Expanding Treatment Options for Children With Selective Mutism: Rationale, Principles, and Procedures for an Intensive Group Behavioral Treatment

Children with selective mutism (SM) experience significant challenges in a variety of social situations, leading to difficulties with academics, peers, and family functioning. Despite the extensive evidence base for cognitive-behavioral interventions for youth anxiety, the literature has seen relatively limited advancement in specialized treatment methods for SM. In addition, geographic disparities in SM treatment expertise and the roughly 6-month duration of some of the supported SM treatment protocols can further restrict the accessibility and acceptability of quality SM care. Intensive group behavioral treatment (IGBT) for SM was developed to expand the portfolio of evidence-based SM treatment options by offering brief, but high-dose, expert SM intervention in a group format for youth ages 3-10 years that can be completed in 1 week. In this article, we outline IGBT for SM program, which has already received initial support in a waitlist-controlled trial. Our presentation is organized around the five main components of the treatment model: (1) individual "lead-in" sessions, (2) camp (i.e., all-day group sessions for children held in a simulated classroom setting, with an emphasis on graduated exposures and structured reinforcement), (3) parent training, (4) school outreach, and (5) booster treatment, as needed. We conclude with a discussion of clinical considerations and future directions for further IGBT refinement and evaluation.