Selective mutism: an effective therapeutic intervention

Key words: Selective mutism, Socialization, Systemic therapy, Meta function, Parents

Selective mutism (SM) is recognized as a disorder linked to a strong anxious component in the child. The SM is considered a disorder of relevant diagnostic and, above all, therapeutic difficulty. The present work reports the experience of the treatment of four cases of SM in female children from four to six years old and describes the fundamental steps of the therapy of their families. The intervention has utilized the systemic therapy, which requires the presence of only parents in the sessions. These, conducted by two systemic psychotherapists, have been from six to ten for each case, with a monthly frequency and about two hours’ duration each. The systemic paradigm claims that the intervention, even if only on one part of the system, has an effect on the whole system, so the parents are considered as a resource in order to favour behaviour changes useful for the child. The treated cases have shown that the so-called “meta function” is unsafe, unstable or, in some cases, non-existent in the couple. “Meta function” refers to parents’ capacity of auto-observation of and auto-reflection on their educative actions. Such kind of approach has permitted the positive resolution of all the treated cases. The SM is reported in the children younger than five years old; it usually appears when they start nursery school, therefore the role of the pediatrician is particularly important since a precocious diagnosis could allow the disorder, which is less complex than the one discovered in the primary school, to be resolved.