Assessment and Behavioral Treatment of Selective Mutism

Abstract

Children with selective mutism present with a complicated set of symptoms, as they not only refuse to speak in particular social situations but are often shy, socially isolative, anxious, and may present as oppositional and negativistic in their behavior. Limited research on treatments for selective mutism suggests a need for additional research examining intervention possibilities. The following case description presents a 10-year-old male with selective mutism and concurrent anxiety symptoms. Treatment included the use of a significantly modified version of Social Effectiveness Therapy for Children (SET-C), a manualized behavioral treatment for social anxiety. In addition to SET-C, treatment also included concurrent parent training in the management of child anxiety. The rationale for the treatment selection and a description of treatment course are provided. Further, a discussion is presented concerning challenges to treatment progress, including cultural differences between the primary clinician and the client.