Application of a web-based cognitive-behavioural therapy programme for the treatment of selective mutism in Singapore: a case series study

Ooi YP, Raja M, Sung SC, Fung DS, Koh JB
Correspondence: Dr Yoon Phaik Ooi, Yoon_Phaik_Ooi@imh.com.sg 

ABSTRACT
Introduction Selective mutism (SM) is characterised by limited or a lack of speech in selected social settings. Recent reviews suggest that cognitive-behavioural therapy (CBT) is an effective and promising treatment approach for SM. However, there is still a lack of studies documenting the applicability of CBT for SM in diverse populations. The goal of the present study was to examine the use of a web-based CBT programme (‘Meeky Mouse’) among Singaporean children diagnosed with SM.
Methods Five children with SM (one boy and four girls aged 6–11 years) participated in the 14-week ‘Meeky Mouse’ programme, in addition to being prescribed with an unchanged dosage of fluoxetine 10–20 mg daily. The progress made by the children throughout the course of the programme was documented by the therapist.
Results Post treatment, four out of the five children demonstrated improvements in the frequency of speech during therapy sessions at home, in school and at other social situations.
Conclusion Findings from the present study provide support for the use of a web-based CBT programme in improving speech and decreasing the severity of SM among affected children.

Keywords: anxiety, cognitive-behavioural therapy, selective mutism, web-based
Singapore Med J 2012; 53(7):446–450