link link link link link link link
link link link link link link link

Encopresis and Enuresis Program Highlights

WARNING: A recent research report out of the Netherlands (see our scientific articles page) indicates that the rectum can become overly stretched and weakened from a megacolon such that the standard "top down" pediatric treatment may be rendered ineffective. In my opinion encopresis should not be allowed to continue indefinitely. Even children recovering under the standard pediatric approach may continue with distended rectums at 4 years follow up. The more aggressive Soiling Solutions protocol using suppositories and enemas with proper timing is well indicated at an earlier time to prevent this consequence. DrC.

We offer separate manual-based treatments for childhood bedwetting (nocturnal enuresis) and soiling (encopresis) problems based on well-known learning principles and psychophysiology.  If both problems coexist, the encopresis should be treated first.  To be more informed about encopresis and our approach we suggest that you "click" on the buttons above in the following order: Home, User Comments, Megacolon, Clean Kid Manual, and About the Doctor. There are many more pages and even links within pages that you may wish to explore. We want you to be well-informed for making your decision to go to our more aggressive approach which requires the use of suppositories and enemas to achieve rapid and definitive control over your child's encopresis. Allowing encopresis to persist may result in a stretched out and ineffective rectum. We will be happy to discuss your concerns for the potential purchase of a manual or treatment package. All treatment packages and costs are described below. Finally, you may order from our store at this site or by calling 1-616-638-1957 (DrC) or 1-616-881-2882 (Sherron). 

Our manual prices (below) are what they are because the Soiling Solutions protocols are not widely accepted by parents and too many professionals. There is a "squeamish" reluctance in Western culture to use suppositories or enemas as part of a perfectly valid and effective treatment approach. Even physicians have been intimidated by today's cultural climate and speak of the current "top down" pediatric practice as the "soft" approach which only has a 40-60% success rate (at best). There is a tension between my more aggressive approach vs. the predominately passive approach of constant reassurance and cavalier promises that a child will "grow out" of the problem. We have had to self-publish because wide sales to libraries and parents likely would not be commercially successful and satisfy any publisher. Yet the demands for my approach after months and even years of practicing failure by parents have sustained sales and parents value the added services of the exclusive parents email forum and the availability of consultation services, which are all described below. This website and its advocacy remains an important and costly venture and Dr. Collins in his "retirement" cannot afford to subsidize it.

Please understand that Dr. Collins will not complete any forms for insurance, family medical leave, or other legal purposes. He will not serve as an expert witness for any issues or disputes regarding the topics of enuresis or encopresis. He has sought to provide for efficient inexpensive ways of treatment that parents can carry through largely on their own with minimal supervision by a health care provider. However, supervision or contact with a health care provider is regarded as highly desirable. Toward that end Dr. Collins is willing to work with your provider for FREE. Your doctor must initiate the contact. See the letter to your physician on our home page. Also, with the receipt of your manual you will find a loose insert in the front describing how to gain FREE access to the exclusive Clean Kid Manual Parents Forum and a letter addressed to your physician. You will be delighted at the support and knowledge that is shared on that forum between newbies and oldbies! Dr. Collins is also available for talks to groups of providers or parents to make his treatment protocol more widely available and familiar.

WIN-WIN Unconditional Money Back Guarantee:

Refunds:

We give a money-back guarantee on the basic cost of your Clean Kid Manual or the Dry Bed Manual, if you are not satisfied at the end of 120-days of treatment (or even before) you should return the manual to us regardless of its condition, but please do NOT return the "specipan", urine measurement container. This applies only to written materials purchased by you directly from this site at undiscounted prices.  The warranties do not apply to the consulting options. Nor do they apply to our products or consultations purchased from a health professional who may be using our program.

Treatment Manual Costs:

The Clean Kid Manual for encopresis costs $69 plus $6 for postage and handling within the USA(T=$75) . State of Michigan residents will see a 6 per cent sales tax added for $4.14 for an order total of $79.14. Different postal and handling rates (packaging, customs forms, etc.) will vary for non-USA orders. Some countries may have a very unreliable internal delivery system or do not support US Global Priority delivery, which is our standard mailing method. You will likely know this and if you require a more reliable service the US Post Office does have special contracts in some countries to assure more reliable and timely service, but it may cost substantially more. Another possibility is to rely on a resident of the USA whom you know to forward the manual to you. If you are willing to take a chance we will mail by airmail parcel post. E-mail Dr. Collins if you wish clarification on costs. Dr Collins handles all orders personally and he will get back to you by e-mail with a cost estimate. If you do order the CKM you are invited to join our exclusive discussion list or forum of parents who are likewise using the manual. This has the advantage of everyone operating from a common platform of knowledge. We do not have a sufficient volume of purchasers for the DBM to justify an exclusive email forum for them, but I have estabished an open forum for all at enuresis.org or bedwetting.org.

THE NEW DRY BED MANUAL PACKAGE INCLUDES THE DRY BED MANUAL ITSELF AND A "SPECIPAN" TOILET INSERT FOR MEASURING EMPTYING VOLUMES CENTRAL TO ASSESSING PROGRESS. This package is a unique value at $50 plus $6.00 for postage and handling within the USA (T=$46). Residents of the State of Michigan will see a 6 per cent sales tax added for $3.00. Different postal and handling rates (packaging, customs forms, etc.) will vary for non-USA orders. Some countries may have a very unreliable internal delivery system, but you will likely know this and if you require a more reliable service the US Post Office does have special contracts in some countries to assure more reliable and timely service, but it may cost substantially more. A cheaper route if Global Priority or a special contract approach cannot work is to mail by air-mail parcel post or "letter", but you will have to accept the chance of it getting to you or not. E-mail Dr. Collins if you wish clarification on costs. He handles all orders personally and he will get back to you by e-mail with a cost estimate.

Following are the contents of this special offer, which are unique and not used in any other bedwetting treatment program:

1). A Urine Measurement Collection Device (use cubic centimeters or cc’s in recording please). No other bedwetting treatment uses this measure, which is essential to monitoring and adjusting treatment if necessary.

2). The all new Dry Bed Treatment Manual on the Bottom Lines for Becoming Dry at Night. This new manual also contains information for treating day time bladder problems (diurnal enuresis).

3). An informational sheet for purchasing separately the very unique Malem Ultimate bedwetting alarm, which features sound, vibration, and flashing lights to promote awakening your child. There is also a recordable version where you can use your child's name and urge him to "get up!" The child's spoken name is a very potent arousal stimulus. It is available through the www.bedwettingstore.com website if you wish to obtain that device in advance.

4). Bathroom or volumetric recording sheets for measuring bladder capacities before bedtime, after an alarm sounding in the nighttime, and upon awakening in the morning. Set aside a blank form for additional reproduction if necessary. It is important to have this form filled out daily during treatment should you wish to consult with me. No other treatment assesses bladder voiding volumes at just the right times. This is vital for successful treatment.

5). Bedside diary sheets for recording the size of wet spots and to rate the degree of arousal after alarm soundings. Set aside a blank form for additional reproduction if necessary. No other treatment monitors both of these critical variables at just the right times for successful treatment. This form is also important should you wish to consult with me.

***Note that we do not furnish a bedwetting alarm. That must be ordered separately. See our list of Alarm Manufacturers for related advice.

Consultation Service Options:

INITIAL (One Time Only) CONSULT OPTION--An initial call to Dr. Collins for clarification, reassurance, or issues you encounter in the manual-based treatment will be charged to your credit card in the amount of $75. Your card information is on file, but we will ask your permission for a debit. Think of this like an office visit. Time will not be a basis for charges, generally we will arrive at a mutually agreeable resolution in 5-30 minutes. $50 of this payment may be applied to the Unlimited Consultation Option, which is described in the next paragraph. Parents may call 1-616-638-1957 for this option or email bobpsy@yahoo.com. Another recent possibility is free telephony over the internet with www.skype.com with which I am presently registered as "soilingsolutions." Request a contact AFTER ordering your manual by email or in a comment when ordering from our store. I will not recognize other requests for Skype contacts.

UP FRONT UNLIMITED CONSULTATION OPTION--Unlimited, highly personalized consultations are offered to parents for $250 via EMail and or by telephone. If you did the initial one time only consult option above, then you may apply $50 of that prior payment to this option. Some parents prefer this option because it is like insurance to know that Dr. Collins is particularly available to you. Even if you don't use it that much it is comforting to know that it is available to you at any time. Contact information is provided in the last paragraph or the footer for this page. Consults may apply to the Clean Kid and Dry Bed Treatments or both combined. This option can be implemented on the store, contacting me through Skype, or with your call in for a consultation.

FREE PARENT EMAIL DISCUSSION FORUM--Strictly speaking this is not a consultation forum with Dr. Collins. It is a parents' forum for sharing insights, suggestions, and support with others who have purchased the Clean Kid Manual. You will have to make a request to Dr. Collins to be added to the forum.

HEALTH PROFESSIONALS--Health professionals, schools, and other agencies are invited to peruse the Professionals' Page (Click Here) or go to our store for options that are targeted to them alone. Professionals may order our manuals in bulk lots at much reduced costs. I do not charge for consultations with professionals and I do not have any exclusive licensing agreements.

This website rejects involvement with any third party insurance carriers and will not cooperate in submitting information to any outside parties. Certain Federal regulations may also come into play if third parties become involved. Our cost structure and fees are all predicated to assist you at very reasonable fees for your out of pocket costs. Dr. Collins left private practice because of the intrusiveness, micromanagement, and over-controlling nature of large corporate health care entities. He enjoys working directly with and advocating for families and children. You always have the option of working with a local health professional, even one using this manual for which insurance or other benfits may apply.

Cautions About Treatment:

If you wish to order the Clean Kid Manual to guide you in treatment on your own, you may certainly do so from our store. We do not require permission to contact your physician. However, we do strongly urge you to inform your physician of your intent. We do have a special rate for doctors who purchase our manuals in bulk. You might want to call this offer to his/her attention. They should examine our store, the professionals page hyperlinked at the top of the Clean Kid Treatment page and/or call (see bottom of this page) for direct ordering by phone. Our refund policy only applies to the purchases of manuals from our site.

Do not use this site for children under age 4-years, moderately or severely mentally retarded children, moderately or severely emotionally impaired children. We cannot ethically do you justice and we do not want you to waste your money and time.

Do not attempt treatment if your household is in a chaotic state or does not allow the same responsible supervising parent to be present almost every day at the same time after a designated meal (for encopresis) or at night for attending to bedwetting alarms. Post-divorce situations are a special problem where the child is switching between households. Inconsistency in treatment and emotional issues affecting your child will make successful treatment very unlikely. Sorry about that!

For encopresis do not attempt treatment if you have any reservations about applying an enema and/or suppositories to your child at certain times following a designated daily meal. This may be required in the early stages of treatment. The same is true for parents of bedwetters who do not want their children or themselves to be disturbed in sleep. Uncertain, ambivalent, or anxious parents will only transmit doubt and likely sabotage treatment results. This is where you would be well advised to invest in my being available to you with one of the email/telephone consult options noted above. You could also gain support for our approach by contacting a health professional who is open to our methods and use your insurance if you prefer. Frankly, my approach is very efficient and you would be paying more in copays with most insurance benefits. But, you are in charge and you do have choices!


Please Note--New Federal HIPAA Rules and Notification

This federal law is so complex and confusing that I do not truly know if any portions of it applies to the services which I provide. I may be exempted because I do not accept any insurance under any circumstances. Meanwhile, here is the best most conservative interpretation that I have arrived at so far.

HIPAA stands for the new Federal Health Insurance Portability and Accountability Act. This notice does not apply, if you only purchase the Dry Bed Manual or the Clean Kid Manual, because your are using it as a Do-It-Yourself manual or book without any direct or personal consultations with me. If you have read this notice before or at the time of ordering my consultation services you may so inform me by email or FAX and that will be sufficient for us to commence any consulting arrangement. RWC

Please note that this site does not accept third party insurance payments in any form. Accordingly, the new HIPAA law does not strictly apply to my services. However, there is an opinion that this law will effectively become a new "standard of care" for health providers. I will seek to comply as much as is possible with the law as they are currently interpreted. This massive new law does still require compliance with an incredible number of new rules and regulations that vary State by State on the maintenance, security, release of records, and consent for treatment. I will post below what applies for the state of Michigan as a good faith effort to comply with this federal law which contains substantial penalties for failures by health providers to comply. The deadline for compliance with this law by health providers is April 14, 2003. All health service providers (pharmacists, dentists, physicians, psychologists, physical therapists, etc. etc.) you consult with will shortly be supplying you with a notice like this one with your rights under HIPAA. Please read the notice set forth below describing how information about your child may be used and disclosed.

This law is designed to protect you so I hope that it will not scare you and that you will not view it as a barrier to seeking out the consultation services offered to supplement the treatment manuals offered by this site. Frankly, it is intended to scare the health providers more than yourselves to be sure that they handle your records with appropriate care and and act to safeguard your privacy and consent to treatment rights.

If you do request my services I will direct you to this web page or email or FAX or mail to you a copy of the notice below as sufficient notice of the HIPPA rules and regulations as adapted to the State of Michigan where I practice and ask that you reply to me stating that you have seen and read them. I expect that there will be some tolerance for future adaptations or changes of this law and that it will continue to evolve over time.

THIS NOTICE DESCRIBES HOW PSYCHOLOGICAL AND MEDICAL INFORMATION ABOUT YOUR CHILD MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

I. DEFINITIONS: Uses and Disclosures for Treatment, Payment, and Health Care Operations:

I may use or disclose your child's protected health information (PHI), for treatment, payment, and health care operations purposes with your consent. To help clarify these terms, here are some definitions:

· “PHI” refers to information in your health record that could identify you.

· “Treatment, Payment, and Health Care Operations”

– Treatment is when I provide, coordinate, or manage your child's health care and other services related to your child's health care over the internet by email, by telephone, or by FAX communications. An additional example of treatment would be when I consult with another health care provider, such as your family physician or another psychologist, but I would do this only with your express authorization in advance unless he or she is an associate working in my office. A purchase by you of one of our treatment manuals is not regarded as treatment because you are using it as a Do-It-Yourself manual or book without any direct or personal consultations with me.
– Payment is when I obtain reimbursement for your healthcare. HOWEVER: Because we avoid third party insurance altogether no information goes into any insurance carrier to become a part of their records. Your credit card company or money order issuer will be the only third party involved and they will only know that a business called "Soiling Solutions" is involved. NOTE: I do not accept any form of insurance reimbursement nor will I assist you in obtaining insurance reimbursement. I require payment in full in advance of mailing you a health manual or providing consultation services and I will not agree to provide services where you expect to receive any form of insurance reimbursement. Again, your purchase of a manual to implement treatment on your own does not constitute treatment or consultation with me.
– Health Care Operations are activities that relate to the performance and operation of my practice. Examples of health care operations are quality assessment and improvement activities, business-related matters such as audits and administrative services, and case management and care coordination.

· “Use” applies only to activities within my office such as sharing, employing, applying, utilizing, examining, and analyzing information that identifies you.

· “Disclosure” applies to activities outside of my office such as releasing, transferring, or providing access to information about you to other parties.

II. Uses and Disclosures Requiring Authorization:

I may use or disclose PHI for purposes outside of treatment, payment, or health care operations when your appropriate authorization is obtained. An “authorization” is written permission above and beyond the general consent that permits only specific disclosures. In those instances when I am asked for information for purposes outside of treatment or health care operations, I will obtain an authorization from you before releasing this information. I will also need to obtain an authorization before releasing your Psychotherapy Notes. “Psychotherapy Notes” are notes I have made about our conversations during email, FAX, or telephone sessions. These notes are given a greater degree of protection than PHI. I will request authorization for any and all releases of PHI or of "Psychotherapy Notes" as I do not separate them in my note taking or email records which I retain as records should you elect my consultation services over and above the purchase of a Soiling Solutions treatment manual. If you request that I separate out "Psychotherapy Notes" from PHI I will do so in those specific instances. For example: you may wish for me to provide minimal information about dates, modifications in treatment procedures, and progress in treatment to a pediatrician or other physician or other health care provider, but not include any more personal information about you or your family which I may have recorded during a phone conversation or which may be contained in email communications. In fact, I will submit what I would release by email (or regular USPO mail or telephone) to you for your expressed approval before sending it on, but I must have verification of your approval by email, regular mail, or FAX.

You may revoke all such authorizations (of PHI or Psychotherapy Notes) at any time, provided each revocation is in writing by email, FAX, or regular mail. You may not revoke an authorization to the extent that I have relied on that authorization. I am fully determined never, ever to deal with any insurance company as I require all payment up front and you have been appropriately informed that you may not seek insurance reimbursement with any help or records from Soiling Solutions. I will not send records to any health insurance or other similar entity on your behalf.

III. Uses and Disclosures with Neither Consent nor Authorization:

I may use or disclose PHI without your consent or authorization in the following circumstances:

· Child Abuse – If I have reasonable cause to suspect child abuse or neglect, I must report this suspicion to the appropriate authorities as required by Michigan law.

· Adult and Domestic Abuse – If I have reasonable cause to suspect that you or your child have been criminally abused, I must report this suspicion to the appropriate authorities in Michigan as required by Michigan law.

· Health Oversight Activities – If I receive a subpoena or other lawful request from the Department of Health in Michigan or the Michigan Board of Psychology, I must disclose the relevant PHI pursuant to that subpoena or lawful request.

· Judicial and Administrative Proceedings – If your child are involved in a court proceeding and a request is made for information about your child's diagnosis and treatment or the records thereof, such information is privileged under Michigan state law, and I will not release information without your written authorization or a court order. The privilege does not apply when your child is being evaluated or a third party or where the evaluation is court ordered. You will be informed in advance if this is the case.

· Serious Threat to Health or Safety – If you or your child communicate to me a threat of physical violence against a reasonably identifiable third person and you have the apparent intent and ability to carry out that threat in the foreseeable future, I may disclose relevant PHI and take the reasonable steps permitted by law to prevent the threatened harm from occurring. If I believe that there is an imminent risk that your child will inflict serious physical harm on him or her self, I may disclose information in order to protect him/her.

· Worker’s Compensation – I may disclose protected health information regarding your child as authorized by and to the extent necessary to comply with laws relating to worker’s compensation or other similar programs, established by law, that provide benefits for work-related injuries or illness without regard to fault in the State of Michigan. (This is unlikely for an unemployed child, but you know lawyers, so as a matter of law, I am including it).

IV. Patient’s Rights and Psychologist’s Duties:

Patient’s Rights:

· Right to Request Restrictions – You have the right to request restrictions on certain uses and disclosures of protected health information. However, I am not required to agree to a restriction you request. Please note that I will not under any circumstance submit any information to any insurance company.

· Right to Receive Confidential Communications by Alternative Means and at Alternative Locations – You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations. (For example, you may not want a family member to know that you are consulting with me. On your request, I will send informatin to another address.)

· Right to Inspect and Copy – You have the right to inspect or obtain a copy (or both) of PHI in my mental health and billing records used to make decisions about you for as long as the PHI is maintained in the record. I may deny your access to PHI under certain circumstances, but in some cases you may have this decision reviewed. On your request, I will discuss with you the details of the request and denial process.

· Right to Amend – You have the right to request an amendment of PHI for as long as the PHI is maintained in the record. I may deny your request. On your request, I will discuss with you the details of the amendment process. Frankly, you will have copies of all emails between us and you can keep notes of any telephone conversations so this point appears not to be needed--but I note it for legal notice reasons only.

· Right to an Accounting – You generally have the right to receive an accounting of disclosures of PHI. On your request, I will discuss with you the details of the accounting process. Again, I will not make any such disclosures ever without your express knowledge and approval. However, any requests you do make will be tracked in my ongoing computer records and can be retrieved directly from those records. This particular requirement exists because most providers rely on insurance payments and send in information to justify reimbursement for their services on a frequent and routine basis without your knowing of each instance of so doing. We won't have to be concerned about this because I do not accept insurance payments.

· Right to a Paper Copy – You have the right to obtain a paper copy of the notice from me upon request, even if you have agreed to receive the notice electronically.

Psychologist’s Duties:

· I am required by law to maintain the privacy of PHI and to provide you with a notice of my legal duties and privacy practices with respect to PHI.

· I reserve the right to change the privacy policies and practices described in this notice. Unless I notify you of such changes, however, I am required to abide by the terms currently in effect.

· If I revise my policies and procedures, I will notify you by 1). email, 2). telephone, including voice mail, 3). and, as a last resort, by regular mail.

V. Complaints:

If you are concerned that I have violated your privacy rights, or you disagree with a decision I made about access to your records, you may contact Sherron Collins, Secretary, 1-616-881-2882.

You may also send a written complaint to the Secretary of the U.S. Department of Health and Human Services. The person listed above can provide you with the appropriate address upon request.

Finally, I have long maintained a list of sources and telephone numbers for registering complaints on the "About The Doctor" page, which you can click on at the top of this page.

VI. Effective Date, Restrictions, and Changes to Privacy Policy:

This notice went into effect on April 14, 2003.

 

 

Home | Diagnosis | Encopresis Treatment | Enuresis Treatment | Program Highlights
About the Doctor | Press Clippings | Scientific Articles |Relevant Links | Online Store
Soiling Solutions Logo

© Copyright Soiling Solutions. All rights reserved.
A Division of Behavioral Solutions
EMail: bobpsy @ yahoo . com
PO Box 293, Spring Lake, MI 49456-0293    
616-638-1957 (DrC's Cell) * 616-881-2882 (Sherron) * FAX: 616-850-8557
Outside of the USA request contact for free with "soilingsolutions" using Skype.com's internet telephony

Dump Diapers Logo
v