Modular Cognitive-Behavioral Treatment of an Adolescent Female With Selective Mutism and Social Phobia: A Case Study

Selective mutism (SM), a debilitating disorder usually appearing in childhood, is diagnosed when an individual capable of speaking fails to speak in social situations in which there is an expectation for the individual to speak. There is very little empirical research on the assessment and treatment of SM in adolescents and adults. The case presented in this article applies a developmental adaptation of a modular cognitive-behavioral therapy approach to treat an adolescent female with SM and social phobia. The treatment consisted of 61 sessions, including sessions on psychoeducation, cognitive restructuring, relaxation, exposure, social skills, and parent training. The presenting symptoms, assessment strategy, and treatment elements are covered in detail. The client’s symptoms were assessed via fear hierarchy ratings, self-report and parent-report measures, and client and parent clinical interviews.