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.