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Dr. Olsen
Dr. Olsen, Psychologist
Category: Mental Health
Satisfied Customers: 2336
Experience:  PsyD Psychologist
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I am a trained school based counsellor and recently I was given

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I am a trained school based counsellor and recently I was given a client with selective mutism . I have not done cases like this one and would like to know how I can help this kid epecially intervention strategies for a start. Client is 12 years old, Chinese
Hello & Welcome to JustAnswer. Thanks for writing in here.

Your student may have anxiety that manifest in the form of Selective Mutism. It is similar to social phobia, though in her case she may not speak in specific social situations. She may have SM due to the stimuli (Specific phobia) or the situations (Social phobia). So you may help her to express what makes her anxious in particular situations first. If her behavior persist, she may need to see a psychologist for CBT and/or a psychiatrist for medication.
Cognitive-behavior therapy (CBT) may be effective for SM: Behavior interventions are In vivo exposure and social skills training. Cognitive interventions are Cognitive self-control or Cognitive behavior group therapy. Medications such as SSRIs, the beta-blocker propranol may be used to reduce her anxiety and SM.
Please let me know if you have more questions or I have overlooked any. Warm regards,
Dr. Olsen and 3 other Mental Health Specialists are ready to help you
Customer: replied 6 years ago.

Thank you for your prompt reply. I am aware that this student might have an anxiety issue and I have put in a lot of effort into rapport building. However, during the past few sessions, I was unable to detect any signs of anxiety. My difficulty is getting her to talk to me and unless that is achieved, I may not be able to use the any counselling approach including CBT approach. I am familiar with CBT. Medication is out as I am not a medical doctor but I will consider referring to one. It would be very helpful if you can share with me some intervention strategies which I can try out in my next few sessions.

Thank you. I have to go and will come back to this station in the evening.

Hi, So you have not seen signs of anxiety in her.So in what situation does this student exhibit SM? Perhaps, you may start asking what she likes and dislike about herself and her school. You may explore her feelings and thoughts in order to discover and identify what she may be anxious about or unhappy about. Feel free to continue discussion if you have more questions.

Edited by Dr. Olsen on 12/1/2010 at 7:52 AM EST
Customer: replied 6 years ago.
I have attempted to explore her likes and dislikes about school. From her non-verbals (shaking or nodding her head ), I believe she was not anxious about the principal, her teachers, her classmates or any person in the school and she was not affected by her environment such as the school building, school rules etc. I will try exploring her feelings and thoughts in the future interviews. Besides anxiety what else can make a person clamp up in certain conditions. I have tried jokes, played board games, did story rewriting with her without much success. She is fairly intelligent as she could understand my jokes and could write fairly well in rewriting stories. So, it is not a cognitive or linguistic issue.
Hi, Thanks for waiting. I wonder if she really has SM. So does she exhibit SM in classroom?
Customer: replied 6 years ago.

I was also doubtful with the psychologist's assessment but then it was a professional assessment. Yes, she exhibits SM in the classroom, in the canteen, in the playing areas (these are the areas where I can observe her behaviour). She eats by herself, walks about by herself during recess, has no friends to chat with, etc but I understand that she speaks normally at home with her parents and siblings which fits into the picture of a classic SM. Actually, I was searching for ideas like stimulus fading, desensitization etc. I think I need to read up more on this subject before I can ask relevant questions. Thank you Dr Oslsen for your time and suggestions. I will work with this kid for a while more and see what are her issues. I may get back to you if I need your help again. Thank you.

Hi, You are very welcome. It sounds like she may have signs of SM. But she may not have anxiety. I wonder if she may lack social skills or Asperger's. Does she appear to be sad and depressed? Well, please contact me on JA anytime if you have any question after seeing this students for a while. I will do my best to assist you. Warm regards,

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