Dissertation

A Program Evaluation of Intensive Group-Based Treatment for Selective Mutism

Robbins, Mary

2024

Overview

Intensive group-based treatment (IBGT) is a targeted intervention for selective mutism adapted from established, evidence-based treatments for other forms of childhood anxiety. Selective mutism (SM) is a severe anxiety disorder occurring in early childhood that presents unique challenges for treatment, given the early onset and the inability to respond verbally in some settings (Furr et al., 2019). The broader treatment literature supports cognitive-behavioral therapy (CBT), delivered in a weekly outpatient format, as the gold standard for childhood anxiety. However, some have proposed brief or intensive interventions as an alternative modality to maximize learning through repeated exposure and to increase access to evidence-based intervention and trained providers (Craske et al., 2012; Ost & Ollendick, 2017). In response to the identified need, Kurtz (2016) developed intensive group-based treatment (IGBT) for selective mutism. IGBT for SM incorporates graduated exposure to speech and targets interaction patterns between children and adults that reinforce symptoms (Cornacchio et al., 2019). Providers deliver the intervention in a high dose, one-week format that allows children to interact with peers and generalize learning to new settings. Theory and emerging evidence support the adaptation of established interventions to an intensive group format, but only one randomized controlled trial and a few feasibility studies have investigated IGBT to date. The current pilot case series study evaluated the feasibility and effectiveness of an existing intensive group program. This study was the first to assess the acceptability and feasibility of IGBT from the perspective of parents of children receiving the treatment and counselors who delivered the intervention using standardized measures. Additionally, we assessed the effectiveness of the intervention immediately following treatment and at a 10-week follow-up with a reliable and valid measure of parent-rated speaking behavior (Bergman et al, 2008). Results of our study indicated that the intervention is acceptable, appropriate for the identified population, and feasible for implementation in an outpatient setting. There was also preliminary evidence supporting its effectiveness at increasing speech across settings. Taken together, these findings justify research on a larger scale to further evaluate the effectiveness of intensive group-based treatment for selective mutism and the subgroups that respond best.

• Publisher: ProQuest Dissertations & Theses
• Subject: Behavioral psychology / Clinical psychology / Cognitive psychology / Mental health
• ISBN: 9798265433954