WHAT IS PCIT-SM?

PCIT-SM is an adaptation of Parent-Child Interaction Therapy (PCIT) for selective mutism, a childhood anxiety disorder. Treatment starts with Child-Directed Interaction — the warm-up phase that builds comfort — then moves to Verbal-Directed Interaction, which works step by step up your child's talking hierarchy: first speaking to a parent with the therapist nearby, then to the therapist, then to new people and places. Once we build a positive, trusting, and fun relationship with an anxious child, they are much more likely to do the hard work of “Brave Talking” exposures with us. Brave Talking exposures are the carefully guided, step-by-step opportunities to practice talking to others in a graduated, carefully controlled and monitored hierarchy from less challenging to more challenging goals.

We run on one rule: comfort comes before talking. An anxious child can’t do hard things for a new person — so we start with one of their parents, playing games they enjoy and find easy. Sessions begin in the a situation where your child already speaks freely, or is able to warm up to speaking. While you play, the therapist joins in gradually, at your child’s pace, until talking with us feels accessible. This “fade in” process makes it less hard for kids to trust us and include us in their talking circle. From there we tackle brave talking in their real world environments – their homes, their schools, and their communities.

As the model recommends, supported by the evidence bade, PCIT-SM is the underlying basis of all of our individual and group SM treatments. We work with you to build a positive, trusting relationship with your child, and then use that relationship to help them develop and practice their brave talking. First we earn your child’s trust. Then we put it to work.

WHAT DOES TREATMENT LOOK LIKE?

Every plan is built on your child's severity and needs through intentional tailoring of treatment. Selective mutism most often impacts children in school; it is typical for treatment to involve teacher consultation, 504/IEP support, and school push-in sessions.

The anxiety that prevents children from engaging in verbal communication often impacts their social pragmatic language development. Children with a history of SM benefit from direct therapy to improve social communication skills and strategies to strengthen peer relationships as they recover and engage more fully in their childhood experience.

WHAT DOES TREATMENT LOOK LIKE?

Treatment is tailored to each patient based on their severity and treatment needs. We offer weekly, mini-intensive and week long intensive treatment. Specific needs will be discussed with your provider in therapy. Teacher and school consultations are often part of treatment to intentionally target the most common place of impairment of children with SM. Treatment is collaborative, evidence-based, and specific to your child.

Intervention options for SM:

• Individual Weekly Sessions

  • Start Here with a typical weekly format of treatment, 60 - 90 Minutes sessions.

• Individual Mini-Intensive

  • Quick start or push through a SM (or other anxiety) sticking point in a 2-4 hour mini-intensive. 

• Individual 3-5 Day On-Site or Off-Site Intensive

  • Start here for moderate to severe SM presentations, or families traveling to Nashville. Individual Intensives may be scheduled for several days, on-site or in your home, school and community included.

• SM Weekly Peer Groups

  • Recommended to maintain treatment gains and support treatment extension through social pragmatic language development goals.

• SM Parent Group

  • Recommended for all parents to complete the parent group. SM Parent Group is scheduled for 7 weeks and is offered 3 to 4 times per year.

• Camp Brave!

  • Intensive Group Behavioral Treatment (IGBT), SM group intensive, in Nashville, TN. January 3-Day Camp Brave and July 5-Day Camp Brave are our signature programs. 

• School consultation, advocacy and push-in sessions

• Teacher training

• 504 and IEP consultations

WHO TREATS YOUR CHILD?

Eleanor Ezell, LCSW, is a certified PCIT-SM therapist and Regional Trainer, trained directly by Dr. Steven Kurtz, her mentor and dear friend. She serves on the Selective Mutism Association's Board of Directors and provides extensive free trainings to support dissemination of SM treatment. Kristin Mathis, M.S., CCC-SLP, brings speech-language treatment into the treatment plan, because the anxiety that blocks speech can slow social language development. One clinic, both specialties.