Art Therapy for Selective Mutism: Communication Beyond Words

A concise definition of selective mutism is “a childhood anxiety disorder characterized by a child’s inability to speak and communicate effectively in select social settings...” These settings may include the school setting with peers and teachers or at large family gatherings. Settings could also be sporting events or other group activities in which the child does not know everyone who is present. The distinction to note with selective mutism is that the child does not have any speech, language, voice, or fluency disorders, but they are only able to speak in settings where they feel safe and calm.  

As an art therapist providing services to children with this diagnosis, I have come to view selective mutism as a disorder of distrust for young kids. Therefore, I focus on forming a strong therapeutic alliance with clients by building a quality relationship to serve as our foundation in treatment.  My first treatment goal is never making a child who has selective mutism speak to me, but rather to help them believe I am worthy of their trust as an adult who exists outside the safety of their family circle. 

Viewing selective mutism as just one symptom of severe social anxiety, I work with parents to identify each client’s specific anxiety triggers and use nonverbal methods of communication such as writing, typing, flashcards, and hand gestures during sessions.  I may also encourage the parent(s) to participate in sessions with us to assure that the client feels comfortable by allowing them to communicate with me through their parent until more trust is built. I incorporate artmaking and play to explore their emotional experience and to help the child process previous events nonverbally. There is so much to be learned about a young person without using words and I have found that working creatively with children is a very effective way to do this. 

Shipon-Blum, Elisa. “June 2019 CommuniCampTM Intensive Group Treatment & Parent Training Program.” Selective Mutism Anxiety Research & Treatment Center | SMart Center, 2018, selectivemutismcenter.org/whatisselectivemutism/.