details specifically,
obviously,
but that might be
the time frame.
It might be the end of summer or the start of school year.
It might be
some other date on the calendar,
but what I would encourage parents to do in a scenario like this is.
Child's name,
you've been choosing to use pull-ups to poop in
for a long time,

(04:15):
and
as soon as you turn 6,
or
as soon as
it's time to start,
maybe 1st grade,
I'm assuming she might be starting 1st grade,
as soon as it's time to start 1st grade,
or by the end of summer,
or by the time we go on vacation in August,
or whatever this future date is.

(04:38):
Pooping in a pull-up is no longer an option.
And you just make the declaration with lots of time in advance of it.
Here's what that does.
The child can begin to work through it.
What am I going to do if I'm not gonna be able to poop in a pull up?
What emotions do I need to process?
What fears do I need to work through?

(04:59):
What questions do I need to ask,
how do I prepare myself for this?
What problem solving needs to begin?
There's all of this stuff that will happen.
But if it's just,
OK,
we're done,
you're not gonna use pull-ups anymore,
that's overwhelming for a child.
So you set a date far in advance of the current date,
but you help a child know it's coming.

(05:20):
And to a 5 year old,
the end of summer feels like an eternity away,
but that's OK.
Because what we're doing is,
I just want to let you know when school's going to start again
and when you become a first grader.
Pooping in a pull-up is no longer an option.
You're a big girl and you can poop in the toilet.
And then you move on.
And as the date gets closer,

(05:40):
you remind here and there,
not like an everyday thing,
but at least once a week.
Just wanted to remind you we have a few more weeks until it's vacation,
end of summer,
start of school,
birthday,
whatever.
And
you know that pull-ups are no longer an option for pooping in.
And over the course of time,

(06:02):
the child is able to resign themselves to the fact that things are changing,
prepare themselves for the change,
and equip themselves to handle it.
And when you do it with far enough in advance,
kids actually usually handle it pretty well.
And with the support of being in therapy with you,
Rachel,
she will also have that benefit of being able to process it with you.

(06:26):
All this is
is habit at this point.
Probably rooted in several things,
but it's a conditioned pattern
and condition patterns can be changed,
but there has to be a time frame in which it's going to change and I agree with you,
mom and dad have gotten themselves out of the power struggle
and they've walked away and said,

(06:47):
OK,
if you're choosing that,
then you're choosing this and kids OK with it,
they're OK with it,
and there's harmony in the home,
good for them.
But there does need to be an end date for this because this isn't an endless struggle.
And that is the way that we typically encourage parents to handle that.
As far as limit setting.
That I would recommend

(07:07):
only in the fact that
we're not going to be doing this after this date.
So,
we kind of get
in that
line of thinking.
Now,
here's what has typically worked really well in that scenario.
You give the child a measure of control
over
what happens after that.

(07:28):
So
child has not felt comfortable pooping on the toilet,
it's not to say that she won't now,
it's been more than a year.
Maybe she is OK with it now,
she's just comfortable with the habit,
but you want to give her a measure of control.
So
now that pooping in pull-ups is no longer an option,
you can choose to

(07:49):
have
A book to read while you go to the bathroom on the toilet,
or you can choose to play music while
you go to the bathroom on the toilet.
Give the child some ownership and buy-in of the environment,
because this is going to be different.
Pooping in the bathroom on the toilet is very different
than grabbing a pull-up and pooping in a pull-up.

(08:10):
So,
give her some control over the environment.
And that typically also has responsibility and ownership built into it,
so she's more likely to abide by the new expectation.
My final thought is
any change is hard,
so it may not be flawless
the first day or 2 days or 4 days

(08:32):
or a week.
You never know how hard a child's going to push,
but
You know that it's temporary,
so
you stick to it,
you say you really wish that you could poop in a pull up,
but
pull-ups aren't for pooping and now you're 6
or it's August or you're a first grader or whatever,
and
then you just stick to it,

(08:54):
the child will adapt,
but there may be some change pain.
It happens.
So you might see resistance,
you might see defiance,
you might see tantrums,
prepare parents for that.
Talk them through that process,
Rachel,
so that they're not caught off guard.
And
you know,
what do we say?
We outwit,
we outlast,
we outplay.
Parents need to do the same.

(09:15):
That's,
that's the goal.
We're not going to give in.
She will eventually go to the bathroom on the toilet.
You just have to stick it out.
All right,
thanks so much for the email,
Rachel.
Thank you for your commitment to kids,
all of you.
Thank you for the,
the concern and the love that are poured into
every single question and email that you send me.

(09:36):
I
very deeply see
how much you strive and long to help kids in the best way that you can.
So I don't receive them just as questions.
I know it's rooted in your love for these kids.
So thanks for caring about kids.
Love you all.
Bye.
Thank you for listening to the Play Therapy Podcast with Dr.
Brenna Hicks.

(09:57):
For more episodes and resources,
please go to www.playtherapypodcast.com.