A simple program of behavioral training that can be implemented at home may solve or alleviate many cases of urinary incontinence, a source of embarrassment and distress for an estimated 10 million Americans, mostly women, over 55, according to a study published last week in the Journal of the American Medical Association.

The therapy, which requires neither surgery nor drugs, is the first published study of a successful behavioral outpatient program, according to Evan C. Hadley, chief of the Geriatrics Program of the National Institute on Aging and one of the study's authors.

The 122 women enrolled in the study conducted by researchers at the Medical College of Virginia tested the effectiveness of a therapy that involves patient education and a strict schedule for urination.

Twelve percent of the women reported complete continence after the trial, and three quarters of the women demonstrated improvement of 50 percent or more.

According to study chief J. Andrew Fantl, the patient education consisted of a program that emphasized the brain's role in controlling urinary function.

To maintain individual schedules for urination, patients were taught to use relaxation and distraction techniques, which are believed to be important in maintaining control.

Managing incontinence costs an estimated $10.3 billion a year and is a major cause of nursing home placements. It is estimated that half the nation's 1.5 million nursing home residents suffer from urinary incontinence.