Intensive group treatment for children with selective mutism: a pilot study with repeated assessments.
- 1Department of Clinical Child and Adolescent Psychology, Justus-Liebig-University Giessen, Otto-Behaghel-Str. 10, 35394, Giessen, Germany. [email protected].
- 2Department of Clinical Child and Adolescent Psychology, Justus-Liebig-University Giessen, Otto-Behaghel-Str. 10, 35394, Giessen, Germany.
Abstract
Background
Selective mutism (SM) is an anxiety disorder characterized by a persistent failure to speak in specific social situations despite speaking normally in others. Preliminary evidence suggests that intensive behavioral group interventions may be a promising treatment approach. This pilot study evaluated the outcomes of such an intervention for children with SM for the first time in a German clinical sample.Methods
Sixteen children aged five to nine with SM were included in the study and fifteen participated in an intensive group intervention based on Parent-Child-Interaction Therapy for Selective Mutism (PCIT-SM). Two baseline, one post-treatment, and one three-month follow-up assessments were conducted. Primary outcome was parent-rated SM symptom severity assessed with the Frankfurt Scale for Selective Mutism (FSSM). Remission status based on a structured clinical interview served as secondary outcome. Changes over time were analyzed using linear mixed-effects models and Cochran's Q tests.Results
SM symptom severity decreased significantly over time with large effects from baseline 1 to post-treatment (dRM = 1.03) and follow-up (dRM = 1.69). No significant differences emerged between the two baseline assessments. Remission rates increased from 0% at first baseline to 47% at follow-up. A significant overall change in diagnostic status across assessments was observed. Exploratory analyses further showed that general anxiety decreased from baseline to follow-up.Conclusions
The findings provide preliminary support for intensive group interventions based on PCIT-SM principles as a promising treatment for children with SM. Future controlled studies with larger samples and longer follow-up periods are needed to evaluate treatment mechanisms and long-term outcomes. Trial registration German Clinical Trials Register (DRKS), DRKS00040917, retrospectively registered on 13 July 2026.
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BibTeX
@article{schwenck2026intensive,
title = {{Intensive group treatment for children with selective mutism: a pilot study with repeated assessments.}},
author = {Christina Schwenck and Megan Williams and Jana Zimmermann-Hauel and Carolin Röse-Werkmann and Gloria Gehb and Naomi L Werkmann},
journal = {Child and adolescent psychiatry and mental health},
year = {2026},
month = oct,
doi = {10.1186/s13034-026-01203-4},
url = {https://europepmc.org/article/MED/42972560},
note = {CC BY},
}
RIS
TY - JOUR
TI - Intensive group treatment for children with selective mutism: a pilot study with repeated assessments.
AU - Christina Schwenck
AU - Megan Williams
AU - Jana Zimmermann-Hauel
AU - Carolin Röse-Werkmann
AU - Gloria Gehb
AU - Naomi L Werkmann
PY - 2026
DA - 2026/10/27
JO - Child and adolescent psychiatry and mental health
DO - 10.1186/s13034-026-01203-4
UR - https://europepmc.org/article/MED/42972560
AB - Background Selective mutism (SM) is an anxiety disorder characterized by a persistent failure to speak in specific social situations despite speaking normally in others. Preliminary evidence suggests that intensive behavioral group interventions may be a promising treatment approach. This pilot study evaluated the outcomes of such an intervention for children with SM for the first time in a German clinical sample.Methods Sixteen children aged five to nine with SM were included in the study and fifteen participated in an intensive group intervention based on Parent-Child-Interaction Therapy for Selective Mutism (PCIT-SM). Two baseline, one post-treatment, and one three-month follow-up assessments were conducted. Primary outcome was parent-rated SM symptom severity assessed with the Frankfurt Scale for Selective Mutism (FSSM). Remission status based on a structured clinical interview served as secondary outcome. Changes over time were analyzed using linear mixed-effects models and Cochran's Q tests.Results SM symptom severity decreased significantly over time with large effects from baseline 1 to post-treatment (dRM = 1.03) and follow-up (dRM = 1.69). No significant differences emerged between the two baseline assessments. Remission rates increased from 0% at first baseline to 47% at follow-up. A significant overall change in diagnostic status across assessments was observed. Exploratory analyses further showed that general anxiety decreased from baseline to follow-up.Conclusions The findings provide preliminary support for intensive group interventions based on PCIT-SM principles as a promising treatment for children with SM. Future controlled studies with larger samples and longer follow-up periods are needed to evaluate treatment mechanisms and long-term outcomes. Trial registration German Clinical Trials Register (DRKS), DRKS00040917, retrospectively registered on 13 July 2026.
SN - 1753-2000
ER -