Selective Mutism
What is Selective Mutism
Selective Mutism (SM) is a type of anxiety disorder where a person, usually a school-aged child, is unable to speak in social situations. Often, the only people they speak to are their immediate family. This is different than social anxiety in that people with SM behave appropriately and are interactive in social groups other than their lack of speech. It is also not a developmental disorder, as evidenced by their normal speech at home.
SM can be very disruptive to a young person’s development, and it is important that they receive prompt treatment in order to prevent the problem from becoming worse.
How do you treat Selective Mutism?
Good Day Mental Health specializes in treating Selective Mutism. Our specialists use a combination of Cognitive Behavioral Therapy (CBT), Exposure Therapy, and Parent-Child Interaction Therapy for Selective Mutism (PCIT-SM) skills.
PCIT-SM is a counseling technique which involves the counselor building a strong and trusting relationship with the client in order to promote “Brave Talking.” Advanced SM treatment sessions often include “exposure therapy,” where the therapist accompanies the client to a public place, such as school or a store, where they can practice their brave talking in order to generalize their skills and reduce their anxiety.
Our counselors have received specialized training in the treatment of clients with SM and have a talent and passion for working with them, regardless of age. We provide routine in-person services and day camps in Northern Utah, as well as in Northern Missouri. For those unable to attend in-person, we offer both virtual and short-term, intensive services in most states, including Hawaii.
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Selective mutism is an anxiety-based condition closely related to social anxiety. Children experience a strong freeze response in certain social situations, especially when speaking is expected, even though they can speak comfortably in other settings. Working with a therapist trained in anxiety and exposure-based treatment can help reduce this response and support gradual, confident communication.
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A child with selective mutism typically speaks freely at home but consistently does not speak in specific settings such as school or social environments. Children may rely on gestures, whispering, nodding, or written communication and may appear frozen or tense when expected to talk. Early therapy focused on exposure and skill-building can help children begin communicating more comfortably across settings.
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Selective mutism is highly treatable, especially with early, specialized intervention. Evidence-based approaches such as exposure therapy, modified cognitive behavioral therapy, and parent coaching can lead to meaningful and lasting improvement. In some cases, psychiatric medication may also be helpful to address underlying anxiety and support therapy progress.
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Children can be evaluated as early as preschool when speech differences across settings become noticeable. If a child speaks at home but not in school or social situations for more than one month, an evaluation is recommended. Early assessment allows therapy to begin sooner and can reduce long-term anxiety and avoidance patterns.
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Yes, selective mutism can persist into adolescence and adulthood if it is not treated earlier. Adults may avoid speaking in specific situations such as work meetings, medical appointments, or social interactions while communicating comfortably in familiar settings. Therapy focused on anxiety, exposure, and confidence-building can be effective at any age, and psychiatric care may support treatment when anxiety symptoms are significant.
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Yes! A Selective Mutism (SM) Day Camp provides intensive, real-world speaking practice that helps children make faster progress than traditional weekly therapy alone. Daily repetition builds momentum, reduces avoidance, and helps children generalize their voice to school, home, and social environments. Families often see increased confidence, improved participation at school, and lasting gains beyond the program. Visit our Outside Voice SM Day Camp page to learn more and see if this program is right for your child.
How do you diagnose Selective Mutism?
At Good Day Mental Health, Selective Mutism is diagnosed through a comprehensive, team-based evaluation process designed to get it right the first time. Our licensed testing psychologists have specialized training in SM assessment and diagnosis. They also work closely with our psychiatric providers. This integrated approach helps reduce the risk of misdiagnosis, which is common without formal testing or careful clinical context.
Our diagnostic process may include a detailed clinical interview, developmental and academic history, behavioral questionnaires, and formal psychological testing when appropriate. The result is a clear, evidence-based diagnosis and a thorough report that explains findings in plain language and outlines personalized treatment recommendations.
By combining psychiatric expertise with in-depth psychological testing, we help patients and families feel confident, informed, and supported in the next steps of care.
Selective Mutism Day Camp for Kids and Teens
A Selective Mutism (SM) Day Camp provides intensive, real-world speaking practice that helps children make faster progress than traditional weekly therapy alone. Daily repetition builds momentum, reduces avoidance, and helps children generalize their voice to school, home, and social environments. Families often see increased confidence, improved participation at school, and lasting gains beyond the program.
Visit our Outside Voice SM Day Camp page to learn more and see if this program is right for your child.
