Effectiveness of an Eight-Week Multidisciplinary Selective Mutism Treatment Group

ABSTRACT

Recent selective mutism (SM) treatment approaches focusing on the delivery of interventions using intensive doses of cognitive behavioral therapy (CBT) and Parent-Child Interaction Therapy (PCIT-SM). In the current study, we sought to examine the effectiveness of an eight-session weekly outpatient group program for youth ages 3 to 14 diagnosed with SM. Group interventions included caregiver coaching and support for CBT skills, particularly graded speaking exposures for youth using the PCIT-SM framework. A total of 112 youth (M_age = 7.26; 57.1% white; 63.4% girls) were referred for treatment; 100 youth completed the weekly program with at least one caregiver. Initial evaluations assessed SM symptomology, communication behavior, anxiety, and impairment due to symptoms at pre-treatment and post-treatment. Parents and clinicians tracked communication behaviors during all treatment sessions. Results suggested a significant reduction in SM symptoms in various settings (e.g., school, social) and impairment associated with anxiety from pre- to post-treatment. Youth demonstrated a significant increase in speaking behaviors across treatment session, with a corresponding decrease in use of nonverbal communication behaviors. Caregivers did not report a significant change in family impairment, though this was not unexpected due to the demands placed on caregivers as part of treatment. Overall, the results of this study support the efficacy of a brief, weekly intervention for SM, even when symptoms are significantly impairing. Weekly outpatient treatment should be considered a viable option when intensive options are not feasible.

Acknowledgments

We thank the youth and families involves in the selective mutism clinic, as well as the psychology and speech pathology trainees who assisted with care.

Disclosure statement

The Institutional Review Board at Seattle Children’s Hospital issued a waiver of consent as data collected were part of ongoing clinical care.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Notes

¹ Gender identity was collected via review of electronic medical record; the degree of disclosure and youth comfort with noting gender identity in the record may have affected accuracy.

² Generalized anxiety was assessed using the Spence Child Anxiety Scale. Information related to this measure, including data analysis, results, discussion, can be found within supplemental materials.