There are many different types of selective mutism treatment, some of which are seen as being more effective and appropriate than others. Most of the time, a variety of therapeutic strategies implemented both at home and in a therapist's office make up the most effective type of treatment. Other approaches, such as medication or alternative communication, can be used as well. Within the broad category of therapy, a number of different techniques are used to create an environment in which the patient can speak and then expand that environment until the problem is reduced. Given that this disorder is highly related to social anxiety, techniques that prove helpful for people with anxiety can often be effective in this case as well.
Selective mutism treatment must begin with a diagnosis of the problem. Determining why the patient cannot speak is necessary in order to make speech easier. This disorder is much more common with children than adults, but unfortunately selective mutism treatment for children is complicated by a reduced ability to communicate in other mediums. Children are also often less able to determine why speech is so problematic, although adults may not understand the problem either.
Therapy as a selective mutism treatment usually involves taking a situation in which speech has already been established, such as a familial situation, and adding in additional participants until the patient feels that he or she can speak freely. Usually, a therapist will prescribe ways of encouraging the patient to speak, sometimes with a reward system involved. When possible, talking about anxiety and ways in which the patient might deal with it is helpful.
There are also approaches to selective mutism treatment that rely primarily on medication. Anxiety medication is useful for this disorder, but because the patients are often children, treating primarily with antidepressants poses certain problems. A child may be able to grow out of selective mutism, but reliance on antidepressants can be crippling. As such, antidepressants are usually used to help move along difficult treatment, but regular therapy is continued.
When the patient is an adult, treatment can be extremely problematic. After a lifetime of not being expected to speak, learning to speak up can be extremely difficult. In this case, encouraging increased social interaction through other mediums can be very effective. For example, if a person feels that he or she is able to communicate without social risk through a video game that has a speech component, encouraging that behavior may be effective. The important thing to remember with this kind of treatment is that it must be dynamic in order to make the transition into regular social speech.