The efficacy of cognitive behavioural therapy in treating selective mutism in young children aged 4 to 10 years old: a qualitative systematic review

• Main Authors: Ng, Benjamin Zeming, Atikah Binte Hassan, Dun, Yawen
• Other Authors: Suzy Styles
• Format: Final Year Project
• Language: English
• Published: Nanyang Technological University 2023
• Subjects: Social sciences::Psychology::Applied psychology
• Online Access: https://hdl.handle.net/10356/168509
• Institution: Nanyang Technological University

The present systematic review evaluates the quality of evidence of empirical studies about the efficacy of cognitive behavioural therapy (CBT) and combination therapy (psychopharmacotherapy) in the treatment of selective mutism in young children aged 4–10 years old. Of the 223 studies returned in a systematic review of the literature from a ten-year period from 2012 to 2022, only fifteen studies matched the selection criteria for the qualitative synthesis. After evaluating these studies against preregistered quality indicators, two of fifteen studies provided “sufficient evidence” to evaluate the efficacy of the treatment, while the other thirteen showed “partial evidence”. From our qualitative analysis, we found that (a) diverse implementations of CBT were effective in treating selective mutism, (b) combination therapy is limited to fluoxetine and CBT, and (c) there are insufficient randomised controlled trials (five of fifteen studies) to firmly conclude that CBT and combination therapy are effective interventions for selective mutism. We highlight the limitations of existing studies and made recommendations to improve the quality of future evidence: future research can benefit from more randomised controlled trials with larger samples that raise the statistical validity of CBT/combination therapy effects. Additionally, researchers should focus on the blinding of all key persons in their studies as a safeguard against biases.