Journal of Consulting and Clinical Psychokwy 1987, Vol. 55, No. 6,902-906 Copyright 1987 by the American Psychological Association, Inc. Q022-006X/87/$00.75 BRIEF REPORTS Filmed Versus Live Delivery of Full-Spectrum Home Training for Primary Enuresis: Presenting the Information Is Not Enough Arthur C. Houts, James P. Whelan, and J. Keith Peterson Memphis State University To extend availability of a behavioral treatment package for enuresis, two outcome studies compared the effectiveness of live versus videotape delivery. In Study 1,40 primary entireties were randomly assigned to live or film delivery. Outcome was superior for the live delivery. Overall, pretreatment measures of family and child psychosocial adjustment failed to predict treatment response. The results were replicated with 18 children, and an impact assessment suggested that film delivery re- sulted in higher confidence of children in their parents but lower confidence of parents in their children. Delivery of treatments by videotape may provide a way to identify nonspecific factors in psychological interventions. Over two decades of outcome research have shown that be- havioral treatments for primary nocturnal enuresis are superior to alternative psychological and medical treatments {Houts & Liebert, 1984). Yet these most effective treatments are still not the ones that are typically delivered to families. One factor that militates against their delivery is cost. Therefore, researchers have examined the efficacy of delivering behavioral packages with minimal professional involvement (Azrin, Theines-Hon- tos, & Besalel-Azrin, 1979; Bollard, Nettelbeck, & Roxbee, 1982; Houts, Liebert, & Padawer, 1983). Full-spectrum home training for primary enuresis is a manu- al-guided behavioral treatment package designed to be deliv- ered in a 1-hr professional consultation to groups of up to 10 families and to then be implemented by parents at home. Treat- ment includes bell-and-pad training, cleanliness training, reten- tion control training, and overlearning. A previous evaluation of this treatment showed it to be as effective as other less cost- efficient approaches (Houts et al., 1983; Houts & Liebert, 1984). To explore further cost reduction, this outcome study (Study 1) and its partial replication (Study 2) evaluated the efficacy of delivering full-spectrum home training through a di- dactic videotape. This research was supported by a Faculty Research Grant from Mem- phis State University and by funds made available to the Department of Psychology at Memphis State University through the Centers of Excel- lence Program of the State of Tennessee. The authors thank Jeffrey S. Berman for his consultation on data analysis. Portions of this research were previously presented at the annual meeting of the Association for the Advancement of Behavior Therapy, Houston, Texas, November 1985. Correspondence concerning this article (and requests for an extended report of this study) should be addressed to Arthur C. Houts, Center for Applied Psychological Research, Department of Psychology, Memphis State University, Memphis, Tennessee 38152. Study 1 Method A Delivery Mode (live vs. film) X Waiting Condition (wait vs. no wait) (2 X 2) factorial design was used. Forty primary enuretics, ranging in age from 5 to 15 years (M = 8.8 years), were randomly assigned to one of two treatment groups, and half of the subjects received treatment immediately or waited 16 weeks and recorded weekly baseline wetting before receiving treatment. Subjects were recruited through media an- nouncements and through referrals from local pediatricians. All sub- jects had a lifelong history of enuresis (none had attained 2 months or more of consecutive dry nights) and met the following screening criteria: (a) no current medical problems and (b) no daytime wetting accidents. Except for gender distribution differences in which the live groups con- tained more girls than the film groups, x 2 0, N = 40) *= 4.80, p < .05, the four groups did not differ reliably on demographic variables such as age, socioeconomic status, medical history, and family history of en- uresis. Parents completed a telephone interview and provided a history of the child's enuresis. The 20 families assigned to the waiting period were instructed to keep nightly records of their child's welting, and the re- maining families received treatment within 2 weeks. Informed consent was obtained, and parents paid a materials cost of $50 plus a $ 15 re- fundable deposit. Parents completed the Behavior Problem Checklist (BPC); (Quay, 1977); the Family Environment Scale (FES); (Moos & Moos, 1981); and the Tolerance for Enuresis Scale (Morgan & Young, 1975). Children aged 8 years and above completed the Piers-Harris Self- Concept Scale (P-H; Piers, 1969). With the exception of the Tolerance for Enuresis Scale, these measures were readministered at a posttreat- ment interview and were used as indicators of change in the child's and family's psychosocial adjustment. At the posttreatment interview, par- ents also completed a consumer satisfaction (5-point Likert) scale on which they rated (a) their global satisfaction with the treatment; (b) the extent to which implementing the treatment was a disruption to normal family life; (c) their difficulty of implementing components (e.g., waking the child, using the alarm); (d) their perceptions of the child's coopera- tion with procedures (e.g., remaking the bed, washing the face); and (e) their perception of change in the child's self-confidence. In both delivery modes, families received the complete full-spectrum 902