Recent research suggests that variants of PCIT may be efficacious in treating early childhood anxiety disorders, including selective mutism (SM). PCIT for SM begins with the use of Child-Directed Interaction (CDI) skills, which help the child develop rapport and feel comfortable with the clinician. CDI is initially done in the absence of speech demands.
After several sessions, Verbal-Directed Interaction (VDI) skills are introduced. Paired with behavioral interventions such as shaping, positive reinforcement, and systematic desensitization, VDI offers a framework for facilitating speech in children with SM. VDI utilizes specific types of questions and commands as well as strategies for responding to and redirecting non-verbal communication attempts.
As speech is established in the clinic, sessions often take place in other environments (e.g., a child’s school, a park or library, local stores or restaurants) to provide opportunities for “brave talking” practice in naturalistic settings. Parents are taught CDI and VDI skills and are encouraged to take on a co-therapist role in order to help generalize treatment gains.
Several BCSC clinicians have extensive experience working with children with SM. Dr. Nathan Lambright, Dr. Ryan Madigan, and Dr. Kaitlyn Wilbur are three of fifteen clinicians in New England recognized by the Selective Mutism Association.