How the Interaction Between Parent and Child Can Lead to Nonadherence: A Case Study of Self-Catheterization

The following case study depicts an outpatient pediatric psychology patient with spina bifida–myelomeningocele who resisted self-catheterization. The patient’s case was initially conceptualized as anxiety toward the catheterization process and behavior was later reconceptualized as oppositional and attention seeking. Parent reluctance to follow through with recommendations that involved placing demands on the patient resulted in slow progress and movement away from self-catheterization. As supported in the literature, the primary barrier to progress toward self-catheterization in this case appeared related to lack of follow-through and overinvolvement on the part of parents, leading to decreased child autonomy and independence.