CBT by Condition

Guide

CBT for Selective Mutism (Youth)

Educational content only. Coordinate with school and pediatric clinicians. See our Medical Disclaimer.

Overview

Selective mutism involves consistent failure to speak in certain settings (e.g., school) despite speaking in others (e.g., home), driven by social anxiety and avoidance learning.

Why CBT helps

  • Graded speaking tasks: whisper → one word → short sentence → conversation.
  • Reduce accommodation: encourage child to respond before adults model/talk for them.
  • Reinforcement: praise effort and brave attempts, not perfection.

Journaling prompts (child + caregiver)

  1. Speaking step I tried today; difficulty 0–100; what helped.
  2. Adult support used (prompt, wait time, praise) before stepping in.
  3. Next tiny step for school/home/community.

Use shared entries; see How to Journal.

When to seek care

School impairment or persistent avoidance warrants clinician‑guided exposure plans with school collaboration.

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